1. Mobile Rapid Response Tobacco
Surveillance
Thomas R. Kirchner, PhD
Research Investigator
The Steven A. Schroeder Institute for
Tobacco Research & Policy Studies
Adjunct Assistant Professor
Johns Hopkins Bloomberg School of Public Health
Adjunct Assistant Professor
Georgetown Lombardi Comprehensive Cancer Center
PRESENTED AT:
CDC OSH EXPERT PANEL ON RAPID RESPONSE METHODOLOGY
FOR TOBACCO CONTROL SURVEILLANCE
CDC OFFICE ON SMOKING AND HEALTH, ATLANTA, GA
JUNE 2, 2011

2. Wireless Penetration: US
CTIA, 2010 Year-end Data
302.9 million active mobile devices
~308.7 million people (+territories)
= ~96% US Market Penetration
Average wireless bill = $47.21
Down 95 cents from 2009
Source:
Wireless
Substitution:
International Assoc. for the Wireless
Telecommunications Industry (CTIA), 2011

3. Minority Smartphone
Preferences
Nielsen, 2011

4. Minority Feature
Preferences
Pew Internet & American Life
Mobile Access, 2010

5. Underserved SMS
PricewaterhouseCoopers
HRI Consumer Survey, 2010

6. Wireless Substitution
%
Adults
living
in
wireless-­‐only
households,
January
2007-­‐June
2010
Source:
Wireless
Substitution:
Early
Release
of
Estimates
From
the
National
Health
Interview
Survey,
January
-­‐
June
2010
by
Stephen
J.
Blumberg,
Ph.D.,
and
Julian
V.
Luke,
Division
of
Health
Interview
Statistics,
National
Center
for
Health
Statistics

7. Ecological Momentary
Assessment
• ~ 2 decades mobile health survey research
EMA 2.0
• Participant provided device
• Dynamic Remote Content Management
• Mixed-mode Integration
• Ecological (i.e., GIS) Integration
• Remote Sensing (e.g., accelerometer)

9. Ecological Momentary
Intervention
Legacy: Become and EX Mobile (iPhone)

10. Ecological Momentary
“Surveillance”
IVR
MMS
SMS
Email
GPS

11. Prospective Targets
• Industry?
• Policy?
• Advocacy?
• Smoker Attitudes / Beliefs?
• Tobacco Product Use Patterns?
• Smoking Initiation and/or Cessation Milestones?

12. Rapid Learning Studies
• Prospective Cohort
• Large, Representative Samples
• Longitudinal (but not “long”)
• Iterative
• c.f., Multiphase optimization strategy (MOST)
• Adaptive
• c.f., Sequential Multiple Assignment Randomized Trial (SMART)

13. Gulf Oil Spill

14. Japan

16. Amazon Mechanical Turk

17. Opportunities
• Methodological
– Reach among Priority Populations
– Prospective, Longitudinal Research Questions
– Rapid Learning Studies
• Logistical
– Existing systems lower cost
– Automation lowers staffing overhead
– Improved retention / follow-up
• Collaborative
– Community Outreach
– Participatory Involvement

18. Challenges
• Privacy
• Platform standards
• Mobile Usage Fees
• Mixed-mode effects
• Reliability / Validity
• Data Processing
• Data Analysis

19. Recommendations
• National Prospective Cohort
• Mobile Platform / Device Independent System Development
• Feature Phone Focus (for now)
• User Preferences Trump Mode Effects
• Mobile + GIS Integration