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Going Mobile For Public Health


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Presentation at CDC Health Communication, Marketing and Media Conference 2008

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Going Mobile For Public Health

  1. 1. The Idea of Mobile Health R. Craig Lefebvre, PhD Presentation in the panel “ Going Mobile for Public Health” National Conference on Health Communication, Marketing and Media 14 August 2008 Atlanta, GA
  2. 3. What’s Social About Behavior? <ul><li>Treatment adherence </li></ul><ul><li>Precaution adoption </li></ul><ul><li>Health information seeking </li></ul><ul><li>Collective action and advocacy </li></ul><ul><li>Screening behaviors </li></ul><ul><li>Quitting addictive behaviors </li></ul><ul><li>Adopting new ones </li></ul>
  3. 4. Social Network Interventions <ul><li>Enhance existing linkages </li></ul><ul><li>Develop new linkages </li></ul><ul><li>Enable indigenous helpers </li></ul><ul><li>Create new networks </li></ul><ul><li>Empower existing ones </li></ul><ul><li>Weave together networks </li></ul><ul><li>Engage communities in new ways </li></ul>
  4. 5. Mobile Thoughts <ul><li>When the expectations </li></ul><ul><li>of wireless experts are </li></ul><ul><li>realized everyone will </li></ul><ul><li>have his own pocket </li></ul><ul><li>telephone and may be </li></ul><ul><li>called wherever he </li></ul><ul><li>happens to be…When that </li></ul><ul><li>invention is perfected, we </li></ul><ul><li>shall have a new series of </li></ul><ul><li>daily miracles. </li></ul>
  5. 7. Mobile Phones in 2008 <ul><li>Worldwide there are about 800 million registered automobiles. </li></ul><ul><li>850 million people use PCs. </li></ul><ul><li>1.1 billion people around the world access the internet. </li></ul><ul><li>Today there are 1.3 billion fixed landline phones. </li></ul><ul><li>1.4 billion people carry at least one credit card. </li></ul><ul><li>There are about 1.5 billion TV sets in use. </li></ul><ul><li>Last year the total worldwide mobile subscriber base grew from 2.1 billion to 2.7 billion. </li></ul>
  6. 8. Eighty percent of the world’s population now lives within range of a cellular network – Sara Corbett, NYT Magazine 7 Apr 2008
  7. 9. 1.8 Billion SMS <ul><li>2X as many users as internet email </li></ul><ul><li>Worth over $80 billion worldwide </li></ul><ul><li>Brits send 6 SMS per person, South Koreans send 10, Singaporeans 12 and the Philippinos 15 SMS every day. </li></ul><ul><li>In South Korea 45% of all music is sold directly to music phones </li></ul><ul><li>54% of Helsinki public transportation single tickets to the trams and subways are paid by mobile </li></ul><ul><li>In South Africa you can have your full paycheck sent to you onto your mobile phone </li></ul><ul><li>Mobile data is used by anywhere from 540 million (internet access via mobile) to 1.1 billion (non-SMS mobile data services used on mobile) to 1.8 billion (mobile data including SMS) </li></ul>
  8. 10. Who Uses It? <ul><li>Over 200 million cell phone subscribers </li></ul><ul><li>40% use SMS (32.5 billion txt msgs sent in last half of 2005) </li></ul><ul><li>44% of people use their mobile as their main camera </li></ul><ul><li>34.6 million use mobile Internet services </li></ul><ul><li>By 2009, every US mobile subscriber will have a SMS-enabled phone; 98% will be web-enabled </li></ul>
  9. 11. … in an increasingly transitory world, the cellphone is becoming the one fixed piece of our identity – Jan Chipchase, User Anthropologist NYT Magazine 7 Apr 2008
  10. 12. Health Marketing SexInfo: San Francisco Department of Public Health <ul><li>Address rising prevalence of STDs among urban youth </li></ul><ul><li>Make it private, personal and timely </li></ul><ul><li>First quarter: </li></ul><ul><ul><li>1,538 inquiries </li></ul></ul><ul><ul><li>Condom failure, STD info and pregnant (?) top three calls </li></ul></ul>
  11. 13. Mobile Health Applications
  12. 14. RFID Enabled Cellphones <ul><li>Supply chain management </li></ul><ul><li>Blood glucose monitoring </li></ul><ul><li>Exposure to asthma triggers </li></ul><ul><li>Radiation </li></ul><ul><li>Product authentication </li></ul>
  13. 15. Mobile Health Monitoring
  14. 16. Clinical Management of Diabetes <ul><li>30 patients random assignment </li></ul><ul><li>Intervention (n=15) received cellphone software with real-time feedback of blood glucose levels, displayed medication regimens and requested additional data needed to evaluate diabetes management. </li></ul><ul><li>Average decrease in A1c for intervention patients was 2.03%, compared to 0.68% ( P < 0.02, one-tailed) for control patients. </li></ul>Quinn, CC, Clough, SS, Minor, JM, Lender, D, Okafor, MC, Gruber-Baldini, A. WellDoc Mobile Diabetes Management Randomized Controlled Trial: Change in Clinical and Behavioral Outcomes and Patient and Physician Satisfaction. Diabetes Technology & Therapeutics . June 1, 2008, 10(3): 160-168. doi:10.1089/dia.2008.0283.
  15. 17. Increasing Physical Activity Levels <ul><li>Random assignment of 77 healthy adults </li></ul><ul><li>Intervention (n=47) received tailored solutions for perceived barriers, a schedule to plan weekly exercise sessions with mobile phone and email reminders, a message board to share their experiences with others, and feedback on their level of physical activity (accelerometers). </li></ul>Hurling R, Catt M, De Boni M, Fairley BW, Hurst T, Murray P, Richardson A, Sodhi JS. Using Internet and Mobile Phone Technology to Deliver an Automated Physical Activity Program: Randomized Controlled Trial. J Med Internet Res 2007;9(2):e7 URL:>
  16. 18.! internet and mobile physical activity intervention
  17. 19.! Results <ul><li>More than 70% of participants logged on at least twice a week for all 9 weeks of the study </li></ul><ul><li>The most popular parts of the system were the activity charts (showing the accelerometer feedback), schedule (weekly exercise planner) and chat-room style message board. </li></ul><ul><li>3 Month Results: Intervention participants more likely to report </li></ul><ul><ul><li>Greater increase in intention/expectation </li></ul></ul><ul><ul><li>to exercise (p<.001) </li></ul></ul><ul><ul><li>More physical activity via self-report </li></ul></ul><ul><ul><li>(p=.03) and accelerometer (p=.02) </li></ul></ul><ul><ul><li>More lost in percent body fat (p=.04) </li></ul></ul>
  18. 20. Mobile Activity Guides
  19. 21. My FoodPhone <ul><li>Photo food journal </li></ul><ul><li>Social network features </li></ul><ul><li>Self-scoring of food choices and portion sizes </li></ul><ul><li>SMS reminders </li></ul><ul><li>Track biometric data </li></ul>
  20. 22. txt2connect: A Parents TXT Tutorial <ul><li>Parents get a quick answer to their questions. </li></ul><ul><li>Kids are more apt to respond to text messages when they are with their friends. </li></ul><ul><li>You, or they, don't have to worry about tone of voice. </li></ul><ul><li>Texting allows you to enter your child’s world. </li></ul><ul><li>Text messaging allows parents to compose and edit a message before pressing send. </li></ul><ul><li>Texting vs. calling gives kids more space but allows parents to keep in touch as often as necessary. </li></ul>
  21. 23. Mobile Alerts The school did not notify students by e-mail of the first shootings until 9:26 a.m., said Matt Dixon, who lives in the dorm. Mr. Dixon did not receive the e-mail message until he returned from his 9:05 class. When he left for that class, he said, a resident adviser told him not to use the central stairs, so he left another way…On dry erase boards, advisers had written, “Stay in your rooms,” Mr. Dixon said. - NYT.