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Edwin D. Boudreaux, PhD. Evaluating Apps. Disclosures. I have consulted for, and own shares of, Polaris Health Directions, a small business that creates e-health interventions . No Polaris programs, or programs sponsored by Polaris’ competitors, are reviewed in this presentation.
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Edwin D. Boudreaux, PhD Evaluating Apps
Disclosures • I have consulted for, and own shares of, Polaris Health Directions, a small business that creates e-health interventions. • No Polaris programs, or programs sponsored by Polaris’ competitors, are reviewed in this presentation.
Objectives • To be familiar with important considerations when evaluating apps. • To learn about rating or evaluation agencies and websites that help to review apps that are publically available. • To evaluate some specific apps related to mood management • To be able to start using at least 1 app on Monday when you return to work
Evaluating Apps: Basics • What is the target behavior, disorder, or symptom? • Standard vs. smartphone • Text only for standard • Android vs. iPhone • What features does the app have? • Information/education • Tracking/Monitoring • Intervention
Evaluating Apps: Dimensions • Usability? • Initial, sustained • Test drive (on computer, download) • Customer driven • # of downloads • User ratings (’s) • Theory based? • Evidence based? • Evidence informed: content rooted in evidence • Empirically supported: high quality clinical trial(s)
“Rating Clearinghouses” • Health On Net – Internet www.hon.ch/ • Consumer Reports • http://news.consumerreports.org/health/2009/10/there-really-is-an-app-for-that-health-interestor-will-be.html • UK National Health Service • http://apps.nhs.uk/ • Academy of Nutrition and Dietetics, Weight Management App Reviews • http://www.eatright.org/Media/content.aspx?id=6442467041
“Rating” Agencies: Happtique • www.happtique.com • http://www.happtique.com/docs/HACP_Certification_Standards.pdf • Ratings done by: http://www.intertek.com/mobile/ • Operability • Privacy • Security • Content
“Rating” Agencies: Happtique • Content • C1. App is based on one or more credible information sources such as an accepted protocol, published guidelines, evidence-based practice, peer-reviewed journal, etc. • C1.01 If recognized source, source is documented • C1.02 If other than recognized source, documentation about how the content was formulated is provided, including relevancy and reliability
Vetting Websites • National Center for telehealth and technology • http://t2health.org/products/mobile-apps • iMedicalApps • http://www.imedicalapps.com/filter/?cat-medical-specialty20=3378
Vetting Websites • Telemental Health Comparisons • http://www.telementalhealthcomparisons.com • Mobihealthnews • http://mobihealthnews.com/research/ • http://mobihealthnews.com/25872/21-types-of-health-apps-the-fda-could-regulate-but-wont/ • ABCT Technology and Behavior SIG • http://www.techandbehavior.com
Vetting Websites • Mhealth Evidence • http://www.mhealthevidence.org/ • WHO’s mTERG and K4Health • http://www.who.int/reproductivehealth/topics/mhealth/mterg/en/index.html • http://www.k4health.org/about-k4health
Mood Management Apps Review • Commercially available • Search iTunes and Google Play • Depression • Anxiety • Compiled top downloaded apps • Chose 5 to complete an in depth eval • 1 Text-based (word of mouth) • 2 iPhone • 2 Android
Mood247 • https://www.mood247.com • Practical mood monitoring text program • Asks for mood rating 1 time a day (0 – 10) • Allows journaling • Must go on-line to see graph • Can share with provider • Patient and provider on-line viewing capabilities • Uses secure http (encrypted), encrypted storage of PHI, only access by Trusted Circle, not shared with commercial vendors
Mood247 (Demo) • https://www.mood247.com/home
T2 Mood Tracker • https://itunes.apple.com/us/app/t2-mood-tracker/id428373825?mt=8 • Track and share mood ratings with provider • Can log notes
T2 Mood Tracker PROS • Intuitive interface • Theory driven (CBT) • Evidence informed • Many features to allow customization of ratings, prompts, access of support • Generates pdf or CSV reports to print or email to provider CONS • Predominately centered on rating and journaling • Difficult to share graphs (multiple steps of saving, then emailing as attachment) • Only available in English • Time investment necessary to get full functionality
Depression CBT Self-Help Guide • http://www.amazon.com/Excel-At-Life-Depression-Self-Help/dp/B007ILDP42/ref=sr_1_1?s=mobile-apps&ie=UTF8&qid=1384195007&sr=1-1&keywords=depression • AKA, Cognitive Diary CBT Self-help • Depression scale (PHQ-9), Diary, CBT related articles, Cognitive Restructuring • Similar app for Worry called Worry Box—Anxiety Self-help: http://www.amazon.com/Excel-At-Life-Box--Anxiety-Self-Help/dp/B0062EV5SO/ref=sr_1_16?s=mobile-apps&ie=UTF8&qid=1384198753&sr=1-16&keywords=depression
Depression CBT Self-Help Guide PROS • Intuitive interface • Theory driven (CBT) • Evidence informed • Links to AchieveMint.com, points/rewards system CONS • Interface aesthetics are a bit crude • Navigation options inconsistent based on the screen you are on • Only available in English • Content heavy • No simple mood tracking option
Digression:AcheiveMint.com • www.achievemint.com • Rewards use of health-related apps with cash
Cognitive Styles CBT Test • https://play.google.com/store/apps/details?id=com.excelatlife.cbttest&hl=en • AKA, Irrational Thinking CBT Test • 110 item test to map cognitive styles, CBT related articles
Cognitive Styles CBT Test PROS • Intuitive interface • Theory driven (CBT) • Evidence informed • Links to Cognitive Diary CBT app CONS • Interface aesthetics are a bit crude • Limited features – “one time app” • Only available in English
eCBT Mood • https://itunes.apple.com/us/app/ecbt-mood/id324060472?mt=8 • Track and share mood ratings with provider • Psychoeducation
eCBT Mood PROS • Intuitive interface • Theory driven (CBT) • Evidence informed • Ratings can be shared with provider, others • Helps to ID and challenge automatic thoughts CONS • Only available in English • Time investment necessary to get full functionality
Positive Activity Jackpot • https://play.google.com/store/apps/details?id=t2.paj&hl=en • Suggestions and monitoring for positive activities, including “random”
Positive Activity Jackpot PROS • Intuitive interface • Complex but easy-to-follow • Theory driven (BT) • Evidence informed (Lewinsohn, Linehan both referenced) • Activities can be done alone, in pairs, or groups (~400 activities) • Can generate activities based on proximity (GPS) • Interconnectity with Facebook and Twitter CONS • Only available in English • Could potentially exhaust realistic options • Time investment necessary to get full functionality
Conclusion • Text based app for standard phone: mood247 • Smartphone app for Android • Easy to use: T2 Moodtracker • More sophisticated: Depression CBT Self-help Guide, Worry Box • Smartphone app for iPhone • Easy to use: T2 Moodtracker • More sophisticated: eCBT Mood