Wellbeing Intervention for Chronic Kidney Disease (WICKD): A Trial of the Aboriginal and Islander Mental Health Initiative (AIMhi) Stay Strong App.

Arm 1-Early Treatment with MCP using the AIMhi Stay Strong App Participants who are randomised to the intervention complete a Motivational Care Plan (MCP) interview using the AIMhi Stay Strong App (on a tablet device) at baseline, with one further session using the App within two to four weeks. Session 1 explores family, current strengths and worries. Participants are encouraged to set 1-2 goals that are achievable, meaningful, and practical for addressing an identified worry. The client-centered nature of the intervention ensures the goals are client driven and empowers them to take manageable steps toward achieving that goal. Session 2 reviews and refines the goals (identifies whether goals and steps were achieved) and helps clients address any barriers to goal attainment and set new goals as appropriate. Participants receive a text message or phone call following the initial treatment reminding them of their goals and steps for making change and a further text message or phone call at weeks 10-11 reminding them of the planned 3 month follow up assessments. Participants in the early treatment group also receive a further two sessions using the AIMhi Stay Strong app following the 3 month follow up assessment. The two sessions also occur 2-4 weeks apart and follow a similar format to the sessions received at baseline – reviewing family, strengths, worries and previous goals set and sets new goals. Participants receive a text message or phone call following the initial treatment reminding them of their goals and steps for making change and further text message or phone call at weeks 21-22 reminding them of the planned 6 month follow up assessments. A text message or phone call is received between the two sessions to remind participants of their goals and the time for the next session. Participants in the early treatment group also receive usual care from their renal service provider. Sessions using the app involve a supervised session during which the session is completed digitally on the app in a face to face session between participant and research officer/therapist. The app is designed to provide step by step instruction for the therapist and to be used by a range of practitioners with little professional training in counselling such as Indigenous wellbeing workers. The research officers delivering the treatment have varied undergraduate and post graduate qualifications. They have all received specific training in the use of the App and related basic counselling techniques. The approximate duration of the treatment session is thirty minutes. The key reason for use of phone reminders rather than text reminders is that of facility with English language. For those with limited English language knowledge a text message is less likely to be an effective means of communication. Most Alice Springs based participants will receive phone calls rather than text messages. The pictorial summary provided is paper based and handed to the participant. It is an electronic summary of what has been entered into the app during the session: supportive family (name, role, relationship); strengths (e.g. work, exercise), stressors (eg physical illness, smoking) and change goals discussed (eg 'decrease smoking' and steps to that goal eg 'contact quit line'). The app software monitors timing of each session and whether each page has been addressed in each session. The researcher/therapist records comments after each session and notes any areas for discussion at regular fidelity review meetings (fortnightly).