Application of Smartphone Technology in the Management and Treatment of Mental Illnesses

Abstract: Background: Mental illness continues to be a significant Public Health problem and the innovative use of technology to improve the treatment of mental illnesses holds great public health relevance. Over the past decade telecommunications technology has been used to increase access to and improve the quality of mental health care. There is current evidence that the use of landline and cellular telephones, computer-assisted therapy, and videoconferencing can be effective in improving treatment outcomes. Smartphones, as the newest development in communications technology, offer a new opportunity to improve mental health care through their versatile nature to perform a variety of functions. Methods: A critical literature review was performed to examine the potential of smartphones to increase access to mental health care, reduce barriers to care, and improve patient treatment outcomes. The review was performed by searching several electronic databases using a combination of keywords related to smartphones and mental health interventions using mobile devices. Literature concerning the use of cell phones, handheld computers, and smartphones to improve access to mental health care and improve treatment outcomes was identified.Results: The majority of studies identified were feasibility and pilot studies on patients with a variety of diagnosed mental illnesses using cell phones and PDAs. Authors report that most study participants, with some exceptions, were capable of using a mobile device and found them acceptable to use. Few studies extensively measured treatment outcomes and instead reported preliminary results and presented case illustrations. Studies which used smartphones successfully used them collect data on patients and deliver multimedia interventions. Discussion: The current literature offers encouraging evidence for the use of smartphones to improve mental health care but also reflects the lack of research conducted using smartphones. Studies which examine care provider use of smartphones to improve care is encouraging but has limited generalizability to mental health care. The feasibility of patient use of smartphones is also encouraging, but questions remain about feasibility in some sub-populations, particularly schizophrenia patients. Pilot testing of mobile devices and applications can greatly increase the feasibility of using smartphones in mental health care. Patients who are unfamiliar with smartphones will likely need initial training and support in their use. Conclusion: The literature identified several ways in which smartphones can increase access to care, reduce barriers, and improve treatment outcomes. Study results were encouraging but scientifically weak. Future studies are needed replicating results of studies using cell phones and PDAs on smartphones. Larger and higher quality studies are needed to examine the feasibility, efficacy, and cost-effectiveness of smartphones to deliver multiple component interventions that improve access to mental health care and improve treatment outcomes

The Feasibility of a Using a Smart Button Mobile Health System to Self-Track Medication Adherence and Deliver Tailored Short Message Service Text Message Feedback

BACKGROUND: As many as 50% of people experience medication nonadherence, yet studies for detecting nonadherence and delivering real-time interventions to improve adherence are lacking. Mobile health (mHealth) technologies show promise to track and support medication adherence. OBJECTIVE: The study aimed to evaluate the feasibility and acceptability of using an mHealth system for medication adherence tracking and intervention delivery. The mHealth system comprises a smart button device to self-track medication taking, a companion smartphone app, a computer algorithm used to determine adherence and then deliver a standard or tailored SMS (short message service) text message on the basis of timing of medication taking. Standard SMS text messages indicated that the smartphone app registered the button press, whereas tailored SMS text messages encouraged habit formation and systems thinking on the basis of the timing the medications were taken. METHODS: A convenience sample of 5 adults with chronic kidney disease (CKD), who were prescribed antihypertensive medication, participated in a 52-day longitudinal study. The study was conducted in 3 phases, with a standard SMS text message sent in phases 1 (study days 1-14) and 3 (study days 46-52) and tailored SMS text messages sent during phase 2 (study days 15-45) in response to participant medication self-tracking. Medication adherence was measured using: (1) the smart button and (2) electronic medication monitoring caps. Concordance between these 2 methods was evaluated using percentage of measurements made on the same day and occurring within ±5 min of one another. Acceptability was evaluated using qualitative feedback from participants. RESULTS: A total of 5 patients with CKD, stages 1-4, were enrolled in the study, with the majority being men (60%), white (80%), and Hispanic/Latino (40%) of middle age (52.6 years, SD 22.49; range 20-70). The mHealth system was successfully initiated in the clinic setting for all enrolled participants. Of the expected 260 data points, 36.5% (n=95) were recorded with the smart button and 76.2% (n=198) with electronic monitoring. Concordant events (n=94), in which events were recorded with both the smart button and electronic monitoring, occurred 47% of the time and 58% of these events occurred within ±5 min of one another. Participant comments suggested SMS text messages were encouraging. CONCLUSIONS: It was feasible to recruit participants in the clinic setting for an mHealth study, and our system was successfully initiated for all enrolled participants. The smart button is an innovative way to self-report adherence data, including date and timing of medication taking, which were not previously available from measures that rely on recall of adherence. Although the selected smart button had poor concordance with electronic monitoring caps, participants were willing to use it to self-track medication adherence, and they found the mHealth system acceptable to use in most cases

In the palm of your hand: supporting rural teacher professional development and practice through the use of mobile phones and other handheld digital devices

Given the huge growth of mobile phone access in Sub Saharan Africa (Minges, 2004) some of the most innovative uses of mobile devices are now to be found in the development context (Economist, 2005). Reviews of the use of mobile technologies point to a range of current and potential development for learning in classrooms, homes and the community (e.g. Naismith et al). This paper draws on the experience of two projects: a large scale project for SMS mediated school administration in Kenya and a small scale research project using eBooks and other digital tools for teacher professional development and practice, carried out in predominantly rural schools in the Eastern Cape, South Africa. This research is set in the wider context of the emerging theory, practice and evaluation of the use of mobile technologies for improving teaching and learning (Leach 2006, Power & Thomas 2006, Traxler & Kukulska-Hulme 2006). The paper considers the potential of currently common mobile phones to aid communication and break down isolation amongst rural teachers and the design, use and evaluation of e-book learning resources on handheld mobile devices, such as current ‘smart-phones’, which the authors anticipate will soon be the ‘normal’ ubiquitous mobile phone. Whilst there is only a small body of evidence on the application of mobile technologies to teacher learning, impacts on teacher development remain a matter for debate. Findings suggest that given the right conditions, uses of mobile technology can significantly enhance teacher professional learning and practice

UN Global Pulse: Annual Report 2013

Through public-private partnerships, innovative analysis and the development of open-source methodologies, Global Pulse is strengthening public sector capacity to leverage digital Big Data for development and resilience. This report provides a brief overview of advances made during 2013

Earthquake Early Warning and Beyond: Systems Challenges in Smartphone-based Seismic Network

Earthquake Early Warning (EEW) systems can effectively reduce fatalities, injuries, and damages caused by earthquakes. Current EEW systems are mostly based on traditional seismic and geodetic networks, and exist only in a few countries due to the high cost of installing and maintaining such systems. The MyShake system takes a different approach and turns people's smartphones into portable seismic sensors to detect earthquake-like motions. However, to issue EEW messages with high accuracy and low latency in the real world, we need to address a number of challenges related to mobile computing. In this paper, we first summarize our experience building and deploying the MyShake system, then focus on two key challenges for smartphone-based EEW (sensing heterogeneity and user/system dynamics) and some preliminary exploration. We also discuss other challenges and new research directions associated with smartphone-based seismic network.Comment: 6 pages, conference paper, already accepted at hotmobile 201

Emerging Opportunities: Monitoring and Evaluation in a Tech-Enabled World

Various trends are impacting on the field of monitoring and evaluation in the area of international development. Resources have become ever more scarce while expectations for what development assistance should achieve are growing. The search for more efficient systems to measure impact is on. Country governments are also working to improve their own capacities for evaluation, and demand is rising from national and community-based organizations for meaningful participation in the evaluation process as well as for greater voice and more accountability from both aid and development agencies and government.These factors, in addition to greater competition for limited resources in the area of international development, are pushing donors, program participants and evaluators themselves to seek more rigorous – and at the same time flexible – systems to monitor and evaluate development and humanitarian interventions.However, many current approaches to M&E are unable to address the changing structure of development assistance and the increasingly complex environment in which it operates. Operational challenges (for example, limited time, insufficient resources and poor data quality) as well as methodological challenges that impact on the quality and timeliness of evaluation exercises have yet to be fully overcome

Digital Food Marketing to Children and Adolescents: Problematic Practices and Policy Interventions

Examines trends in digital marketing to youth that uses "immersive" techniques, social media, behavioral profiling, location targeting and mobile marketing, and neuroscience methods. Recommends principles for regulating inappropriate advertising to youth