81 The feasibility of daily monitoring 4 the app. If a participant proceeded to the next diary item without answering the latter item, the application asked the participants to confirm this. Prior to the study, the application, the items and the response scale were piloted by four adolescents with a mild intellectual disability. During the intake, the researcher read each standard item out loud to the participant and asked the participant to confirm whether its meaning was clear. The participant, care professional and the researcher then added personalized diary items to the eight pre-selected, standardized diary items. Each participant could opt to add personally relevant closed or open-ended questions, as few or as many as they wanted. The participants essentially generated these items themselves. That is, each participant was asked what they notice that tells them whether they had a good or bad day. Participants then generally came up with either specific (e.g., my sleep) or very broad concepts (my mood), to which the researcher then asked ‘How would you phrase this as a question that you can ask yourself daily in the app?’. The care professionals received no instructions on how to help choose individualized items. They are, however, aware of (therapeutic) goals and needs of the participant, and typically helped by offering suggestions, but it was ultimately the participant's choice. In a few cases, participant and care professional had trouble coming up with concepts or questions. The researcher then provided a few examples for inspiration. Once per week during the 60-day diary period, the researcher sent an overview of the participant's responses in the daily diary application to their care professional so they may integrate it in the treatment. There were no instructions for care professionals on how to use the daily diary entries in their everyday practice. The nature of therapy varied between participants. For example, some received protocolled dialectical behavioral therapy by a registered psychotherapist while others received more unstructured therapy in which their youth worker coached them on adaptive behaviors such as eating behavior or managing money. Importantly, the care professional agreed to (1) ensure the privacy of response overviews and (2) in case the participant reported on behaviors that are against the community rules (e.g. substance use), entries would be free of disciplinary consequences. The weekly overviews always contained an Excel file with all closed- and open-ended responses and a summarizing data visualization of all items that were answered on the same 5-point scale (see Figure 2 for an illustrative example).
RkJQdWJsaXNoZXIy MTk4NDMw