Pilot Study on the Clinical Utility of the Tulsa Life Chart

Study Overview
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Brief Summary
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The proposed study aims to examine the usability, utility, and feasibility of the Tulsa Life Chart (TLC) in a sample of patients seeking mental health treatment and their healthcare providers. The TLC is an interactive, web-based application used to create a graphical interface for visualizing a patient's life history.

Detailed Description
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Understanding the longitudinal course of mental health is critical for case conceptualization. One approach for capturing the complexity of an individual's illness course is to depict it graphically. The first attempt for this method was the National Institute of Mental Health Life Chart for Bipolar Disorder. Subsequent research indicated Life Charts are useful clinically and time- and cost-effective. Despite clinical utility and time and cost efficiency, this approach has not been widely adopted in the mental health field. Possible explanations are the prior focus on bipolar disorder, time required to collect information, and prior versions have not had automatic translation of the patient information into an image. The Tulsa Life Chart (TLC) was developed by researchers at the Laureate Institute for Brain Research (LIBR). The TLC was developed to address weaknesses of previous life chart methods and help patients and healthcare professionals (HCPs) quickly identify patterns of mental health symptoms across diagnostic categories. To date only one formal exploration of the TLC has been conducted in a sample of individuals with mood, anxiety, eating disorders, and substance use disorders, which suggested that participants felt the TLC was helpful in understanding their mental health symptoms and was pleasant to complete. Unpublished focus groups with HCPs suggest HCPs believe the TLC could help to improve patient encounters by increasing understanding of patients and facilitating conversations. Based on these findings the goal of the proposed study is to examine clinical usability, utility, and feasibility in a pragmatic pilot trial. The current trial will recruit individuals seeking treatment within the Laureate Psychiatric Clinic and Hospital and healthcare professionals involved with their care. Treatment-seeking patients who are invited to participate will be asked to complete the TLC soon after establishing care in a health system setting. Subsequently, the patient's HCP will review the chart during the intake process and complete several measures related to the chart and their experience (baseline assessment point). Patients and HCPs will engage in treatment as usual in between the TLC and assessment time points. Prior to or shortly following discharge/termination of treatment (approximately 4 to 12 weeks depending on the clinic), patients and HCPs will be asked to again complete questions to determine the TLC's usefulness during treatment. The overarching aim of the current study is to examine the usefulness of the Tulsa Life Chart for treatment-seeking individuals and healthcare professionals.

Official Title
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Pilot Study on the Clinical Utility of the Tulsa Life Chart: A Graphical Representation of Patient Life History

Conditions
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Mental Health Issue, Mental Health Disorder, Assessment, Self

Intervention / Treatment
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* Other: Tulsa Life Chart (TLC)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Treatment Seekers Inclusion Criteria: Actively seeking mental health treatment at Laureate Psychiatric Clinic and Hospital Provision of informed consent or if <18 assent and parental consent Age 15 to 65 years Necessary resources to engage in a technology-based intervention English proficiency Willingness to grant access to medical records HCPs Inclusion Criteria: Employed at Laureate Psychiatric Clinic and Hospital in a patient care role Informed consent English proficiency Access to resources to engage in technology-based intervention Exclusion Criteria: Treatment Seekers Exclusion Criteria: Active suicidal ideation with plan or intent No access to resources to participate in a technology-based intervention Completed more than 2 sessions of therapy with their current provider prior to enrollment in the study Not proficient in English HCPs Exclusion Criteria: No access to resources to participate in a technology-based intervention Not proficient in English

Ages Eligible for Study
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Minimum Age: 15 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Treatment seeking individuals<br>Individuals seeking treatment in the Laureate Psychiatric Clinic and Hospital (LPCH). | Other: Tulsa Life Chart (TLC)<br>* The TLC is a self-administered, interactive assessment of patient history. Participants are asked to provide information from birth to their current age in developmental epochs (i.e., ages 0 to 5; 6 to 10; 11 to 14; 15 to 18; 19 to 25; 26 to 35; and so on in 10-year increments). Participants are first asked to rate their average mood during the epoch. They are then asked about locations lived, schools attended, people they were close to, hobbies, medical conditions, medications, hospitalizations, direct and indirect substance use exposure, mental health symptoms, mental health treatment, and important life events. The information is then displayed in an interactive, graphic of the individual's life that is reviewable by the patient and the healthcare providers enrolled in the study that the patient consents to having access.<br>|
| Healthcare professionals<br>Healthcare professionals (HCPS) include nurses, psychologists, therapists, medical doctors, dieticians, etc who work at LPCH and are engaged in direct patient care. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| mHealth App Usability Questionnaire (MAUQ) Total Usability Score (Patient) | Validated self-report survey in which participants indicate how usable the assessment tool was, with scores ranging from 18 to 126. Higher scores indicate greater usability. | Baseline assessment | 
| mHealth App Usability Questionnaire (MAUQ) Total Usability Score (Healthcare Professional) | Validated self-report survey in which healthcare professional participants indicate how usable the assessment tool was, with scores ranging from 18 to 126. Higher scores indicate greater usability. | Baseline assessment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| mHealth App Usability Questionnaire (MAUQ) - Ease of Use Subscale (Patient) | Subscale of a validated self-report survey in which patient participants report how easy the assessment tool was to use. Ease of use scores range from 5 to 35 with higher scores indicating greater ease of use. | Baseline assessment | 
| mHealth App Usability Questionnaire (MAUQ) - Ease of Use Subscale (Healthcare Professional) | Subscale of a validated self-report survey in which healthcare professional participants report how easy the assessment tool was to use. Ease of use scores range from 5 to 35 with higher scores indicating greater ease of use. | Baseline assessment | 
| mHealth App Usability Questionnaire (MAUQ) - Interface and Satisfaction Subscale (Patient) | Subscale of a validated self-report survey in which patients rate their satisfaction with the assessment tool and the interface of the tool. Interface and satisfaction scores range from 7 to 49 with higher scores indicating greater satisfaction. | Baseline assessment | 
| mHealth App Usability Questionnaire (MAUQ) - Interface and Satisfaction Subscale (Healthcare Professional) | Subscale of a validated self-report survey in which healthcare professionals rate their satisfaction with the assessment tool and the interface of the tool. Interface and satisfaction scores range from 7 to 49 with higher scores indicating greater satisfaction. | Baseline assessment | 
| mHealth App Usability Questionnaire (MAUQ) - Usefulness Subscale (Patient) | Subscale of a validated self-report survey in which patients rate the usefulness of the assessment tool. Usefulness scores range from 6 to 42 with higher scores indicating greater usefulness. | Baseline assessment | 
| mHealth App Usability Questionnaire (MAUQ) - Usefulness Subscale (Healthcare Professional) | Subscale of a validated self-report survey in which healthcare professionals rate the usefulness of the assessment tool. Usefulness scores range from 6 to 42 with higher scores indicating greater usefulness. | Baseline assessment | 
| Time spent to complete the Tulsa Life Chart (Patient) | Treatment seekers self-report of time to complete the TLC and embedded time count from the TLC application. | Baseline assessment | 
| Time spent to reviewing the Tulsa Life Chart (Healthcare Professional) | Healthcare professionals' self-report of time spent reviewing the TLC and embedded time count from the TLC application. | Baseline assessment | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Assessment, Life Chart, Web-based application, Clinical intake assessment, Pragmatic Clinical Pilot