mHealth Research Digest with Mohamed Elawad

Paper based data collection has long been the typical method for research subjects to report data on themselves during clinical trials, such as what they are eating for each meal or any side effects related to a drug.

A problem that often occurs with this method of data collection is that the subjects often record their data after the prescribed times in order to “fill in the blanks.”

This data may be based on “selective memory”, often making it inaccurate and unreliable. A recent paper published in Finland studies the feasibility of using mobile phone diaries to collect data from the subjects of an experimental physical exercise study as a way to avoid the problems encountered with the traditional data collection method and provide a better way for patients to report data on themselves in clinical trials. The new approach was tested in this physical exercise study.

158 menopausal women between the ages of 44 and 63 participated in the a 24-week study. Half were randomly chosen to be put into an intervention group which would be prescribed a regular exercise regime, while the other half were part of the control group. The application program containing the mobile diary was Symbian based and downloaded onto the subjects’ own phones. If the a subject’s own phone was not compatible with the program a phone was offered. The data was sent via the internet (3G or WAP) through a password-protected interface.

The questionnaire provided on the program was required to be to be filled in twice a day; upon waking up in the morning and before retiring to bed. It could not be filled in afterwards. A reminder text would be sent to a subject if she had not been active for 48 hours. There were three types of responses to questions: select yes/no, multiple-choice, and text response. 5 questions would be were asked in the morning and 9 in the evening.

Response rates to the questionnaire were at 74.4% and 69.4% for the morning and evening groups respectively for the intervention group while those of the control were slightly lower.

The System Usability Scale was used in order to measure usability of the mobile phone as a data collection tool as used in this experiment. It was answered by 107 of the participants after the intervention. Usability of the questionnaire scored an average of 75.4 out of 100. In addition, 101 out of 111 participants answering open-ended questions about the questionnaire responded positively.

Some noted that it became “routine” and that it was easy to remember filling in as mobile phones had become part of everyday life. Most participants answered “nothing” when asked what they found negative about using the phone diary. Negative answers included technical issues such as network connection problems while some stated that questions were “monotonous” and some would have liked the option to “explain and add responses.”

The results show that the response rate and usability of the mobile phone diary were good throughout the intervention. The researchers acknowledge that they did not validate their method against another method. Also, among the issues noted were that some of the women had problems assessing the severity of their own symptoms and that some had difficulty answering the questionnaire when not using their own phone. The feasibility of an offline mode when dead zones and network connection problems are encountered should also be looked into.

Overall, using mobile phone diaries to monitor subjects of a study is of benefit to both subjects and researchers and should be further studied and tweaked.

Authors:

Reetta Heinonen, Riitta Luot,Pirjo Lindfors,Clas-Hakan Nygard

Institutions:

  • School of Health Sciences, University of Tampere, Tampere, Finland
  • Institute for Health Promotion Research, Tampere, Finland
  • National Institute for Health and Welfare, Helsinki, Finland

Original Abstract: