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Strategies for mHealth Research: Lessons from 3 Mobile Intervention Studies

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Abstract

The capacity of Mobile Health (mHealth) technologies to propel healthcare forward is directly linked to the quality of mobile interventions developed through careful mHealth research. mHealth research entails several unique characteristics, including collaboration with technologists at all phases of a project, reliance on regional telecommunication infrastructure and commercial mobile service providers, and deployment and evaluation of interventions “in the wild”, with participants using mobile tools in uncontrolled environments. In the current paper, we summarize the lessons our multi-institutional/multi-disciplinary team has learned conducting a range of mHealth projects using mobile phones with diverse clinical populations. First, we describe three ongoing projects that we draw from to illustrate throughout the paper. We then provide an example for multidisciplinary teamwork and conceptual mHealth intervention development that we found to be particularly useful. Finally, we discuss mHealth research challenges (i.e. evolving technology, mobile phone selection, user characteristics, the deployment environment, and mHealth system “bugs and glitches”), and provide recommendations for identifying and resolving barriers, or preventing their occurrence altogether.

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References

  • Andersson, G., Bergström, J., Holländare, F., Carlbring, P., Kaldo, V., & Ekselius, L. (2005). Internet-based self-help for depression: Randomised controlled trial. The British Journal of Psychiatry, 187, 456–461.

    Article  PubMed  Google Scholar 

  • Bardram, J. E., Frost, M., Szántó, K., Faurholt-Jepsen, M., Vinberg, M., & Kessing, L. V. (2013). Designing mobile health technology for bipolar disorder: A field trial of the MONARCA system. In Proceedings of the 31st ACM International Conference on Human Factors in Computing Systems, CHI 2013 (pp. 2627–2638), Paris, France. doi:10.1145/2470654.2481364.

  • Beck, K. (2003). Test-driven development: By example. Boston, MA: Addison-Wesley Professional.

    Google Scholar 

  • Ben-Zeev, D. (2012). Mobile technologies in the study, assessment, and treatment of schizophrenia. Schizophrenia Bulletin, 38, 384–385.

    Article  PubMed Central  PubMed  Google Scholar 

  • Ben-Zeev, D., Brenner, C. J., Begale, M., Duffecy, J., Mohr, D. C., & Mueser, K. T. (2014). Feasibility, acceptability, and preliminary efficacy of a smartphone intervention for schizophrenia. Schizophrenia Bulletin. doi:10.1093/schbul/sbu033.

    PubMed  Google Scholar 

  • Ben-Zeev, D., Davis, K., Kaiser, S., Krzos, I., & Drake, R. E. (2013a). Mobile technologies among people with serious mental illness: Opportunities for future services. Administration and Policy in Mental Health and Mental Health Services Research, 40, 340–343.

    Article  PubMed Central  PubMed  Google Scholar 

  • Ben-Zeev, D., Drake, R. E., Corrigan, P. W., Rotondi, A. J., Nilsen, W., & Depp, C. (2012). Using contemporary technologies in the assessment and treatment of serious mental illness. American Journal of Psychiatric Rehabilitation, 15, 357–376.

    Article  Google Scholar 

  • Ben-Zeev, D., Kaiser, S. M., Brenner, C. J., Begale, M., Duffecy, J., & Mohr, D. C. (2013b). Development and usability testing of FOCUS: A smartphone system for self-management of schizophrenia. Psychiatric Rehabilitation Journal, 36, 289–296.

    Article  PubMed  Google Scholar 

  • Burns, M. N., Begale, M., Duffecy, J., Gergle, D., Karr, C. J., Giangrande, E., et al. (2011). Harnessing context sensing to develop a mobile intervention for depression. Journal of Medical Internet Research, 13, e55.

    Article  PubMed Central  PubMed  Google Scholar 

  • Carlbring, P., Nilsson-Ihrfelt, E., Waara, J., Kollenstam, C., Buhrman, M., Kaldo, V., et al. (2005). Treatment of panic disorder: Live therapy vs. self-help via the Internet. Behaviour Research and Therapy, 43, 1321–1333.

    Article  PubMed  Google Scholar 

  • Chambless, D. L., & Hollon, S. D. (1998). Defining empirically supported therapies. Journal of Consulting and Clinical Psychology, 66, 7–18.

    Article  CAS  PubMed  Google Scholar 

  • Cohn, M. (2004). User stories applied: For agile software development. Boston, MA: Addison-Wesley Professional.

    Google Scholar 

  • Cohn, M. (2005). Agile estimating and planning. Boston, MA: Addison-Wesley Professional.

    Google Scholar 

  • Collins, L. M., Baker, T. B., Mermelstein, R. J., Piper, M. E., Jorenby, D. E., Smith, S. S., et al. (2011). The multiphase optimization strategy for engineering effective tobacco use interventions. Annals of Behavioral Medicine, 41, 208–226.

    Article  PubMed Central  PubMed  Google Scholar 

  • Eyrich-Garg, K. M. (2010). Mobile phone technology: A new paradigm for the prevention, treatment, and research of the non-sheltered “street” homeless? Journal of Urban Health, 87, 365–380.

    Article  PubMed Central  PubMed  Google Scholar 

  • Faurholt-Jepsen, M., VInberg, M., Christensen, E. M., Frost, M., Bardram, J., & Kessing, L. V. (2013). Daily electronic self-monitoring of subjective and objective symptoms in bipolar disorder—the MONARCA trial protocol (MONitoring, treatment and pRediCtion of bipolar disorder episodes): A randomised controlled single-blind trial. BMJ Open, 3, e003353.

    Article  PubMed Central  PubMed  Google Scholar 

  • Harrison, V., Proudfoot, J., Wee, P. P., Parker, G., Pavlovic, D. H., & Manicavasagar, V. (2011). Mobile mental health: Review of the emerging field and proof of concept study. Journal of Mental Health (Abingdon, England), 20, 509–524.

    Article  Google Scholar 

  • Hekler, E. B., Klasnja, P., Froehlich, J., & Buman, M. (2013). Mind the theoretical gap: Interpreting, using, and developing behavioral theory in HCI research. In Proceedings of the 31st ACM International Conference on Human Factors in Computing Systems, CHI 2013 (pp. 3307–3316), Paris, France. doi:10.1145/2470654.2466452.

  • Heron, K. E., & Smyth, J. M. (2010). Ecological momentary interventions: Incorporating mobile technology into psychosocial and health behaviour treatments. British Journal of Health Psychology, 15, 1–39.

    Article  PubMed Central  PubMed  Google Scholar 

  • ITU. (2011). The world in 2011: ICT facts and figures. Retrieved from http://www.itu.int/en/ITU-D/Statistics/Documents/facts/ICTFactsFigures2011.pdf.

  • ITU. (2013). The world in 2013: ICT facts and figures. Retrieved from http://www.itu.int/en/ITU-D/Statistics/Documents/facts/ICTFactsFigures2013.pdf.

  • Kaplan, R. M., & Stone, A. A. (2013). Bringing the laboratory and clinic to the community: Mobile technologies for health promotion and disease prevention. Annual Review of Psychology, 64, 471–498.

    Article  PubMed  Google Scholar 

  • Klasnja, P., Consolvo, S., & Pratt, W. (2011). In Proceedings of the 29th ACM International Conference on Human Factors in Computing Systems, CHI 2011 (pp. 3063–3072), Vancouver, BC, Canada. doi:10.1145/1978942.1979396.

  • Kumar, S., Nilsen, W. J., Abernethy, A., Atienza, A., Patrick, K., & Swendeman, D. (2013). Mobile health technology evaluation: The mHealth evidence workshop. American Journal of Preventive Medicine, 45, 228–236.

    Article  PubMed Central  PubMed  Google Scholar 

  • Luxton, D. D., McCann, R. A., Bush, N. E., Mishkind, M. C., & Reger, G. M. (2011). mHealth for mental health: Integrating smartphone technology in behavioral healthcare. Professional Psychology: Research and Practice, 42, 505–512.

    Article  Google Scholar 

  • Marsch, L. A., & Ben-Zeev, D. (2012). Technology-based assessments and interventions targeting psychiatric and substance use disorders: Innovations and opportunities. Journal of Dual Diagnosis, 8, 259–261.

    Article  Google Scholar 

  • Martin, R. C. (2003). Agile software development: Principles, patterns, and practices. Englewood Cliffs, NJ: Prentice Hall.

    Google Scholar 

  • Mohr, D. C., Cheung, K., Schueller, S. M., Brown, C. H., & Duan, N. (2013). Continuous evaluation of evolving behavioral intervention technologies. American Journal of Preventive Medicine, 45, 517–523.

    Article  PubMed  Google Scholar 

  • Pagliari, C. (2007). Design and evaluation in eHealth: Challenges and implications for an interdisciplinary field. Journal of Medical Internet Research, 9, e15.

    Article  PubMed Central  PubMed  Google Scholar 

  • Proudfoot, J., Klein, B., Barak, A., Carlbring, P., Cuijpers, P., Lange, A., et al. (2011). Establishing guidelines for executing and reporting internet intervention research. Cognitive Behaviour Therapy, 40, 82–97.

    Article  PubMed  Google Scholar 

  • Riley, W. T., Glasgow, R. E., Etheredge, L., & Abernethy, A. P. (2013). Rapid, responsive, relevant (R3) research: A call for a rapid learning health research enterprise. Clinical and Translational Medicine, 2, 1–6.

    Article  Google Scholar 

  • Rotondi, A. J., Sinkule, J., Haas, G. L., Spring, M. B., Litschge, C. M., Newhill, C. E., et al. (2007). Designing websites for persons with cognitive deficits: Design and usability of a psychoeducational intervention for persons with severe mental illness. Psychological Services, 4, 202–224.

    Article  Google Scholar 

  • Rounsaville, B. J., Caroll, K. M., & Onken, L. S. (2001). A stage model of behavioral therapies research: Getting started and moving on from stage I. Clinical Psychology: Science and Practice, 8, 133–142.

    Google Scholar 

  • Rudd, J., Stern, K., & Isensee, S. (1996). Low vs. high-fidelity prototyping debate. Interactions, 3, 76–85.

    Article  Google Scholar 

  • Schueller, S. M., Muñoz, R. F., & Mohr, D. C. (2013). Realizing the potential of behavioral intervention technologies. Current Directions in Psychological Science, 22, 478–483.

    Article  Google Scholar 

  • Smith, A. (2013). Pew internet and American life project: Smartphone Ownership 2013. Retrieved September 10, 2013 from http://pewinternet.org/Reports/2013/Smartphone-Ownership-2013.aspx.

  • Vogel, A. L., Hall, K. L., Fiore, S. M., Klein, J. T., Bennett, L. M., Gadlin, H., et al. (2013). The team science toolkit: Enhancing research collaboration through online knowledge sharing. American Journal of Preventive Medicine, 45, 787–789.

    Article  PubMed  Google Scholar 

  • Wichansky, A. M. (2000). Usability testing in 2000 and beyond. Ergonomics, 43, 998–1006.

    Article  CAS  PubMed  Google Scholar 

  • World Health Organization. (2011). Global Observatory for eHealth series—Volume 3: mHealth: New horizons for health through mobile technologies. Geneva, Switzerland: World Health Organization.

    Google Scholar 

Download references

Acknowledgments

This publication was made possible by Grants from the U.S. Department of Health and Human Services: Grants Nos. R34 MH100195 (PI: Ben-Zeev), P20 MH090318 (PI: Mohr), and R34 MH095907 (PI: Mohr) from the National Institute of Mental Health, and Grant No. C1MS331052 (PI: Kane) from the Centers for Medicare and Medicaid Services. Its contents are solely the responsibility of the authors and have not been approved by the Department of Health and Human Services, National Institute of Mental Health, or Centers for Medicare and Medicaid Services.

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Correspondence to Dror Ben-Zeev.

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Ben-Zeev, D., Schueller, S.M., Begale, M. et al. Strategies for mHealth Research: Lessons from 3 Mobile Intervention Studies. Adm Policy Ment Health 42, 157–167 (2015). https://doi.org/10.1007/s10488-014-0556-2

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