Mobile health technology, also called mHealth, can affect behavioral change.
Some love it. Some hate it. Either way, mobile communication devices seem inescapable in today’s digital society [1]. This can sometimes feel like a nuisance when millenials—and a few older folks too—seem permanently glued to their smartphone screens. Nonetheless, the ubiquity of cell phones has made it possible for people to access health information wherever they go, right in the palms of their hands [2]. These mobile health programs, sometimes abbreviated as mHealth, are relatively inexpensive to scale upwards and expand for larger audiences [1]. With 9 in 10 adults in the U.S. owning a cell phone [1], mobile health programs have the potential to help individuals through a wide range of issues [2], including:
Inspiring healthier living [2]: Lifestyle habits can be extremely hard to change, perhaps in part because it often doesn’t happen without frustrations and setbacks [3]. However, mobile health programs that provide reminders and incentives can help change deep-rooted behaviors to improve health [4]. One such program, called TeXT-MED, enrolled inner-city patients with diagnosed diabetes to receive three text messages daily for three weeks [4]. Text messages included educational and “challenge” features about healthy living [4]. By the end of the trial, 4 in 5 participants reported eating fruits and vegetables every day, whereas only half did so prior to intervention [4]. Three-fourths reported regular exercise, whereas previously less than half did [4].
Closing economic gaps in access to health care: Text4baby is an mHealth parenting program designed by the Department of Health and Human Services and available for free. The aim is to deliver evidence-based information about pregnancy and early parenting to busy women who may not have access to this information in more traditional settings (e.g., face-to-face parenting classes). A recent pilot study enrolled socioeconomically disadvantaged women who were pregnant or newly mothering to receive text messages that aimed to increase their knowledge of health care access and improve their own health care choices [5]. By the end of the study, three times more women enrolled in the program felt ready to be a new mother compared to those in the control group who did not receive the program [5].
Putting the power of behavior change in your hands: While a number of smoking aids exist on the market, many of them require the person to have accountability in using them. For example, if you use a telephone quit line, you have to make time in your day to call them, and then remember to call them for subsequent meetings. If you use a product like nicotine gum, you need to have it with you when you have a craving. mHealth programs can be more proactive by sending users messages without them having to do anything but read their texts. These types of programs can also be an interactive experience that can bolster motivation for the user [6]. In our own mHealth program, Stop My Smoking, participants said that the positivity of the text messages was helpful – especially when they felt stressed or discouraged [6]. Additionally, encouragement from Stop My Smoking motivated at least one in five of our participants to try pharmacotherapy [6]. Four weeks after their Quit Day, almost twice as many intervention participants (39%) had quit smoking by four weeks after intervention than control participants (21%) [7].
To learn more about Stop My Smoking, please visit www.stopmysmoking.com
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Acknowledgments: Thanks to Emilie Chen for her contributions to this blog.
References:
[1] Pew Research Center. (2014, Feb. 13) Mobile Technology Fact Sheet. Available at: http://www.pewinternet.org/fact-sheets/mobile-technology-fact-sheet/
[2] Cole-Lewis, H. & Kershaw, T. (2010). Text messaging as a tool for behavior change in disease prevention and management. Epidemiologic Reviews. 32(1); 56-69.
[3] Harvard Women’s Health Watch (2007). Why it’s hard to change unhealthy behavior—and why you should keep trying. Available at: http://www.health.harvard.edu/newsweek/Why-its-hard-to-change-unhealthy-behavior.htm
[4] Arora, S., Peters, A.L., Agy, C., & Menchine, M. (2012). A mobile health intervention for inner city patients with poorly controlled diabetes: Proof-of-concept of the TExT-MED program. Diabetes Technology & Therapeutics. 14(6); 492-496.
[5] Study Shows mHealth Service for Moms is Beneficial. (2013, May 6) Available at: https://text4baby.org/index.php/news/364-study-shows-mhealth-service-for-moms-is-beneficial
[6] Ybarra, M.L., Holtrop, J.S., Prescott, T.L., & Strong. D. (2014). Process evaluation of a mHealth program: Lessons learned from Stop My Smoking USA, a text messaging-based smoking cessation program for young adults. Patient Education and Counseling.
[7] Ybarra, M.L., Holtrop, J.S., Prescott, T.L., Rahbar, M.H., & Strong. D. (2014). Pilot RCT results of Stop My Smoking USA: A text messaging-based smoking cessation program for young adults. Nicotine & Tobacco Research. 15(8); 1388-1399.