Table 2.

Summary of adaptations suggested and accepted for mobile health First Episode Digital Monitoring.

Reason for suggested adaptation				Goal was to increase or improve		What was suggested and adapted		Type of adaptation made
Recipient level
	Health narratives and priorities
		Time burden	Fit with recipients, feasibility		Repeat or reassure that skipping some questionnaires is OK		Implementation strategy: content-repeating
		Privacy or confidentiality	Reach and engagement		Repeat information regarding confidentiality		Implementation strategy: content-repeating
		Person-centered care	Fit with recipients, satisfaction		Report: use person-centered, experience-based language vs medicalized language		Content: tailoring or tweaking or refining
		Recovery-oriented approach	Fit with recipients, satisfaction		App: ask how bothersome symptom is and impact on functioning		Content: adding elements
	Access to resources
		Technology	Reach and engagement, feasibility		Check smartphone compatibility before enrollment		Implementation strategy: context, format
	Crisis or emergent circumstance
		Participant safety	Fit with recipients		Include suicidal ideation as exclusionary criteria		Context: population
	Comorbidities
		Multiple mental health symptoms or conditions	Effectiveness		Clarify instructions to include multiple psychiatric medications		Implementation strategy: content-tailoring or tweaking or refining
		Physical health side effects	Fit with recipients, satisfaction		App: ask about weight gain as potential side effect		Content: adding elements
Provider level
	Clinical judgment
		Clinically meaningful information	Satisfaction, effectiveness		App: ask about timing of medication use and factor in for adherence		Content: adding elements
		Clinically meaningful information	Satisfaction, effectiveness		Report: include substance use and caffeine use on report		Content: adding elements
		Clinically meaningful information	Satisfaction, effectiveness		Report: include lines for daily averages on report’s granular graphs		Content: adding elements
		Previous training or skills	Feasibility		Train providers to read report and include legend		Training content: adding elements
	Preferences
		Data visualization	Satisfaction		Report: reduce report or graph density (eg, focus on subset of symptoms or side effects)		Context: format
		Data visualization	Satisfaction		Report: use dots on report’s granular graphs		Context: format
Organization level
	Service structure
		Team-based care	Feasibility, effectiveness		Option to share report with multiple staff		Context: personnel
	Mission or culture
		Shared decision-making	Satisfaction, effectiveness		Option for clinician to show report to the participant		Context: format
Sociopolitical level
	Existing policies
		COVID-19 pandemic social distancing mandates	Reach and engagement		Attend web-based program meeting for introduction or warm handoff to client for recruitment		Implementation strategy: context, format
		COVID-19 pandemic social distancing mandates	Reach and engagement		Option to receive an e-gift card as participant reimbursement		Implementation strategy: context, format