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Lessons for the mHealth HIV Community

By Jeremy Vanderlan, Lead Programmer, and Michelle Samplin-Salgado, New Media Strategist, AIDS.gov

At last week’s mHealth Summit Exit Disclaimer, we had the opportunity to connect with many of our Federal and community partners about how to leverage the mobile web to improve health outcomes (check out the Summit’s YouTube Channel Exit Disclaimer to watch videos of several of the keynotes).

We heard from leading experts, industry leaders, and Federal colleagues over the course of the three-day summit. During the session, “Lessons Learned from Around the Globe Exit Disclaimer”, Patricia Mechael Exit Disclaimer, Director of Strategic Application of Mobile Technology for Public Health at Columbia University Exit Disclaimer summed up many of the lessons learned in her “top 10 list for the mHealth community”. Below is her list followed by some of our AIDS.gov commentary about how it relates to the HIV community.

10. We must unpack the pathways to mobile behavior change and evaluate the impact that mobile technology is really making on health. Let’s answer the question: How are mobile phones changing health-related behavior?
“There was no shortage of good ideas and pilot projects at mHealth but one of the greatest challenges is moving the ones that are successful to scale,” Andrew Wilson, from SAMHSA told us.

9. We need to tease out locally-generated content and focus on local context. We need a down up model, not top down.
Researchers from across the country and around the world presented their findings, including some encouraging findings from Mount Sinai Hospital that showed that texting medication reminders to patients and their caregivers can increase adherence. For the HIV community, we can learn from our colleagues in Virginia Exit Disclaimer and Chicago about using text messaging for HIV-treatment reminders. But it’s also important to remember what works in one place won’t necessarily work in another.

8. Let’s move away from a user-satisfaction focus and evaluate the health outcomes. This is the only way to sustain mHealth programs—create targets and benchmarks at the beginning of program creation.
There were many programs and initiatives that offer subscription-based text messages about topics ranging from sexual health, to prenatal care, to nutrition advice. And while the reach is impressive (Text4Baby Exit Disclaimer has more than 100,000 subscribers!) we know that knowledge does not necessarily translate into sustained behavior change. There are some important efforts underway by the Department of Defense and HRSA to evaluate the program and we look forward to learning from their findings and assessing how we can adapt similar programs with the HIV community.

7. We must be realistic and become practical about what really works/what doesn’t—integrate mobile technology realistically.
At the mHealth Summit, most of the projects and presentations were focused on text messaging, like Text4Baby and HookUp Exit Disclaimer or mobile apps, but the poster presentations Exit Disclaimer (PDF 7.9 MB) ran the gamut from a special device that extends the battery life of your mobile phone to an application to monitor logistics in Zambia. Regardless of the form or function, mobile is about responding to our communities’ needs...realistically and appropriately.

6. Let’s invest in participatory design programs—work with who it will impact. We should invest in local developers, designers.
At AIDS.gov, we have started to do this through our microgrant program and by sharing lessons learned on this blog.

5. Let’s take a systems-thinking approach and think about adjacent fields which will be affected in our programs. We need to avoid single-issue thinking—packaging together services will help.
We were thrilled to announce the mobile version of our HIV Prevention & Service Provider Locator, where you can find local HIV testing, treatment, and service providers from any phone that lets you access the web. We've partnered with SAMHSA, HUD, CDC, HRSA, and others on this innovative tool. And it’s integrated with Google Maps, so you can get walking, biking, and driving directions, too (we’re hoping that Google will eventually enable public transportation directions for others to use, as well).

4. Collaborate don’t compete—it is not about whose app is best—we all need to win and benefit.
The mHealth Summit was an opportunity for us to come together to share best practices. But there is too much happening to cover in three days. It’s important that we stay connected and find more ways to collaborate.

3. Recycle, reuse, and repurpose
This is becoming increasingly important for us at AIDS.gov. We’re working with organizations across the country, like the Global Business Coalition on HIV/AIDS, Malaria, and Tuberculosis Exit Disclaimer to extend the reach our HIV Prevention & Services Locator. It’s about working together, sharing resources, and reaching as many people as possible with HIV information and resources. Mobile is essential for us to reach those most at-risk for HIV.

2. mHealth at scale can only come from a leadership linked to local health priorities, that then link to tools.
The mHealth Summit brought together local, national, and global leaders and we were thrilled that of the few breakout sessions, sexual health and adolescents were two themes that were highlighted. We must not forget that it is about people...which leads us to the number one lesson for the mHealth (and HIV) community:

1. It’s not all about technology—it’s about a state of health and wellbeing. We’re all impacted. Let’s work together.

We are grateful to the Summit leadership Audie Atienza, Scientific Adviser for Technology Partnerships, and Barbara Mittleman, Director, Public-Private Partnership Program, both from the Office of Science Policy at National Institutes of Health for bringing together Federal staff who work on mobile projects to review existing collaborations and discuss areas where we can work together.

And on that note: How can we best work together? How can AIDS.gov use mobile to support your programs? What ideas do you have for using mobile in the HIV community?