Small Screens, Big Changes: Frontiers in Mobile Technology for Nutrition, Health and Wellness

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Will Masters, Professor and Chair, Department of Food and Nutrition Policy, Friedman School of Nutrition Science and Policy at Tufts University, invited me to moderate a panel on Feb 26, 2014 on mobile health. Panelists Charles Teague, LoseIt!, Nick Patel, Wellable, and Neal Lesh, Dimagi, were fantastic. They gave me permission to post their slides, which end with the questions I prepared:

1.My mother-in-law downloaded LoseIt and wants to know how it takes into consideration your age and physical ability to exercise? The broader question here is:
–How are all people accommodated and when is it okay for a specific demographics' needs to be met be in age, location, or health condition?
2.From Twitter: Why does LoseIt treat iPhone users better than Android? Larger question:
–What is the impact of the changes in technology: cell phones, smart phones, tablets etc on your products?
3.What would a healthcare provider need to know to "prescribe" your app? Why would someone "adhere" to that prescription?
4.If you had unlimited funds what would you each do in the next year?

I wish I had documented all their excellent and insightful answers.

Interested in Mobile Health - consider Mobile Health Design course http://publichealth.tufts.edu/Academics/HCOM-Program/Summer-Institute/Mobile-Health-Design

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Small Screens, Big Changes: Frontiers in Mobile Technology for Nutrition, Health and Wellness

  1. 1. Small Screens, Big Changes: Frontiers in Mobile Technology for Nutrition, Health and Wellness Charles Teague, LoseIt!, charles@loseit.com Nick Patel, Wellable, nick@wellable.co Neal Lesh, Dimagi, nlesh@dimagi.com Moderator: Lisa Gualtieri, Tufts University School of Medicine, lisa.gualtieri@tufts.edu February 26, 2014
  2. 2. Mobile changes everything Top 10 mobile searches Top 10 web searches 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Chlamydia Bipolar disorder Depression Smoking/quit smoking Herpes Gout Scabies Multiple Sclerosis Pregnancy Vitamin A Cancer Diabetes Symptom Pain Weight Infection Virus Diet Thyroid Sleep
  3. 3. What fascinates me about mobile health • Selection and adoption of apps • Sustained use necessary for behavior change and health benefits • Making devices and sensors appealing • More adaptive and personalized
  4. 4. What is Lose It!? The best weight loss system available Connected– connects you to the people, devices, and food you need to succeed Personal– customizes a weight loss plan that fits your life. Effective– based upon proven principles of calorie tracking and peer support Facts and Figures Available on iOS, Android, and the web Top 5 Free / Grossing Health and Fitness application across platforms iTunes Editor’s choice, Best of 2013 Time Magazine top 50 iPhone apps Winner, Surgeon General’s Healthy App
  5. 5. Weight loss at scale 18 million registered users 25 billion foods logged 2 billion exercises logged 246 million weigh ins 25,000 interactions each minute
  6. 6. Demographics
  7. 7. Mobile- so what?  Clinically successful approaches to weight loss are actually well understood in many cases Tracking + Peer Support = Foundational Approach  But approaches suffer from poor compliance, in consumer terms, poor engagement  Mobile allows us to make huge strides in engagement Recapture lost time throughout the day Engage users at moments of decision Mobile = Proximity to choice and action Reduced cost, increased access
  8. 8. A Few More Trends to Consider  Consumer activation around wellness Health and Fitness in the App Store is incredibly competitive Top apps in the category are among the 100 most popular apps on the platform  Wearables and devices Activity trackers, scales, and other connected devices exploding New opportunity to measure user behavior with very low friction for users  Data at scale Explosion in scale of data and potential for intelligence Huge challenge to create actionable insights for users, not just charts
  9. 9. Nick Patel @GetWellable
  10. 10. [ ] 43,700 health care mobile apps available to consumers 11
  11. 11. [ ] 90% scored less than 40 on an scale of 100 for functionality 12
  12. 12. [ ] 5 15% apps generate of downloads 13
  13. 13. [ ] 1/2 of remaining apps were downloaded less than 500 times 14
  14. 14. [ ] 32% mobile device owners use fitness apps 15
  15. 15. [ ] 50% mobile health app users were fitness app users 16
  16. 16. [ ] By 2015, more than 500 million consumers will use health apps on their mobile device 17
  17. 17. WHAT IS WELLABE? Consumer Focused Health and Wellness Mobile Apps Enterprise Wellness Programs EMPLOYERS PROVIDERS HEALTH PLANS 18
  18. 18. IT’S JUST NOT ABOUT CONNECTING APPS… ANALYTICS COMMUNICATION WELLABLE APP PARTNERS SOCIAL / GAMIFICATION 19
  19. 19. WHERE DO YOU FIT IN? Legacy Health Coach Model Wellable Health Coach Model REAL-TIME DATA 20
  20. 20. Mobile apps to strengthen community health in low-income countries Neal Lesh, Dimagi – Feb 2014 nlesh@dimagi.com
  21. 21. Dimagi • Leader in open source mobile technology for low-income countries • Create mobile solutions that don’t require developers to deploy • 10 years experience working on over 150+ projects in 40+ countries
  22. 22. COMMCARE: MOBILE APPLICATIONS FOR COMMUNITY HEALTH WORKERS
  23. 23. CommCare in use by a CHW
  24. 24. CommCare: Multimedia for Counseling
  25. 25. CommCare: Case Management 1. Find Case 2. View Case Summary 3. Step-by-Step Guidance
  26. 26. Example: CommCare Workflow SMS Reminder Question Reena is overdue for his follow-up treatment please follow-up with her. Select Exit Select Find Existing Clients Record Client information Provide Multimedia counseling and Disseminate information Exit Follow-up with clients CommCareHQ Information System Build / Modify Application Manage Your Data and Workforce
  27. 27. Frontline Programs Launched in India in 2013 Maternal & Child Health (16) Nutrition (6) Sexual & Reproductive Health (2) Tuberculosis (2) Malaria (1) HIV (1) Domestic Violence (1) Agriculture (3) Education (2) Tobacco Cessation (1) Disaster Preparedness (1) Affordable Energy (1) Supervision (2) Household Survey (1) All of these apps will be published on the CommCare Exchange
  28. 28. ADRA’s SALOHI mHealth Nutrition Program Application Purpose: • To improve data quality of Growth Monitoring and Promotion (GMP) • Support health volunteers in providing counseling messages Application Details: • Tracks children’s monthly nutritional anthropometric status • Calculates weight-for-age Z score • Record MUACs • Provides appropriate nutritional counseling messages
  29. 29. CommCare for Growth Monitoring
  30. 30. Evidence base • Dimagi partners with many research groups to evaluate CommCare Level • 16 peer-reviewed publications on CommCare. Most evidence-based mobile platform for Frontline Workers • No Impact studies yet, many gray-lit Client KAP studies Study Published? #Yes #No 4 2. Implementation • Full Evidence Base is available online (http://tinyurl.com/cut6pkt) 1. Conceptual 6 3. FLW Interviews 2 3 4. FLW Activity 4 4 5. Client KAP Total # Studies 4 16 11
  31. 31. SOME LESSONS HARD LEARNED
  32. 32. Design Under the Mango Tree 33
  33. 33. Data should be Actionable
  34. 34. Frequency of Visis (Work by Brian DeRenzi et. al) B. DeRenzi, L. Findlater, G. Borriello, J. Jackson, J. Payne, B. Birnbaum, T. Parikh, N. Lesh, “Improving Community Health Worker Performance Through Automated SMS”, ICTD 2011, to appear
  35. 35. Thank you! Contact: Neal Lesh (nlesh@dimagi.com) Additional Videos: CommCare Overview Video: http://youtu.be/ZpfvISKxylE CommCare Demo Video with multi-lingual support from India: http://youtu.be/30Ftk6STM3U Recorded Webex of CommCare Presentation given to NetHope: http://bit.ly/tiLaYy Additional Resources: http://groups.google.com/group/ict4chw http://www.commcarehq.org http://www.dimagi.com
  36. 36. Dimagi Global Head-office 585 Massachusetts Ave Cambridge, MA 02139 USA T: +1.617.649.2214 F: +1.617.274.8393 For more Information E: information@dimagi.com W: www.dimagi.com W: www.commcarehq.org W: www.dimagi.com/category/blog/
  37. 37. Questions 1. My mother-in-law downloaded LoseIt and wants to know how it takes into consideration your age and physical ability to exercise? The broader question here is: – How are all people accommodated and when is it okay for a specific demographics' needs to be met be in age, location, or health condition? 2. From Twitter: Why does LoseIt treat iPhone users better than Android? Larger question: – What is the impact of the changes in technology: cell phones, smart phones, tablets etc on your products? 3. What would a healthcare provider need to know to "prescribe" your app? Why would someone "adhere" to that prescription? 4. If you had unlimited funds what would you each do in the next year?

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