Archive for: May 2011

Games for Health 2011: Play as Written

May 17, 2011, 1:12 AM, Posted by RWJF Blog Team

The 7th annual Pioneer-sponsored Games for Health Conference got underway this morning, with a preconference day that focuses on the intersection of mobile platforms/technologies, videogames and health. (For a real-world example of health videogame work being pursued with an eye towards mobility, check out a project that one of our Health Games Research grantees is working on called Lit2Quit). The main event starts tomorrow and will continue on until Thursday, with hundreds of thought leaders converging in Boston to discuss how to move the field forward.

Games for Health director Ben Sawyer kicked things off this morning, framing this year’s convening as an opportunity to form collaborations that will scale-up the amazing body of work that has been happening over the last several years.  And as more projects come to fruition and consumers begin to engage – and rely upon – technologies like games as tools to manage their day-to-day health, it’s important we start thinking of these technologies as legitimate medical interventions.

To that end, we’re supporting a "What's Your Game Prescription" thought activity where we will ask attendees to fill out game prescriptions that share their visions for how videogames could impact a certain health condition.  This is a chance for those in the health games field to envision a moment in the not so distant future, when some health professional writes you, or someone you care for, a prescription to play a videogame to improve a specific component of your health – be it management of a chronic disease or preventative in nature. It can be for games and functionality that exist now, or ideas yet to be developed.

 By thinking now about a future in which games are actively prescribed, we can be better prepared to identify the right paths, the best targets, and the work that’s needed to make game prescriptions a reality.

The “prescriptions” will be posted at the conference and we will be tweeting highlights of them throughout the week, in addition to posing questions to build on the conversation. You can follow along on Twitter (@pioneerrwjf) or the main conference hashtag #G4H11.  

Building the mHealth Evidence Base

May 13, 2011, 6:04 AM, Posted by RWJF Blog Team

By Brian Quinn, RWJF assistant vice president, Research and Evaluation

Last week at Stanford, innovation guru B.J. Fogg hosted a conference called Mobile Health 2011: What Really Works.  As a new member of the Pioneer team, the conference was a great opportunity to learn more about mHealth and meet some of the key players in the field.  As the title suggests, this year’s conference focused on what we know about how mHealth is changing behavior and improving health outcomes.  Here are three reflections on the conversations that took place during the conference:

  1. There is widespread recognition that mHealth has the potential to change behavior and improve health.  The good news is that we’re starting to develop some evidence that backs up this belief.  But as Eric Hekler said during his presentation, we need to know more. We can’t rest on the basic understanding that if we throw the mHealth kitchen sink at a problem, it can work. We need to learn more about the subtleties of when and where and why and how mHealth works. We also need more research on the long-term effects and sustainability of mHealth technologies on health outcomes. These aren’t trivial issues; they get to the heart of the difference that mHealth can make.
  2. Many speakers at the conference expressed frustration with the medical research community and its focus on the randomized controlled trial (RCT) as the gold standard of research. These criticisms are not new, nor are ones that point out the extremely slow nature of the research process, which can deter learning and innovation. Yet what a lot of mHealth’s RCT critics perhaps don’t realize is that for the last several decades, the health services research community has developed a wide range of observational, quasi-experimental and qualitative research techniques. These rigorous analytical approaches offer a credible alternative to RCTs and are best used in the messy real world situations where mobile technologies live.  Just as Fred Muench pointed out that the mHealth field would be well served to build off the literature on public health messaging, it may also benefit from use of some public health research methods.    
  3. Finally, members of the aforementioned health services research community need to pay more attention to mHealth and get involved in research on the topic. I suspect many health services researchers are unaware of all the activity taking place around mHealth. The truth is that mHealth research should be front and center on their list of research priorities. mHealth offers ample supply of the thing that researchers crave most: data. And because that data is rich and produced in real time, mHealth offers a tremendous opportunity for researchers to explore new issues and analytic methods.

“What really works” is the key question that should be driving all of our work right now, whether you’re a patient or a provider, a funder or a developer. If we really believe that mHealth can transform our ability to lead healthy lives, we need to develop a solid evidence base that helps us advance the field.  RWJF’s Pioneer team is doing more work in this area, sponsoring an mHealth Evidence meeting Aug. 16, along with the National Institutes of Health, the McKesson Foundation, the U.S. Department of Health and Human Services and the National Science Foundation. If you’d like to contribute to developing this critical evidence base, we encourage you to share your knowledge by contributing a whitepaper on the subject and submitting it by May 27. Authors of accepted papers will be invited to attend the mHealth Evidence meeting and will have their travel expenses paid for. 

Time to Evolve Health Care's Gold Standard? Thoughts From 2011 Mobile Health Health Conference

May 9, 2011, 5:25 AM, Posted by Al Shar

What does "works" mean? Like many things that seem superficially simple, the reality is much deeper. When BJ Fogg chose that as his theme and condition for the recent Mobile Health 2011 conference, he set the bar very high. The good news is that at some level the sessions all had an aspect of things working.

But there was some not so good news as well. Many still see Randomized Controlled Trials (RCT) as the universal and exclusive gold standard for evidence.  For a number of reasons, I think that's unfortunate in the mobile health field. First, to be realistic, the time scale for testing an mHealth intervention needs to be short, often on the order of at most 90 days. That will not provide sufficient evidence for dealing with a long term chronic illness where the time scale is measured in years, not days. I believe that many mobile health treatments that work in the short term will not be sustained long term, unless they change – and change is something that is generally not part of an RCT model.

Second, RCTs generally take a long time and require a fixed methodology, something that doesn't make much sense when dealing in a space where the technology is rapidly changing. By the time you can reach a conclusion, the intervention is often obsolete.

Finally, and perhaps most importantly, by its nature, mobile technology generates a large amount of data that can't be well controlled and is generally discarded (or ignored) in an RCT. Medicine may be the only field that I know of where we discard real life data in favor of clean, laboratory controlled measures. Imagine if the manufactures and maintainers of jet engines relied only on controlled tests and ignored measuring the real world wear and tear on an engine. If that were the case, I would certainly fly a lot less.The United States dropped the monetary gold standard in 1933. Isn't it about time that we at least consider the same thing for medicine?

We recognize this, as do others, and an mHealth Evidence meeting that we are cosponsoring with National Institutes of Health, McKesson, Department of Health and Human Services and the National Science Foundation on August 16 is focused on dealing with this directly. I'm happy to say that the response to the call for white papers for the mHealth Evidence workshop was such that the flyers I brought to Mobile Health 2011 were insufficient to meet the demand, and copies had to be made, not once, but twice.

Luckily, there were enough people with whom this resonates.

You can submit a white paper here on our website. If yours is accepted, you will be invited to attend the mHealth Evidence workshop (travel support will be provided).

Hope to see you there!

mHealth Evidence: Call for Whitepapers

May 9, 2011, 3:44 AM, Posted by RWJF Blog Team

Mobile health (mHealth) has the potential to simultaneously reduce the cost of health care and improve our health by encouraging healthy behaviors, providing continuous monitoring to prevent or reduce health problems, reducing acute health care visits, and providing personalized, real-time intervention in the mobile environment. However, traditional methods of evaluation needed to address efficacy and safety in mHealth are not well aligned to the pace of technological development.

 To address this need, we’ve formed a partnership with the McKesson Foundation, the National Science Foundation and the Office of Behavioral and Social Sciences Research at NIH. As part of this partnership, we are issuing a call for white papers on alternative research designs to the traditional randomized control trial that could be applied to mHealth intervention research or in analyses of rich longitudinal data sets that could be applied to analyzing the data obtained from mHealth applications.

Authors of accepted whitepapers will be invited to attend the August 2011 mHealth Evidence Meeting in Bethesda, MD, which will bring together individuals with diverse expertise in data analysis and experimental design to identify innovative methods that can accelerate the evaluation of the efficacy and safety of mHealth technologies. Travel will be reimbursed by the event’s sponsors. Results from the workshop will be used to define the research agenda for evaluation of mobile health technology.

A couple of important dates to keep in mind:

Deadline for submission: May 27 (11:59 EST)

Notification of Invitation: June 10

Complete Self-Tracking Resource Guide (beta) to be Unveiled at Quantified Self Conference

May 4, 2011, 6:08 AM, Posted by RWJF Blog Team

"We use numbers when we want to tune up a car, analyze a chemical reaction, predict the outcome of an election. We use numbers to optimize an assembly line. Why not use numbers on ourselves?" – The New York Times on The Data Driven Life

In so many aspects of our lives, we crave quality information to help us make more informed decisions. In our work, it is essential. In our homes, we can tell you the price of almost everything. Even in our leisure time, we can recite facts and figures on how many homeruns a baseball player has hit or the number of Oscar nominations a film has received.

Yet in perhaps the most important area–our own personal health–Americans seem to have very little information. For example, only 30% of us know our own blood type and less than 20% of older Americans can tell you their blood pressure. If information is king, when it comes to our health most of us are paupers.

Fortunately, a small group of pioneers are developing the tools and technologies that allow us to collect and track a whole host of quantifiable qualities that can provide insight into our health and health-related behaviors—heart rate, mood, footsteps, attention span, body motion, blood pressure and beyond. Their goal is to enablepeople to collect their own data, aggregate and analyze it so that they are empowered to be active stakeholders in their own care and understand how their decisions impact their health. Visionaries like Gary Wolf, co-founder of The Quantified Self, are making personalized metrics easier to track and more meaningful to apply.

At Pioneer, we are intrigued by self-tracking and the quantified self movement, and are eager to explore its potential to transform health and health care. To that end, we will be participating in the first Quantified Self Conference to explore, collect and share ideas and collaborate with those on the cutting edge of this movement—leading users, self-trackers, software developers, business leaders, academics and health practitioners.

At the conference, Gary will also debut a beta version of a complete self-tracking resource guide. Quantified Self and the Institute for the Future (IFTF), through an RWJF Pioneer grant, will work with self-tracking leaders to develop this online guide, which assembles many of the tools people are creating, in order to share evolving strategies with the next generation of self-trackers. According to Pioneer team member and RWJF Chief Technology and Information Officer Steve Downs, "The first wave of quantified self practitioners is largely made up of those with the technical skills to build their own self-tracking tools. The next wave will not have those same skills, so it will be important to make available the tools that have already been built and see how they are adopted."

If these ideas get your brain synapses firing, too, we encourage you to join us at the Conference.  Come rub elbows with cutting-edge thought leaders and explore with us the potential this movement could have on improving your health and the health of our country.