This Roadmap is intended as a guide for developers and implementers of mHealth interventions for at-risk women. It is our hope that the experience of the authors and the information provided will assist users in creating programs that meet the demands of that target audience and improve the quality of services available.
The Roadmap includes best practices in the field, a review of mobile tools as well as a literature review, lessons learned, evidence-based data, and information on the mHealth interventions available and appropriate for this at-risk population.
The manual also contains a comprehensive explanation of methodology and practical recommendations on the strategic planning of behavior change interventions based on mobile devices for different groups of at-risk women – those with a history of substance abuse, commercial sex workers, and women preparing to start or who have recently completed prison terms.
The authors of this study aimed to study the effect of mHealth tools on cardiovascular disease causes - poor diet and physical inactivity: “Mobile phone-based health interventions have been shown to help promote weight loss and increase physical activity and are an attractive approach for health-care systems with limited resources. We aimed to assess whether mHealth with advice for lifestyle improvements would reduce blood pressure, promote weight loss, and improve diet quality and physical activity in individuals with prehypertension living in low-resource urban settings in Latin America.”
The authors of this review examined recent developments in online and mobile mental health applications (they also looked at online patient portals to support care, of less interest for this database). As with other health topics, they found that the implementation of new technologies for addressing mental health issues often outpaced testing for effectiveness – there are some reviews about the effectiveness of new apps, but not sufficient.
The authors look at underserved populations as potential audiences for mHealth interventions. They identify key administrative, technological, and logisticalchallenges involved in doing mHealth research with these groups, using a sample of urban American Indian and Alaska Native mothers, in order to assist future investigators. (“We conducted community consultations and a process monitoring phase for a pilot trial aimed at measuring the effect of a brief counseling session on participants' adherence to use of a mobile app.”)
This pilot study conducted a survey among users of an app, Stop-cannabis aimed at helping cannabis users reduce or stop consumption. Of the 428 respondents, 80% reported that the app helped them “a little” or “a lot,” supporting the feasibility of this initiative:
“This study suggests that the Stop-cannabis mobile app is acceptable and perceived as useful by the users. The app was appreciated by most of the participants and was furthermore considered helpful in either stopping or reducing cannabis use. More than 80% of users considered the app to have helped them “a little” or “a lot” to stop or reduce cannabis consumption. The study was not, however, designed to assess the effectiveness of the app and cannot provide an assessment of the effect of the app on cannabis use.”
In this feasibility study, the researchers looked at whether a teen audience would use an app aimed at delivering early mental health interventions by fostering “positive mental health in adolescents through emotional self-monitoring and the promotion of positive coping strategies.”
The authors of this paper conducted a systematic review and meta-analysis to determine the potential success/feasibility of mHealth interventions for clients with schizophrenia to assess mobile phone ownership and interest in mHealth among patients with psychosis.
The authors of this tutorial note that mHealth interventions are often developed with minimal input from target groups, and quality assessment by those groups is often limited to post-development “like/dislike” assessment.
This feasibility study examines access to the Internet through mobile phones and computers in the southern United States among pregnant women, because data on such access is limited, and the authors state that Internet-based behavioral programs may be an effective way to improve prenatal care and pregnancy outcomes.
This viewpoint article in the Journal of Medical Internet Research provides a summary of the current state of mHealth and mental health mobile apps, the potential for growth in the field, and cites evidence-based benefits of mental health mobile applications. The authors also discuss the diffusion of this innovation (defined as “the process of communicating an innovation over time among members of a social system”), and solutions for improving diffusion, among mental health professionals.
The authors stated that the aim of this review was to “identify mobile text-messaging interventions designed for health improvement and behavior change and derive recommendations for practice.”
This preliminary evaluation study examined the effectiveness of a mobile application intended to aid in smoking cessation. The app, SmokeFree28, had a goal of 28 days of abstinence for smokers over the age of 16 with a goal quit date. It was available for free download on the iTunes store.
This literature review analyzed 42 articles on the use of mobile phones for public health issues related to MARPs, mainly female-focused. The programs addressed a wide range of audiences, such as substance abusers, recent parolees, economically disadvantaged groups, etc.
This article describes a program run in 2010 in St. Petersburg, Russia, by the Health and Development Foundation. Clients who came to St. Petersburg Maternity Hospital No. 16, a hospital for high-risk patients, during pregnancy or for delivery were invited to join the program based on the following criteria: injection drug use in their medical history, experience as a commercial sex worker, or HIV+ status (169 women total). Female clients were selected for the same criteria at St. Petersburg State Narcological Hospital (86 total).
This study looked at the feasibility, acceptability, and initial efficacy of a smartphone intervention for schizophrenia (FOCUS), which targets symptom management, mood regulation, medication adherence, improved sleep, and social functioning.
This pilot study examined whether an SMS messaging service employing EMA (real-time data collection and assessment of KAB) and CBT methods would be helpful in positively affecting the behavior of clients with schizophrenia. Targeted areas were medication adherence, socialization, and hallucinations.
In this paper, researchers attempt to create a systematic design process for developing mHealth interventions for “culturally informed behavioral intervention technologies.” The paper points out that there is little literature available on designing programs for minority groups, and discusses the different theoretical models they used in the initial information-gathering part of program design.
The study was a randomized clinical trial to assess the effectiveness of cellular phone interventions for smoking cessation among people who are HIV positive. Those randomly selected for the cellular phone group received 8 counseling sessions via mobile phones with an additional 3-month follow-up period.
This review of mHealth programs as they are used for international development in public health. The review looks at four distinct applications of mHealth: (1)drug adherence and remote monitoring (2) remote dissemination of information (3) data collection and disease outbreak surveillance (4) diagnostic treatment and support.
Migrant farm workers are an underserved population, with high levels of chronic diseases but limited access to health care. Like IDUs, they need to be kept in the loop of health care, made difficult by the fact that their jobs often take them from state to state, difficult to identify and stay in touch with health care facilities and physicians. Also, many do not speak English, and concerns about immigration status may make them reluctant to share information (a concern with sharing through mobile phones). This study sought to determine whether mobile phones could be an effective way to reach/keep in contact with this at-risk group.