The Present and Promise of mHealth

July 2012

Only 15 percent of people who need drug abuse treatment seek help, in part because it is difficult to take the first step. Responding to this issue, NIDA researchers have developed a computer program that motivates and encourages treatment seeking at a particularly opportune juncture: when an individual is in a primary care physician’s waiting room. Program users enter information on a portable device and receive feedback about health risks related to their drug abuse, along with advice, immediately prior to seeing their physician.

This program, called the Video Doctor, was developed at the University of California, San Francisco, and takes advantage of some of the capabilities that make today’s mobile communications devices immensely powerful tools for health promotion and research. Cell phones, tablet computers, and portable entertainment systems can nonconfrontationally engage individuals on sensitive topics, collect information, make personalized assessments, and deliver appropriate messages virtually anywhere and anytime. The deployment of these devices for health uses—called mHealth—is today a focus of intense activity in the addiction field as well as throughout medicine.

NIDA-funded researchers are devising a variety of mHealth approaches to enhance the reach, potency, and cost-effectiveness of drug abuse prevention and treatment. Some aim to help patients meet common challenges in treatment. Patients might log into one application, for example, in moments of stress or drug cravings. The application would assist the patient through the crisis, perhaps with reminders of skills learned in therapy, with distractions or with calls to supportive friends. Another possible mHealth application would remind patients to take medications. This would maintain the health of many drug abusers, including those with HIV, among whom strict adherence to medication schedules reduces both disease progression and disease transmission.

Among several inventive NIDA-supported mHealth prevention research initiatives, one has patients recording their stress levels in electronic diaries on devices enabled for global positioning. The researchers will use the data to map the contours of risk in the patients’ environments and identify where prevention and treatment resources are needed most. A similar project is testing how well mobile devices can link locations with behaviors related to risk for HIV and other sexually transmitted infections among drug abusers along the United States-Mexico border.

NIDA first entered the field that would become mHealth in 1997, when the Institute supported a project that gave nicotine-dependent individuals hand-held devices to access antismoking messages whenever and wherever they felt a need. Soon after, researchers began using cell phones and interactive voice-response technology to assess relapse risk among crack cocaine abusers. No one at the time of these initial forays could have envisioned the vast potential that mHealth offers today, thanks to astonishing technological advances and the population’s embrace of the devices. Likewise, the mHealth of the future surely will outstrip today’s vision. As in 1997, NIDA is determined to remain in the forefront of these developments, fully exploiting technologies for effective, research-proven applications that reduce drug abuse and its health and social consequences.

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