This document discusses facilitating cross-disciplinary collaboration in developing mHealth interventions. It notes that few existing mHealth apps are evidence-based, linked to healthcare, or used more than once. The document advocates applying behavioral theory to guide intervention content, initiation, user-app interaction, and communication. However, most mHealth apps currently lack a theoretical basis. Qualitative research with users is needed to understand meaning and personalization beyond what analytics provide. An example intervention applying these lessons developed text messages for safer drinking through focus groups and an advisory panel. Overall, the document argues behavioral theory and qualitative methods are needed early in design to create useful mHealth tools that change behavior.
Shelia R. Cotten, PhD Director, Sparrow/MSU Center for Innovation and Research Director, Trifecta Professor and Associate Chair for Research, Department of Media & Information Michigan State University cotten@msu.edu
9/17/2015
Incorporating SMS Reminders into a School Based STD Screening ProgramYTH
Data results and lessons learned from the inclusion of SMS reminders as an expansion of a school-based STD screening program. Presented by Veronica Whycoff from the DC Department of Health at YTH Live 2014 session "Advances in STD Diagnosis and Results."
Shelia R. Cotten, PhD Director, Sparrow/MSU Center for Innovation and Research Director, Trifecta Professor and Associate Chair for Research, Department of Media & Information Michigan State University cotten@msu.edu
9/17/2015
Incorporating SMS Reminders into a School Based STD Screening ProgramYTH
Data results and lessons learned from the inclusion of SMS reminders as an expansion of a school-based STD screening program. Presented by Veronica Whycoff from the DC Department of Health at YTH Live 2014 session "Advances in STD Diagnosis and Results."
ROLE OF LIBRARIAN IN HEALTH CARE INSTITUTIONSAnaivko
Librarians in health care institutions get an increasing role in searching adequate literature. New technologies and open access to medical databases offer new ways in providing medical literature. In addition clinicians have more possibilities to get scientific information. The aim of this research is to assess the role of information specialists in supporting Evidence Based Health Care as a part of activities of Continuing Medical Education (CME). The research is based on 91 clinicians’ requests to the information specialist for searching databases concerning patients’ care during October 2006. They could not reach adequate literature by themselves for different reasons. Using only Google for their search was not enough.
By searching Evidenced Based Medicine (EBM) sources, the information specialist solved 85% of the requests. Searching for literature failed in 15 % only, caused by copyright of publisher and denied access to the data source. EBM has an increasing influence on information specialists’ work and includes only the best evidence from recent clinical practices.
Experience and skills of information specialist in the retrieval process supporting EBM avoids accumulation of unnecessary literature, makes searching databases short, valuable, time -efficient and useful to the maximal extent.
Patient Engagement in Health Economic and Outcomes Research: Current and Future ISPOR Initiatives, presentation from the ISPOR 20th International meeting Philadelphia, May 2015, by the Patient Centered Special Interest Group
Riff: A Social Network and Collaborative Platform for Public Health Disease S...Taha Kass-Hout, MD, MS
A hybrid (event-based and indicator-based) platform designed to streamline the collaboration between domain experts and machine learning algorithms for detection, prediction and response to health-related events (such as disease outbreaks or pandemics). The platform helps synthesize health-related event indicators from a wide variety of information sources (structured and unstructured) into a consolidated picture for analysis, maintenance of “community-wide coherence”, and collaboration processes. The platform offers features to detect anomalies, visualize clusters of potential events, predict the rate and spread of a disease outbreak and provide decision makers with tools, methodologies and processes to investigate the event.
Overview Presentation: Measuring the Content of Postnatal Care for WomenMEASURE Evaluation
Presented during a webinar on "Measuring the Content of Postnatal Care for Women: What Do We Know and Where Do We Need to Go?" in September 2017. See the second presentation at https://www.slideshare.net/measureevaluation/validating-intervention-coverage-indicators-for-maternal-postnatal-care/measureevaluation/validating-intervention-coverage-indicators-for-maternal-postnatal-care
Stand out from the crowd by adding Evidence-Informed Public Health (EIPH) to your portfolio! Join us to learn about EIPH and resources you can use to develop these in-demand skills.
Workshop: Effective Patient Adherence Management by Engaging Enabling Technologies
Pei-Yun Sabrina Hsueha, Vimla L. Patelb, Fernando Sanchezc, Marcia Itod,e, Chohreh Partoviana, María V. Giussi Bordonig, Marion Ballf,a
a IBM T.J. Watson Research Center, Yorktown Heights, NY, USA
b Center for Cognitive Studies in Medicine and Public Health, the New York Academy of Medicine, New York, NY, USA
c Health and Biomedical Informatics Center, University of Melbourne, Melbourne, Australia
d IBM Brazil Research Lab, Sao Paolo, Brazil
e Telehealth/Teledentistry Center, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
f Johns Hopkins University, Baltimore, MD, USA
g Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina.
Abstract
Effective patient adherence management strategies require better understanding of patient-generated data, including patient-reported data and measurements from devices and sensors, as key to assisting providers in learning more about their patients’needs and enhancing patient centric care. Gaining “meaningful use” of patient-generated data could ultimately lead to improvements in patient safety and outcomes. In this workshop, we review proof of concept studies using technology to assess patient health literacy and self-efficacy with the goal of providing timely intervention, remedy, and improvements in cost and quality of care. In particular, we focus on engagement-enabling technolgoies that can leverage non-clinical information sources and reflect patient activities in the “wild”. We look into barriers to adherence, patients and providers roles in improving adherence, and the use of technology to assist patients in staying on track. The speakers will address the issues related tothe integration of patient-generated data into everyday life and clinical practice and share lessons learned from implementing these designs in practice. This workshop aims to share requirements gathered for the design of next-generation healthcare systems, especially in areas where the explosive availability of patient-generated data is expected to make impacts.
Before we change actions or activities within the healthcare, the first point is to understand how staff and consumers think about the system we are in now.
ROLE OF LIBRARIAN IN HEALTH CARE INSTITUTIONSAnaivko
Librarians in health care institutions get an increasing role in searching adequate literature. New technologies and open access to medical databases offer new ways in providing medical literature. In addition clinicians have more possibilities to get scientific information. The aim of this research is to assess the role of information specialists in supporting Evidence Based Health Care as a part of activities of Continuing Medical Education (CME). The research is based on 91 clinicians’ requests to the information specialist for searching databases concerning patients’ care during October 2006. They could not reach adequate literature by themselves for different reasons. Using only Google for their search was not enough.
By searching Evidenced Based Medicine (EBM) sources, the information specialist solved 85% of the requests. Searching for literature failed in 15 % only, caused by copyright of publisher and denied access to the data source. EBM has an increasing influence on information specialists’ work and includes only the best evidence from recent clinical practices.
Experience and skills of information specialist in the retrieval process supporting EBM avoids accumulation of unnecessary literature, makes searching databases short, valuable, time -efficient and useful to the maximal extent.
Patient Engagement in Health Economic and Outcomes Research: Current and Future ISPOR Initiatives, presentation from the ISPOR 20th International meeting Philadelphia, May 2015, by the Patient Centered Special Interest Group
Riff: A Social Network and Collaborative Platform for Public Health Disease S...Taha Kass-Hout, MD, MS
A hybrid (event-based and indicator-based) platform designed to streamline the collaboration between domain experts and machine learning algorithms for detection, prediction and response to health-related events (such as disease outbreaks or pandemics). The platform helps synthesize health-related event indicators from a wide variety of information sources (structured and unstructured) into a consolidated picture for analysis, maintenance of “community-wide coherence”, and collaboration processes. The platform offers features to detect anomalies, visualize clusters of potential events, predict the rate and spread of a disease outbreak and provide decision makers with tools, methodologies and processes to investigate the event.
Overview Presentation: Measuring the Content of Postnatal Care for WomenMEASURE Evaluation
Presented during a webinar on "Measuring the Content of Postnatal Care for Women: What Do We Know and Where Do We Need to Go?" in September 2017. See the second presentation at https://www.slideshare.net/measureevaluation/validating-intervention-coverage-indicators-for-maternal-postnatal-care/measureevaluation/validating-intervention-coverage-indicators-for-maternal-postnatal-care
Stand out from the crowd by adding Evidence-Informed Public Health (EIPH) to your portfolio! Join us to learn about EIPH and resources you can use to develop these in-demand skills.
Workshop: Effective Patient Adherence Management by Engaging Enabling Technologies
Pei-Yun Sabrina Hsueha, Vimla L. Patelb, Fernando Sanchezc, Marcia Itod,e, Chohreh Partoviana, María V. Giussi Bordonig, Marion Ballf,a
a IBM T.J. Watson Research Center, Yorktown Heights, NY, USA
b Center for Cognitive Studies in Medicine and Public Health, the New York Academy of Medicine, New York, NY, USA
c Health and Biomedical Informatics Center, University of Melbourne, Melbourne, Australia
d IBM Brazil Research Lab, Sao Paolo, Brazil
e Telehealth/Teledentistry Center, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
f Johns Hopkins University, Baltimore, MD, USA
g Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina.
Abstract
Effective patient adherence management strategies require better understanding of patient-generated data, including patient-reported data and measurements from devices and sensors, as key to assisting providers in learning more about their patients’needs and enhancing patient centric care. Gaining “meaningful use” of patient-generated data could ultimately lead to improvements in patient safety and outcomes. In this workshop, we review proof of concept studies using technology to assess patient health literacy and self-efficacy with the goal of providing timely intervention, remedy, and improvements in cost and quality of care. In particular, we focus on engagement-enabling technolgoies that can leverage non-clinical information sources and reflect patient activities in the “wild”. We look into barriers to adherence, patients and providers roles in improving adherence, and the use of technology to assist patients in staying on track. The speakers will address the issues related tothe integration of patient-generated data into everyday life and clinical practice and share lessons learned from implementing these designs in practice. This workshop aims to share requirements gathered for the design of next-generation healthcare systems, especially in areas where the explosive availability of patient-generated data is expected to make impacts.
Before we change actions or activities within the healthcare, the first point is to understand how staff and consumers think about the system we are in now.
MIE Medical Informatics in Europe: European Federation for Medical Informatics (EFMI) annual meeting
Worklshop: Addressing Patient Adherence Issues by Engaging Enabling Technologies
Chair: Pei-Yun Sabrina Hsueh (IBM T.J. Watson Research Center)
Pei-Yun Sabrina HSUEHa, , Marion BALL b,a, Michael MARSCHOLLEKc, Fernando J. MARTIN-SANCHEZd , Chohreh PARTOVIANa, and Vimla PATELe
aIBM T.J. Watson Research Center, NY, USA
b John Hopkins University, MD, USA
c Hannover Medical School, Germany
d Melbourne Medical School, Australia
e Center for Cognitive Studies in Medicine and Public Health, The New York Academy, USA
Abstract One of the well known issues providers have contended with for many years is the issue of patients’ adherence to their care plans and medications outside clinical encounters. In this workshop, we review proof of concept studies using technology at the point of care to assess patient literacy and self-efficacy to provide timely intervention, remedy, and improvements in cost and quality. We focus on patient-generated information, including patient reported data and measurements from devices and sensors, as key to improving patient safety, gaining “meaningful use” data, improving patient centric care, and assisting providers in learning more about their patient needs to improve outcomes. We look into barriers to adherence, basic understanding of the patients and providers roles in improving adherence, and the use of technology to assist patients in staying on track. The participants will address their findings in the integration of patient-generated information into everyday life and clinical practice and share lessons learned from implementing these designs in practice. This workshop aims to share requirements for the next-generation healthcare systems, especially in areas where the explosive availability of patient-generated data is expected to make impacts.
Getting Knowledge into Action for Best Quality HealthcareNHSScotlandEvent
NHS Education for Scotland and Healthcare Improvement Scotland are working with NHS Boards to define new approaches to implementing and sharing knowledge which support practitioners to get knowledge into action at the frontline. This shift in focus from accessing to applying knowledge will integrate knowledge management more closely with quality improvement. This interactive workshop will use creative knowledge management techniques to challenge the way we apply knowledge in practice.
This slides wer presented at the Medicine 2.0 conference at Stanford University on 09.17.11 and include data that was collected as part of a research collaboration b/w Bob Miller (Hopkins), Bryan Vartabedian (Baylor), Molly Wasko (UAB), and the team at CE Outcomes. This research was funded in part by the Medical Education Group at Pfizer, Inc.
Join us for a discussion of methods and tools that can be used to support evidence-informed decision making in the context of health equity. Learn about resources to help you apply health equity principles to planning processes that contribute to evidence informed public health.
Guest speakers from Niagara Region Public Health discussed the use of the 10 promising practices to address health equity. This included the results of a qualitative study to identify barriers and facilitators, and provided recommendations for strengthening planning and implementation practice to improve health equity.
This webinar is jointly produced by the National Collaborating Centre for Methods and Tools (NCCMT) and the National Collaborating Centre for Determinants of Health (NCCDH), and is supported through funding from the Public Health Agency of Canada.
The National Collaborating Centre for Methods and Tools is funded by the Public Health Agency of Canada and affiliated with McMaster University. The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada.
NCCMT is one of six National Collaborating Centres (NCCs) for Public Health. The Centres promote and improve the use of scientific research and other knowledge to strengthen public health practices and policies in Canada.
Community engagement in public health interventions for disadvantaged groups:...Health Evidence™
Health Evidence hosted a 60 minute webinar examining the effectiveness of community engagement in public health interventions for disadvantaged groups. Click here for access to the audio recording for this webinar: https://youtu.be/tUZ-u7QbMCY.
Alison O'Mara-Eves, Senior Researcher, University College London, EPPI-Centre and Ginny Brunton, Senior Health Researcher, University College London, EPPI-Centre presented findings from their review:
O'Mara-Eves A., Brunton G., Oliver S., Kavanagh J., Jamal F., & Thomas J. (2015). The effectiveness of community engagement in public health interventions for disadvantaged groups: A meta-analysis . BMC Public Health, 15, 129.
Community engagement is becoming an increasingly popular component included in the development and implementation of public health interventions. Involved community members take on roles that range from merely being informed, to being consulted, to collaborating or leading on the design, delivery and evaluation of public health strategies. This review examines the use of public health interventions with a community engagement component, particularly for its use in reducing health inequities among disadvantaged populations. Findings of the review suggest community engagement in public health interventions has an effect on several health outcomes, including health behaviours and self-efficacy. This webinar will examine the effectiveness and components of public health interventions that include community engagement and the impact on health outcomes.
HEC 2016 Panel: Putting User-Generated Data in Action: Improving Interpretabi...Pei-Yun Sabrina Hsueh
Chair/Moderator: Pei-Yun Sabrina HSUEH, PhD (IBM T.J. Watson Research Center)
Panelists: XinXin ZHU, Bian YANG, Ying-Kuen CHEUNG , Thomas WETTER, and Sanjoy DEY
a IBM T.J. Watson Research Center, USA
b Norwegian University of Science and Technology, Norway
c Mailman School of Public health, Columbia University, USA
d, Department of Biomedical Informatics, University of Washington, USA
e Department of Medical Informatics, University of Heidelberg, Germany
The rise of consumer health awareness and the recent advent of personal health management tools (including mobile and health wearable devices) have contributed to another shift transforming the healthcare landscape. Despite the rise of health consumers, the impact of user-generated health data remains to be validated. In fact, many applications are hinged on the interpretability issues of this sort of data. The aim of this panel is two-fold. First, this panel aims to review the key dimensions in the interpretability, spanning from quality and reliability to information security and trust management. Secondly, since similar issues and methodologies have been proposed in different application areas ranging from clinical decision support to behavioral interventions and clinical trials, the panelists will also discuss both the success stories and the areas that fall short. The opportunities and barriers identified can then serve as guidelines or action items individuals can bring to their organizations to further improve the interpretability of user-generated data.
Using Social Media to Support Youth Healthy Sexual BehaviorYTH
Erin Wright of the mHealth Impact Laboratory at the Colorado School of Public Health, provides an overview of Just/Us, a study to analyze the impact of social networking sites to effectively support healthy sexual behavior for young people. Presented at YTH Live 2014 session "Social Media for Sexual Health Outreach."
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Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Facilitating cross-talk in mHealth intervention development
1. Facilitating cross-talk:
How to bridge the
interdisciplinary divides in
mHealth intervention
development
Megan L. Ranney MD MPH
Department of Emergency Medicine
Alpert Medical School, Brown University
@meganranney
3. Percent of Emergency Department
patients with cellphones
Ranney Annals of EM 2012
@meganranney
4. According to @PewResearch 2012
Data
http://www.pewinternet.org/Reports/2012/Mobile-Health/Key-Findings.aspx
@meganranney
5. What isn’t working with mHealth?
• < 30% of apps
downloaded more
than 50 times
• < 10% used more
than once
• Few are evidencebased or linked to
the healthcare
system
http://www.imshealth.com/deployedfiles/
imshealth/Global/Content/Corporate/IM
S%20Health
%20Institute/Reports/Patient_Apps/IIHI
@meganranney
6. Where is the evidence?
How do I know they’re
good?
Are they safe and private
for my patient?
Do they exist for my OS?
Do they exist for my
disease?
She doesn’t even look at my
data!
@meganranney
7. Why do the researchers insist on
testing this a gazillion times?
They’re asking for the
impossible!
I need to deploy this quicker.
My investors need ROI!
9. “If knowledge and feedback was all it
took to change unhealthy behaviors,
psychologists would be superfluous in
the world” (Leslie Schover)
http://thehealthcareblog.com/blog/2013/10/11/health
cares-tech-disconnect-why-arent-we-building-theproducts-patients-really-need/
@meganranney
12. Outline
Behavioral theory for mHealth interventions
What’s been missing:
• Deficiencies in current applications of behavioral theory
to mHealth design
Filling that gap
• Efficient steps based on behavioral & social science
• ACTIONABLE data
• Role of qualitative inquiry
Example
13. Why use Behavioral Theory?
Provides framework upon which to build an
intervention
Provides a testable model for how variables relate
to one another
Behavioral Theory for mHealth
Understand when, how and why people change their
behavior
Whether they maintain those changes
? user experience
? & App design
14. Behavioral Theory guides
intervention:
Content
Ex: Self-Efficacy Theory
Initiation of program
Ex: Stages of Change model
Interaction between the user & the device/app
Ex: Systems Contingency Approach
Amount, frequency & type of communication
Ex: social-ecological model
15. What’s been lacking
• Most mHealth interventions have been one-step
(receive data –> provide output)
– But are increasingly becoming interactive
• Most have no theoretical basis underlying the
intervention
– So if it works, we don’t know ‘why’
• Current theory may be inadequate as interventions
become more interactive and dynamic
– Suggests the need for new approaches and
strategies
17. Qualitative Research methods for
mHealth
• Focus Group Discussions (FGD)
– Series of groups, each with 6-8
people
– 5 key topic areas
– Information: breadth and trends
• Individual In-depth interviews (IDI)
– 10-30 individual interviews
– 5-8 key topic areas
– Information: depth and
personalization
18. Recent research and resources
•
Dennison et al. 2013
– Opportunities and Challenges for Smartphone Applications in Supporting
Health Behavior Change: Qualitative Study. Journal of Medical Internet
Research 15(4)
•
Palmier-Claus et al 2013
– Integrating mobile-phone based assessment for psychosis into people’s
everyday lives and clinical care: A qualitative study BMC Psychiatry 34(1)
•
Hingle, Nichter et al 2013
– Texting for health: the use of participatory methods to devleop healthy
lifestyle messages for teens. Journal of Nutrition Education and Behavior
45(1)
•
Special issues on mHealth
– Translational Behavioral Medicine September 2013
– Journal of Substance Abuse Treatment September 2013
• Technology-based interventions for the treatments and recovery management
of substance use disorders
19.
20. Initial approach…
Planned approach: focus groups
•
•
•
•
Show design ideas to target population
Get feedback
Adjust delivery & design
Conduct pilot study
Initial Design
•
•
•
Enroll in TMAP to learn safer drinking strategies
Complete a survey for personalized text messages.
Receive text messages for 6 weeks
21. Planned text messages
Behavioral strategies
•
Still thirsty? Switch to water. You’ll thank yourself tomorrow!
Tips & Suggestions
•
Eat foods with lots of protein and fat, like cheese and nuts, before
drinking.
Factual messages
•
It takes the body 60-90 minutes to feel the effects of alcohol on a
full stomach. Drink slowly.
22. Advisory Panel
• Linguistic Theory: McWhorter “Text as fingered
speech”
• Advisory panel with representative population
– Weekly meetings
– Texts generated during the meetings (in vivo)
– on topics drawn from focus group results
AND
– They texted us sample texts daily during the week
(ecologically valid)
– Produced “library” of over 300 texts
• RCT (2014)
23. The Challenges for mHealth
• Using behavioral theory to design interventions
• Using technology in an ecologically valid way
• Incorporating qualitative methods early in
development to produce
– A product that is desired by the target audience
– That will be used by the target audience
– That they find useful and that will change behavior
• Avoid the *wow factor* running the science
Welcome to our talk. I am an emergency physician and an mHealth researcher, and I will be moderating this symposium today. I am going to start by giving you a little background on the rationale for why we put this symposium together, and on our goals for our discussion today.
So I don’t need to sell you on the value of mHealth. We all know that the healthcare system, as it exists, is broken. And we know that our society needs help.
In my practice setting, the emergency department, alone -- a small percent of the patients represent a large % of visits. But even those people who aren’t “frequent users” articulate a host of psychosocial reasons for being in the ED. And they cost a lot of money.
Unluckily, we simply don’t have the resources to help these people. Studies show that even people with GOOD INSURANCE can’t get followup. It’s especially tough to get psychosocial or behavioral resources. mHealth holds the promise of being able to help these folks.
50% of my patients can’t get follow-up
10% are “frequent users” of the ED
We have a dearth of preventive care
Indeed, pts – even the high-risk ones seen in the ED -- have access to cellphones. Please note, however, that less than half of them have smartphones.
Many of them tell me that they WANT a cellphone program to help them manage their weight, their anxiety, their smoking.
And they’re TRYING to get what they want. According to Susannah Fox’s data, of adult American cellphone users:
About 1/3 look up health-related info on their phone
About 1/10 have downloaded an app or use texting programs for help.
This disparity between what kinds of phones ppl have, and what they’re doing with them, represents an opportunity. Clearly, the apps and texting programs that are out there aren’t serving our patients’ needs.
Indeed: we know that…
Out of ~20,000 consumer-facing health apps, less than 20% of them have ever been downloaded. Just five apps account for 15 person of all health app downloads
The minority of apps out there are based on “evidence.”
Even fewer are used more than once! ONLY 20% CAPTURE USER-ENTERED DATA
Pain mgmt
Smoking cessation http://www.ajpmonline.org/article/PIIS0749379713004790/abstract
I can tell you the clinician’s perspective.
I can tell you the patient’s perspective.
And although I don’t have a technical background, I’ve worked with a number of companies over the past few years, and these are the frustrations that I’ve heard from them:
16% report using health-related apps “regularly”
I know that we’re all trying. That’s why we’re here. And after all:
Goal of the talk: brief overview of how & why to use behavioral theory to inform mHealth intervention development
(“I’m not drinking cuz I’m thirsty!”)
(Dude, that’s good info, but that’s not the way you’re going to say it to me)
(Here, let me write this for you!)
Add what we learned: Caring, Timing, No DARE program! PSA announcements! “Don’t tell me not to drink, tell me you care about how I drink & help me do it safely”
Also learned that our texts don’t sound like their texts.
