Human Behavior with Mobile Health: Smartphone/ Devices, Apps and Cognition

Crossmark: check for updates

Authors

  • Donald M. Hilty Associate Chief of Staff, Mental Health, N. Cal. VA Health Care System, CA 95655, USA
  • Steven Chan Clinical Informatics Fellow, UC San Francisco, Division of Hospital Medicine, CA 94117, USA

DOI:

https://doi.org/10.17140/PCSOJ-4-141

Keywords:

Apps, Behavior, Cognition, Devices, Mobile, Smartphones, Technology

Abstract

Mobile health, telemedicine and other services are considered part of a telehealth or e- health spectrum of care. Mobile health
mental health options (i.e., smartphones/devices and apps) are part of a broader framework of e-mental health options. Technology
usually offers portability for access anytime/anywhere, are relatively inexpensive and have additional features (e.g., context-
aware interventions and sensors with real-time feedback). The evidence-based literature shows that many people have an
openness to technology as a way to engage others, change behaviors and obtain clinical services. Skills/competencies for mobile
health, smartphone/device and app have similarities and differences from in-person and telepsychiatric care. It is suggested that
evidence-based apps be used with an evidence-based approach. Relatively few treatment studies evaluate outcomes for mobile
health, directly compare it to in-person and e-behavioral healthcare or compare new technology-based care options to one another.
Few studies have assessed the cognitive function related to smartphone/device and app use. At least three facets of cognition
that are affected by these technologies: attention, memory and delay of gratification (reward processing). More research is
needed with respect tohealth services delivery models, effectiveness, competency outcomes and how a paradigm shift like mobile
health re-contextualizes digital healthcare.

References

Hilty DM, Chan S, Hwang T, et al. Advances in mobile mental health: Opportunities and implications for spectrum of e-men-tal health services. MHealth. 2017; 21(3): 34. doi: 10.21037/ mhealth.2017.06.02

Tachakra S, Wang XH, Istepanian RS, et al. Mobile e-health: The Review | Volume 4 | Number 2 | unwired evolution of telemedicine. Telemed J E Health. 2003; 9(3): 247-257. doi: 10.1089/153056203322502632

Frydman GJ. Patient-driven research: Rich opportunities and real risks. J Participat Med. 2009.

Institute of Medicine. The Core Competencies Needed for Health Care Professionals. Health Professions Education: A Bridge to Quality. Washington, DC, USA: The National Academies Press, 2003.

Institute of Medicine. Health Professions Education Summit. Health Professions Education: A Bridge to Quality. Washington, DC, USA: The National Academies Press, 2003.

Hilty DM, Chan S, Torous J, et al. New frontiers in healthcare and technology: Internet- and web-based mental options emerge to complement in-person and telepsychiatric care options. J Health Med Informat. 2015; 6: 1-14. doi: 10.4172/2157-7420.1000200

Hilty DM, Ferrer D, Callahan EJ. The effectiveness of telemen-tal health: A 2013 review. Telemed J E Health. 2013; 19(6): 444-454. doi: 10.1089/tmj.2013.0075

Yellowlees PM, Odor A, Iosif AM, et al. Transcultural psychi-atry made simple: Asynchronous telepsychiatry as an approach to providing culturally relevant care. Telemed J E Health. 2013; 19: 1-6. doi: 10.1089/tmj.2012.0077

Silva BMC, Rodrigues JPC, de la Torre I, et al. Mobile-health: A review of current state in 2015. J Biomed Inform. 2015; 56: 265-272. doi: 10.1016/j.jbi.2015.06.003

Laxminarayan S, Istepanian RS. UNWIRED E-MED: The next generation of wireless and internet telemedicine systems. IEEE Trans Inf Technol Biomed. 2000; 4: 189-193.

Istepanian RSH, Lacal J. Emerging mobile communication technologies for health: some imperative notes on m-health. In: Proceedings of the 25th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 1414-1416, 2003; IEEE, USA.

Steinhubl SR, Muse ED, Topol EJ. Can mobile health technol-ogies transform health care? JAMA. 2013; 310: 2395-2396. doi: 10.1001/jama.2013.281078

Lal S, Adair CE. E-mental health: A rapid review of the litera-ture. Psychiatr Serv. 2014; 65: 24-32. doi: 10.1176/appi.ps.201300009

Bert F, Giacometti M, Gualano MR, Smartphones and health promotion: A review of the evidence. J Med Syst. 2014; 38(1): 9995. doi: 10.1007/s10916-013-9995-7

Laranjo L, Arguel A, Neves AL, et al. The influence of social Review | Volume 4 | Number 2 | Hilty DM, et al networking sites on health behavior change: A systematic review and meta-analysis. J Am Med Inform Assoc. 2015; 22: 243-256. doi: 10.1136/amiajnl-2014-002841

Torous J, Chan RS, Yee-Marie Tan S, et al. Patient smartphone ownership and interest in mobile apps to monitor symptoms of mental health conditions: A survey in four geographically distinct psychiatric clinics. JMIR Ment Health. 2014; 1: e5. doi: 10.2196/ mental.4004

Luxton D, Hansen RN, Stanfill K. Mobile app self-care versus in-office care for stress reduction: a cost minimization analysis. J Telemed Telecare. 2014; 20: 431-435. doi: 10.1177/1357633X14555616

Zhao J, Freeman B, Li M. Can mobile phone apps influence people’s health behavior change? An evidence review. J Med Internet Res. 2016; 18(11): e287. doi: 10.2196/jmir.5692

Wilmer HH, Sherman LE, Chein JM. Smartphones and cog-nition: A review of research exploring the links between mobile technology habits and cognitive functioning. Front Psychol. 2017; 8: 605. doi: 10.3389/fpsyg.2017.00605

Egan T. The Eight-Second Attention Span. New York, NY: The New York Times, 2016.

Nikken P, Schols M. How and why parents guide the media use of young children. J Child Fam Stud. 2015; 24(11): 3423-3435. doi: 10.1007/s10826-015-0144-4

Bondaronek P, Alkhaldi G, Slee A, et al. Quality of publicly available physical activity apps: Review and content analysis. JMIR Mhealth Uhealth. 2018; 6(3): e53. doi: 10.2196/mhealth.9069

Ahmed I, Ahmad NS, Ali S, et al. Medication adherence apps: Review and content analysis. JMIR Mhealth Uhealth. 2018; 6(3): e62. doi: 10.2196/mhealth.6432

Badawy SM, Barrera L, Sinno MG, et al. Text messaging and mobile phone apps as interventions to improve adherence in ado-lescents with chronic health conditions: A systematic review. JMIR Mhealth Uhealth. 2017; 5(5): e66. doi: 10.2196/mhealth.7798

Free C, Phillips G, Felix L, et al. The effectiveness of m-health technologies for improving health and health services: A systematic review protocol. BMC Res Notes. 2010; 3: 250. doi: 10.1186/1756- 0500-3-250

Fox S, Duggan M. Tracking for health. Pew Research Center. 2013.

Bauer AM, Rue T, Keppel GA, et al. Use of mobilehealth (mHealth) tools by primary care patients in the WWAMI region practice and research network (WPRN). J Am Board Fam Med. 2014; 27: 780-8. doi: 10.3122/jabfm.2014.06.140108

Hall AK, Cole-Lewis H, Bernhardt JM. Mobile text messaging for health: A systematic review of reviews. Annu Rev Public Health. 2015; 36: 393-415. doi: 10.1146/annurev-publhealth-031914-122855

Lim MS, Wright C, Hellard ME. The medium and the message: Fitting sound health promotion methodology into 160 characters. JMIR Mhealth Uhealth. 2014; 2: e40. doi: 10.2196/mhealth.3888

Honeyman E, Ding H, Varnfield M, et al. Mobile health appli-cations in cardiac care. Interv Cardiol. 2014; 6(2): 227-240.

Odeny TA, Newman M, Bukusi EA, et al. Developing content for a mHealth intervention to promote postpartum retention in prevention of mother-to-child HIV transmission programs and early infant diagnosis of HIV: A qualitative study. PLoS One. 2014; 9: e106383. doi: 10.1371/journal.pone.0106383

Carlson EB, Field NP, Ruzek JI, et al. Advantages and psycho-metric validation of proximal intensive assessments of patient-re-ported outcomes collected in daily life. Qual Life Res. 2016; 25: 507- 516. doi: 10.1007/s11136-015-1170-9

Van Os J, Delespaul P, Barge D, et al. Testing an mHealth mo-mentary assessment routine outcome monitoring application: A focus on restoration of daily life positive mood states. PLoS One. 2014; 9: e115254. doi: 10.1371/journal.pone.0115254

Moskowitz DS, Young SN. Ecological momentary assessment: what it is and why it is a method of the future in clinical psychop-harmacology. J Psychiatry Neurosci. 2006; 31: 13-20.

Torous J, Staples P, Shanahan M, et al. Utilizing a custom ap-plication on personal smartphones to assess PHQ-9 depressive symptoms in patients with major depressive disorder. JMIR Ment Health. 2015; 2(1): e8. doi: 10.2196/mental.3889

Berkman ET, Giuliani NR, Pruitt AK. Comparison of text messaging and paper-and-pencil for ecological momentary assess-ment of food craving and intake. Appetite. 2014; 81: 131-137. doi: 10.1016/j.appet.2014.06.010

Thompson WK, Gershon A, O’Hara R, et al. The prediction of study emergent suicidal ideation in bipolar disorder: A pilot study using ecological momentary assessment data. Bipolar Disord. 2014; 16: 669-677. doi: 10.1111/bdi.12218

Magallón-Neri E, Kirchner-Nebot T, Forns-Santacana M, et al. Ecological momentary assessment with smartphones for measur-ing mental health problems in adolescents. World J Psychiatry. 2016; 6(3): 303-310. doi: 10.5498/wjp.v6.i3.303

Seligman MEP, Tierney J. We aren’t Built to Live in the Moment. New York, NY: The New York Times, 2017.

Hilty DM. Technology and the brain: What can we learn from 45 Hilty DM, et al our life experience, patient care, social media and Internet use? Psy-chol Cogn Sci Open J. 2017; 3(3): 89-93. doi: 10.17140/PCSOJ-3-128

Kahneman D. Thinking, Fast and Slow. New York, NY: Farrar, Straus and Giroux, 2012.

Välimäki M, Anttila K, Anttila M, et al. Web-based interven-tions supporting adolescents and young people with depressive symptoms: Systematic review and meta-analysis. JMIR Mhealth Uhealth. 2017; 5(12): e180. doi: 10.2196/mhealth.8624

Keating SR, McCurry MK. Systematic review of text messag-ing as an intervention for adolescent obesity. J Am Assoc Nurse Pract. 2015; doi: 10.1002/2327-6924.12264

Grist R, Porter J, Stallard P. Mental healthmobile apps for pre-adolescents and adolescents: A systematic review. J Med Internet Res. 2017; 19(5): e176. doi: 10.2196/jmir.7332

Carson NJ, Gansner M, Khang J. Assessment of digital media use in the adolescent psychiatric evaluation. Child Adolesc Psychiatr Clin N Am. 2018; 27: 133-143. doi: 10.1016/j.chc.2017.11.003

Mihajlov M, Vejmelka L. Internet addiction: A review of the first twenty years. Psychiatr Danub. 2017; 29(3): 260-272. doi: 10.24869/psyd.2017.260

Pontes HM. Investigating the differential effects of so-cial networking site addiction and internet gaming disorder on psychological health. J Behav Addict. 2017; 6(4): 601-610. doi: 10.1556/2006.6.2017.075

Van Geel M, Vedder P, Tanilon J. Relationship between peer victimization, cyberbullying, and suicide in children and adoles-cents: a meta-analysis. JAMA Pediatr. 2014; 168(5): 435-442. doi: 10.1001/jamapediatrics.2013.4143

Englander E. Risky business talking with your patients about cyberbullying and sexting. Child Adolesc Psychiatr Clin N Am. 2018; 27(2): 287-305. doi: 10.1016/j.chc.2017.11.010

United States Stop Bullying. Website: https://www.stopbul-lying.gov/cyberbullying/establishing-rules/index.htmlhttps:// www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/ resilience/Pages/Bullying-and-Cyberbullying.aspx. Accessed June 1, 2018.

Saparova D. Motivating, influencing, and persuading patients through personal health records: A scoping review. Perspect Health Inf Manag. 2012; 9: 1f.

Carli V, Hoven CW, Wasserman C, et al. A newly identified group of adolescents at “invisible” risk for psychopathology and suicidal behavior: Findings from SEYLE study. World Psychiatry. 2014;13(1): 78-86. doi: 10.1002/wps.20088 Review | Volume 4 | Number 2 |

Hilty DM, Hwang T, Turvey C. Staying abreast of information in the information age: Digital continuing education and levering technology to stay current for clinical psychiatric practice. Curr Psy-chiat Rep. 2018; 12; 20(3): 15. doi: 10.1007/s11920-018-0878-y

Stothart C, Mitchum A, Yehnert C. The attentional cost of re-ceiving a cell phone notification. J Exp Psychol Hum Percept Perform. 2015; 41(4): 893-897. doi: 10.1037/xhp0000100

Thornton B, Faires A, Robbins M, et al. The mere presence of a cell phone may be distracting: Implications for attention and task performance. Soc Psychol. 2014; 45: 479-488. doi: 10.1027/1864- 9335/a000216

Caird JK, Johnston KA, Willness CR, et al. A meta-analysis of the effects of texting on driving. Accid Anal Prev. 2014; 71: 311-318. doi: 10.1016/j.aap.2014.06.005

Lee YK, Chang CT, Lin Y, et al. The dark side of smart-phone usage: Psychological traits, compulsive behavior and tech-nostress. Comput Hum Behav. 2014; 31: 373-383. doi: 10.1016/j. chb.2013.10.047

Csikszentmihalyi M, Abuhamdeh S. Flow and the Foundations of Positive Psychology. Dordrecht, Netherlands: Springer. 2014.

Ophir E, Nass C, Wagner AD. Cognitive control in media mul-titaskers. Proc Natl Acad Sci U S A. 2009; 106(37): 15583-15587. doi: 10.1073/pnas.0903620106

Monsell S. Task switching. Trends Cogn Sci. 2003; 7(3): 134-140.

Özkul D, Humphreys L. Record and remember: Memory and meaning-making practices through mobile media. Mob Med Com-mun. 2015; 3: 351-365. doi: 10.1177%2F2050157914565846

Barr N, Pennycook G, Stolz JA, et al. The brain in your pocket: Evidence that smartphones are used to supplant thinking. Comput Hum Behav. 2015; 48: 473-480. doi: 10.1016/j.chb.2015.02.029

Henkel LA. Point-and-shoot memories: The influence of taking photos on memory for a museum tour. Psychol Sci. 2013; 25: 396- 402. doi: 10.1177%2F0956797613504438

Lenhart A. Teens, Social Media and Technology Overview 2015. Smartphones Facilitate Shifts in Communication Landscape for Teens. Washington DC, USA: Pew Research Center. 2015.

Alsop R. Instant Gratification & Its Dark Side. Website: http://www.bucknell.edu/communications/bucknell-magazine/ instant-gratification-and-its-dark-side.html. Accessed June 1, 2018.

Katz E, Blumler JG, Gurevitch M. Uses and gratifications re-search. Public Opin Q. 1973; 37: 509-523. Review | Volume 4 | Number 2 | Hilty DM, et al

Wang Z, Tchernev JM. The “Myth” of media multitasking: Reciprocal dynamics of media multitasking, personal needs, and gratifications. J Commun. 2012; 62: 493-513. doi: 10.1111/j.1460- 2466.2012.01641.x

Werner NE, Cades DM, Boehm-Davis DA, et al. What makes us resilient to interruptions? Understanding the role of individual differences in resumption. Presented at: Proceed Human Factors Ergonomics Soc Ann Meeting. Thousand Oaks, CA, 296-300; 2011.

Hilty DM, Belitsky R, Cohen MB, et al. Impact of the informa-tion age residency training: The impact of the generation gap. Acad Psychiatry. 2015; 39(1): 104-107. doi: 10.1007/s40596-014-0196-6

Chan SR, Torous JB, Hinton WL, et al. Psychiatric apps: Patient self-assessment, communication, and potential treatment interven-tions. In: Mucic D, Hilty DM (eds). e-Mental Health. New York, NY: Springer Publishing, 2015; 217-229.

Donker T, Petrie K, Proudfoot J, et al. Smartphones for smarter delivery of mental health programs: A systematic review. J Med In-ternet Res. 2013; 15(11): e247. doi: 10.2196/jmir.2791

Berrouiguet S, Baca-García E, Brandt S, et al. Fundamentals for future mobile-health (mHealth): A systematic review of mobile phone and web-based text messaging in mental health. J Med Internet Res. 2016; 18: e135. doi: 10.1371/journal.pone.0163796

Luxton DD, McCann RA, Bush NE, et al. mHealth for mental health: Integrating smartphone technology in behavioral healthcare. Prof Psychol Res Practice. 2011; 42: 505-512. doi: 10.1037/a0024485

Hilty DM, Yellowlees PM, Parish MB, et al. Telepsychiatry: Effective, evidence-based and at a tipping point in healthcare de-livery. Psychiatr Clin North Am. 2015; 38: 559-592. doi: 10.1016/j. psc.2015.05.006

Bush NE, Skopp N, Smolenski D, et al. Behavioral screening measures delivered with a smartphone app: Psychometric proper-ties and user preference. J Nerv Ment Dis. 2013; 201: 991-995. doi: 10.1097/NMD.0000000000000039

Kauer SD, Mangan C, Sanci L. Do online mental health services improve help-seeking for young people? A systematic review. J Med Internet Res. 2014; 16: e66. doi: 10.2196/jmir.3103

Berger M, Wagner TH, Baker LC. Internet use and stigma-tized illness. Soc Sci Med. 2005; 61: 1821-1827. doi: 10.1016/j. socscimed.2005.03.025

Griffiths KM, Calear AL, Banfield M. Systematic review on internet support groups (ISGs) and depression (1): Do ISGs re-duce depressive symptoms? J Med Internet Res. 2009; 11: e40. doi: 10.2196/jmir.1270

Agyapong VI, Rogers C, Machale S, et al. Factors predicting adherence with psychiatric follow-up appointments for patients as-sessed by the liaison psychiatric team in the emergency department. Int J Psychiatry Med. 2010; 40: 217-228. doi: 10.2190/PM.40.2.g

Gonzalez J, Williams JW, Noël PH, et al. Adherence to mental health treatment in a primary care clinic. J Am Board Fam Pract. 2005; 18: 87-96.

Schrank B, Sibitz I, Unger A, et al. How use patients with schiz-ophrenia the internet: Qualitative study. J Med Internet Res. 2010; 12: e70. doi: 10.2196/jmir.1550

Koivunen M, Välimäki M, Pitkänen A, et al. A preliminary usa-bility evaluation of Web-based portal application for patients with schizophrenia. J Psychiatr Ment Health Nurs. 2007; 14: 462-469. doi: 10.1111/j.1365-2850.2007.01111.x

Depp CA, Moore RC, Perivoliotis D, et al. Technology to assess and support self-management in serious mental illness. Dialogues Clin Neurosci. 2016; 18: 171-183.

Cain AE, Depp CA, Jeste DV. Ecological momentary assess-ment in aging research: A critical review. J Psychiatr Res. 2009; 43: 987-996. doi: 10.1016%2Fj.jpsychires.2009.01.014

Frank JR, Mungroo R, Ahmad Y, et al. Toward a definition of competency-based educationin medicine: A systematic review of published definitions. Med Teach. 2010; 32(8): 631-637. doi: 10.3109/0142159X.2010.500898

Accreditation Council on Graduate Medical Education. Common Program Requirements. Website: https://www.acgme. org/acgmeweb/Portals/0/PFAssets/ProgramRequirements/ CPRs2013.pdf. Accessed June 1, 2018.

Royal College of Physicians and Surgeons, CanMEDS Frame-work. Website: http://www.royalcollege.ca/portal/page/portal/ rc/canmeds/framework. Accessed June 1, 2018. Submit your article to this journal | https://openventio.org/submit-manuscript/ 47 Hilty DM, et al

Hilty DM, Crawford A, Teshima J, et al. A framework for telep-sychiatric training and e-health: Competency-based education, eval-uation and implications. Int Rev Psychiatry. 2015; 27: 569-592. doi: 10.3109/09540261.2015.1091292

Hilty DM, Maheu M, Drude K, et al. Telebehavioral health, tele-mental health, e-therapy and e-health competencies: The need for an interdisciplinary framework. J Tech Behav Sci. 2017. doi: 10.1007/ s41347-017-0036-0

Maheu M, Drude K, Hertlein K, et al. An interdisciplinary framework for telebehavioral health competencies. J Tech Behav Sci. 2018. doi: 10.1007/s41347-017-0038-y

Hilty DM, Zalpuri I, Stubbe D, et al. Social media/networking as part of e-behavioral health and psychiatric education: Compe-tencies, teaching methods,and implications. J Tech Behav Sci.2018. doi: 10.1007/s41347-018-0061-7

Hilty DM, Chan S, Torous J, et al. A competency-based frame-work for psych/behavioral health apps for trainees, faculty, pro-grams and health systems. Acad Psychiat. In Press.

Capon H, Hall W, Fry C, et al. Realising the technological prom-ise of smartphones in addiction research and treatment: An eth-ical review. Int J Drug Policy. 2016; 36: 47-57. doi: 10.1016/j.drug-po.2016.05.013

Istepanaian RSH, Zhang YT. Guest editorial introduction to the special section: 4G health – the long-term evolution of m-health. IEEE Trans Inf Technol Biomed. 2012; 16: 1-5. doi: 10.1109/ TITB.2012.2183269

Bahga A, Madisetti VK. A cloud-based approach for interoper-able electronic health records (EHRs). IEEE J Biomed Health Inform. 2013; 17: 894-906. doi: 10.1109/JBHI.2013.2257818

Pullier MR, Daviss S. A call for a digital health consortium. J Tech Behav Sci. 2017; 1: 16. doi: 10.1007/s41347-017-0011-9 Review | Volume 4 | Number 2 |

Downloads

Published

2018-10-22

How to Cite

Donald M. Hilty, & Steven Chan. (2018). Human Behavior with Mobile Health: Smartphone/ Devices, Apps and Cognition. Psychology and Cognitive Sciences , 4(2), 36–47. https://doi.org/10.17140/PCSOJ-4-141

Similar Articles

<< < 1 2 3 4 > >> 

You may also start an advanced similarity search for this article.