Ginger.io Behavioral Health Study

Procedures involved in the Human Research Overview: The investigators will use a quasi-experimental study with a pre-post intervention design to evaluate the usability, feasibility, acceptability, and potential utility of a smartphone app to improve patient-behavioral health provider communication and care for patients with mood disorders (e.g. depression, anxiety, bipolar). The smartphone app will collect patient smartphone interaction data and survey data from patients on their health and functioning including mood, depression, and anxiety levels. At various points during the study, patients will be surveyed about their experience using the smartphone application, Ginger.io.

All behavioral health providers at Community Health Center, Inc. (CHCI) who are using the app with their patients will be granted access to a secured, password-protected, web-based dashboard that will collect and display information related to patients' health and behavior. The research assistant and behavioral health providers will use the web-based dashboard to monitor patient activation and survey completion, and the behavioral health provider will use it to proactively reach out to patients and aid in discussions with the patient about the care he/she receives at CHCI. At various points during the study, behavioral health providers will be surveyed about their experience using the secured, password-protected web-based provider dashboard.

Behavioral health providers at multiple CHCI sites will be using this app with their patients as part of their care. From the pool of Ginger.io existing users, about 500 patients will sign written informed consent and join the research study. These patients will provide survey information that will be used in the research study. Comparison data will also be gathered from CHCI's electronic health record and via the completion of paper surveys for approximately 100 patients that sign written informed consent and who are receiving routine behavioral health care at CHCI but are not using the Ginger.io app. Baseline data on the patient's depression, bipolar and anxiety will be collected the first time using the Ginger.io app or filling out paper forms in control clinics.

Intervention patients will be asked to use the Ginger.io smartphone app for a minimum of 6 months, to answer depression, anxiety and mood questions. The Ginger.io app may also be used by patients on a less frequent (e.g. weekly, biweekly, or monthly) basis to answer more detailed surveys like the self-report hospitalization or Patient Health Questionnaire (PHQ-9), which collects data on depression. These daily and weekly assessments of patient mood, depression and anxiety, including data on the patient's mobility and communication, will be collected by the Ginger.io smartphone application, and available 24/7 in the dashboard, so that the dashboard monitor can take appropriate action (or should they choose, the behavioral health clinician could view as well at monthly visits). Most importantly, behavioral health providers will be performing proactive outreach to patients that are identified by alerts as being at higher likelihood of mood disorder irregularities. These alerts are powered by patient survey responses and smartphone passive behavioral changes.

Intervention Description: