By Dylan Galos
Epidemiology, PhD
I read an article in the New York Times recently about an experiment where an app was used in smartphones to reduce anxiety in patients through gaming. It was an interestingly designed study, but its effect may not have been huge. I have an interest in this intersection between technology and health, and I think something like this has a lot of potential; one potential use cited in the article was to improve the effectiveness of therapy for people who are meeting face-to-face.
Another interesting idea is to reach people who can't (or won't) seek counseling one-on-one. An important barrier to accessing behavioral health services is cost; if someone is uninsured or doesn't have adequate coverage, accessing this can be nearly impossible, regardless of intent. Depending on the funding offered by the government, some places may be able to offer different payment options, but if the clinics aren't receiving strong enough subsidies to help those who can't pay the full price on their own, this point becomes moot. The privacy of having it on a phone and not going to a clinic, can be useful.
Studies like this have a lot of potential. Delivery via a smartphone allows us to reach people more easily. It allows us to be able to follow-up and contact them more often. One important barrier is cost, though; therapy is expensive, but can someone who can't afford therapy afford a smartphone? Maybe, maybe not. I see this type of technology as having huge potential for those of us in public health to deliver interventions, and the research is already developing. For my own interest, the possibility of HIV prevention via smartphone is interesting, but its ethical (and resulting methodological) issues become even more problematic (how many people are willing to give their geolocation and IP address to a study saying they're MSM and documenting their HIV risk behavior?).
I don't think personally, the technology is quite there yet, but studies like this show a great idea for the future of public health reaching an increasingly mobile population. For counseling, it's no substitute for the real thing, but if it can help, I think it's surely useful. With proper planning , methods like this can help a great deal.
It's hard to imagine this conversation at the grocery store. Or maybe it's not hard to imagine at all.
Patient: "Siri, I'm feeling nervous today!"
Siri: "There, there user. On a scale of 1 to 10, with 10 being extremely anxious, and 1 being not anxious at all, how anxious do you feel?"
Maybe it can be recommended with headphones.
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