Mobile health apps: The emperor’s new clothes? Dr Brian McMillan, Eamonn Hickey, Dr Mahendra Patel, Dr Caroline Mitchell Background The WHO estimates that.

Slides:



Advertisements
Similar presentations
The Cochrane Library. What is The Cochrane Library? The Cochrane Library offers high-quality evidence for health care decision making
Advertisements

Clinical Expertise Database Sue Watson Head of MedTech Services Health Enterprise East.
Protocol Development.
Evaluating health informatics projects Reasons for and problems of evaluation Objective model Subjective model.
Participation Requirements for a Guideline Panel Co-Chair.
Evaluation Mary Rowlatt MDR Partners. Definition of project evaluation Evaluation focuses on whether the project was effective, achieved its objectives,
Definitions Patient Experience Patient experience at NUH results from a range of activities that all impact upon patient care, access, safety and outcomes.
NICE Guidance and Quality Standard on Patient Experience
Participation Requirements for a Patient Representative.
Implementation of new technologies Dr Keith Cooper Southampton Health Technology Assessments Centre University of Southampton.
A feasibility study to explore patient, clinician and GP decision making of acute recurrent tonsillitis for NATTINA: The NAtional Trial of Tonsillectomy.
Parvaneh Rabiee, Kate Baxter, Gillian Parker and Sylvia Bernard RNIB Research Day 2014: Rehabilitation and social care RNIB, 105 Judd Street, London 20.
Understanding and changing professional practice: the use of behaviour change technique methodology Susan Michie and Robert West Professors of Health Psychology,
Michelle O’Reilly. Quantitative research is outcomes driven Qualitative research is process driven Please offer up your definitions.
Theme 6. Cochrane Reviews: innovative reviews and methodology.
Patient Experiences of Primary Care in Malta Dr Glorianne Bezzina Dr Philip Sciortino.
The process of formulating responses remains
The nature of SDM in mental health Emma Kaminskiy PhD Student Faculty of Health and Social Care.
The ICH E5 Question and Answer Document Status and Content Robert T. O’Neill, Ph.D. Director, Office of Biostatistics, CDER, FDA Presented at the 4th Kitasato-Harvard.
How do nurses use new technologies to inform decision making?
Problem Analysis Intelligence Step 2 - Problem Analysis Developing solutions to complex population nutrition problems (such as obesity or food insecurity)
Evaluation: Inspections, Analytics & Models
Understand your role 1 Standard.
In partnership with E-mental health: Opportunities for efficiency and transformation?
The Nuffield Council on Bioethics Report : The collection, linking and use of data in biomedical research and health care: ethical issues. Martin Richards.
1. Critical appraisal and qualitative research: exploring sensitivity analysis Angela Harden Methods for Research Synthesis Node, ESRC National Centre.
MEDICAL STUDENTS – POTENTIAL CONTRIBUTORS TO SMOKING CESSATION PROVISION: THE ADDED BENEFITS OF THE ONLINE NCSCT TRAINING King’s Undergraduate Medical.
Methods for assessing fidelity and quality of delivery of smoking cessation behavioural support Fabiana Lorencatto, Robert West, Carla Bruguera, & Susan.
Systematic review: the barriers and facilitators for minority ethnic groups in accessing urgent and prehospital care Lincolnshire Community Health Services.
Dr Robert Wilson Consultant in Public Health Medicine 1.
Presenter-Dr. L.Karthiyayini Moderator- Dr. Abhishek Raut
Could the transition to retirement be an opportunity for physical activity promotion? Inka Barnett, Conny Guell, David Ogilvie 24 th January 2012 Institute.
The Audit Process Tahera Chaudry March Clinical audit A quality improvement process that seeks to improve patient care and outcomes through systematic.
A pilot assessment of the impact and resource implications of a 48-hour ward-based stewardship team review on antibiotic use in a tertiary centre Nicola.
Clinical Risk Unit University College London International Perspectives Feedback from the review board Charles Vincent Clinical Risk Unit University College.
Applicability of the AGREE II Instrument in Evaluating the Development Process and Quality of Current National Academy of Clinical Biochemistry Guidelines.
Systematic Reviews.
Elizabeth Kinnucan Bethany Perry Jessica Way.  Practice based on research findings “Evidence based practice provides opportunities for nursing care to.
Evidence-Based Public Health Nancy Allee, MLS, MPH University of Michigan November 6, 2004.
Plymouth Health Community NICE Guidance Implementation Group Workshop Two: Debriding agents and specialist wound care clinics. Pressure ulcer risk assessment.
Results Student Engagement : Students generally found logbooks easy to use and practical in the hospital setting. Purpose : There appeared to be a perceived.
NICE - in evidence based commissioning Gateshead Council Gillian Mathews, Implementation Consultant - North 9 September 2011.
The Nursing Process ASSESSMENT. Nursing Process Dynamic, ongoing Facilitates delivery of organized plan of nursing care Involves 5 parts –Assessment –Diagnosis.
EBP Team Project Jessica Alred, April Dye, Tiffany Scroggins, Leisa Taylor Auburn Montgomery.
For children with speech, language and communication needs A library of evidenced interventions to support professional decision-making.
SINGING FROM THE SAME HYMN SHEET Address to SATS Study Day 29 June 2013 Dr Sue Armstrong.
Research article structure: Where can reporting guidelines help? Iveta Simera The EQUATOR Network workshop 10 October 2012, Freiburg, Germany.
Evidence Based Practice (EBP) Riphah College of Rehabilitation Sciences(RCRS) Riphah International University Islamabad.
HTA Efficient Study Designs Peter Davidson Head of HTA at NETSCC.
MRCGP The Clinical Skills Assessment January 2013.
1 Access to and use of aids to smoking cessation in the UK Robert West University College London Austin, Texas February 2007.
Registration and monitoring compliance Michele Golden Compliance Manager 2 November 2010.
Joanna Briggs Institute Evidence-based Healthcare resources Roger Tritton: Senior Publisher, ProQuest.
Dr Karl Davis Consultant Geriatrician. Public Health Wales All the frameworks highlighted the following six areas as key priorities (although there is.
By Dr Hidayathulla Shaikh. Objectives  At the end of the lecture student should be able to –  Define survey  Mention uses of survey  Discuss types.
Robert West University College London November 2015
An Audit to Determine if Prescribers are Reviewing Antimicrobial Prescriptions Hours After Initiation. Natalie Holman, Emma Cramp, Joy Baruah Hinchingbrooke.
FOLLOW US Suffolk County Council School Nurse messaging service.
Chronic Obstructive Pulmonary Disease in the Wessex CLAHRC -Respiratory Theme Dr Lucy Rigge, Clinical Research Fellow Collaboration for Leadership in Applied.
Investigating obesity related behaviours in friendship networks among the youth: a systemized review Noor Alsayed Dr.Tillal Eldabi Prof.Habin Lee.
score (see methods section, phase 3)
Developing Sustainable Behaviour Change Training
Smartphone Applications to Assist in Medication Adherence
Brriers to healthy lifestyle
Dr Annegret Schneider Research interest:
Extracting large sets of data from systematic reviews:
Unit 7: Instructional Communication and Technology
BeTheChange The Problem BeTheChange Results of the scheme Conclusion
Building Evidence for Technology and Autism
Levels of involvement Consultation Collaboration User control
Presentation transcript:

Mobile health apps: The emperor’s new clothes? Dr Brian McMillan, Eamonn Hickey, Dr Mahendra Patel, Dr Caroline Mitchell Background The WHO estimates that 63% of deaths are a result of lifestyle related diseases, many of which are preventable through the reduction of smoking, physical inactivity, excessive alcohol use, and unhealthy eating 1. The increasing capabilities of mobile phones and tablet devices has seen an explosion in the number of mobile applications (‘apps’), targeting health behaviour change 2. 93% of UK adults have a mobile phone, 61% have a smartphone 3, and 90% of those are in possession of it 24 hours a day 4. Mobile apps are low cost, can be individually tailored in real time to suit the needs of the user and can collect, analyse and relay data back to researchers 5. Of the 2.4 million apps available, over 97,000 are related to health and fitness 6. There is growing evidence for the efficacy of apps in health behaviour change, however, one particular concern is that of quality control 5. The NHS Apps library uses expert peer review to ensure that apps included in the library are relevant to people living in England, use information from a verifiable or trusted source, comply with the Data Protection Act, and are clinically safe 7. In addition to these safeguards, it would be useful to have a quality control process for health behaviour change apps that would enable users and health professionals to ascertain how closely the app developers had considered the NICE behaviour change guidance 9. This study ascertained how the NICE (2014) Behaviour Change Guidance (BCG) could be applied to mobile app health behaviour change interventions. Academic Unit of Primary Medical Care A qualitative analysis of the NICE BCG was conducted in order to ascertain which aspects could be relevant for an app quality assessment process. Suggestions in the guidance were then converted to yes/no questions of relevance to app quality. Health behaviour change intervention apps in the NHS apps library were examined (N=49). Answers to questions extracted from the NICE guidance were entered into a SPSS database, along with other relevant details regarding the apps to be examined, such as; app name, behaviour being targeted, the platform on which the app was available, and cost. Additional questions were added, such as one pertaining to whether or not the app was “Information Standard” certified. Each of the behaviour change apps in the library were then coded into the database, using information that was gleaned from the app description in the library, on the app store, and on any related websites. The individual apps themselves were not installed on any device. Table 1 shows the 9 themes emerging from a qualitative synthesis of the NICE BCG, average % positive responses and average inter-rater agreement. App purpose was usually clear. Overall, under a quarter of apps showed strong evidence of thorough planning & development and one fifth showed evidence of addressing behavioural maintenance and relapse. Few apps demonstrated a focus on usability, and evidence for evaluation of app efficacy was poor. Documentation varied: with a third of questions relating to initial assessment and tailoring answered positively. Under half of questions relating to behaviour change techniques (BCT) were answered positively. Inter-rater agreement was high with the exception of data protection. Table 1: Results from qualitative synthesis of NICE Behaviour Change Guidance ThemeExample question Average % Yes % rater agreement PurposeIs the target behaviour clearly specified? Planning & developmentApp developed in collaboration with target group? UsabilityDoes the app have special features for specific needs? Assessment & TailoringDoes the app assess users motivation to change? BCTDoes the app facilitate access to social support? Maintenance & RelapseDoes the app include techniques to address relapse? EvaluationWill the efficacy of the app be evaluated? DocumentationIs there a publically available manual for the app? Data ProtectionDoes the app comply with data protection standards? Discussion This study represents the first attempt to apply the NICE Behaviour change guidance to mobile apps aimed at health behaviour change. The nine themes that emerged from this study could usefully form the basis of an app quality assessment process. The importance of clarity in the questions posed during this process was evident in the poor level of inter-rater agreement on the issue of data protection. Further exploration of inter-rater disagreements revealed differences in question interpretation. Space limitations have prevented the full range of quality assessment questions being included here but one issue raised by this study pertains to how much weight an app quality evaluation process should place upon independent raters, and how much of the process could be carried out using self-submission by app developers themselves. Conclusions and practice implications This adaption of the NICE guidance could form the basis of a structured approach to health behaviour change app quality assessment. Future work could focus on developing a consensus of expert and user opinion. A database of ‘kite marked’ health behaviour change apps would be valuable not only for users but also for healthcare professionals who could recommend them to patients secure in the knowledge they had been subjected to a rigorous quality assessment process. Methods Results References 1. World Health Organization (2010). Global status report on non communicable diseases. Geneva: World Health Organization. 2. Curtis, K. & Karasouli, E. (2014). An assessment of the potential of health promotion apps to support health behaviour change. Health Psychology Update, 23(2), Ofcom (2014). The Communications Market Report. London: Ofcom. Retrieved November 11, 2014 from 4. Glynn, L. G., Hayes, P. S., Casey, M., Glynn, F., et al. (2014). Effectiveness of a smartphone application to promote physical activity in primary care: the SMART MOVE randomised controlled trial. BJGP, 64(624), Free, C., Phillips, G., Galli, L., Watson, L., Felix, L., Edwards, P., Patel, V., Haines, A. (2013). The Effectiveness of Mobile-Health Technology-Based Health Behaviour Change or Disease Management Interventions for Health Care Consumers: A Systematic Review. PLoS Medicine 10(1): e doi: /journal.pmed Research2guidance. (2013). Mobile health market report : the commercialization of mHealth applications (Vol. 3). Berlin: Research2guidance. 7. NHS Choices Health Apps library. Accessed on 30 November 2014 from; 8. National Institute for Health and Care Excellence (2014). Behaviour Change: individual approaches. London: NICE.