1. Interagency Working Group for mHealth April 6, 2010

2. April 6 th Agenda Mobile Behavioral Change Communication Review of ICT4D Webinar Defining Requirements for mHealth Next Steps (Next meeting is May 12)

3. Selecting Resources on Mobile BCC Over 30 Pubmed articles Over 30 grey resources Distribute resources to Working Group Which are useful and relevant? Instructive > Exhaustive

4. Framing Resources on Mobile BCC for Developing Countries Instructive AspectPublishedGrey Standard of EvidenceHighLow (No/Poor Methodology) GeneralizabilityLow (Developed Countries) High Clear Design/Rationale (Mediators, Moderators) Low (IT and Study Design) Low (Sometimes IT Design) Grey: Feasibility and relevance in developing countries Published: Evaluation method Neither: How select a design for mobile BCC

5. Framing Mobile BCC How to review resources How to design mHealth programs Best practices (standard of evidence? universal?) Best principles (general agreement?) Best questions (a good start)

6. Mobile BCC Framework: What Questions Can You Ask? Outcome Type of Information Message Characteristics Direction & Control Privacy & Context Introduction/Integration Audience Use Format Platform design

7. What Are Your Outcomes? Individual: prevention, self-care, adherence, attendance Interpersonal: partner communication, provider-patient interaction Community: norms, mobilization, social capital Policy: advocacy, organization

8. What Information is Sent? Reminder Education/skills Referral/location Response to information seeking Behavior monitoring Motivation, social support Peer-to-peer outreach Coordination

9. Message Characteristics: Timing? Time of event, intervention gap, or convenience Frequency of event or convenience Sequence of health issue, stage of individual or of campaign

10. Message Characteristics: Specificity? Targeted to group (Meet patient needs) Tailored to individual (My barrier is _____ ) Tailored timing (Before I go to work) Responsive messages (I did/not take my pill…)

11. Message Characteristics: Direction? 1-way (most mass media) 2-way (interactive) Multi-way (social media)

12. Who Initiates and Controls Use? Initiator ▫Push (program driven, e.g. reminder) ▫Pull (demand driven, e.g. information seeking) User Control ▫Event and demand driven ▫Convenient and appropriate timing

13. Is Privacy a Concern? User: Personal privacy- shared phones, stored information, social situation Anonymity – user identity Real and perceived privacy Program: External security Internal/partner controls

14. What is the Context of Communication? Health communication from provider or peer (ad hoc intervention, opportunity) Non-health communication (competing spam) Unhealthy communication (meet sex partners)

15. How Do You Introduce and Integrate Mobile Messages? Registration: active or passive Source: reputation/credibility, brand, perceived Cross-channel, multi-channel, intra-channel Ongoing relationship with user, identification and cultivation of repeat use Reinforce with other program components

16. Do You Know Your Audience/User? Tech access: ownership/access (to phone, credits, connectivity/coverage, power ….consistency, frequency, cost, ease) sharing, intermediaries, amount of phones & cards, phone number turnover Tech use: frequency and types of use (send vs. receive, free vs. paid services) Cultural fit: reasons for phone use, communication counterparts, literacy, gender

17. Which Format Do You Use? Call Voicemail Interactive voice recording IVR SMS Please call me Flash Music Photo Web Video Games

18. What Is the Format’s Capacity? Information (multidimensional) Standalone or reference to other sources (print, IPC, etc.) Personal appeal

19. What Are the Format’s Requirements for Users? Convenience/burden of use Technological (SMS vs. Java vs. video stream) (handset and infrastructure) Cost to user (handsets, credits, intermediary, social cost of borrowing, power, repair)

20. (Lastly) Platform Design Blast SMS SMS to registered users (patients, local leaders) SMS interactive quiz SMS information menu Data collection and tailored response Hotline SMS promotion of hotline SMS Q&A “textline” Interactive voice response (IVR) Peer to peer- SMS/voice Closed user group- SMS/voice Text diary

21. “mFrame” for Mobile BCC: Classify, Brainstorm, Select, Plan

22. Summary of ICT4D Webinar by Carrie Miller & Dina Brick, CRS (other slide deck)

23. Needs Assessment & Requirements Worksheet: developing sound functional requirements Problem or Opportunity Definition Stakeholders Goal / Purpose Needs Assessment Outcomes Goals and objectives Process Objectives Evaluation Criteria Goals & Objectives Who needs to communicate what with whom? Who will pay for the service? What level of support is required?.... Functional Requirements Best Practices are well understood by the NGO / AID sector, but…. …new technical and “productization” considerations are required to enable sustainability & scalability. Could your organizations benefit from this? Would you like to review or provide input to a draft for review at a Working Group meeting?

24. Next Steps Provide resources, start technical group on mobile BCC Conference call on mobile data collection Begin mLearning Online collaboration Next meeting is May 12

25. Interagency Working Group for mHealth Kelly Keisling kkeislin@jhuccp.org

26. mHealth Working Group Principles Frame mHealth within global health strategy Apply public health standards and practices Emphasize appropriate, evidence-based, and scalable approaches in resource-poor settings Build capacity of implementing agencies