AUTHORS

  • Virgil Wong, Health Cognition Technology Researcher, Columbia University
  • Kóan Jeff Baysa, MD, Chief Medical Officer, Medical Avatar LLC
  • Sayantani DasGupta, MD, MPH, Assistant Clinical Professor at NewYork-Presbyterian Hospital/Columbia, Program in Narrative Medicine
  • John Black, PhD, Professor at Columbia University Teachers College, Director of the Institute for Learning Technologies

200462290-001

ABSTRACT

Providers and payers have an urgent financial need for patients to take more responsibility in educating themselves, managing their personal health, and consuming healthcare services. As personal health records (PHR) and patient web portals typically report very low rates of utilization, mHealth is frequently cited as a far more effective solution for teaching and engaging patients.

This article focuses on the process and impact of mHealth education and engagement strategies based on research in narrative medicine and educational psychology. The ability to visually explain complex medical stories has been shown to significantly influence outcomes for both acute and chronic disease patients. Using apps and self-tracking devices, patients can visualize a wide array of changing symptoms over time together with medical record data to help clinicians make more accurate diagnoses and provide better care. Case studies include patients using mHealth applications to prevent adverse health conditions as well as to cope, manage, and overcome catastrophic illnesses.

[pullquote]With the advent of wearable technologies, the patient’s own body is not only the container of health data but a direct mechanism for understanding health.[/pullquote] Each study connects to critical concepts in educational psychology that directly affect how people respond to mHealth technologies. The Transtheoretical Model for Health Behavior Change (Prochaska, 1997) assesses readiness and provides strategies for changing unhealthy lifestyles. Each step in the Transtheoretical Model is designed to develop personalized mental models where patients develop decision-making frameworks for day-to-day choices over many years related to their diet, fitness, or smoking cessation. mHealth predictive analysis tools can project the short and long term effects of these decisions. If the behavior is represented by a digital persona, the Proteus Effect suggests that an individual can learn to conform with that persona. With the advent of wearable technologies in mHealth, the patient’s own body is not only the container of health data but a direct mechanism for understanding his or her own health. Embodied cognition describes how high-level mental constructs and cognitive performance can be shaped physically by the human body.

Key metrics for mHealth narrative and educational psychology strategies are also addressed, including the reduction of misdiagnoses through improved symptom tracking, lower claim costs from health information exchanges, and decreased hospital re-admissions through education and preventive measures.

LIST OF CONTENTS

  • Learning and Engagement Through Narrative Medicine
  • Behavioral, Cognitive, and Constructivist Views of mHealth Learning
  • Transtheoretical Model for Health Behavior Change
  • Personalized Mental Models
  • The Proteus Effect
  • mHealth and Embodied Cognition
  • mHealth Metrics for Education and Engagement
    • Lifestyle Behavior Change
    • Optimization of Patient/Physician Communication
    • Medication and Treatment Compliance
    • Reduction of Preventable Readmissions

SELECTED REFERENCES

Abroms, L. C., Padmanabhan, N., Thaweethai, L., Phillips, T. (2011). iPhone Apps for Smoking Cessation: A Content Analysis, American Journal of Preventive Medicine, 40, 3, 279-285.

Bandura, A. (1998). Health promotion from the perspective of social cognitive theory. Psychology & Health, 13, 4, 623-649.

Fox, J., & Bailenson, J. N. (2009). Virtual self-modeling: The effects of vicarious reinforcement and identification on exercise behaviors. Media Psychology, 12:1–25.

Prochaska, J. O., Velicer, W. F. (1997), The transtheoretical model of health behavior change, American Journal of Health Promotion, 12, 1, 38-48.

Yee, N., Bailenson, J. N., & Ducheneaut, N. (2009). The Proteus effect: Implications of Transformed Digital Self-Representation on Online and Offline Behavior. Communication Research, 36(2), 285-312.