R. Craig Lefebvre

Mobile health technology evaluation: the mHealth evidence workshop.

Creative use of new mobile and wearable health information and sensing technologies (mHealth) has the potential to reduce the cost of health care and improve well-being in numerous ways. These applications are being developed in a variety of domains, but rigorous research is needed to examine the potential, as well as the challenges, of utilizing mobile technologies to improve health outcomes. Currently, evidence is sparse for the efficacy of mHealth. Although these technologies may be appealing and seemingly innocuous, research is needed to assess when, where, and for whom mHealth devices, apps, and systems are efficacious. In order to outline an approach to evidence generation in the field of mHealth that would ensure research is conducted on a rigorous empirical and theoretic foundation, on August 16, 2011, researchers gathered for the mHealth Evidence Workshop at NIH. The current paper presents the results of the workshop. Although the discussions at the meeting were cross-cutting, the areas covered can be categorized broadly into three areas: (1) evaluating assessments; (2) evaluating interventions; and (3) reshaping evidence generation using mHealth. This paper brings these concepts together to describe current evaluation standards, discuss future possibilities, and set a grand goal for the emerging field of mHealth research.

Social marketing and nutrition education: Inappropriate or misunderstood?

• The adequacy and appropriateness of social marketing as a model for education in general and nutrition education specifically; • Whether social marketing principles, techniques, or processes are educational in the sense of helping learners become autonomous decision makers; • That marketers and social marketers employ techniques such as focus groups and audience interviews for purposes of analysis and not to create an opportunity for undistorted discourse, real dialogue, or discussion free from constraint or domination; • That social marketing and marketing campaigns are unable to foster intellectual development; • That marketing strives for no level of cognitive mastery by consumers and that marketers seek to promote specific behaviors without consumer understanding; • That the emphasis on marketing in educational settings establishes learners as customers or consumers who are to be served by educators and that educationally such a consumer orientation is unhealthy and ultimately counterproductive; • That marketers convey messages but educators convey meanings, which emerge from a framework of understanding; • That social marketing places the burden for resolving health problems solely on individuals through personal behavior change, in this way ignoring the broad policies and social and economic conditions that help create or sustain those health problems.

Efficacy of an incentive-based community smoking cessation program

Although the number of smokers has declined in recent years, many people remain resistant to traditional smoking cessation programs. Therefore, new and innovative approaches have been attempted. This study describes the application and effects of a community-wide smoking cessation program over three successive years. Smoking cessation rates ranged from 10.6% (CO verified) to 30.1% (self-report) at 1 month, and 17.3% to 24.5% at 1 year follow-up. Analyses revealed that successful quitters were more likely to have heart about the program at work and to have used materials contained in the self-help kit; and were more likely to be married and have a higher average income than either people who attempted to quit or made no attempt. Twelve-month follow-up data were used to classify participants into four new, distinct groups: maintainers, new quitters, relapsers, and nonquitters. Maintainers were more likely to have heard about the program at work and less likely to have become involved at Octoberfest. These programs do reach representative samples of the community. Their results compare favorably to other minimal contact intervention and physician-mediated efforts.

Bringing 5 A Day Consumers into Focus: Qualitative Use of Consumer Research to Guide Strategic Decision Making

Abstract As part of the national 5 A Day for Better Health program, a communication strategy based on a social marketing model was developed to guide the programs media campaign. Using this approach, the campaign focused on consumer wants and needs to help increase the prospects of influencing consumer behavior.The work discussed herein describes how consumer research was used to select and profile a target audience for the national 5 A Day media campaign. It shows how formative consumer research data from multiple sources were integrated to make practical strategic campaign decisions based on the target consumers perspective.