Recently we had the opportunity to attend a Mobile Health Forum put on by ICF International near Washington, DC, entitled, “Federal Efforts to Advance Public Health and Health Research with Mobile Technology”. It was an excellent showcase of several federal efforts – past, present and future – around using mHealth to enable effective, theory-based interventions.
The forum featured two expert researchers from the National Institutes of Health (NIH) – Dr. Audie Atienza and Dr. Catherine ‘Cay’ Loria – and was moderated by Lew Berman, Vice President at ICF International. They shared their observations, experiences and insights from several different mHealth initiatives throughout NIH, highlighting both challenges and successes related to mobile technology in the health arena.
- Timelines – One key theme that the speakers mentioned was that the typical grant period (5 years) was much longer than the entire time period that saw the dawn and rise of the iPhone, Android, iPad and other innovative inventions over the last 5 years. Thus, starting a 5-year grant premised on using today’s technology and performing intensive research around that technology, may not be the most effective approach. With today’s environment of ‘App Challenges’, ‘Hackathons’ and other rapid-fire innovation generators, 5 years is a relative eternity.
- Efficacy – While 5 years may be too long in many scenarios, and the ‘App Challenges’ and other unique problem-solving approaches can prove valuable, one issue needs to be addressed – the efficacy of solutions under shorter timelines. There are a multitude of health & wellness and related mHealth apps available – both public and commercial – but it’s not always clear to what extent many of these tools are utilizing theory-based approaches, nor being evaluated against desired objectives and outcomes. The scientific method, sample sizes, proper evaluation techniques and data analysis are just some of the related considerations.
- Populations – As many of the example projects highlighted in the forum were centered around creating meaningful and lasting interventions (e.g., diet modification, smoking cessation, teen smoking, etc.), it is clear that no one way works for everybody (in what walk of life is that true?:). The researchers and their teams naturally had to carefully consider many populations, sub-populations and the unique norms and habits of those different groups. One example given was communicating with teens around preventing or stopping smoking. Emails and phone calls were not expected to be effective, whereas SMS texting was considered the most effective means with which to communicate and effect a positive outcome. In short, a multi-pronged and multi-media approach is going to be needed for addressing far-reaching problems.
- Dealing with Data – In the field of research, data is king. This presents the questions of what data to capture, how to analyze it and how to present it to those that can do something with it. The federal government has a treasure trove of data that it has begun to release over the last few years with the ‘OpenGov’ initiative. In addition, there are many publicly available, privately created data sources that can be integrated. With ‘data overload’ facing researchers, determining the right data to integrate and how to integrate it can be a challenge.
- Other Human Factors – In addition to considering the populations and their tendencies mentioned above, there were several other human considerations that naturally came into play. For example, some users involved in a study will tend to be more disciplined and methodical in utilizing an app to record data, while others may not be. With users ‘out in the field’ of life utilizing the apps, it’s difficult to determine exactly how they are capturing data. In addition, when problems are reported with the app or the device, it naturally is more problematic for researchers and engineers to determine whether the issue is with the particular device, the app, or simply a user training issue. Another consideration was the length of the studies – even the shorter studies that last 1 or 2 years. That is still a significant length of time and therefore a sizable commitment, for even the most disciplined individuals.
- Technology Shifts and Looking Ahead – In addition to the general timeline issue mentioned earlier, rapid changes in technology, even within shorter time windows, were often an issue that researchers had to contend against. From frequent operating system updates arriving on phones, to new devices being purchased by participants, keeping apps properly functioning and supported took some time. In addition, since some of the studies began several years ago, when mobile toolsets and processes were even more immature, the teams naturally had to be resourceful, adapt and work with what was available at the time. At this point, lessons learned and best practices are beginning to be accumulated and shared. The next evolution will likely be around establishing more standardized approaches and perhaps standardizing on toolsets, such as cross-platform tools like Appcelerator Titanium that allow native apps to be built for iOS, Android, BlackBerry, HTML5 and Windows 8. This is a time and cost-savings approach recommended by Gartner and discussed in this Government Computer News article. Other possibilities might be shared reusable code repositories for common features and functions to be leveraged by various teams. In addition, mobile analytics tools such as Flurry and Google Analytics, as well as remote debugging tools such as TestFlight and BugSense could be used to record user behaviors and also identify technical support issues.
In summary, it was an insightful and well-done event that highlighted the work that the federal government is doing to ‘adapt and adopt’ the use of mobile technologies in its research and in fulfilling its missions to promote public health.
About the Author
Brian Blankenship is a Senior Mobile Solutions Provider with Clearly Innovative, Inc. He is an experienced mobile developer, as well as a certified project manager with experience and certifications in agile development. He has developed apps for various industries including the federal government.
Clearly Innovative, Inc.
Clearly Innovative, Inc. is a certified small business and a premier provider of mobile technology solutions for iPhone, iPad, Android, BlackBerry, HTML5, Windows 8, Nook and Kindle. Based in Washington, DC and founded in 2009, Clearly Innovative has developed dozens of apps and serves clients in various industries such as the Federal, DoD, Commercial, Social Media, Non-profit arenas. Clearly Innovative specializes in mobile app development using the Appcelerator Titanium platform, which essentially allows code to be written once and ‘published’ across multiple platforms – drastically reducing time and cost throughout the development lifecycle. Clearly Innovative is an official Appcelerator Gold-Level Integration partner, with many certified mobile app developers and deep expertise on the platform. In addition to bringing top-notch mobile expertise, Clearly Innovative brings solid project management and process improvement expertise to support a solid and lasting solution.