Mobile Rapid Response Tobacco Surveillance

Thomas R. Kirchner, PhD

Research Investigator

The Steven A. Schroeder Institute for Tobacco Research & Policy Studies

Adjunct Assistant Professor

Johns Hopkins Bloomberg School of Public Health

Adjunct Assistant Professor Georgetown Lombardi Comprehensive Cancer Center

PRESENTED AT: CDC OSH EXPERT PANEL ON RAPID RESPONSE METHODOLOGY

FOR TOBACCO CONTROL SURVEILLANCE CDC OFFICE ON SMOKING AND HEALTH, ATLANTA, GA

JUNE 2, 2011

CTIA, 2010 Year-end Data

Wireless Penetration: US

Source:  Wireless  Substitution:  International Assoc. for the Wireless Telecommunications Industry (CTIA), 2011  

302.9 million active mobile devices ~308.7 million people (+territories) = ~96% US Market Penetration

Average wireless bill = $47.21 Down 95 cents from 2009

Minority Smartphone Preferences

Nielsen, 2011

Minority Feature Preferences

Pew Internet & American Life Mobile Access, 2010

Underserved SMS

PricewaterhouseCoopers HRI Consumer Survey, 2010

%  Adults  living  in  wireless-­‐only  households,  January  2007-­‐June  2010    

Source:  Wireless  Substitution:  Early  Release  of  Estimates  From  the  National  Health  Interview  Survey,  January  -­‐  June  2010    by  Stephen  J.  Blumberg,  Ph.D.,  and  Julian  V.  Luke,  Division  of  Health  Interview  Statistics,  National  Center  for  Health  Statistics    

Wireless Substitution

Ecological Momentary Assessment

•  ~ 2 decades mobile health survey research

EMA 2.0 •  Participant provided device

•  Dynamic Remote Content Management

•  Mixed-mode Integration

•  Ecological (i.e., GIS) Integration •  Remote Sensing (e.g., accelerometer)

Ecological Momentary Intervention

Legacy: Become and EX Mobile (iPhone)

IVR MMS SMS Email GPS

Ecological Momentary “Surveillance”

Prospective Targets

•  Industry?

•  Policy?

•  Advocacy? •  Smoker Attitudes / Beliefs?

•  Tobacco Product Use Patterns?

•  Smoking Initiation and/or Cessation Milestones?

•  Prospective Cohort

•  Large, Representative Samples •  Longitudinal (but not “long”)

•  Iterative •  c.f., Multiphase optimization strategy (MOST)

•  Adaptive

•  c.f., Sequential Multiple Assignment Randomized Trial (SMART)

Rapid Learning Studies

Gulf Oil Spill

Japan

Amazon Mechanical Turk

Opportunities

•  Methodological –  Reach among Priority Populations

–  Prospective, Longitudinal Research Questions

–  Rapid Learning Studies

•  Logistical –  Existing systems lower cost

–  Automation lowers staffing overhead

–  Improved retention / follow-up

•  Collaborative –  Community Outreach

–  Participatory Involvement

Challenges

•  Privacy

•  Platform standards

•  Mobile Usage Fees

•  Mixed-mode effects

•  Reliability / Validity

•  Data Processing

•  Data Analysis

Recommendations

•  National Prospective Cohort

•  Mobile Platform / Device Independent System Development

•  Feature Phone Focus (for now)

•  User Preferences Trump Mode Effects

•  Mobile + GIS Integration