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AndWellness: An Open Mobile System for Activity and Experience Sampling
Advances in technology and infrastructure have positioned mobile phones as a convenient platform for real-time assessment of an individuals health and behavior, while offering unprecedented accessibility and affordability to both the producers and the consumers of the data. In this paper we address several of the key challenges that arise in leveraging smartphones for health: designing the complex set of building blocks required for an end-to-end system, motivating participants to sustain engagement in long-lived data collection, and interpreting both the data and the quality of the data collected.We present AndWellness, a mobile to web platform that records, analyzes, and visualizes data from both prompted experience samples entered by the user, as well as continuous streams of data passively collected from sensors onboard the mobile device. In order to address the system design and participation motivation challenges, we have incorporated feedback from hundreds of behavioral and technology researchers, focus group participants, and end-users of the system in an iterative design process. AndWellness additionally includes rich system and user analytics to instrument the act of participation itself and ultimately to contextualize and better understand the factors affecting the quality of collected data over time. We evaluate the usability and feasibility of AndWellness using data from 3 studies with a variety of populations including young moms and recent breast cancer survivors. More than 85% of the diverse set of participants who responded to exit surveys claim they would use AndWellness for further personal behavior discovery
The PREEMPT study - evaluating smartphone-assisted n-of-1 trials in patients with chronic pain: study protocol for a randomized controlled trial.
BackgroundChronic pain is prevalent, costly, and clinically vexatious. Clinicians typically use a trial-and-error approach to treatment selection. Repeated crossover trials in a single patient (n-of-1 trials) may provide greater therapeutic precision. N-of-1 trials are the most direct way to estimate individual treatment effects and are useful in comparing the effectiveness and toxicity of different analgesic regimens. The goal of the PREEMPT study is to test the 'Trialist' mobile health smartphone app, which has been developed to make n-of-1 trials easier to accomplish, and to provide patients and clinicians with tools for individualizing treatments for chronic pain.Methods/designA randomized controlled trial is being conducted to test the feasibility and effectiveness of the Trialist app. A total of 244 participants will be randomized to either the Trialist app intervention group (122 patients) or a usual care control group (122 patients). Patients assigned to the Trialist app will work with their clinicians to set up an n-of-1 trial comparing two pain regimens, selected from a menu of flexible options. The Trialist app provides treatment reminders and collects data entered daily by the patient on pain levels and treatment side effects. Upon completion of the n-of-1 trial, patients review results with their clinicians and develop a long-term treatment plan. The primary study outcome (comparing Trialist to usual care patients) is pain-related interference with daily functioning at 26 weeks.DiscussionTrialist will allow patients and clinicians to conduct personalized n-of-1 trials. In prior studies, n-of-1 trials have been shown to encourage greater patient involvement with care, which has in turn been associated with better health outcomes. mHealth technology implemented using smartphones may offer an efficient means of facilitating n-of-1 trials so that more patients can benefit from this approach.Trial registrationClinicalTrials.gov: NCT02116621 , first registered 15 April 2014