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Let's Discuss! mhealth Initiatives and Cancer Control

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November’s cyber-seminar was a wonderful exploration of some exciting mHealth initiatives and the lessons learned and implications for public health practitioners and researchers.  Drs. Atienza, Gustafson, and Augustsom did an excellent job of laying out the issues and sharing their tools as and resources which demonstrate the breadth of mHealth and the depth of opportunities.

Now it is your turn to participate...ask a question of the speakers or your fellow R2R members, share your stories of using mhealth in your programs.  What lessons have you learned or tools have you developed that others might benefit from.

Join us in the discussion!

If you missed the live seminar, the archive will be available next week.  Watch and then come share your thoughts.


Posts/Comments

Great seminar and innovative

Great seminar and innovative work!

A question for Dr. Atienza.

Given the mismatch between the 7 year traditional trajectory for research grants (from idea generation to findings) and the rapid pace of technological change, can we expect different types of funding mechanisms, as well as research designs, that will allow researchers to test priority questions in this area and quickly share findings?

Thanks!

Diane

There was a question asked of

There was a question asked of Dr. Augustson near the end of this wonderful seminar - concerning the utilization of behavioral theory in developing intervention research.  He had an interesting comment - that was cut somewhat short - because the time was gone.  He indicated, something like, the theories used (which have been around for years) have not been adapted (or accounted for) in the way in which information is captured (volume of information, flow/frequency of information, etc.)  Does he think 'traditional' behavioral theories can indeed be modified/adapted to be 'predictive' (to develop a good intervention) in the social media environment of today?  OR will we need to develop a whole new class of behavioral theory - given the dramatic changes in patterned communicative behavior?  Thanks!

Joe

PS.  So, will we be able to also get .pdf copies of the PowerPoint presentations next week as well?

I wanted to share one

I wanted to share one additional question that we didn't have a chance to get to during the seminar.  It is an important question regarding mHealth initiatives and health disparities: One of our users asked of all the speakers, "How will we ensure that technology gains do not widen the gap of health disparities/services in rural areas or among those who are hardest to reach?"

Thank you to all the users who posed questions during the cyber-seminar and to you, Joseph and Diane, for your thoughful questions.  We look forward to having Drs. Atienza, Gustafson, and Augustson's responses.  But we also encourage all our R2R users to share your thoughts and experiences on any or all of these issues.

PS. If you are interested in a PDF copy of the slides, you can send an email to researchtoreality@mail.nih.gov and request they be sent to you -- the archive will be also be posted next week.

 

Hello! I would like to ask

Hello! I would like to ask the presenters if there is any social media or mobile technology to increase participation of adolescents in clinical trials?

Thank you,

Maria

 

Hi R2R!  In her post above,

Hi R2R!  In her post above, Peyton mentioned a very thoughful question one of our participants posed on the call yesterday around mobile technology and health disparities.  I have included a response from Dr. Gustafson below:

How will we ensure that technology gains do not widen the gap of health disparities/services in rural areas or among those who are hardest to reach?

There are a number of things happening that should help reduce this issue.  First the telecommunication companies are developing new technologies that should make it much more practical to reach into rural areas.  As I understand it, many of the companies have two or three towers in the same area with different levels of reach and power.   New technology will allow them to reach much further at a lower cost and thus will greatly reduce one barrier to reaching into rural areas.  Unfortunately, for those living in hilly areas even the new technology will not reach the valleys.

Secondly, many poor people only use cell phones and as the technology evolves those cell phones will nearly always be smart phones.  So in a sense the problem will take care of itself, at least partially.   In our aging work, we are struggling with the hardest to reach (some that have no electricity and even o  running water).  It may be that we will have to reach them through loved ones, neighbors and friends.  At least that is our thinking currently.

We are working to get the answers to the other great questions that have been posted to this forum, and should have responses shortly...so please stay tuned!

Additonally, here is the video that Dr. Gustafson shared during his presentation:

Q: Given the mismatch between

Q: Given the mismatch between the 7 year traditional trajectory for research grants (from idea generation to findings) and the rapid pace of technological change, can we expect different types of funding mechanisms, as well as research designs, that will allow researchers to test priority questions in this area and quickly share findings?

A: How to fund mHealth research given the rapid pace of technology change remains a challenge. Recently NIH partnered with others to explore this specific question. See: mHealth Evidence Meeting and videocast at http://obssr.od.nih.gov/scientific_areas/methodology/mhealth/mhealth-workshop.aspx. And NIH is exploring the use of the Common Fund to support mHealth research: http://commonfund.nih.gov/InnovationBrainstorm/post/Innovative-Mobile-and-Wireless-Technologies-(mHealth)-to-Improve-Health-Research-and-Health-Outcomes.aspx. In addition, other funders, such as NSF, RWJF, and Intel have expressed interest in supporting mHealth research. Yet, still to be resolved is how to optimize the timing and process of funding this research to capitalize on the rapid evolution of the technology.

Q: ...the theories used (which have been around for years) have not been adapted (or accounted for) in the way in which information is captured (volume of information, flow/frequency of information, etc.)  Does he think 'traditional' behavioral theories can indeed be modified/adapted to be 'predictive' (to develop a good intervention) in the social media environment of today?  OR will we need to develop a whole new class of behavioral theory - given the dramatic changes in patterned communicative behavior?

A: This remains an empirical question. The 'traditional' behavioral theories were developed during the age BEFORE mobile technology and social media. With the development of mobile technology and social media, real-time and real-world data can now be collected (not just experimental lab data).  The factors proposed as responsible for behavior change by 'traditional' behavioral theories can now actually be tested with real-time data, rather than assessments at just 2 or 3 time points (e.g., pre-test, post-test), and with multiple types of data (e.g., self-report, objective, physiologic, etc.). It seems reasonable to suggest that if the central theorems of 'traditional' behavioral theories do not hold up with the data that can be collected with mobile technology and social media, we should consider modifying the theory or develop newer theories that reflect what the data actually reveal. If the data support 'traditional' theories, then it strengthens the theory.  If the data do not support 'traditional' theories, it would seem odd to maintain the respective theory as proposed in light of new empirical findings.

Q: Hello! I would like to ask the presenters if there is any social media or mobile technology to increase participation of adolescents in clinical trials?

A: I currently am not aware of social media or mobile technology that is being used to increase participation of adolescents in clinical trials. There have been examples for adults. For example, PatientsLikeMe.com offers their social network links to clinical trial tools (http://www.patientslikeme.com/clinical_trials). ACOR.org offers the same service for their cancer patient network (http://www.acor.org/clinical.html). I recommend that you contact someone at NICHD (http://www.nichd.nih.gov/about/org/crmc/cdb/) to see if they are aware of mobile technology and/or social media resource that connect adolescents to clinical trials.

  @ Maria and others We have

 

@ Maria and others

We have seen a few apps that aim to make clinical trials information more easily accessible on mobile devices. These take clinical trial information from databases like ClinicalTrials.gov or NCI’s Cancer.gov listing of trials and make them available for searching on mobile – examples include Clinical Trials Mobile, TrialX Mobile, and apps from pharmaceutical companies such as Pfizer and Glaxo.  Many of these applications leave a lot to be desired in terms of user design, navigability, and searchability.  Also, we don’t know much about the success or use of these apps. 

 I have also not seen any write-ups of the use of text messaging to recruit to trials, particularly with young adults. That is certainly an area to explore. But this kind of targeted recruitment would also need to go through IRB approval just like other recruitment approaches.  And IRB’s are always nervous about security issues involved.

Access is of course, only one part of the recruitment challenge. With clinical trials accrual, as you may know, the evidence indicates that presenting clinical trials as an option in the context of care is more effective.  As we see more integration of clinical trials information into electronic medical records, personal health records, and patient portals, and these then become available on mobile devices, perhaps, then  the  potential of mobile devices in this area will be realized.

Lakshmi

I also wanted to update you

I also wanted to update you on NCI's efforts in the mobile arena.

Early next year, we will launch a mobile version of our Web site (m.cancer.gov). The site is the result of extensive user research about content, features, and functionality  that would be most useful for our target audiences. It will primarily be designed for patients, caregivers, friends and family members and will draw on existing information that is will now be optimized for display on mobile devices. In terms of prioritization of content, our selection was informed by Web analytics that showed us content that people were accessing from mobile devices on our regular Web site. 

We chose to go the mobile web route for a variety of reasons, not the least of which was to meet the needs of users whose primary access to the web is through a mobile device. Since at least for now, apps are platform specific (no matter what the hype is about building apps in a platform-independent way), we felt that we would reach the most number of mobile users by choosing to go in the mobile web direction.

We would love to partner with others who are developing apps - particularly if they want to use our evidence-based information. One example of this partnership is the app that the Lance Armstrong Foundation developed using NCI's Dictionary of Cancer Terms in English and Spanish (http://itunes.apple.com/us/app/livestrong-english-spanish/id375144785?mt=8).

Other offices at NCI are also exploring mobile apps - our Center for Cancer Training developed a neat app for summer interns last year  (we get hundreds of them every year) that combined calendar of events, local resources, maps etc.

Be happy to chat with folks who are thinking of going mobile and are looking for resources.

Lakshmi