Table 3.

Summary of remote technology intervention studies for psychoeducation, supporting recovery, and promoting health and wellness in persons with SMI

Study	Origin	Design	N	Diagnosis	Study Duration	Intervention	Main Feasibility and Acceptability Findings
Alvarez-Jimenez et al., (2013); Gleeson et al., (2014)	Australia	Uncontrolled pilot study	20	First episode psychotic disorder or mood disorder	1 month	HORYZONS online platform includes psychosocial interventions targeting risk factors for relapse, peer-to-peer online social networking, and expert moderation.	60% of participants used HORYZONS, 70% used it for at least 3 weeks, and 95% used the peer-to-peer social networking component. Depressive symptoms significantly decreased. No clinical, privacy or security concerns emerged.
Baikie et al., (2012)	Australia	RCT	848	Bipolar disorder; schizoaffective disorder	4 months	Participants randomized to expressive writing (share and explore deepest thoughts and emotions), positive writing (share most positive experience), or control writing (generic topic).	High attrition (74%) partly due to concerns about sharing traumatic experiences. No differences between groups. Decreased depression and improved mental health symptoms across all groups.
Jones et al., (2014)	United Kingdom	Pilot RCT	39	Bipolar disorder	10 weeks	Web-based self-directed parenting intervention for bipolar parents provides instruction for managing child behavior. Compared to waitlist control.	High attrition in the intervention group (42% completed). Significant improvement in child behavior and perceived parenting measures.
Kaplan et al., (2014)	United States	RCT	60	Schizophrenia spectrum disorder; affective disorder	3 months	Web-based education and social support intervention designed to enhance parenting skills, improve coping skills and decrease parental stress for mothers with SMI. Compared to an online healthy lifestyle intervention.	Intervention enhanced parenting skills, improved coping skills, and decreased parental stress. No improvement in efficacy or support. Mothers with SMI are interested and capable of receiving online parenting education and support.
Kaplan et al., (2011)	United States	RCT	300	Schizophrenia spectrum disorder; affective disorder	12 months	Intervention with unmoderated, unstructured Internet peer support. Participants randomized to experimental Internet peer support via a listserv; experimental Internet peer support via a bulletin board; or a waitlist control condition.	No differences between groups for recovery, quality of life, empowerment, social support, and distress. Greater participation in Internet peer support resulted in higher levels of distress; positive experiences with Internet peer support associated with more distress.
Naslund et al., (2014)	United States	Uncontrolled pilot study	10	Schizophrenia; bipolar disorder	5 months	Wearable activity monitoring devices (FitBit Zip or Nike FuelBand) and Apple iPhone 4S smartphones to access the mobile application for these devices.	Participants wore the devices 89% of the days enrolled in the study and reported high satisfaction. Shows feasibility and acceptability.
Pijnenborg et al., (2010)	Netherlands	Controlled trial	62	Schizophrenia; schizoaffective disorder; psychotic disorder	18 weeks	Automated SMS text message prompts to support daily goals and functioning, taking medication, attending mental health care appointments, or grocery shopping. Compared to a waitlist control.	Percentage of goals achieved was greater in the intervention group, but decreased after withdrawing the SMS prompts. Keeping appointments and participating in leisure activities increased with prompts, but no change in medication adherence.
Proudfoot et al., (2012)	Australia	RCT	407	Bipolar disorder	8 weeks	Participants randomized to: online Bipolar Education Program (BEP) aimed at providing education and skill building; BEP enhanced with email support from peers; or a control condition consisting of basic facts about bipolar disorder.	No differences between groups. Increased perceptions of control, decreased perceptions of stigmatization, and improvements in anxiety and depression across all groups. Higher adherence to BEP with peer support compared to BEP alone.
Rotondi et al., (2010) and (2005)	United States	RCT	31*	Schizophrenia; schizoaffective disorder	12 months	Schizophrenia Online Access to Resources (SOAR) is a web-based psychoeducation program for persons with schizophrenia and their supporters (family and friends) that provides engagement, education about illness and treatment, support, and coping strategies. Compared to usual care.	Significant reduction in positive symptoms and significant increase in knowledge about schizophrenia. Participants showed strong engagement and sustained use of the SOAR intervention.
Simon et al., (2011)	United States	RCT	118	Bipolar disorder	3 weeks	MyRecoveryPlan online program includes education, self-monitoring, and social networking. Participants were assigned to MyRecoveryPlan with peer coaching or MyRecoveryPlan only group.	Participants who received peer coaching were more likely to continue using the program, and used several of the program modules more often when compared to participants who only received the program.
Smith et al., (2011) and Poole et al., (2012)	United Kingdom	RCT	50	Bipolar disorder	10 months	Beating Bipolar web-based psychoeducational intervention provides instruction about bipolar disorder, medications, relapse prevention and early intervention. Compared to usual care.	Significant improvement in the psychological domain of the quality of life scale. No differences in other outcomes. Intervention was feasible and acceptable to participants with access to a computer.

^*This study also included 24 supporters (family and friends) of the participants with schizophrenia.