Pediatrics 2.0: Digital Health Promotion for Behavior Change
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UF Pediatrics Grand Rounds talk given on May 16, 2013 at UF/Shands Hospital in Gainesville, Florida USA
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Pediatrics 2.0: Digital Health Promotion for Behavior Change
- 1. @jaybernhardt Pediatrics 2.0: Digital Health Promotion for Behavior Change Jay M. Bernhardt, PhD, MPH Professor and Chair, Department of Health Education and Behavior Director, Center for Digital Health and Wellness College of Health and Human Performance Pediatrics Grand Rounds, May 16, 2013 University of Florida College of Medicine http://nicolehowley.visionsmartnews.com/post/images/000/005/110/original_250x1000_0.jpg
- 2. @jaybernhardt Pediatrics 2.0 Grand Rounds Overview • New media trends among youth • Digital health innovations for pediatric health promotion research and practice • Learning Objectives: – Summarize trends in new media use among youth – Identify applications of digital health to pediatrics footage.shutterstock.com
- 3. @jaybernhardt • “Web 2.0” “…a set of economic, social, and technological trends that collectively form the basis for the next generation of the Internet – a more mature, distinctive medium characterized by participation, openness, and network effects.” (Musser & O’Reilly, 2006) • “Health 2.0” “The use of a specific set of tools by actors in healthcare including doctors, patients, and scientists, using principles of open source and generation of content by users, and the power of networks in order to personalize healthcare, collaborate, and promote health education.” (Hughes et al. 2008)
- 5. @jaybernhardt Internet Use by Age, 2000-2012 Three in four teens access the internet on cell phones, tablets, and other mobile devices. 50% of parents of online teens have used parental controls or other means of blocking, filtering, or monitoring their child’s online activities http://www.pewinternet.org/Reports/2012/Teens-and-Privacy/Summary-of-Findings.aspx
- 10. @jaybernhardt
- 12. @jaybernhardt http://saasuserexperience.wordpress.comhttp://blog.clicktale.com/2011/05/29/analyzing-the-impact-of-the-digital-fold http://www.digitaltrends.com/mobile/vuzix-previews-its-revolutionary-smart-augmented-reality-glasses-technology-video Screen Ubiquity & Proliferation http://living.msn.com
- 13. @jaybernhardt http://manhattanresearch.com/Images---Files/Infographics/Taking-the-Pulse-US-2012.aspx
- 14. @jaybernhardt Overview of Youth Media Trends • Television remains dominant platform – With media multitasking increasing • Significant increases in social media use – Facebook, YouTube, Twitter • Significant increases in mobile use – Texting, Gaming, Photos/Videos, Apps – Growing use of mobile tablet computing
- 15. @jaybernhardt designmind.frogdesign.comwww.iphoneincanada.ca www.apartmenttherapy.com www.socialfirefly.com New Media for Pediatric Health Promotion
- 16. @jaybernhardt Pediatrics 2.0: Health Information Seeking • Searches start at Google • Searches via mobile growing • Stories > Data & Facts • Participation = Engagement • Search Engine Optimization • Mobile-enhanced design • Narratives, Videos, Games • Allows users to contribute
- 17. @jaybernhardt Pediatrics 2.0: Health Information Seeking Promising areas for research and practice: • ePatients & “Patient Engagement” with Electronic Medical Records and Personal Health Records • Health Information Rx to credible and “accessible” sites based on literacy, language, culture, etc. • Deeply-tailored health messages delivered via web and other communication platforms • Programs to enhance health and eHealth literacy
- 18. @jaybernhardt Pediatrics 2.0: Social Networks • Users: Facebook > 1B, YouTube > 800M, Twitter > 500M • Health & Patient Social Networks (Patients Like Me, SmartPatients) • Aggregation tools (e.g., Hootsuite) help organize data streams • Data mining tools and algorithms facilitate audience analysis
- 19. @jaybernhardt Pediatrics 2.0: Social Networks Promising areas for research and practice: • Social network effects on health behaviors, prevention, and medical decision making • Creating and leveraging social networks of caregivers, patients, and/or parents • Mining “big (social) data” for health trends, predictive patterns, emerging risks, norms
- 20. @jaybernhardt Pediatrics 2.0: mHealth (m=mobile) http://www.technobuffalo.com/mobile-devices/phones/the-all-in-one-conundrum-a-delightful-rant/ SMS* or MMS Voice & Video (calls, IVR) Email or Instant Message Secure data transmission Video files (M4V, etc.) Audio files (MP3 etc.) Mobile Web Geo-Location Tracking & Monitoring Custom application program (“apps”) *More than 2,000,000,000,000 SMS messages/year and growing!
- 21. @jaybernhardt mHealth Intervention Opportunities mHealth Applications: • Call Centers • Emergency Alerts • Appointment Reminders • Patient Records • Health Surveys • Monitoring & Surveillance • Treatment Adherence • Health Promotion • Mobile Telemedicine • Community Mobilization • Decision Support Systems mHealth Channels: • SMS or MMS • Voice (human, recorded, IVR) • Email or IMs • Audio files • Video files • Mobile Web • Monitoring • Custom apps
- 22. @jaybernhardt Location Based mHealth Programs
- 24. @jaybernhardt Mobile Apps & Games (and Developer Challenges) DoctorCalc VaxTrax SwineFlu The Game
- 25. @jaybernhardt Mobile Tracking (“Quantified Self”) http://www.diabetesmine.com http://sleepzine.com http://fitbit.com http://nike.com
- 26. @jaybernhardt Don’t forget your multivitamin! Baby’s spine and brain are developing now. Getting 400 micrograms of folic acid daily is key to help prevent birth defects. Reply Back http://text4baby.org SMS (Text-Based) Mobile Interventions
- 27. @jaybernhardt Hasvold & Wooton (2011) Use of telephone and SMS reminders to improve attendance at hospital appointments: A systematic review. Journal of Telemedicine and Telecare. • Reviewed 29 studies with 33 interventions – Study sizes: n=325-2864 – Study durations: 2-7 months • 32 of 33 interventions showed benefits of sending patient reminders prior to appointments – Manual calls more effective than automated reminders (39% vs. 29%) but higher cost – No differences on reminder timing
- 28. @jaybernhardt Cole-Lewis & Kershaw (2010) Text messaging as a tool for behavior change in disease prevention and management. Epidemiologic Review. • Reviewed 12 studies (17 articles) using SMS – Intervention length ranged from 3-12 months – Sample sizes (n=16-126, + 1,705) – Disease management: Diabetes, Asthma – Disease prevention: Medication adherence, Weight loss, Physical activity, Smoking cessation – 8 of 9 powered studies found evidence of significant behavior change
- 29. @jaybernhardt SMS for Vaccine Promotion Studies • SMS reminders to promote HPV vaccine (Kharbanda et al., 2011) – 52% of girls of parents who opted in and received up to 3 weekly SMS reminders received next vaccine dose compared to 35% who did not receive SMS messages • SMS to promote flu vaccine in low income urban pediatric/adolescent pop. (Stockwell et al., 2012) – 43.6% of children of parents who received up to 5 weekly SMS messages received flu vaccine compared to 39.9% who did not receive the SMS messages
- 30. @jaybernhardt Pediatrics 2.0: mHealth Intervention Promising areas for research and practice: • SMS-based interventions to improve care, such as vaccines, treatment adherence, prevention, etc. • Mobile health promotion apps if theoretically- informed, science-based, rigorously-evaluated • Tracking quantified-self devices if they utilize data for personalized messages and motivation • Multi-platform 360˚ tailored interventions with right-place, right-time, right-platform messages
- 31. @jaybernhardt Conclusions: Advantages of Pediatrics 2.0 • Increased and Sustained Reach/Repetition • Stronger Patient Relevance/Involvement • Deeper Audience Engagement • Scalable and Affordable Interventions • Facilitates Measurement and Evaluation
- 32. @jaybernhardt Conclusions: Challenges for Pediatrics 2.0 • Privacy of data and regulatory restrictions • Access and understanding among professionals, patients, and priority communities • Research and evaluation to determine and disseminate evidence-based best practices
Notes de l'éditeur
- http://www.pewinternet.org/Infographics/2010/Internet-acess-by-age-group-over-time-Update.aspx
- http://www.pewinternet.org/Infographics/Generational-differences-in-online-activities.aspx