Table 2.

Certified Peer Specialists’ Perspective of the Barriers and Facilitators to Mobile Health Engagement (N=74)

	Facilitators	Barrier
Intervention Characteristics
Affordability	(+) “lower costs of smartphones [would] encourage participation” and “government subsidizes [are needed] for smartphones—not flip phones.”	(−) “Limited data due to cost”; “cost”; “monthly expense with the use of the phone”
Formal training	(+) “clear short courses on using a smartphone”, “classes to help them fix things as they come up” and “education on how to get an email address password and use email and texts contacts etc….. must show mental health consumers exactly how smartphone will benefit them. They also must understand what they CANNOT use the smartphone for.”	(−) “I need help keeping up with technology”; “The smart phone is so powerful, but I am old school and haven’t learned to take advantage of it.”
Connectivity		(--) “Poor signal in many areas (rural areas, my office is in the basement)”; (--)”Not as fast as other methods of accessing the internet [TABLET]”; (--) “Internet connection”; (--)”The one I have is very slow and now it is not connected to my mobile phone so I cannot use it. [TABLET]”
Peer support: A human factor to promote mHealth engagement	(+) “peer support text messages for those with mental health and physical health issues”, “real connection--- The older the peer, the more need for a real person connection”, and “assess person’s preference about including real person in interventions as social challenges are current for some.”
Characteristics of Individuals
Physical and psychological barriers to mHealth engagement		(−)”phone so hard to navigate and see” and “difficulty with the strain on the eyes when using in low light conditions and age- related [problems] seeing text and hearing voices”) and psychological barriers (i.e., [problems] hearing voices”). (−) “some are fearful of internet risks such as Identity theft” and “not believing the CIA and NSA has tapped their phone or tablet”.
Beliefs and preferences	(+) “I much prefer using a tablet than a smartphone”; (+) “laptop and smart phone enough [TABLET]”; (+) “at times it is not necessary [TABLET]”	(−) “I am change averse - using a flip phone”; (−) “Size not as convenient as smartphone size [TABLET]”
mHealth interventions may promote social isolation		(−) “WHEN YOU USE AN APP, YOU ARE ***ALONE***. Unless the app is purely to get people TOGETHER, it ISOLATES”