Engagement with Mobile Technology in Research & Treatment

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Meghan Waters
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1 Engagement with Mobile Technology in Research & Treatment MATTHEW PRICE CENTER FOR RESEARCH ON EMOTION, STRESS, AND TECHNOLOGY UNIVERSITY OF

2 What can phones do? Communication Phone call SMS Reminder Calendar Scheduling In the moment information Internet access Location based sensors Entertainment Bio feedback Healthkit

3 But What Is Used?

4 The challenges that apps face New apps are rarely downloaded Or used Comscore, 2014

5 What leads people to use technology-based treatments?

6 Time How long will it take? Usability How hard is it to do? Relevance Why am I doing this? THREE KEY POINTS Chiu & Eysenbach, 2010; Eysenbach 2004

7 50% 40% Reason for not accessing the intervention 41% 30% 20% 18% 15% 10% 3% 8% 0% You were too busy You did not feel it would be useful to you You were concerned about the security of the website You did not feel it was relevant to your situation You went to the website but had trouble using it

8 You Get One Thing

9 Connecting to Help After Trauma (CHAT) Mobile phone based assessment protocol Daily assessments of symptoms of recovery Monitoring of symptoms can facilitate the recovery process Lower cost and broad reach (90% cell phone ownership) Aims: Better understand process of recovery Evaluate use of SMS protocol Determine the ease with which providers can Rx

10 Approach: 15 Days of SMS Domain Social Support Item How supported, close, and/or connected to friends &family have you felt today? (1=not at all; 7 =completely) In Hospital Assessed for PTSD, Depression, Social Functioning Oriented to text responses Hypervigiliance How much did you feel overly alert, jumpy, and/ or have difficulty concentrating today? (1=not at all; 7=all the time) Avoidance How much have you avoided people, places or activities that may remind you of the trauma today? (1=not at all; 7=completely) 15 days post discharge Daily text sent that assessed 1 of 5 domains Avoidance, Hyperarousal, Re-experiencing, Social Functioning, Pain Reexperiencing Pain How often did you have negative memories or thoughts about the trauma today? (1=none at all; 7=a lot) How much physical pain were you in today? (1=none; 10=a lot) 1-Month 3-Month Re-assessed for PTSD, Depression, Disability, Social Functioning

11 Response Rates % 80.00% 60.00% 40.00% 82.80% 63.10% 41.70% 20.00% 0.00% Response rate Adherence rate Adherence rate > 75%

12 Participants Thoughts About SMS Interaction My family didn t want to talk about it I felt like I had someone to talk to about the experience with the texts. Someone cared, was concerned, and worried about me You were concerned about my recovery. I knew that every day at 7 someone was there to talk to me. It felt that someone everyday really cared about me...

13 Technological Limitations Single messages limited the amount of data that could be collected Wanted personalized feedback from their texts Participants wanted questions about the problems they were experiencing as opposed to the data we were collecting

14 Shift to an App Based System Mobile applications offer greater flexibility for treatment and research Developed a mobile prototype for symptom monitoring with team at UVM Speed of completing the assessments Ease of Use Flexibility in assessment

15 Usability Evaluation Time to complete 7 items with 6 sliders and 1 toggle in seconds: M = 29.37, SD = 7.53 Perceptions of App-based interface Increase communication with doctor Easy to use Clean interface that was engaging Recommendations 2-way communication Share Data, Don t Give Data Technology should not replace personal interaction with providers Make sure to use the data obtained from the app in practice Provide feedback after completing questions Price et al., under review

16 A note on feedback People like this But they do not like this

17 Conclusions Ease of use is critical for sustained engagement Share data, don t give data Data from applications should facilitate conversations Feedback is essential Automated encouragement is acceptable Critical feedback or identification of problems should be addressed in person

18 Ways to Get More Than 1 Thing Use Sensors

19 After you have successfully implemented your 1 thing, you can add

20 Acknowledgements u Anna Bellard u Andrew Brown u Annie Maheux u Rachel Merriam u Hanna Ward Tyler Sawyer Madison Harris Joshua Barry Rebecca Norton Tosha Hawley Jenna Bushor Frank Treiber, PhD Sachin Patel, MBA Kalev Freeman, MD PhD Jennifer Gratton, NP Chelsea Manning Thomas Sewasky Michael O Keefe Kenneth J. Ruggiero, PhD Heidi Resnick, PhD UL1 RR (Seed Grant), PI: Price Samir Fakhry, MD Pamela Ferguson, PhD Debbie Coulliard, RN UVM REACH Grant, PI: Price, Skalka, Freeman NBH Microgrant, PI: Price, Skalka, Freeman

21 Thank You For Your CENTER FOR RESEARCH ON EMOTION, STRESS, AND TECHNOLOGY

Post-Traumatic Stress Disorder (PTSD)

Have you lived through a very scary and dangerous event? A R E A L I L L N E S S Post-Traumatic Stress Disorder (PTSD) Post Traumatic Stress Disorder (PTSD) NIH Publication No. 00-4675 Does This Sound