I had an awesome week at the Africa mHealth Research Institute (AmHRI) workshop held last week in Nairobi. We had an amazing faculty and a group of scholars. It was great spending the week learning and sharing with peers in mhealth research. Below are highlights from the week-long workshop.
Fogarty-National Institutes of Health (Laura Povlich, PhD)
Moi University School of Medicine (Profs. Violet Naanyu; Ann Mwangi; Eunice Kamaara; Juddy Wachira)
Vanderbilt University, School of Medicine (Martin Were,MD MS; Holly Cassell, MPH)
Yale School of Medicine (Saria Hassan, PhD)
Purdue University (Young Kim, PhD; Munirul Haque, MD, PhD)
University of Georgia (Juliet Sekandi, PhD)
Scholars: We were 31 scholars from not-for –profit organizations, academic institutions and technology companies. These included Medic Mobile, Partners in Health, Rwanda, KEMRI, Regional Centre of Excellence for Biomedical Engineering and e-Health, Rwanda, Makerere University, Mbarara University, Intellisoft, Mount Kenya University, University of Bergen, University of Botswana, Africa Health Research Institute, South Africa and Moi University
1. mHealth overview
During this session Martin Were and Young Kim walked us through mHealth innovation and trends between 1992 to present. Types of mHealth Applications in developing country settings as outlined by the mHealth Alliance Evidence Working Group (EWG)
The seven considerations for mHealth interventions which I find very useful to have at the back of our minds as we deploy digital health solutions for CHWs. These include (i) security & privacy , (ii) scalability versus pilotitis, (iii) conformity to health informatics standards, (iv) interoperability and information exchange (v) cost, payer vs. beneficiary (vi) ethics & equity considerations (insert article from Prof. Kamara) and (vii) evidence of impact of mHealth solution. Additionally the use of the BEACON tool to assess a site’s readiness to implement a digital health intervention. https://drive.google.com/drive/u/0/folders/1mpXtbQpjx7HkPsXdgM182iXOrYNSqUeZ
2. Research proposal writing
This session was valuable in providing guidance on writing successful medical research, grant writing tips, publishing the research findings and the NIH grant application process and components. This was very useful as we were working on our on the team science assignment. Please find a link to articles on successful grant writing and acing research aims @chris and @doreen you may find this helpful for other funding opportunities https://drive.google.com/drive/u/0/folders/1kA2BQci9_QKbCTuRX8yccPzld10A9ZQk
I would like to share this quote from Norm Braveman, NIH on grant writing “There is no grantsmanship that will turn a bad idea into a good one, but there are many ways to disguise a good idea.” Additionally Holly Cassell, MPH reminded us that “Good” proposals seldom get funded, but “Excellent” ones have a good chance!
3. Adopting implementation research approaches to evaluate mHealth interventions
I was pleased to see implementation science included in this mHealth workshop @isaacholeman We have often discussed the need to consider implementation research approaches for evaluation of mHealth interventions to classic gold-standard research approaches given the iterative nature of our tools. The focus of this session was on the steps to incorporating implementation science principles as well as theories, frameworks and models we could adopt when evaluating these interventions
Nielsen implementation science framework highlighting the five categories of theories, models and frameworks used in implementation science (https://drive.google.com/drive/u/0/folders/1FHUHHReXJXxCKcUKr2qKFWmd6cDnVHdw)
Susan michie et al. behavior change wheel –a framework used for designing interventions https://drive.google.com/drive/u/0/folders/1FHUHHReXJXxCKcUKr2qKFWmd6cDnVHdw
4. Sensors and machine learning
This was one of the most intuitive sessions for both scholars and faculty. Dr. Young Kim discussed the evolution of smartphones and sensors and how we can leverage on sensors for mHealth. Most smartphone devices have built-in sensors that measure motion, orientation, and various environmental conditions. https://www.linkedin.com/pulse/validity-using-smartphone-sensors-measure-clinical-outcomes-byrom/ .This presentation highlighted 15 smartphone sensors and examples of how these have been used for mHealth i)activity monitoring mHealth ii) Cardiovascular health; iii)Respiratory mHealth (https://www.mayoclinic.org/testsprocedures/spirometry/about/pac-20385201); iv) Ophthalmology (Smartphone-based retinal imaging system) https://www.nature.com/articles/s41598-018-28585-6; v) Hematology (https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3369797) @isaacholeman @marc @derick
IBM Research Africa shared their work on machine learning and specifically the IBM Watson tool and its use in the field of oncology. Indeed they are doing some great work on AI, but would have appreciated hearing how they have deployed this within a real-world settings. I had hoped to learn their experiences deploying the AI tool in LMIC, challenges and the algorithm validation process.
5.Gamification to improve CHW performance
As part of our team science assignment we were to evaluate an innovation leveraging on gamification to change the behavior and improve CHWs performance for HIV testing and counseling in Kenya. Gamification is the use of game elements and game-design in non-game contexts” (Werbach & Hunter, 2012) to engage and motivate people to achieve their goals by providing a whole different user experience. It aims at stimulating people’s motivation in doing an activity by trying to make it rewarding for itself (https://drive.google.com/drive/u/0/folders/1mpXtbQpjx7HkPsXdgM182iXOrYNSqUeZ) Gamification was quite a new term to me prior to this workshop, however, I realized this was something I would engage with day-to-day for example when using Duolingo language app leaderboard
6. Panel discussions with funders
On the final day of the workshop we had a panel discussion with funders (Ministry of Health, Kenya –Research and Innovation (Dr.Joyce Wamishwe rep. Dr. Nzioka), NIH (Laura Povlich), USAID-Washington, DC (Michelle Jones), Vanderbilt (Holly Cassell) on funding opportunities for mHealth research. They shared insights of what funders look for in proposal and shared a list of resources on funding opportunities https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6096297/pdf/main.pdf
NIH is shifting focus to research around new and emerging technologies such
- Combining data science with data-driven technologies (machine and deep learning)
- Leveraging on internet of things
USAID does not provide funding primarily for research but rather for applied research to improve development. Some of the opportunities include THE PEER program, LASER program as well as the women connect challenge. USAID will soon release it’s digital strategy and encourage those in the digital health space to provide feedback.
We will continue to interact with the faculty through the workshop online platform and they have expressed a willingness to work with us on projects, publications and grant writing process @isaacholeman @joshnesbit . They will continually share grant calls and we could leverage on scholars’ expertise and submit joint applications. I would really recommend this course for those interested. We were the first cohort for this workshop and they intend to engage this year’s scholars in subsequent workshops.
We had a couple of scholars who are interested in our work and open-source tools within the CHT and may have already requested for a demo @francesca