Psychological measures have many uses in clinical practice including screening, outcomes assessment, and treatment planning.1–3
In particular, outcomes assessment allows for the measurement of treatment effectiveness and has become increasingly important not only to researchers but also to clinical agencies.3
Intervention research has traditionally used pen and paper for the baseline and follow-up assessments required in outcomes evaluation, but this method of data collection poses some potential problems for effectiveness research that is conducted in the real world of treatment delivery where efficiency and ease are especially valuable. Firstly, responding to items via traditional pen and paper creates a time delay of both data reporting and entry. Paper-and-pen data collection also enables a broader margin of error, with the possibility for error in data entry, as well as lost time and effort on data entry, re-entry, comparison, and cleanup. There is also the issue of missing data in paper-based data collection, which can be attenuated in computerized systems by prompting participants to answer questions they have skipped.4
Accordingly, there has been greater attention given to instantaneous data capture in recent years. Computerized administration of measures allows for cleaner data capture and potentially saved time, which not only benefits researchers but also the mental health consumers and clinical staff completing and responding to measures.5
Research has shown that administering measures via computer is less expensive and less time consuming than conducting face-to-face interviews or paper-based assessments.6–8
Furthermore, most consumers do not have difficulty using electronic devices to complete assessments. One study using a touchscreen computer found that between 97% and 99% of consumers were able to correctly answer a series of questions about the proper use of the device.9
Computerized assessment has been shown to be particularly beneficial when consumers were asked about sensitive issues such as substance abuse and suicidal ideation, producing more honest responses and increasing consumers’ comfort with revealing personal information.8
Computerized assessment has proven to be a reliable method of data collection for measures of mental health and general functioning.10,11
In addition, multiple studies have found that the results of computerized assessments are equivalent to those obtained using paper-based versions across a variety of measures.7,8,12–14
Consumers report high levels of satisfaction with computerized assessment, typically preferring computer-based measures to those completed using paper and pen.6,11,13,15
Ease of use and privacy are cited as advantages of computerized assessment.9,13
These studies were conducted using multiple scales across a variety of populations, including inpatient and outpatient populations in both mental health and non-mental health settings.
Although these results suggest that computerized assessment is superior to traditional pen and paper administration of measures, very few studies have utilized mobile forms of technology to assess patient outcomes. With the majority of research employing mobile, handheld computers has been conducted in an experience sampling or ecological momentary assessment format.16–22
However, at least one study has utilized handheld computers to administer longer measures, assessing the outcomes of youth with severe emotional disturbances.23
The authors concluded that handheld computers are an efficient, effective means of administering assessments in clinical populations.
Just as computer-based assessments are an improvement over pen and paper, handheld computers offer a number of advantages over desktop models. These advantages are especially relevant in community mental health centers (CMHCs), where space is often limited. The portability and small screen size of handheld computers allows consumers to complete assessments in any location throughout the CMHC while maintaining confidentiality. The small size and comparatively cheap price of handheld computers also permits CMHCs to buy and store multiple devices, ensuring that several consumers can complete measures simultaneously—a significant asset given the high patient flow that is typical of community clinics. This guards against potential missed data collection as well, since consumers can still complete assessments if individual devices temporarily stop functioning.
Although various studies have used computer-based assessments to administer measures to clinical populations, very few have assessed the feasibility of using these devices in CMHCs, and even fewer have compared consumer satisfaction with assessment via handheld computer versus traditional pen and paper. Wolford et al. and Eisen et al. confirmed the viability of conducting computerized assessments in community mental health populations, but neither study examined consumer satisfaction with handheld computers.6,7
Cook et al. assessed the feasibility of administering the Quick Inventory of Depressive Symptomatology on a tablet computer among outpatients diagnosed with major depressive disorder.13
However, patients were recruited from university-affiliated clinics, rather than CMHCs, suggesting that results may not be generalizable to those seeking services at CMHCs. For example, consumers at CMHCs are typically less educated than those who seek services at other sites. In addition, the poor and indigent population seeking services at a CMHC have likely had less exposure to and experience with electronic devices. The current project assessed consumer satisfaction with handheld computers in relation to demographic and clinical variables in order to account for the differences found amongst community populations. The study was designed to evaluate any specific difficulties that CMHC consumers might have in completing assessments via handheld computer, a particularly important investigation given the singular usefulness of handheld devices in busy community clinics with limited resources.
This project aimed to assess the feasibility of administering the BASIS-24 via handheld computers in CMHCs. The validity of the computerized version of the BASIS-24 has been tested in one, small-scale investigation that did not specifically evaluate the feasibility of administration via handheld computer.7
More specifically, the current study sought to (1) provide descriptive results of consumer satisfaction with completing the BASIS-24 via handheld computer, (2) evaluate consumers’ satisfaction with this assessment delivery method in relation to demographic and clinical variables, and (3) establish internal consistency reliability of handheld computer administration of the BASIS-24 as well as concordance with paper administration of this measure. These aims were carried out in a large CMHC outpatient sample.