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Table 3 Emergent themes, sub-themes, and illustrative quotes from focus group discussions

From: Client perceptions of the mental health engagement network: a qualitative analysis of an electronic personal health record

Themes Sub-themes Illustrative quotes
1. Versatile functionality of the LSR and smartphone facilitated use ▪ Enhanced ability to contact and be contacted (by care providers and family/friends) was important ▪ “…good way for me to…keep in contact with [my]social worker so we could send…messages…in between appointments”
▪ Tracking and appointment reminders were valuable functions ▪ “…keeps me on track…to actually stay on my meds”
▪ Applications associated with the smartphone (e.g., music, internet browsing, social media), made it an appealing tool to integrate into daily life ▪ “Definitely I’ve been happier just because I can like actually listen to my music…and watch it…before I could only listen to it, now I can watch it”
2. Aspects of the technologies as barriers to use ▪ Lack of knowledge about technology and data plans prevented use ▪ “I just don’t understand plans, so I just don’t get it. Like the minutes and the data, I don’t get that”
▪ An onerous login process and the requirement to remember a password for the LSR was challenging
▪ “… it was…frustrating to have to…log in at every single point… and…wait for the loading process…”
▪ The LSR was too slow
▪ Prompts and reminders did not always occur as programmed ▪ “I find it sometimes hard to keep track of all the password (sic)I have now”
▪ Small font and button size on the smartphone was difficult to see/use ▪ “I put it in for a reminder and it emails at the beginning of the day. Well that doesn’t help remind…to take my bedtime meds”
▪ Smartphone battery life was insufficient ▪ “the text messages are a little too small”
▪ “the iPhone keyboard is terrible……a real deterrent to using the iPhone”
▪ “…the battery only lasted a couple hours”
3. Use of the MHEN technologies resulted in perceived positive outcomes ▪ Enhanced feelings of safety, security, independence, and confidence ▪ “I’ve added emergency contacts”
▪ “I feel more secure because it has all these records and all these things on it, and if I get too depressed I know I can grab my phone for help”
▪ Increased connection with family/friends and care providers
▪ Increased tracking of symptoms and moods ▪ “I’ve enjoyed the instant connection to people”
▪ Positive effects on mood ▪ “it’s very nice to go back and look at what you’ve written before and also sort of monitor your mood that way”
▪ Positive feelings towards the MHEN technologies increased over time
▪ “I’m more aware of how my moods are, since that I’ve been keeping track of it”
▪ “I find it really helpful and it is really good to have it in my hand because then I don’t have to go and log on the computer and wait for it to boot up”
4. Future enhancement of the LSR and intervention is recommended ▪ The appearance and functionality of the LSR should be improved ▪ “I would make it [look] less clinical”
▪ “could be nicer if gives forwarding messages to my email then I [would] get to see it directly”
▪ Alerts should be sent directly to the smartphone when messages or changes are made to the LSR
▪ “there’s so much on the SMART record that I don’t even know what to do with it”
▪ Additional training should be provided on the use of the LSR