@jaybernhardtPediatrics 2.0:Digital HealthPromotion forBehavior ChangeJay M. Bernhardt, PhD, MPHProfessor and Chair, Depar...
@jaybernhardtPediatrics 2.0 Grand Rounds Overview• New media trends among youth• Digital health innovations for pediatrich...
@jaybernhardt• “Web 2.0”“…a set of economic, social, and technologicaltrends that collectively form the basis for the next...
@jaybernhardtNew MediaYouth Trendswww.journalreview.com
@jaybernhardtInternet Use by Age, 2000-2012Three in four teensaccess the interneton cell phones,tablets, and othermobile d...
@jaybernhardthttp://www.pewinternet.org/Infographics/Generational-differences-in-online-activities.aspx
@jaybernhardthttp://www.frankwbaker.com/mediause.htmhttp://www.radio-info.com/new-media/connected/the-class-of-2011-how-te...
@jaybernhardthttp://www.arbitron.com/downloads/infinite_dial_2011_presentation.pdf
@jaybernhardthttp://www.arbitron.com/downloads/infinite_dial_2011_presentation.pdf
@jaybernhardt
@jaybernhardthttp://www.deseretnews.com/photos/midres/web-637477.jpg
@jaybernhardthttp://saasuserexperience.wordpress.comhttp://blog.clicktale.com/2011/05/29/analyzing-the-impact-of-the-digit...
@jaybernhardthttp://manhattanresearch.com/Images---Files/Infographics/Taking-the-Pulse-US-2012.aspx
@jaybernhardtOverview of Youth Media Trends• Television remains dominant platform– With media multitasking increasing• Sig...
@jaybernhardtdesignmind.frogdesign.comwww.iphoneincanada.ca www.apartmenttherapy.com www.socialfirefly.comNew Media for Pe...
@jaybernhardtPediatrics 2.0: Health Information Seeking• Searches start at Google• Searches via mobile growing• Stories > ...
@jaybernhardtPediatrics 2.0: Health Information SeekingPromising areas for research and practice:• ePatients & “Patient En...
@jaybernhardtPediatrics 2.0: Social Networks• Users: Facebook > 1B, YouTube > 800M, Twitter > 500M• Health & Patient Socia...
@jaybernhardtPediatrics 2.0: Social NetworksPromising areas for research and practice:• Social network effects on health b...
@jaybernhardtPediatrics 2.0: mHealth (m=mobile)http://www.technobuffalo.com/mobile-devices/phones/the-all-in-one-conundrum...
@jaybernhardtmHealth Intervention OpportunitiesmHealth Applications:• Call Centers• Emergency Alerts• Appointment Reminder...
@jaybernhardtLocation Based mHealth Programs
@jaybernhardthttp://mobihealthnews.com/13368/report-13k-iphone-consumer-health-apps-in-2012/Consumer Health Apps (2012)
@jaybernhardtMobile Apps & Games(and Developer Challenges)DoctorCalc VaxTrax SwineFluThe Game
@jaybernhardtMobile Tracking (“Quantified Self”)http://www.diabetesmine.comhttp://sleepzine.comhttp://fitbit.comhttp://nik...
@jaybernhardtDon’t forget yourmultivitamin! Baby’s spineand brain are developingnow. Getting 400micrograms of folic acidda...
@jaybernhardtHasvold & Wooton (2011) Use of telephoneand SMS reminders to improve attendance athospital appointments: A sy...
@jaybernhardtCole-Lewis & Kershaw (2010) Text messaging as atool for behavior change in disease prevention andmanagement. ...
@jaybernhardtSMS for Vaccine Promotion Studies• SMS reminders to promote HPV vaccine(Kharbanda et al., 2011)– 52% of girls...
@jaybernhardtPediatrics 2.0: mHealth InterventionPromising areas for research and practice:• SMS-based interventions to im...
@jaybernhardtConclusions: Advantages of Pediatrics 2.0• Increased and Sustained Reach/Repetition• Stronger Patient Relevan...
@jaybernhardtConclusions: Challenges for Pediatrics 2.0• Privacy of data and regulatory restrictions• Access and understan...
@jaybernhardtjaybernhardt@ufl.edujaybernhardt.com@jaybernhardthttp://www.flickr.com/photos/kenleewrites/4770359099/
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Pediatrics 2.0: Digital Health Promotion for Behavior Change

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UF Pediatrics Grand Rounds talk given on May 16, 2013 at UF/Shands Hospital in Gainesville, Florida USA

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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
  • Pediatrics 2.0: Digital Health Promotion for Behavior Change

    1. 1. @jaybernhardtPediatrics 2.0:Digital HealthPromotion forBehavior ChangeJay M. Bernhardt, PhD, MPHProfessor and Chair, Department of Health Education and BehaviorDirector, Center for Digital Health and WellnessCollege of Health and Human PerformancePediatrics Grand Rounds, May 16, 2013University of Florida College of Medicinehttp://nicolehowley.visionsmartnews.com/post/images/000/005/110/original_250x1000_0.jpg
    2. 2. @jaybernhardtPediatrics 2.0 Grand Rounds Overview• New media trends among youth• Digital health innovations for pediatrichealth promotion research and practice• Learning Objectives:– Summarize trends in newmedia use among youth– Identify applications ofdigital health to pediatricsfootage.shutterstock.com
    3. 3. @jaybernhardt• “Web 2.0”“…a set of economic, social, and technologicaltrends that collectively form the basis for the nextgeneration of the Internet – a more mature,distinctive medium characterized by participation,openness, and network effects.” (Musser &O’Reilly, 2006)• “Health 2.0”“The use of a specific set of tools by actors inhealthcare including doctors, patients, andscientists, using principles of open source andgeneration of content by users, and the power ofnetworks in order to personalize healthcare,collaborate, and promote health education.”(Hughes et al. 2008)
    4. 4. @jaybernhardtNew MediaYouth Trendswww.journalreview.com
    5. 5. @jaybernhardtInternet Use by Age, 2000-2012Three in four teensaccess the interneton cell phones,tablets, and othermobile devices.50% of parents ofonline teens haveused parentalcontrols or othermeans of blocking,filtering, ormonitoring theirchild’s onlineactivitieshttp://www.pewinternet.org/Reports/2012/Teens-and-Privacy/Summary-of-Findings.aspx
    6. 6. @jaybernhardthttp://www.pewinternet.org/Infographics/Generational-differences-in-online-activities.aspx
    7. 7. @jaybernhardthttp://www.frankwbaker.com/mediause.htmhttp://www.radio-info.com/new-media/connected/the-class-of-2011-how-teens-interact-with-media
    8. 8. @jaybernhardthttp://www.arbitron.com/downloads/infinite_dial_2011_presentation.pdf
    9. 9. @jaybernhardthttp://www.arbitron.com/downloads/infinite_dial_2011_presentation.pdf
    10. 10. @jaybernhardt
    11. 11. @jaybernhardthttp://www.deseretnews.com/photos/midres/web-637477.jpg
    12. 12. @jaybernhardthttp://saasuserexperience.wordpress.comhttp://blog.clicktale.com/2011/05/29/analyzing-the-impact-of-the-digital-foldhttp://www.digitaltrends.com/mobile/vuzix-previews-its-revolutionary-smart-augmented-reality-glasses-technology-videoScreen Ubiquity & Proliferationhttp://living.msn.com
    13. 13. @jaybernhardthttp://manhattanresearch.com/Images---Files/Infographics/Taking-the-Pulse-US-2012.aspx
    14. 14. @jaybernhardtOverview of Youth Media Trends• Television remains dominant platform– With media multitasking increasing• Significant increases in social media use– Facebook, YouTube, Twitter• Significant increases in mobile use– Texting, Gaming, Photos/Videos, Apps– Growing use of mobile tablet computing
    15. 15. @jaybernhardtdesignmind.frogdesign.comwww.iphoneincanada.ca www.apartmenttherapy.com www.socialfirefly.comNew Media for Pediatric Health Promotion
    16. 16. @jaybernhardtPediatrics 2.0: Health Information Seeking• Searches start at Google• Searches via mobile growing• Stories > Data & Facts• Participation = Engagement• Search Engine Optimization• Mobile-enhanced design• Narratives, Videos, Games• Allows users to contribute
    17. 17. @jaybernhardtPediatrics 2.0: Health Information SeekingPromising areas for research and practice:• ePatients & “Patient Engagement” with ElectronicMedical Records and Personal Health Records• Health Information Rx to credible and “accessible”sites based on literacy, language, culture, etc.• Deeply-tailored health messages delivered viaweb and other communication platforms• Programs to enhance health and eHealth literacy
    18. 18. @jaybernhardtPediatrics 2.0: Social Networks• Users: Facebook > 1B, YouTube > 800M, Twitter > 500M• Health & Patient Social Networks (Patients Like Me, SmartPatients)• Aggregation tools (e.g., Hootsuite) help organize data streams• Data mining tools and algorithms facilitate audience analysis
    19. 19. @jaybernhardtPediatrics 2.0: Social NetworksPromising areas for research and practice:• Social network effects on health behaviors,prevention, and medical decision making• Creating and leveraging social networks ofcaregivers, patients, and/or parents• Mining “big (social) data” for health trends,predictive patterns, emerging risks, norms
    20. 20. @jaybernhardtPediatrics 2.0: mHealth (m=mobile)http://www.technobuffalo.com/mobile-devices/phones/the-all-in-one-conundrum-a-delightful-rant/SMS* or MMSVoice & Video(calls, IVR)Email orInstant MessageSecure datatransmissionVideo files(M4V, etc.)Audio files(MP3 etc.)Mobile WebGeo-LocationTracking &MonitoringCustomapplicationprogram (“apps”)*More than 2,000,000,000,000 SMS messages/year and growing!
    21. 21. @jaybernhardtmHealth Intervention OpportunitiesmHealth Applications:• Call Centers• Emergency Alerts• Appointment Reminders• Patient Records• Health Surveys• Monitoring & Surveillance• Treatment Adherence• Health Promotion• Mobile Telemedicine• Community Mobilization• Decision Support SystemsmHealth Channels:• SMS or MMS• Voice (human,recorded, IVR)• Email or IMs• Audio files• Video files• Mobile Web• Monitoring• Custom apps
    22. 22. @jaybernhardtLocation Based mHealth Programs
    23. 23. @jaybernhardthttp://mobihealthnews.com/13368/report-13k-iphone-consumer-health-apps-in-2012/Consumer Health Apps (2012)
    24. 24. @jaybernhardtMobile Apps & Games(and Developer Challenges)DoctorCalc VaxTrax SwineFluThe Game
    25. 25. @jaybernhardtMobile Tracking (“Quantified Self”)http://www.diabetesmine.comhttp://sleepzine.comhttp://fitbit.comhttp://nike.com
    26. 26. @jaybernhardtDon’t forget yourmultivitamin! Baby’s spineand brain are developingnow. Getting 400micrograms of folic aciddaily is key to help preventbirth defects.Reply Backhttp://text4baby.orgSMS (Text-Based) Mobile Interventions
    27. 27. @jaybernhardtHasvold & Wooton (2011) Use of telephoneand SMS reminders to improve attendance athospital 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 ofsending patient reminders prior to appointments– Manual calls more effective than automatedreminders (39% vs. 29%) but higher cost– No differences on reminder timing
    28. 28. @jaybernhardtCole-Lewis & Kershaw (2010) Text messaging as atool for behavior change in disease prevention andmanagement. 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 foundevidence of significant behavior change
    29. 29. @jaybernhardtSMS for Vaccine Promotion Studies• SMS reminders to promote HPV vaccine(Kharbanda et al., 2011)– 52% of girls of parents who opted in and received up to3 weekly SMS reminders received next vaccine dosecompared to 35% who did not receive SMS messages• SMS to promote flu vaccine in low income urbanpediatric/adolescent pop. (Stockwell et al., 2012)– 43.6% of children of parents who received up to 5weekly SMS messages received flu vaccine comparedto 39.9% who did not receive the SMS messages
    30. 30. @jaybernhardtPediatrics 2.0: mHealth InterventionPromising areas for research and practice:• SMS-based interventions to improve care, such asvaccines, treatment adherence, prevention, etc.• Mobile health promotion apps if theoretically-informed, science-based, rigorously-evaluated• Tracking quantified-self devices if they utilize datafor personalized messages and motivation• Multi-platform 360˚ tailored interventions withright-place, right-time, right-platform messages
    31. 31. @jaybernhardtConclusions: Advantages of Pediatrics 2.0• Increased and Sustained Reach/Repetition• Stronger Patient Relevance/Involvement• Deeper Audience Engagement• Scalable and Affordable Interventions• Facilitates Measurement and Evaluation
    32. 32. @jaybernhardtConclusions: Challenges for Pediatrics 2.0• Privacy of data and regulatory restrictions• Access and understanding among professionals,patients, and priority communities• Research and evaluation to determine anddisseminate evidence-based best practices
    33. 33. @jaybernhardtjaybernhardt@ufl.edujaybernhardt.com@jaybernhardthttp://www.flickr.com/photos/kenleewrites/4770359099/

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