Skip to main content

Advertisement

SpringerLink
Log in

mHealth Technology as a Persuasive Tool for Treatment, Care and Management of Persons Living with HIV

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Mobile health (mHealth) technology can be a valuable tool in the management of chronic illnesses, including HIV. Qualitative research methods were used to identify the desired content and features of a mobile app for meeting and improving the healthcare needs of persons living with HIV (PLWH). We conducted six focus group sessions with 50 English-or Spanish-speaking PLWH in New York City. To inform data analysis and to illustrate how mHealth technology can be used as a persuasive strategy for improving the health of PLWH, we integrated Fogg’s functional role triad for computing technology model with the self-determination theory to illustrate how mHealth technology can be used as a persuasive strategy for improving the health of PLWH. Participants suggested several tools for meeting their healthcare needs, including: reminders/alerts, lab results tracking, and notes on health status. mHealth technology can function as a social actor by providing chat boxes/forums, testimonials of lived experiences, and personal outreach. Examples of media that can be used as a persuasive technology include games/virtual rewards, coding of health tasks, and simulations on how to connect with PLWH. Findings from these focus groups can be used to design a mobile app for PLWH that is targeted to meet their healthcare needs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Kumar S, Nilsen W, Pavel M, Srivastava M. Mobile health: revolutionizing healthcare through trans-disciplinary research. Computer. 2013;46(1):28–35.

    Article  Google Scholar 

  2. Estrin D, Sim I. Health care delivery. Open mHealth architecture: an engine for health care innovation. Science. 2010;330(6005):759–60.

    Article  CAS  PubMed  Google Scholar 

  3. Akter S, Ray P. mHealth - an Ultimate Platform to Serve the Unserved. IMIA Yearbook 2010: Biomedical Informatics: Building Capacity Worldwide. 2010;5(1):94–100.

  4. Klasnja P, Pratt W. Healthcare in the pocket: mapping the space of mobile-phone health interventions. J Biomed Inform. 2012;45(1):184–98.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Lenhart A, Hitlin P, Madden M. Teens and Technology: Pew Internet and American Life Project; 2005 [cited 2010 March 28]. Available from: http://www.pewinternet.org/Reports/2005/Teens-and-Technology/06-Communications-Tools-and-Teens/17-Cell-phone-text-messaging-emerges-as-a-formidable-force.aspx?r=1. Accessed 1 Sept 2014.

  6. Smith A. African Americans and Internet Use. Pew Research Center, 2013.

  7. Duggan M. Cell Phone Activities 2013 [updated May 19, 2013]. Available from: http://www.pewinternet.org/2013/09/19/cell-phone-activities-2013/. Accessed 26 Aug 2014.

  8. Centers for Disease Control and Prevention. HIV in the Unites States: At A Glance Atlanta, GA 2013 [cited 2014 June 11]. Available from: http://www.cdc.gov/hiv/statistics/basics/ataglance.html. Accessed 29 Aug 2014.

  9. Remien RH, Mellins CA. Long-term psychosocial challenges for people living with HIV: let’s not forget the individual in our global response to the pandemic. AIDS. 2007;21:S55–63. doi:10.1097/01.aids.0000298104.02356.b3.

    Article  PubMed  Google Scholar 

  10. Center for Disease Control and Prevention (CDC). HIV Among Latinos 2014. Available from: http://www.cdc.gov/hiv/risk/racialEthnic/hispanicLatinos/facts/index.html. Accessed 11 June 2014.

  11. Centers for Disease Control and Prevention (CDC). HIV Among African Americans Atlanta, GA 2014. Available from: http://www.cdc.gov/hiv/risk/racialEthnic/aa/facts/. Accessed 1 Sept 2014.

  12. Hall HI, Song R, Rhodes P, Prejean J, An Q, Lee LM, et al. Estimation of HIV incidence in the United States. JAMA. 2008;300(5):520–9.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  13. Brown W III. New Media Interventions in Youth Sexual Health Promotion and HIV/STI Prevention. Berkley: University of California, Berkeley; 2010.

    Google Scholar 

  14. Tufts KA, Johnson KF, Shepherd JG, Lee J, Ajzoon MSB, Mahan LB, et al. Novel interventions for HIV self-management in African American women: a systematic review of mHealth interventions. J Assoc Nurses AIDS Care. 2014. doi:10.1016/j.jana.2014.08.002.

  15. Kirk GD, Himelhoch SS, Westergaard RP, Beckwith CG. Using mobile health technology to improve HIV care for persons living with HIV and substance abuse. AIDS Res Treat. 2013;2013:194613.

    PubMed Central  PubMed  Google Scholar 

  16. Catalani C, Philbrick W, Hamish F, Mechael P, Israelski D. mHealth for HIV treatment & prevention: a systematic review of the literature. Open AIDS J. 2013;7:17–41.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Horvath T, Azman H, Kennedy GE, Rutherford GW. Mobile phone text messaging for promoting adherence to antiretroviral therapy in patients with HIV infection. Cochrane Database Syst Rev. 2012;3:CD009756.

    PubMed  Google Scholar 

  18. Free C, Phillips G, Galli L, Watson L, Felix L, Edwards P, et al. The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: a systematic review. PLoS Med. 2013;10(1):e1001362.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Pellowski J, Kalichman S. Recent advances (2011-2012) in technology-delivered interventions for people living with HIV. Curr HIV/AIDS Rep. 2012;9(4):326–34.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Muessig KE, Pike EC, Legrand S, Hightow-Weidman LB. Mobile phone applications for the care and prevention of HIV and other sexually transmitted diseases: a review. J Med Internet Res. 2013;15(1):e1.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Ramanathan N, Swendeman D, Comulada WS, Estrin D, Rotheram-Borus MJ. Identifying preferences for mobile health applications for self-monitoring and self-management: focus group findings from HIV-positive persons and young mothers. Int J Med Inform. 2013;82(4):e38–46.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Holstad M, Ofotokun I, Farber E, Logwood S, Hira R. There’s an App for That! Promoting Antiretroviral Medication Adherence in Rural Georgia: The Music for Health Project. J Mob Technol Med. 2013;2(4):18.

    Article  Google Scholar 

  23. Thursky KA, Mahemoff M. User-centered design techniques for a computerised antibiotic decision support system in an intensive care unit. Int J Med Inform. 2007;76(10):760–8.

    Article  PubMed  Google Scholar 

  24. Sayles JN, Hays RD, Sarkisian CA, Mahajan AP, Spritzer KL, Cunningham WE. Development and psychometric assessment of a multidimensional measure of internalized HIV stigma in a sample of HIV-positive adults. AIDS Behav. 2008;12(5):748–58.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Whiddett R, Hunter I, Engelbrecht J, Handy J. Patients’ attitudes towards sharing their health information. Int J Med Inform. 2006;75(7):530–41.

    Article  PubMed  Google Scholar 

  26. Deci EL, Ryan RM. Handbook of self-determination research. Rochester: University Rochester Press; 2002.

    Google Scholar 

  27. Deci el, Ryan RM, editors. A motivational approach to self: integration in personality. Nebraska Symposium on Motivation; 1991.

  28. Deci EL, Ryan RM. Human autonomy. Efficacy, agency, and self-esteem. New york: Springer; 1995. p. 31–49.

    Google Scholar 

  29. Deci EL, Ryan RM. The “What” and “Why” of Goal Pursuits: Human Needs and the Self-Determination of Behavior. Psychol Inq. 2000;11(4):227–68.

    Article  Google Scholar 

  30. Williams GC, McGregor HA, Sharp D, Levesque C, Kouides RW, Ryan RM, et al. Testing a self-determination theory intervention for motivating tobacco cessation: supporting autonomy and competence in a clinical trial. Health Psychol. 2006;25(1):91–101.

    Article  PubMed  Google Scholar 

  31. Friedland J, Renwick R, McColl M. Coping and social support as determinants of quality of life in HIV/AIDS. AIDS Care. 1996;8(1):15–32.

    Article  CAS  PubMed  Google Scholar 

  32. Fogg BJ. Persuasive technology: using computers to change what we think and do. Jonathan G, Jakob N, Stuart C, editors: Science \& Technology Books, San Francisco; 2002.

  33. Strauss A, Corbin J. Basics of qualitative research: techniques and procedures for developing grounded theory. Thousand Oaks: Sage; 1998.

    Google Scholar 

  34. Brown W 3rd, Yen PY, Rojas M, Schnall R. Assessment of the Health IT Usability Evaluation Model (Health-ITUEM) for evaluating mobile health (mHealth) technology. J Biomed Inform. 2013;46(6):1080–7.

    Article  PubMed  Google Scholar 

  35. Sheehan B, Lee Y, Rodriguez M, Tiase V, Schnall R. A comparison of usability factors of four mobile devices for accessing healthcare information by adolescents. Appl Clin Inform. 2012;3(4):356–66.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  36. Winkelman WJ, Leonard KJ, Rossos PG. Patient-perceived usefulness of online electronic medical records: employing grounded theory in the development of information and communication technologies for use by patients living with chronic illness. J Am Med Inform Assoc. 2005;12(3):306–14.

    Article  PubMed Central  PubMed  Google Scholar 

  37. Coiera E. When conversation is better than computation. J Am Med Inform Assoc. 2000;7(3):277–86.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  38. Wantland DJ, Holzemer WL, Moezzi S, Willard SS, Arudo J, Kirksey KM, et al. A randomized controlled trial testing the efficacy of an HIV/AIDS symptom management manual. J Pain Symptom Manag. 2008;36(3):235–46.

    Article  Google Scholar 

  39. Schnall R, Wantland D, Velez O, Cato K, Jia H. Feasibility testing of a web-based symptom self-management system for persons living with HIV. J Assoc Nurses AIDS Care. 2014;25(4):364–71.

    Article  PubMed Central  PubMed  Google Scholar 

  40. Robbins RN, Brown H, Andries Ehlers B, Joska JA, Thomas KG, Rhonda Burgess M, et al. A smartphone app to screen for HIV-related neurocognitive impairment. J Mob Technol Med. 2014;3(1):23–36.

    Article  PubMed Central  PubMed  Google Scholar 

  41. Martínez-Pérez B, de la Torre-Díez I, López-Coronado M, Sainz-De-Abajo B. Comparison of mobile apps for the leading causes of death among different income zones: a review of the literature and app stores. J Med Internet Res. 2014;2(1):e1. doi:10.2196/mhealth.2779.

  42. Lenhart A. Teens and Mobile Phones Over the Past Five Years: Pew Internet Looks Back: Pew Internet and American Life Project; 2009 [cited 2010 March 28]. Available from: http://www.pewinternet.org/Reports/2009/14–Teens-and-Mobile-Phones-Data-Memo/1-Data-Memo/5-How-teens-use-text-messaging.aspx?r=1.

  43. Jackson CS, Gracia JN. Addressing health and health-care disparities: the role of a diverse workforce and the social determinants of health. Public Health Rep. 2014;129(Suppl 2):57–61.

    PubMed Central  PubMed  Google Scholar 

  44. Maguire M. Methods to support human-centred design. Int J Hum Comput Stud. 2001;55(4):587–634.

    Article  Google Scholar 

  45. CDC’s Division of Adolescent and School Health. New York City: Bringing HIV/AIDS Prevention Education into the Spotlight Atlanta, GA, 2008. Available from: http://www.cdc.gov/healthyyouth/stories/pdf/2008/success_08_ny.pdf. Accessed 26 Dec 2011.

  46. New York City Department of Health and Mental Hygiene. AIDS deaths by year pre-1981-2003, New York City. HIV Epidemiology Program, HIV/AIDS Surveillance Statistics 2003. Available from: www.nyc.gov/html/doh/downloads/pdf/ah/surveillance2003_table2.pdf. Accessed 26 Dec 2011.

  47. Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, 2003 (Vol. 15) Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2004. Available from: http://www.cdc.gov/hiv/surveillance/resources/reports/2003report/. Accessed 26 Dec 2011.

  48. New York City Department of Health and Mental Hygiene. HIV/AIDS Information New York 2011. Available from: http://www.nyc.gov/html/doh/html/ah/ah.shtml. Accessed 26 Dec 2011.

Download references

Acknowledgment

This publication was supported by a cooperative agreement between Columbia University School of Nursing and the Centers for Disease Control and Prevention (CDC; 1U01PS00371501; PI: R Schnall). The authors would like to acknowledge Jocelyn Patterson Mosley, Monique Carry and Deborah Gelaude at the Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Prevention Research Branch, Atlanta, GA for their contributions to this project. The findings and conclusions in this report do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Author information

Authors and Affiliations

  1. Columbia University School of Nursing, 617 West 168th Street, New York, NY, 10032, USA

    Rebecca Schnall, Marlene Rojas & Jasmine Travers

  2. Department of Biomedical Informatics and School of Nursing, Columbia University, New York, NY, USA

    Suzanne Bakken

  3. HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, NY, USA

    Alex Carballo-Dieguez

Authors
  1. Rebecca Schnall
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Suzanne Bakken
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marlene Rojas
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jasmine Travers
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alex Carballo-Dieguez
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rebecca Schnall.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Schnall, R., Bakken, S., Rojas, M. et al. mHealth Technology as a Persuasive Tool for Treatment, Care and Management of Persons Living with HIV. AIDS Behav 19 (Suppl 2), 81–89 (2015). https://doi.org/10.1007/s10461-014-0984-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-014-0984-8

Keywords

Search

Navigation