Mobile Health & Behavior Research Support at ARL BioComputing (BCF)
Mobile Health (mHealth) is the practice of public health and medicine, supported by mobile devices. Behavioral research and interventions often utilize mHealth components and we see many synergies in developing software tools, potentially with hardware integration, to serve researchers in both areas. The use of technologies to improve health and well-being, such as mobile phones, wearable computers, tablets, and myriad sensors -- along with administrative web applications for management, coordination, and data aggregation -- is a rich area of opportunity where we can advance the state of the art. To that end, BCF has leveraged its technological expertise to partner in innovation with diverse collaborators in public health, nutrition, psychiatry, nursing, pharmacy, and medicine.
Recent mHealth and Behavioral Research Projects
Stealth Health - combatting childhood obesity by exploring new mechanisms to engage youth with messages promoting physical activity and better diet; created initial bulk two-way PriM text messaging system
Recaller Project – mobile to web interfaces for upload of pictures of meals for dietary recall study
Texting for Teens – promoting skin cancer awareness/prevention among youths via text messaging
CADDE – ecological momentary assessment for medically compromised patients
Walk Across Arizona – allowed participants to easily log their steps to website
Healthy is Happy – added opt-in system for sending health oriented text messaging to youths
LIvES – call center and relationship management VoIP web application (with SMS texting capabilities) that is optimized for behavioral research
- EPICKids – an interactive, family focused program to reduce diabetes factors in children.
- Kidenga – a mobile Community Based Disease Detection System which allows us to detect people who have symptoms suggestive of dengue, chikungunya, and Zika
- ASHLine – Arizona Smoker's Help Line call center
Call Center / VoIP Software Features
- Interfaces with Twilio (twilio.com) for VoIP and SMS send/receive functionality – inexpensive, highly scalable, no physical phone line infrastructure required – call from the computer over the internet
- Call schedules:
- automatically created for each participant as participants added
- can vary for intervention versus control
- presented per coach, participant, or aged (easy to distinguish upcoming versus overdue calls)
- All calls recorded and archived for future review and/or coaching evaluation
- Bulk text messaging:
- two-way with easy management of incoming replies
- view conversations by participant
- see PRiM Info Sheet for full list of SMS texting functionality
- Easy to use interfaces allow staff to add and access reference content
- Web-based forms provide for easy creation and management of online surveys
- Integrated dashboard of online forms, reference information, contact history, and call via computer for coaches
- Extensive real-time reporting, import, and export functionality – all data saved and accessible to administrators
- Extensive access control features
- IRB and HIPAA friendly – secure, with protection of Patient Health Information (PHI) a paramount design mandate, separate intake system, uses TSL/SSL (Transport Layer Security/Secure Sockets Layer)
PRiM: Platform for Research integrated Messaging
PRiM is a web-based software suite that allows scientists to easily integrate and manage integration of SMS/text messaging, instant messaging (IM), Twitter and other social media streams into their research projects.
- Low cost: PRiM integrates with the Twilio gateway service. Twilio charges $2 per month for a dedicated phone number and one cent per text message.
- Just one number – and no expensive infrastructure needed for phones/phone lines: text messages will appear to recipients to come from the same number (the one leased from Twilio). Twilio provides the infrastructure so you don’t have to - go for 10 to 100,000 users in a study without additional infrastructure costs.
- Based on the Drupal web application framework: the system can be easily extended with contributed modules from the Drupal ecosystem, or by writing custom modules.
- Participants can be grouped into researcher-defined groups.
- Conversation pages: for each participant, you can view all messages to and from any participant together in "conversation" style.
- It is easy to get data out of the system. Built-in reports will serve most researchers needs, and if necessary, the reports can be easily customized. All reports may be viewed on the included management web site and for CSV (Excel compatible) download.
- Easy web form message sending from web site: messages can be sent to all users of the site, or to all users in a group, through a web form on the management web site.
- Messages can be sent to individual users through a web form. They can be sent immediately or set up for delayed send.
- Easy to manage incoming messages: when users reply to messages, or when they choose to direct a message to the system, this kicks off a useful management action. If the message was directed to another user, then it is recorded and forwarded appropriately. But when the message is meant to go to the system, it is recorded and a notification email is sent to a gmail address. The gmail address can then forward to whomever desired - allowing for multiple recipients, and to easily change recipients with staff attrition. The email sent notifies staff that an incoming message has arrived, and provides handy links to the conversation page for that user (to put the message in context), and to the page for sending a reply back to the user.
- Bulk messaging: pre-defined series of messages intended for a specific group can be set-up in advance, and each message will be sent to all group members at the appropriate pre-determined time for each message.
- IRB and HIPAA friendly – system is easily set-up to ensure participant privacy requirements by including only de-identified data. Alternatively, patient data can be secured by setting up on your own or our secure servers, taking advantage that the system is password-protected, and can work with SSL.
- All messages and associated data (when, from whom, etc) are saved and archived to a MySQL or PostgreSQL database, and a web interface is provided to easily backup the database to any researcher’s computer for future analysis/audits
Future Directions & Opportunities
Future directions depend heavily on what your interests and needs are as our potential research collaborator. We are here to support you in collaborative innovation whatever your mHealth and behavioral research goals. Below are some of the opportunities we see and would be especially excited to work with you on:
Extending SMS messaging to MMS messaging (adding images and other multi-media to text messaging)
SMS-based surveys and forms
Hybrid-mobile and responsive design applications
Advanced call center features
Interactive chat and whiteboards
Social network integration
Video conferencing and the use of video for interacting with subjects
Validation and use of more wearables
Leveraging excitement about the “Internet of Things”
FitBit and other commercial device integration – but focused on exporting the granularity of data truly needed by researchers
Bundling of our platform in SaaS (Software as a Service) and PaaS (Platform as a Service) offerings to support a broader range and larger number of researchers
Exploring RaaS (Research as a Service) possibilities in collaboration with you