Clinician Perspectives on Incorporating Physical Activity and Sleep Prescriptions Using eHealth for Youth With Comorbid Psychiatric Disorders: Qualitative Focus Group Study.

backgroundPhysical activity and sleep prescriptions are indicated for the treatment of psychiatric disorders among youth. However, there is limited clinical adoption of these practices. Exergaming (ie, games that require physical activity) is a feasible intervention to promote physical activity and sleep hygiene and is appealing to youth given their interest in video gaming. Integrating exergaming prescriptions into clinical mental health practices may offer an opportunity to expand access to these interventions, yet pragmatic considerations for adopting these programs are poorly understood.

objectiveThis study aimed to gain feedback from practicing clinicians on adopting GamerFit, an app-based intervention that incorporates exergames, step and sleep tracking, and online coaching to promote physical activity and sleep, as a tool in treatment plans for youth aged 13 to 17 years with psychiatric disorders.

methodsMental health clinicians participated in 2 online focus groups. A semistructured interview collected information on perceptions of the importance of physical activity and sleep, considerations for using GamerFit with clients, and approaches for incorporating GamerFit into standard care. Qualitative analysis included a hierarchical thematic coding system of isolated quotes, with the structure, frequency, and interrelationships of the coded quotes used for analysis.

resultsAll clinicians (8/8, 100%) endorsed physical activity and sleep prescriptions as important interventions, although they were not typically a focus of treatment. Clinicians reported varying levels of self-efficacy in encouraging physical activity goals (6/8, 75%) and, to a lesser extent, sleep hygiene (4/8, 50%). Most perceived eHealth approaches positively (7/8, 88%) and noted their appeal given the accessibility of this physical activity option via gaming (2/4, 50%). Clinicians were optimistic about the feasibility of using GamerFit; the exergame and health coaching aspects of GamerFit were perceived favorably (5/8, 62%). Clinicians desired to access app data in electronic health systems to incorporate in therapeutic sessions (4/8, 50%) and recommended using the app in residential settings with continued use at home (2/8, 25%). Clinicians expressed concern regarding the implementation of GamerFit with families with low technology literacy, noting that some patients would likely require parental assistance to help with reminders and technology use (1/8, 12%). Suggestions for improvement included a greater variety of exergames and features to increase adolescents' engagement (6/8, 75%). There was a considerable willingness to incorporate this technology into clinicians' clinical practices and a strong desire for insurance provisions to cover coaching and technological components (7/8, 88%).

conclusionsClinicians perceived GamerFit as a feasible and acceptable clinical approach to physical activity and sleep prescriptions for youth with psychiatric disorders. The remote delivery of this intervention was perceived to be of interest to patients and provided helpful guidance for clinicians who were short on time to address many important topics within limited session time frames.