Implications
psychosis
The EMPOWER trial itself had pre-defined criteria for determining intervention acceptability and feasibility [As identified in previous qualitative research with people who experience psychosis [EMPOWER patient participants had all had a recent relapse. Several participants who were still using EMPOWER at the point of interview remarked that they were no longer noticing any positive changes from using the intervention and felt that it had offered them all it could, and they felt they had moved on in their recovery journey. Since mental health staff did not appear to be actively involved in implementing the intervention beyond providing encouragement and curiosity, there is a need to focus on why patients implemented EMPOWER into the context of their daily life. These findings indicate that there is likely to be an optimal engagement period, but that this will likely very much depend on the individual patient.Going forward, a potential role for peer support workers, whom many patient participants endorsed a trusting relationship with, could be to have discussions with people whom they support about the pros and cons of continuous usage so that patients can make an informed choice about whether continuous monitoring tools are benefifical in their recovery.Interventions which are flexible and empower participants to discover affordances which are personally meaningful to them seem likely to be well implemented. Affordances are an interaction between a person and an object in their environment, with this in mind one key recommendation from our research is that future interventions work closely with patients to discover what would drive them to engage. Co-design and user engagement is in line with current guidance from the MRC complex intervention development framework [