# Implementing mHealth for Schizophrenia in Community Mental Health Settings

> **NIH NIH R01** · UNIVERSITY OF WASHINGTON · 2020 · $827,668

## Abstract

PROJECT SUMMARY
 Schizophrenia spectrum disorders (SSD) are a major public health concern. Evidence-based illness
management interventions can extend the recovery periods and improve the outcomes of people with SSD but
these are seldom available at community mental health clinics (CMHCs) where the majority of individuals with
SSD receive care. Widely available mobile technologies can help overcome the capacity constraints of
CMHCs, expand the reach of evidence-based mental healthcare, and provide much needed illness
management skills and resources for people with SSD, wherever they may be.
 FOCUS is a Mobile Health (mHealth) illness-management system specifically designed for people with
SSD. A series of studies conducted with over 500 participants with SSD across ten states has shown that
FOCUS is feasible, usable, engaging, and effective. CMHC clinicians and administrators express a strong
interest in integrating FOCUS into their offerings and workflow. While FOCUS is well-poised for deployment,
how best to implement mHealth interventions in real-world community care settings is unclear.
 Two Practice Facilitation strategies may be suitable for implementation of FOCUS in CMHCs: External
Facilitation (EF) and Internal Facilitation (IF) approaches. We propose to conduct a comparative effectiveness
prospective cluster randomized hybrid type 3 trial to compare EF vs. IF implementation of the FOCUS
intervention in 20 CMHCs in Washington State. Specifically, we aim to 1. Evaluate and compare
implementation outcomes; 2. Examine moderators (i.e., readiness for change, culture, urban vs. rural status)
and mediators (absorptive capacity) of implementation effects; and 3. Evaluate and compare patient outcomes,
including evaluation of intervention mechanism of action. We will examine whether the implementation
strategies differentially affect patient engagement, psychiatric symptom severity, and illness management
capacity. The project addresses several NIMH strategic priorities and is highly innovative in its objectives,
composition of the investigative team, data collection strategy, intervention and implementation models, and
study design. The study adopts the NIMH experimental therapeutics approach and evaluates proposed
mechanisms of action for both implementation and patient outcomes. At a micro-level, the study will help
determine which strategies may facilitate, enhance, or hinder the uptake and clinical effects of FOCUS. At a
macro-level, study findings will have broader implications for successful implementation of mHealth
interventions in the years ahead. With multiple NIMH-funded mHealth and eHealth development and clinical
trials currently underway, now is the opportune time to examine implementation strategies that will help pave
the way for real-world uptake of the digital interventions that emerge as most promising.

## Key facts

- **NIH application ID:** 9844984
- **Project number:** 5R01MH116057-02
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Dror Ben-Zeev
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $827,668
- **Award type:** 5
- **Project period:** 2019-01-04 → 2023-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9844984

## Citation

> US National Institutes of Health, RePORTER application 9844984, Implementing mHealth for Schizophrenia in Community Mental Health Settings (5R01MH116057-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9844984. Licensed CC0.

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