Engagement with Mobile Technology in Research & TreatmentMATTHEW PRICE

CENTER FOR RESEARCH ON EMOTION, STRESS, AND TECHNOLOGY

UNIVERSITY OF VERMONT

@DR_MATT_P

Outline

Overview of what phones can do and what we do with them

Empirical and rational evaluation of app use in general

The “One Thing” Strategy as a means to integrate apps into treatment and research

Ways to expand beyond “One Thing”

Strategies to sustain use

What do we do after treatment/protocol ends?

Disclosure

The following presentation is based on: Empirical Evidence

Anecdotal Evidence

Clinical Experience

Personal Experience

What can phones do?

Communication

Phone call

SMS

Reminder

Calendar

Scheduling

In the moment information

Internet access

Location based sensors

Entertainment

Bio feedback

Healthkit

Smartphones Are Used Frequently!

IDC Research, 2013

But What Is Used?

I lied… most check the weather

New Apps Are Rarely Downloaded

Comscore, 2014

New Apps Rarely Make It Into Rotation

Most People Spend Heavily Use 1-2 Apps

What Apps Do People Look For?

“It’s hard out there for an app”

-GARY BENNETT

What leads people to use technology-based treatments?

Time – “How long will it take?”Usability – “How hard is it to do?”Relevance – “Why am I doing this?”THREE KEY POINTS

The Unrealistic Expectation of Apps

The Best Advice I Ever Received When Planning My Wedding Was…

You Get One Thing

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

Response Rates

Response rate Adherence rate Adherence rate > 75%

0.00%

20.00%

40.00%

60.00%

80.00%

100.00%

82.80%

63.10%

41.70%

Responsiveness to SMS Approach

61.1% found them helpful to very helpful

77.8% felt that 15 days of texts was sufficient 16.7% wanted more than 15 days

72.2% felt 1 per day was good, but 27.8% wanted them every other day Those that wanted daily messages had higher PTSD, Depression, and

Disability at follow up assessments

Participants’ Thoughts About SMS

“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(:00PM) someone was there to talk to me. It felt that someone everyday really cared about me...”

Provider Burden During Messages

Activity

Time Per Patient/Per

Month

Text review of patient text content 2-7 minutes

1-month follow up interview (diagnostic interview, assessment of functioning, referral )

27.5 minutes

Follow-up calls that did not yield a response 2 minutes

Total Time Spent 31.5 - 36.5

Examples of One Thing Apps

One Thing for Clinical Care

Record session feature

Easy way to record sessions

Easy to locate place to play back session

Recording does not get sent to iTunes when connected

Able to check if recording was played back

One Thing for Research

Ways to Get More Than 1 Thing

Use Sensors

Or Be On Facebook

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

How Do We Sustain Engagement?

Supportive Accountability Model

Apps should be adjuncts to treatment…

“I would not use this app if it meant I would have less time with my doctor.”-Usability Participant

Provide Feedback

“Share data, not give data”

A note on feedback

People like this But they do not like this

Game-ify the Treatment Experience

“How do we make getting over PTSD fun?”-Joe Ruzek, National Center for PTSD

Sustained Use After Treatment

What should we do about a desire to sustained use?

Should we cut participants/patients off at a specified time?

Where will data go?

Will/should therapist still have access to the data?

Thank You For Your Time!MATTHEW.PRICE@UVM.EDU

@DR_MATT_P

HTTP://WWW.UVM.EDU/~CREST/

CENTER FOR RESEARCH ON EMOTION, STRESS, AND TECHNOLOGY