Identification of Factors to Improve Effectiveness and Implementation of a Multi-faceted COVID-19 Mental Health Intervention: Follow-up to the SPIN-CHAT Trial

The COVID-19 pandemic has spread rapidly, seen an increasing number of deaths, and taxed economies. Fears due to risk of infection, collapsing healthcare systems, unknown isolation/restriction periods, and that resources will be insufficient have resulted in poor mental health outcomes. Such outcomes may be worse among those with pre-existing medical conditions. Individuals with the autoimmune disease, scleroderma are representative of other vulnerable groups in terms of COVID-19 mental health ramifications due to their frailty, pre-existing respiratory concerns, and suppressed immune systems. Governments, organizations, and researchers have suggested that multi-faceted interventions are required during this time. Yet, only one study has tested such an intervention during COVID-19: The Scleroderma Patient-centered Intervention Network COVID-19 Home-Isolation Activities Together (SPIN-CHAT) Program, which was rapidly designed and tested with 172 participants. The SPIN-CHAT Program consisted of 3 group sessions/week over 4 weeks. Trained facilitators led the sessions and professional educators provided mental health, physical activity, and other anxiety and worry-management strategies. Early results suggest the intervention may be effective. As this was a practical program, with tremendous potential to be tested again, modified for other vulnerable populations, and eventually implemented into care, exploring how to optimize the SPIN-CHAT Program and study is necessary. Collecting multiple perspectives from participants, facilitators, professional educators, and trial management can provide in-depth information from differing viewpoints to explore benefits accrued, identify aspects of the SPIN-CHAT Program and study were and were not helpful, determine acceptability, and guide improvement efforts. Ultimately, this project will identify ways to improve the SPIN-CHAT Program and study to ensure a greater number of vulnerable individuals can receive this intervention.