The digital world moves fast. When the digital realm in question is the use of mobile devices, social media, and related technologies in medical research (mHealth), it isn’t always easy for researchers who use these tools to keep pace. And that is why, just a few months after we first highlighted several examples of mHealth projects in a special issue of Bench to Bedside, it’s already time for a quick update.
Two events held last month provided the perfect opportunity. The mHealth Research Affinity Group (RAG) at the Children’s Hospital of Philadelphia held its inaugural mHealth research project showcase Sept. 19. To stimulate dialogue and spark ideas among their peers, teams from CHOP and the University of Pennsylvania put their projects on display and shared progress on a wide range of mobile apps, text-messaging studies, social-media studies, and studies using mobile monitoring of wearable devices. And CHOP’s Recruitment Enhancement Core hosted its second annual half-day “Know Your Community” conference Sept. 21, which focused on connecting with communities and the use of digital tools in both recruitment and conduct of research.
Need an App for That? mHealth Resources Created at CHOP and Penn Find Wider Adoption
Several exhibitors at the mHealth project showcase shared their efforts developing an app or development platform that has found wider use in medicine or research outside of the CHOP and Penn community, while others offered home-grown development services for researchers here. For example:
- The Way to Health platform made multiple appearances at the mHealth Project Showcase. This Penn-developed technology includes a mobile-friendly web-based platform that automates healthy behavior interventions, leverages remote monitoring technology, and capitalizes on behavioral economics principles. The technology is in use in studies assessing text-message reminders for adherence to asthma medication (tracked via a smart sensor on the inhaler), a study of post-operative walking in adults (tracked with a wearable fitness tracker), and the BE in CONTROL study of glycemic control behaviors of youth with Type 1 diabetes. Way to Health continues to take on new projects and studies and is expanding into the clinical realm.
An iPad app for genetic counselors and other clinicians, Proband, got its start as a study tool developed at CHOP by Jeff Miller in the department of Biomedical and Health Informatics for use in genetic research. Proband allows an easy, gesture-based digital translation of the pen-and-paper process of drawing a patient’s genetic pedigree. Based on user requests, the Proband team has developed back-end tools for shared access to data, and they are developing analytical capabilities and integration into electronic health records.
- Pedi Crisis, a mobile app for clinical decision support during pediatric critical events developed at CHOP several years ago, is freely available and is in use worldwide. The CHOP team is continuing to seek funding for ongoing development.
Additionally, at the Know Your Community conference, investigators from Penn shared their teams’ experiences developing mHealth research apps:
- Apple ResearchKit formed the basis for development of an app for studying the rare disease sarcoidosis. Daniel O’Connor, a medical student at the Perelman School of Medicine, discussed his work with Penn principal investigator Misha Rosenbach, MD, to develop an iOS app using the platform, which offered them free, open-source programming code with resources such as consent form templates, surveys, active tasks, and integration with data in Apple’s HealthKit. Individual medical centers generally see too few patients with sarcoidosis to pool data in large numbers, but a mobile app can reach participants across a wide geographical area. When developing with ResearchKit, O’Connor advised that investigators consult with the Institutional Review Board early and that they be flexible in their choices of participant tasks and hosting providers for their data.
- The mHealth service in the Center for Human Phenomic Science in Penn’s Institute for Translational Medicine and Therapeutics offers Android app development and consultation on mHealth study design to members of the Penn and CHOP research community. Project manager Mauricio Novelo demonstrated one of the group’s projects at the mHealth showcase event, focused on surveying patients about their post-operative recovery from neurosurgery. Novelo and Nalaka Gooneratne, MD, also spoke at the Know Your Community conference about considerations for including mHealth tools in research.
Research Rolls Along: Updates on Ongoing mHealth Projects
Among the many exhibitors at the mHealth project showcase were several that we have previously featured here on Cornerstone or in Bench to Bedside. Here is a quick rundown to bring you up to speed on progress in these projects since we last covered them:
- Adolescent and Young Adult HIV projects “iknowUshould2” and “TreatYourSelf”: The iknowUshould2 campaign is making progress in expanding its emphasis on HIV pre-exposure prophylaxis (PReP) for at-risk youth, including information about the medication itself as well as a youth-tailored locator tool to find clinics that offer it. Among other steps and a larger trial, new funding has allowed development of an iOS version of the TreatYourSelf app to begin.
- The AYA STEPS study for self-management of adolescent and young adult cancer survivors recently completed its focus groups to get feedback on the text messages planned for the upcoming clinical trial, insight into teens’ interests and perspectives, and more. Based on this feedback, the team is working on more tailoring of messages and emphasis on personal values that matter to these youth, such as their emerging independence and maturity. Recruitment for the study will begin soon.
- The PRIMM trial to optimize childhood immunization in Ondo State, Nigeria is underway. This randomized controlled trial is designed to determine if customized automated text messages, calls, and email immunization reminders can improve immunization rates at 12 months of life in a rural community. Project leader and CHOP neonatology fellow Osayame Ekhaguere, MBBS, plans to further develop the software to monitor adequacy of child growth in low-resource settings and prompt interventions when needed.
Keep Up with mHealth Research at CHOP
The CHOP mHealth RAG’s next event will feature Christopher Cushing, PhD, of the University of Kansas. Dr. Cushing, an expert on pediatric behavioral eHealth interventions, will deliver a talk Nov. 3 at noon entitled “Precision Medicine: Methods and Measures for Realizing the Potential of mHealth.” Please RSVP here to attend.