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Using Mobile Phones to Deliver Person-centred Population Health Prograames
 

Using Mobile Phones to Deliver Person-centred Population Health Prograames

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Dr Robyn Whittaker

Dr Robyn Whittaker
Clinical Trials Research Unit, University of Auckland
www.ctru.auckland.ac.nz
(P37, 1/10/09, Skellerup Room, 4.25)

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    Using Mobile Phones to Deliver Person-centred Population Health Prograames Using Mobile Phones to Deliver Person-centred Population Health Prograames Presentation Transcript

    • Dr Robyn Whittaker Clinical Trials Research Unit Using mobile phones to deliver person-centred population health programmes
    • Mobile phones in health
      • Appointment reminders
      • Reporting test results
      • Text medication reminders
      • Support self-management
        • Self-testing & adjustment medications
      • Telemedicine
      • Remote sensors
      • Access to personal health information
      • Population health programmes
        • Stand-alone
        • Person-centred/individualised
        • But at less cost
        • With the reach of mass media
      • Behaviour change support to reduce the risk of disease
    • Examples
      • Txt messaging stop smoking support (00/01)
      • Video messaging stop smoking support (06/09)
      • Multimedia messaging depression prevention
      • (2008/11)
    • STOMP programme
      • Voice or web registration
        • smoking history, triggers etc
      0 weeks
      • Quit Day
      • free text messaging begins
      1-3 weeks Daily text message countdown + action plan Quit calendar web page Personalised text message tips Introduction to CellPall (“quit buddy”) Text your friends “ TXT crave” 4 personalised text message tips per day Quiz or poll eg “top 5 reasons to quit” Web page Quit Meter (eg $ saved), profiles Target Date Quit Relapse 6 weeks 26 weeks
    • Why mobile phones?
      • Wide reach - more mobile phone accounts than people
      • Delivery via method that is already integrated into daily life
      • Always with people regardless of location
      • Less ‘digital divide’ than with other technological methods
      • Household Economic Survey
        • Less socio-economic gradient than access to internet
      • ACNielsen Survey 04
        • No difference between Maori & non-Maori % using mobile phones
        • Regular txt messaging higher in Maori and Pacific than others
    • STUB IT participants 24% Maori 10% Asian 7.5% Pacific
    • STOMP: % quit at 6 weeks Age Gender Ethnicity Income Region
        • Overall relative risk 2.8, 95% CI 2.1-3.5, p <0.0001
    • Functionality meets theory
      • Benefits/barriers
      • Outcome expectations
      • Self-efficacy
      • Positive reinforcement
      • Observational learning
      • Preparation cues/triggers
      • Social support
      • State behavioural intentions
      • Tailoring
      • Engagement
    • Functionality meets theory
      • Benefits/barriers
      • Outcome expectations
      • Self-efficacy
      • Positive reinforcement
      • Observational learning
      • Preparation cues/triggers
      • Social support
      • State behavioural intentions
      • Tailoring
      • Engagement
      • Provide information
      • Proactive & timely messages
      • Video messaging
      • Ask for help on demand
      • Social network/contacts
      • Long-term
      • Direct & individual
      • Interactive
    • Proactive & timely
      • STUB IT
        • select two message time periods
        • automatically sends out randomly within those time periods
        • e.g. first cigarette in the morning, lunch break, after work
      • “ Good reminders of what I’m trying to do”
    • Ask for help when/where needed
      • Text ‘CRAVE’
        • Get immediate txt or video in response
        • Context-specific (drinking, stressed, boredom)
      • Text RELAPSE
        • Get 3 messages over next 2 hours
        • Motivation to keep going
        • Go to website & increase messages
    • Provide observational learning
      • Role models
        • ‘ Ordinary’ kiwis going through quitting or same issues as them
        • Talk about what difficulties they have experienced & what they did to get through it or how they faced it
        • Feel good cos got through another day/ sorted a problem
    •  
    • Promote social support
      • STOMP: Txting friends & family on quit day in order to get messages of support
      • STOMP: Quit buddy
    •  
    • What they liked about STUB IT
      • “ The constant/daily support”
      • “ Felt like I was quitting as a group”
      • “ Real people doing it”
      • “ That people were sharing their own experiences so I was not feeling alone”
    • Provide long-term support
      • MEMO:
      • Mobile website for summary info & how to get help out to 12 months
    • Tailored
      • Select Quit Date
      • Select role model or topics of interest
      • Select appropriate time periods
      • Use nickname
      • Relapse programme
    • Provide interactivity
      • Data collection questions
        • How many cigs have u smkd in past 7 days?
      • CRAVE
      • Polls & surveys in STOMP
        • How long does it take nicotine 2 leave yr body? 2hrs, 2days or 2 wks
      • Submit video messages in STUB IT
      • Participants website
    • Results - STOMP
      • 1705 participant RCTrial
      • Doubled short-term quit rates
        • 28% cf. 13% (RR2.20, 95% CI 1.79-2.70)
      • Equally effective for all sub-groups
      • As effective for Māori as non-Māori
    •  
    • Results – STUB IT
      • Failed to recruit sufficient participants to show statistically significant difference
        • 36.7% have not gone back to daily smoking at 6 mths cf.25.8%
      • Why?
        • Readiness to quit of target popn
        • ‘ Ahead of the curve’ wrt mobile technology
        • Competition/Incentives/Low coverage
    • Acknowledgements
      • Prof A.Rodgers, Dr S.Merry, RB.Lin,M.Wills, M.Jones, T.Corbett, Dr D.Bramley, Dr T.Riddell, Dr S.Denny, R.Maddison, C.Bullen, H.MacRobbie, P.Salmon, V.Parag, Dr K.Stasiak, M.Shepherd, Dr H.McDowell, I.Doherty, Dr S.Ameratunga
      • E.Dorey, J.Strydom, J.vanRooyen, S.Chua, M.Malik
      • Funders:
        • Health Research Council of NZ
        • National Heart Foundation
        • Cancer Society of NZ Ministry of Health
        • Auckland UniServices Ltd Digital Strategy
        • Vodafone NZ Ltd Oakley Foundation
        • Alcatel
    • Publications
      • STOMP
        • Rodgers et al. Tobacco Control 2005
        • Bramley et al. NZMJ 2006
      • STUB IT
        • Whittaker et al. JMIR 2008
      • [email_address]
      • www.ctru.auckland.ac.nz