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Mobile Advantage:
 Context and Immediacy in
 Health Information Seeking
            Lisa Gualtieri, PhD, ScM
               Assistant Professor
Dept. of Public Health and Community Medicine
      Tufts University School of Medicine
          Email: l.gualtieri@tufts.edu
             Twitter: @lisagualtieri
Health search is everywhere
• Last night, in J.K. Rowling’s The
  Casual Vacancy, I read…
  – “She navigated away from the
    Parish Council message board and
    dropped into her favorite medical
    website, where she painstakingly
    entered the words "brain" and
    "death" in the search box.
    The suggestions were endless.
    Shirley scrolled through the
    possibilities…”
Agenda
• Past
• Present
  – Focus on what
    mobile devices
    provide health
    seekers
• Future


                     3
Past, present, and future of health
         information seeking behavior
                                     ?
                  “Democratization
                  of location”             Future?
Democratization
of medical                  Present: Look it
information                 up on mobile
                 Past: Look device in waiting
                 it up at   room, elevator,
                 work or at car, walking, etc.
 Distant past: home
 Literature,
 family, friends                                     4
Before looking at mobile health search,
need to ask if people use mobile devices
• 321.7M wireless subscribers in US at end of 2011
  – Penetration of 101%
• Smartphones now outnumber feature phones for
  the first time in the US
• 1 in 8 internet page views are on smartphone or
  tablet, doubling in just a year
  – Comscore 9/12
• Almost impossible to focus only on laptops and
  desktops when considering health information
  seeking
Not only are mobile devices used but
they may eradicate the “digital divide”
• Smartphone ownership in US
  – 49% of Hispanics
  – 47% of African Americans
  – 42% of whites
  – Pew Internet & American Life Project 9/12
Some people are only using mobile devices
 • 34% of US household are wireless only
    – Stephen J. Blumberg, Julian V. Luke, Wireless
      Substitution: Early release of estimates from the
      National Health Interview Survey, July-December
      2011, National Center for Health Statistics, 2012,
      http://www.cdc.gov/nchs/data/nhsr/nhsr061.pdf
 • But one device or many?
Some people are using
         lots of mobile devices
• 40% of US households have 3 or more mobile
  devices in addition to their PCs & TVs
• Differences in
  – Where mobile phones and tablets are used
  – Frequency of use
Where are mobile phones and tablets used?
           Note that doctor’s office isn’t listed!                                                  56%
                        Living room                                                                                              88%
                          Bedroom                                                              53%
                                                                                                                        79%
                              Work                                                           49%
                                                                           35%
                          Outdoors                                                      48%
                                                                       31%
                                Car                                                    45%
                                                                    29%
                             Stores                                              42%
                                                    12%
             Restaurant/coffee shop                                              41%
                                                                        32%
            Other room in my house                                           39%
                                                                        32%
                            Kitchen                                        36%
                                                                                              51%
                              Hotel                                       34%
                                                                                   44%
                          Bathroom                                  30%
                                                                     30%
                    Airport/airplane                                29%
                                                                                 41%
                             Events                               28%                                               mobile
                                                     14%
                        Home office                              26%                                                tablet*
                                                                           35%
                              Other                        18%
                                               9%
                  Train/subway/bus                       18%
                                                       15%
                             School                      17%
                                                       15%
                             Library                  15%
                                                       16%
                              Bank                   13%
                                            6%
          Church or place of worship         6%
                                            6%    Base: 2,116 US online adults who own a mobile phone; Base: 549 US online adults who own a tablet
Source: North American Technographics Telecom And Devices Online Recontact Survey, Q3 2011 (US)
Tablets are used more frequently than smartphones with the exception of
                            daily health content users

                                                               25%                                          24%


                                                               20%                                                        Smartphone
                                                                                                                          Tablet
                                                                               16%
                                                               15%
                                                                                         13%             13%
                                                                                                                        11%
                                                               10%                                  9%
                                                                                                                              8% 8%
                                                                                                                   6%
                                                                                               5%
                                                                 5%


                                                                 0%
                                                                                  Daily        5-6x per 2-4x per   Once a Less than
                                                                                                Week     Week      week    1x per
Source: comScore Custom Research – Jan/Feb 2010 Total n=1191 and Jan 2012 Total n=1033                                      week
How often do you use your device for health purposes?
What do mobile devices
          provide health seekers?
•   Immediacy and access
•   Affinity
•   Multiple methods of input/output
•   Context
Immediacy and access
• 85% of respondents had cell phones
   – 53% of these, or 45% of US adults, had smartphones
   – Cell phone owners
       • 31% look for health or medical information
       • 11% have health apps
       • 9% receive text updates or alerts from doctor or pharmacist
   – Pew 9/12 via Susannah Fox
• Mobile devices may be used immediately after leaving doctor’s
  office, especially with a new diagnosis or prescription
   – Impact on health literacy especially recall and retention
   – Impact on patient-physician communication
       • Could patients listen or ask questions differently due to reliance on search?
What do mobile devices
          provide health seekers?
•   Immediacy and access
•   Affinity
•   Multiple methods of input/output
•   Context
                               More lovable
                               when they’re
                               cute and little
Affinity
• People relate to computers differently than people
   – What about smartphones? Tablets?
• Mobile users have an ongoing intimate and
  personalized relationship with their “digital
  appendage” or “cognitive prosthetic device”
• Do people seek information differently?
   – Searches on mobile devices tend to be about
     private/sensitive conditions: sexually transmitted
     diseases, mental health
• How is use changing?
   – Greater online community use
Top 10 health searches 2011
Web                     Mobile
•   1. Cancer           •   1. Chlamydia
•   2. Diabetes         •   2. Bipolar disorder
•   3. Symptom          •   3. Depression
•   4. Pain             •   4. Smoking/quit smoking
•   5. Weight           •   5. Herpes
•   6. Infection        •   6. Gout
•   7. Virus            •   7. Scabies
•   8. Diet             •   8. Multiple Sclerosis
•   9. Thyroid          •   9. Pregnancy
•   10. Sleep           •   10. Vitamin A

• Healthline Networks
Online research is up in every category with the greatest growth
                       in community support

                                           64%      65%           64%
                                                                                            2010               2012               Largest shift: more people
                                                                                                                                     were seeking online
                                                            55%
                                                                                  54%
                                                                                                                                        communities!
                                                                                                  53%         52%
                                                                           47%
                                                                                            45%
                                                                                                        41%
                                                                                                                          39%
                                                                                                                    33%
                                                                                                                                      32%


                                                                                                                                                  22%
                                                                                                                                15%
                                                                                                                                            10%




Source: comScore Custom Research – Jan/Feb 2010 Total n=1191 and Jan 2012 Total n=1033
What types of health-related information have you looked for online in the last 6 months?
What do mobile devices
          provide health seekers?
•   Immediacy and access
•   Affinity
•   Multiple methods of input/output
•   Context
Methods of input/output
• Input: less typing, fewer spelling mistakes
   – Text: Autocomplete, word suggestions, etc.
   – Voice: “Siri, what is…”
   – QR codes
• Search: many types of mobile search: app and browser
   –   In mobile browser
   –   On mobile website
   –   In app store
   –   In an app
• Output: limitations are screen size and location/privacy
   – Text
   – Images
   – Video
14,000
                     More Mobile Health Access
                                                                                                                      52%
            12,000
                     through Browser than App
Thousands




            10,000




                                                                                                                 59%
             8,000


             6,000


             4,000


             2,000


                -
                     Mar-11   Apr-11 May-11   Jun-11   Jul-11   Aug-11   Sep-11   Oct-11   Nov-11   Dec-11   Jan-12   Feb-12   Mar-12




                      Accessed health information [Application]                   Accessed health information [Browser ]
                                                                        SOURCE: COMSCORE MOBIL LENS, 3 MOS ENDING MARCH 2012
Number of search results viewed on
  smartphone versus computer
What do mobile devices
          provide health seekers?
•   Immediacy and access
•   Affinity
•   Multiple methods of input/output
•   Context
Context
• People are exposed to a wealth of contextual
  information: what they see, hear, feel, remember
  – How do people act on it using their mobile device?
• Multiple devices monitor and record contextual
  information, including sensors and GPS
  – How do weather, location, time of day, blood
    pressure, etc. impact personalization and tailoring?
• Big data and predictive analytics
Sometimes asking questions leads to
 more questions: fighting the Hydra
Some of my questions…
• Do people conduct health searches differently
   –   On smartphones or tablets?
   –   In mobile browsers or mobile websites or app stores or apps?
   –   Using text or voice?
   –   Based on location?
• Are people more or less easily able to locate “helpful”
  information?
• Are there different indicators of quality or reliability?
• How can mobile health search better help people to seek
  information and achieve their health goals?
Near future
• Design for mobile first instead of retrofitting
  health websites into mobile format
• Make smarter smartphones and better integrate
  sensor data
• Learn from strategies used by well-funded retail
  – Use of big data and predictive analytics to provide
    accurate and timely health information
Future
• From digital appendages to… Google glasses
• The ultimate in seamless mobile health search?
• Stay in touch
  – Email: l.gualtieri@tufts.edu
  – Twitter: @lisagualtieri

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Mobile Health Search Lisa Gualtieri APHA12

  • 1. Mobile Advantage: Context and Immediacy in Health Information Seeking Lisa Gualtieri, PhD, ScM Assistant Professor Dept. of Public Health and Community Medicine Tufts University School of Medicine Email: l.gualtieri@tufts.edu Twitter: @lisagualtieri
  • 2. Health search is everywhere • Last night, in J.K. Rowling’s The Casual Vacancy, I read… – “She navigated away from the Parish Council message board and dropped into her favorite medical website, where she painstakingly entered the words "brain" and "death" in the search box. The suggestions were endless. Shirley scrolled through the possibilities…”
  • 3. Agenda • Past • Present – Focus on what mobile devices provide health seekers • Future 3
  • 4. Past, present, and future of health information seeking behavior ? “Democratization of location” Future? Democratization of medical Present: Look it information up on mobile Past: Look device in waiting it up at room, elevator, work or at car, walking, etc. Distant past: home Literature, family, friends 4
  • 5. Before looking at mobile health search, need to ask if people use mobile devices • 321.7M wireless subscribers in US at end of 2011 – Penetration of 101% • Smartphones now outnumber feature phones for the first time in the US • 1 in 8 internet page views are on smartphone or tablet, doubling in just a year – Comscore 9/12 • Almost impossible to focus only on laptops and desktops when considering health information seeking
  • 6. Not only are mobile devices used but they may eradicate the “digital divide” • Smartphone ownership in US – 49% of Hispanics – 47% of African Americans – 42% of whites – Pew Internet & American Life Project 9/12
  • 7. Some people are only using mobile devices • 34% of US household are wireless only – Stephen J. Blumberg, Julian V. Luke, Wireless Substitution: Early release of estimates from the National Health Interview Survey, July-December 2011, National Center for Health Statistics, 2012, http://www.cdc.gov/nchs/data/nhsr/nhsr061.pdf • But one device or many?
  • 8. Some people are using lots of mobile devices • 40% of US households have 3 or more mobile devices in addition to their PCs & TVs • Differences in – Where mobile phones and tablets are used – Frequency of use
  • 9. Where are mobile phones and tablets used? Note that doctor’s office isn’t listed! 56% Living room 88% Bedroom 53% 79% Work 49% 35% Outdoors 48% 31% Car 45% 29% Stores 42% 12% Restaurant/coffee shop 41% 32% Other room in my house 39% 32% Kitchen 36% 51% Hotel 34% 44% Bathroom 30% 30% Airport/airplane 29% 41% Events 28% mobile 14% Home office 26% tablet* 35% Other 18% 9% Train/subway/bus 18% 15% School 17% 15% Library 15% 16% Bank 13% 6% Church or place of worship 6% 6% Base: 2,116 US online adults who own a mobile phone; Base: 549 US online adults who own a tablet Source: North American Technographics Telecom And Devices Online Recontact Survey, Q3 2011 (US)
  • 10. Tablets are used more frequently than smartphones with the exception of daily health content users 25% 24% 20% Smartphone Tablet 16% 15% 13% 13% 11% 10% 9% 8% 8% 6% 5% 5% 0% Daily 5-6x per 2-4x per Once a Less than Week Week week 1x per Source: comScore Custom Research – Jan/Feb 2010 Total n=1191 and Jan 2012 Total n=1033 week How often do you use your device for health purposes?
  • 11. What do mobile devices provide health seekers? • Immediacy and access • Affinity • Multiple methods of input/output • Context
  • 12. Immediacy and access • 85% of respondents had cell phones – 53% of these, or 45% of US adults, had smartphones – Cell phone owners • 31% look for health or medical information • 11% have health apps • 9% receive text updates or alerts from doctor or pharmacist – Pew 9/12 via Susannah Fox • Mobile devices may be used immediately after leaving doctor’s office, especially with a new diagnosis or prescription – Impact on health literacy especially recall and retention – Impact on patient-physician communication • Could patients listen or ask questions differently due to reliance on search?
  • 13. What do mobile devices provide health seekers? • Immediacy and access • Affinity • Multiple methods of input/output • Context More lovable when they’re cute and little
  • 14. Affinity • People relate to computers differently than people – What about smartphones? Tablets? • Mobile users have an ongoing intimate and personalized relationship with their “digital appendage” or “cognitive prosthetic device” • Do people seek information differently? – Searches on mobile devices tend to be about private/sensitive conditions: sexually transmitted diseases, mental health • How is use changing? – Greater online community use
  • 15. Top 10 health searches 2011 Web Mobile • 1. Cancer • 1. Chlamydia • 2. Diabetes • 2. Bipolar disorder • 3. Symptom • 3. Depression • 4. Pain • 4. Smoking/quit smoking • 5. Weight • 5. Herpes • 6. Infection • 6. Gout • 7. Virus • 7. Scabies • 8. Diet • 8. Multiple Sclerosis • 9. Thyroid • 9. Pregnancy • 10. Sleep • 10. Vitamin A • Healthline Networks
  • 16. Online research is up in every category with the greatest growth in community support 64% 65% 64% 2010 2012 Largest shift: more people were seeking online 55% 54% communities! 53% 52% 47% 45% 41% 39% 33% 32% 22% 15% 10% Source: comScore Custom Research – Jan/Feb 2010 Total n=1191 and Jan 2012 Total n=1033 What types of health-related information have you looked for online in the last 6 months?
  • 17. What do mobile devices provide health seekers? • Immediacy and access • Affinity • Multiple methods of input/output • Context
  • 18. Methods of input/output • Input: less typing, fewer spelling mistakes – Text: Autocomplete, word suggestions, etc. – Voice: “Siri, what is…” – QR codes • Search: many types of mobile search: app and browser – In mobile browser – On mobile website – In app store – In an app • Output: limitations are screen size and location/privacy – Text – Images – Video
  • 19. 14,000 More Mobile Health Access 52% 12,000 through Browser than App Thousands 10,000 59% 8,000 6,000 4,000 2,000 - Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 Accessed health information [Application] Accessed health information [Browser ]  SOURCE: COMSCORE MOBIL LENS, 3 MOS ENDING MARCH 2012
  • 20. Number of search results viewed on smartphone versus computer
  • 21. What do mobile devices provide health seekers? • Immediacy and access • Affinity • Multiple methods of input/output • Context
  • 22. Context • People are exposed to a wealth of contextual information: what they see, hear, feel, remember – How do people act on it using their mobile device? • Multiple devices monitor and record contextual information, including sensors and GPS – How do weather, location, time of day, blood pressure, etc. impact personalization and tailoring? • Big data and predictive analytics
  • 23. Sometimes asking questions leads to more questions: fighting the Hydra
  • 24. Some of my questions… • Do people conduct health searches differently – On smartphones or tablets? – In mobile browsers or mobile websites or app stores or apps? – Using text or voice? – Based on location? • Are people more or less easily able to locate “helpful” information? • Are there different indicators of quality or reliability? • How can mobile health search better help people to seek information and achieve their health goals?
  • 25. Near future • Design for mobile first instead of retrofitting health websites into mobile format • Make smarter smartphones and better integrate sensor data • Learn from strategies used by well-funded retail – Use of big data and predictive analytics to provide accurate and timely health information
  • 26. Future • From digital appendages to… Google glasses • The ultimate in seamless mobile health search? • Stay in touch – Email: l.gualtieri@tufts.edu – Twitter: @lisagualtieri

Notas del editor

  1. Monday, October 29, 2012 : 9:10 AM - 9:30 AMMobile devices are changing health search because of the immediacy they provide and their integration of context. With the infiltration of mobile devices into populations who were traditionally less likely to have internet access, increased reach is possible. However, health literacy skills remain an issue as does privacy. Beyond browser-based health searches, mobile devices open a new set of challenges: how consumers locate health apps, learn about the credibility of apps, and if apps incorporate evidence-based guidelines. The talk will address these topics and will place an emphasis on the discussion of how these tools have changed how and when people seek health information.Learning Objectives: 1. Discuss the potential of mobile devices to reach healthcare consumers 2. Explain how context and immediacy offer advantages to healthcare consumers 3. Define the issues in how consumers search for credible and reliable health apps
  2. Beyond individual use
  3. Immediacy
  4. http://www.ctia.org/advocacy/research/index.cfm/aid/10323Country with largest number of subscribers
  5. Digital divide of disparities
  6. Digital divide of disparities
  7. Digital divide of disparities
  8. Mobile users have an ongoing intimate and personalized relationship with their digital appendage and, through it, with otherspeople are more likely to share tablets
  9. http://mobihealthnews.com/15325/top-10-health-searches-from-mobile-devices-in-2011/
  10. Digital divide of disparities
  11. Digital divide of disparities
  12. Digital divide of disparities
  13. Whenever your smartphone does something “smart” it is acting on contextual informationDigital divide of disparitiessmartphones that are smart and better integrated into daily lifeIn the small and in the large
  14. Fighting the Hydra
  15. Charles Duhigg: How Companies Learn your Secrets