mCollegeHealth: Leveraging Mobile for Healthier Campus

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Presentation made by Jay Bernhardt, PhD, MPH to the Southern College Health Association Meeting in Gainesville, Florida on March 2, 2012.

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  • http://www.pewinternet.org/Infographics/2010/Internet-acess-by-age-group-over-time-Update.aspx
  • http://www.pewinternet.org/Infographics/Generational-differences-in-online-activities.aspx
  • mCollegeHealth: Leveraging Mobile for Healthier Campus

    1. 1. mCollegeHealth: Leveraging Mobile for Healthier Campuses Jay M. Bernhardt, PhD, MPHProfessor and Chair of Health Education and Behavior Director, Center for Digital Health and Wellness College of Health and Human Performance @jaybernhardt
    2. 2. Epidemiology of mHealth Access http://rememberitnow.com/blog/tag/mhealth/ @jaybernhardt
    3. 3. Internet Use by Age, 2000-2010 @jaybernhardt
    4. 4. http://www.pewinternet.org/Infographics/Generational-differences-in-online-activities.aspx @jaybernhardt
    5. 5. Social Media Use by Age, 2005-2010 @jaybernhardt
    6. 6. http://www.pewinternet.org/Reports/2010/Home-Broadband-2010/Summary-of-Findings.aspx @jaybernhardt
    7. 7. Cellphone Use by US AdultsTopic Dec 2005 Dec 2010Wireless subscribers 208M 303MWireless penetration 69% 96%Wireless only households 8% 27%Minutes of use 1.5T 2.2TAnnual text messages 81B 2.1T http://www.ctia.org/advocacy/research/index.cfm/AID/10378 @jaybernhardt
    8. 8. @jaybernhardt
    9. 9. Mobile-Only Household Health @jaybernhardt
    10. 10. mHealth Dynamic Growth @jaybernhardt
    11. 11. @jaybernhardt
    12. 12. @jaybernhardt
    13. 13. http://healthpopuli.com/wp-content/uploads/2011/06/Adoption-of-mHealth-Initiatives-and-Phases-Globally.jpg @jaybernhardt
    14. 14. mHealth > SMS SMS or MMS Video file (M4V, etc.) Voice (human, recorded, IVR) Mobile Web Email or MonitoringInstant Message Custom Audio file application (MP3, etc.) program (“apps”) http://www.technobuffalo.com/mobile-devices/phones/the-all-in-one-conundrum-a-delightful-rant/ @jaybernhardt
    15. 15. http://mobihealthnews.com/13368/report-13k-iphone-consumer-health-apps-in-2012/ @jaybernhardt
    16. 16. http://medhealthworld.code.com/wp-content/uploads/2011/03/smarthealth-apps-2015.jpg @jaybernhardt
    17. 17. mHealth State of the Science @jaybernhardt
    18. 18. What works in mHealth?• Hundreds of pilots = Limited evidence base• Conducted a “review of systematic reviews” – Google Scholar search for ‘review’ and terms: mHealth, mobile, SMS, cell phone, wireless• Found 6 full-text systematic-reviews – Broad topics: Healthcare, Health services, Maternal and Child Health, Behavior change – Narrow topics: Diabetes management, Chronic pain, Hospital appointments – Mobile channels: Voice, SMS, email, etc. @jaybernhardt
    19. 19. Free et al. (2010) The effectiveness of m-healthtechnologies for improving health and health services: A systematic review protocol. BMC Research Notes.• mHealth interventions taxonomy: – Improve diagnosis, treatment, monitoring – Deliver treatment or disease management, health promotion, improve treatment compliance – Improve processes, attendance, reminders @jaybernhardt
    20. 20. Free et al. (2010) The effectiveness of m-healthtechnologies for improving health and health services: A systematic review protocol. BMC Research Notes.• Clinical decision support • Treatment programs systems (diagnosis & • Chronic disease disease management) management• Medical education • Medication adherence• Disease monitoring • Health behavior change• Data collection tools • Acute disease• Medical records management• Test results notification • Untargeted mass health• Appointment reminders promotion @jaybernhardt
    21. 21. Cole-Lewis & Kershaw (2010) Text messaging as atool for behavior change in disease prevention and management. Epidemiologic Review.• Reviewed 12 studies (17 articles) using SMS – Intervention length ranged from 3-12 months – Sample sizes (n=16-126, + 1,705) – Disease management: Diabetes, Asthma – Disease prevention: Medication adherence, Weight loss, Physical activity, Smoking cessation – 8 of 9 powered studies found evidence of significant behavior change @jaybernhardt
    22. 22. Holtz & Lauckner (2012) Diabetes Management via Mobile Phones: A Systematic Review, Telemedicine and e-Health• 21 studies reviewed from 2010 and 2011• Interventions: – Diary/log, Reminders, Education• Significant outcomes: – Self-efficacy, HbA1c, Self-management behaviors• Limitations: – Small samples (n=6-100) – Short durations (2 weeks - 1 year) – Technical issues (67% of studies) @jaybernhardt
    23. 23. Krishna et al. (2009) Healthcare via Cell Phones:A Systematic Review, Telemedicine and e-Health• 25 studies conducted in 13 countries• Interventions: SMS, voice, email, or combination• Message frequency: 5x day – 1x week• Significant Improvements (60% of measures): – Processes: Appointment attendance, Diagnosis and treatment time, Improved teaching and training. – Clinical outcomes: Adherence, Asthma, HbA1C, Stress levels, Smoking quit rates, Self-efficacy. – Limited data on cost/benefit @jaybernhardt
    24. 24. Fjeldsoe et al. (2009) Behavior change interventions delivered by mobile telephone short-message service. AJPM.• Reviewed 14 studies (4 = prevention; 10 = care) – Intervention length: 6 weeks to 1 year – Sample sizes: 10-1705 – 4 of 14 used theory-based intervention• 13 of 14 found positive behavior change outcomes• Most effective SMS interventions: – SMS dialogue initiation – Tailored SMS content – Interactive SMS exchanges @jaybernhardt
    25. 25. Hasvold & Wooton (2011) Use of telephone and SMS reminders to improve attendance at hospital appointments: A systematic review. Journal of Telemedicine and Telecare.• Reviewed 29 studies with 33 interventions – Study sizes: n=325-2864 – Study durations: 2-7 months• 32 of 33 interventions showed benefits of sending patient reminders prior to appointments – Manual calls more effective than automated reminders (39% vs. 29%) but higher cost – No differences on reminder timing @jaybernhardt
    26. 26. Tamrat & Kachnowski (2011) Special Delivery: An analysis of mHealth in maternal and newborn healthprograms and their outcomes around the world. MCHJ.• Reviewed 34 articles in developing countries – Topics: Emergency medical response, point-of- care support, health promotion, data collection• Most studies showed positive benefits – Minimize time barriers and facilitate urgent care – Address low coverage and professional isolation – SMS messages/reminders for health promotion – Data collection and interoperability @jaybernhardt
    27. 27. mHealth Review of Reviews: Summary• SMS-based interventions can be effective for: – Simple behaviors (e.g., reminders, appointments) – Short-term complex behaviors (e.g., adherence, smoking cessation, disease self- management) if: • SMS messages are individually-tailored • SMS messages facilitate interactive dialogue• More research and evaluation are needed: – Larger samples, longer durations, more cost data – mHealth beyond SMS (voice, IVR, mWeb, apps) @jaybernhardt
    28. 28. Selected mHealth Examples: Adult and College Health @jaybernhardt
    29. 29. Don’t forget yourmultivitamin! Baby’s spineand brain are developing now.Getting 400 micrograms offolic acid daily is key to helpprevent birth defects.Reply Back http://text4baby.org @jaybernhardt
    30. 30. http://voxiva.com @jaybernhardt
    31. 31. @jaybernhardt
    32. 32. Location Based mHealth Programs @jaybernhardt
    33. 33. Mobile Web @jaybernhardt
    34. 34. Quantified Self http://nike.com http://fitbit.com http://www.diabetesmine.com http://sleepzine.com @jaybernhardt
    35. 35. http://challenge.gov @jaybernhardt
    36. 36. Top mHealth Apps for College Students @jaybernhardt
    37. 37. “Real” Top mHealth Apps for College Students http://www.watblog.com http://www.gadgetsdna.com http://hireheathervilla.com @jaybernhardt
    38. 38. mHealth OverviewmHealth Applications: mHealth Channels:• Call Centers• Emergency Alerts • SMS or MMS• Appointment Reminders • Voice (human,• Patient Records recorded, IVR)• Health Surveys • Email or IMs• Monitoring & Surveillance • Audio files• Treatment Adherence • Video files• Health Promotion • Mobile Web • Monitoring• Mobile Telemedicine • Custom apps• Community Mobilization• Decision Support Systems @jaybernhardt
    39. 39. College mHealth Summary• Many positives for mHealth interventions – Increased & Sustained Reach – Audience Relevance, Involvement, and Engagement – Scalable and Affordable Interventions – Facilitates Measurement and Program Evaluation – Early evidence-base for SMS interventions is promising• Many challenges remain for mHealth – Limited expertise and resources among professionals – More research and evaluation with sustained programs @jaybernhardt
    40. 40. THANK YOUjaybernhardt@ufl.edu jaybernhardt.com @jaybernhardt http://collegelife.bellerosewebmedia.com/thinking-of-joining-a-fraternity?ref=frontpage @jaybernhardt

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