In the United States, chronic illnesses such as heart disease, arthritis, diabetes, pain, cancer or asthma are responsible for 75 percent of health care costs. New Mexico State University College of Health and Social Services faculty members have partnered to study how mobile technology can improve health behaviors.
“Our project was to develop and to evaluate an intervention that would help individuals manage their chronic illnesses,” said Kristynia Robinson, associate professor in NMSU’S School of Nursing. “We worked with residents in our county including rural areas and we used promotoras, which are community health workers.”
Robinson is the lead investigator on an Institutional Development Award Program Infrastructure for Clinical and Translational Research (IDeA-CTR) project. Robinson is working with co-investigator Cindy Kratzke, NMSU public health sciences assistant professor, and Beatriz Favela, Southern Area Health Education Center (SoAHEC) program operations director on “Technology Use to Support Behavior Change: A Pilot Study.”
The four-month project examined the impact of chronic disease self-management program workshop outcomes using mobile technology. With minority populations in rural areas having an increased interest in mobile phone usage, mobile messages, applications and texting, the project evaluated whether access to technology can prompt behavior changes.
Through the $50,000 sub-award grant, which was funded from the National Institutes of Health through the Mountain West Research Consortium, local promotoras were trained using iPad air devices. The tablets helped promotoras to communicate with each other and collect data.
“We were testing the feasibility of using technology in a larger program to help outcomes by training promotoras how to use the iPad to enhance communication, to enhance their knowledge of the topics and to communicate with one another,” Robinson said. “We also sent text messages that were specific to the program content and we sent health apps for them to try out.”
Promotoras were trained in early March and the project was completed at the end of June.
The project studied the habits of 81 individuals with an average age of 55.
“When we finished the project, we were pleased to see participants more active and engaged in their health,” Kratzke said. “This is very important to providers because we teach them how to talk to doctors, problem solve, set goals, work with their doctors and follow up afterwards with their doctors. A community-based program is important so that providers can refer their patients to these programs. This program was a six-week program so we covered lots of information.”
During the project, promotoras were sent two text messages and one email message per week.
“There’s a current trend in the National Institutes of Health, Institute of Medicine, different organizations are pushing for individuals to take more responsibility in taking care of themselves and not just rely on their visits to the doctor to remain healthy,” Robinson said. “This is a very important piece to add to the literature to say that these interventions help you get where you want to go.”
A 2012 report on chronic conditions by the Institute of Medicine stressed the need for improved coordinated activities with programs in community-based settings. Community prevention education or disease management programs are vital in rural and underserved communities because of the lack of access to providers. Out of New Mexico’s 33 counties, 26 are considered rural.
“One of the things that was so important about the project is we kept the fidelity of the chronic disease symptom management program, which is offered in Spanish and English by the promotoras,” Robinson said. “We now know that we can capture the attention and help the engagement and activation of individuals in the community to help them take care of themselves.
“We found that the promotoras loved it,” Robinson said. “They absolutely loved it. They felt empowered. They said si se puede (yes we can). We saw a significant increase in interest in the use of technology just by having the participants use the iPad to collect data pre and post. They want to use technology. They want to learn about it.”
Information from NMSU