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NCT Number: NCT07080827

TTM-Based Social Media Psychoeducation for Psychosis

This doctoral research investigates the effect of a Transtheoretical Model (TTM)-based psychoeducation program delivered via social media on treatment adherence in individuals diagnosed with psychosis. The study follows a randomized controlled trial design with pretest, posttest, and three-month follow-up assessments.

A total of 60 participants were selected from among 354 individuals registered at the Balıkesir Community Mental Health Center (CMHC), based on predefined inclusion and exclusion criteria. Participants were randomly assigned into three groups:

1. an online intervention group receiving a 5-week TTM-based treatment adherence psychoeducation program via WhatsApp; 2. a face-to-face intervention group receiving a standard, non-TTM-based treatment adherence psychoeducation program over 3 weeks at the CMHC; and 3. a control group that received no educational intervention, only assessments.

Data collection instruments include a Sociodemographic Information Form, the Stage of Change Identification Form, the Medication Adherence Report Scale (MARS-5), and the Clinical Global Impression-Severity Scale (CGI-S). Measurements were conducted at baseline, post-intervention, and three months after the intervention.

The study hypotheses are:

Research Hypotheses H1: The treatment adherence scale scores of individuals diagnosed with psychosis who participate in the TTM-based psychoeducation group administered via social media will differ compared to the scores of individuals who participate in the face-to-face treatment adherence psychoeducation group.

H2: The treatment adherence scale scores of individuals diagnosed with psychosis who participate in the TTM-based psychoeducation group administered via social media will differ compared to the scores of individuals who do not receive TTM-based psychoeducation.

This study aims to provide evidence for the efficacy of theory-based, technology-supported psychoeducation programs in enhancing treatment adherence among individuals with psychosis. Furthermore, it evaluates whether a model-based online psychoeducation program is more effective than a conventional treatment adherence education.

Active, Not Recruiting

This study is active but is not currently recruiting participants.

Key information

Conditions

Treatment Compliance Behavior Health Behavior Mental Disorders Patient Acceptance of Health Care Patient Compliance Psychotic Disorders Schizophrenia Spectrum and Other Psychotic Disorders Social Media Treatment Adherence and Compliance

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Balıkesir Provincial Health Directorate, Community Mental Health Center

Balıkesir, 10050, Turkey (Türkiye)

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age between 18 and 65 years
  • Diagnosed with a psychotic disorder according to DSM-5 criteria, including:
  • Schizophrenia
  • Schizophreniform disorder
  • Schizoaffective disorder (with mild mood symptoms)
  • Brief psychotic disorder
  • Substance/medication-induced psychotic disorder (in remission)
  • Paranoid disorder
  • On the same prescribed psychiatric medication for at least one month
  • Able to communicate in Turkish
  • Has access to the internet and owns at least one active social media account (Instagram, Twitter, Facebook, WhatsApp, etc.)
  • Literate and able to complete self-report forms
  • Willing to participate and provide informed consent
  • Clinical Global Impression-Severity (CGI-S) score of 4 or below

Exclusion criteria

  • Under 18 or over 65 years of age
  • Acute psychotic episode at the time of recruitment
  • Comorbid psychiatric diagnoses not covered under the inclusion list
  • Diagnosed with neurocognitive disorders (e.g., dementia)
  • Diagnosed with intellectual disability (mental retardation)
  • Unable to use smartphone, tablet, or other digital communication tools
  • Missed more than 20% of the intervention sessions

Treatment and study plan

TTM-Based Online Psychoeducation Program

Behavioral

A 5-week structured psychoeducation program based on the Transtheoretical Model (TTM), delivered via WhatsApp. Educational content was tailored to the participant's stage of change and included videos, texts, and interactive materials to promote treatment adherence in individuals with psychosis.

Standard Face-to-Face Psychoeducation Program

Behavioral

A 3-week conventional psychoeducation program delivered face-to-face at the Community Mental Health Center. The program focused on general treatment adherence without utilizing the Transtheoretical Model and included verbal education, printed materials, and discussions.

TTM-Based Online Psychoeducation Program

Other

The intervention was provided after a 3-month delay following initial observation. Participants received the same 5-week online psychoeducation program as the main intervention group

Primary outcomes

  1. Medication Adherence (Treatment adherence)

    Time frame: Baseline (Week 0) and Post-Intervention (Week 5)

    Score on a 5-point Likert scale

  2. Change in Medication Adherence Scores (MARS-5)

    Time frame: Baseline, Post-Intervention (Week 5), and 3-Month Follow-Up

    Medication adherence will be assessed using the 5-item Medication Adherence Report Scale (MARS-5), originally developed by Horne and Hankins (2001). It is a generic, self-reported Likert-type scale validated across various chronic physical and psychiatric conditions, including bipolar disorder, hypertension, asthma, and schizophrenia. Each item is rated on a 5-point scale from 1 (always) to 5 (never), yielding a total score between 5 and 25. Higher scores indicate better adherence.

    The Turkish version of the scale was adapted by the investigators and demonstrated acceptable internal consistency (Cronbach's α = 0.78). Factor analyses supported a unidimensional structure (KMO = 0.79; CFI = 0.97; RMSEA = 0.089), consistent with the original.

    In this study, MARS-5 will be administered at three time points: prior to the intervention (baseline), immediately following the intervention (post-test), and three months after the intervention (follow-up) to assess changes in treatment adherence

Sponsors and collaborators

Lead sponsor

Istanbul University - Cerrahpasa

Other

Registry information

Official study title

The Effect of Transtheoretical Model-Based Psychoeducation Via Social Media on Treatment Adherence in Individuals Diagnosed With Psychosis

Acronym: TAPS

Important dates

Study start
2025
Primary completion
2025
Study completion
2025
First posted
Jul 23, 2025
Registry last updated
Jul 23, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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