Using a Mobile Health Platform for Daily Life Observations of Obese

YouthChristina M. Sabee

Katherine K. Kim

Janelle Charles, Holly Logan, Edmund Nat Ying Young

San Francisco State University

Background and Rationale

Obesity

Low Access to Resources

Depression

12-19: from 5% to 18%

Only 30% of SF 9th

graders achieve all FITNESSGRAM

standards

33% girls and 22% boys felt “sad or hopeless” every day for 2 weeks

Adolescent depression is a risk factor for

obesity

Obesity disproportionately

affects underprivileged

Observations of Daily Living

• What is useful for patients to track about

themselves?

• What is useful for practitioners to learn about

patients’ daily observations?

Challenges for Low-Income Youth

with Obesity and

Anxiety/Depression

• Low income

• Lack of owned computers

• Don’t feel sick or know they have a

condition of concern

• Hospital/Medical model is not relevant

• Lack of tools to reach out from patient to

provider and provider to patient

Reaching Out to Patients and Providers

• What communication methods work best for our

obese and depressed youth?

• How can our providers reach out to and manage

this youth population?

• What are the ideal characteristics for a platform

that tracks ODLs for both patients and providers?

Method

• Focus group interviews with:

o Youth in our target population

o Providers who serve our target population

Findings

Providers and

Patients

Time

TrustTenacity

Time“Everybody wants to serve teens here and all

the providers would like to see more teens . . .

And then to maintain that requires a lot of

staff work. For instance, [medical assistants]

were calling the adolescences to come in for

their annual visits because they don‟t come in.

But that took a lot of their time to follow up

with them. And we haven‟t the resources to

keep it up.”

Time

“maybe like five [minutes], like five, a minute or two at

like each meal or something, but not like a huge

amount of time, like putting in a whole bunch of data

„cause that would get really boring.”

“when I, when I collect the data, I don‟t want any, I

don‟t want any more than like five touches. I don‟t

care about the time, but (laughter) if it takes me like I

have to type in my name and log in information”

Trust

“You know, it‟s a big, particularly the adolescents,

building trust is a big issue. . . . at some point, you

know, you realize what you‟re hearing or what they‟re

reporting is not reality.”

Trust“There‟s the perception that they‟ll be… that their

disapproval may lead to some stern consequence like

being judged against or you know like bad writings on

your medical record you know or lectures or you know

no one wants to make someone else unhappy . . .

you wouldn‟t tell them that, you wouldn‟t be so open

with them because they‟re going to be intimately

disapproving of the things you‟re doing like, “WHAT!!!

That‟s really bad!” Whereas your friends won‟t be as

judgmental, I guess.”

Trust

“I think as long as it‟s, as long as you‟re talking to

someone who‟s closer to your age, it… for me, after

that it doesn‟t really matter where [the information] is

gonna be for the most part as long as you‟re talking to

someone who sort of feels like a friend, someone

closer to your age.”

Tenacity

“Yeah, you know what, ideally what would happen is

that the whole, with these guys and everybody here

knows. The whole health coaching model of having a

health coach come and huddle with me before the

visit. Show me this report we talk about o.k. what‟s the

game plan for the visit so that either before I go into

the room or after I leave the room, that health coach

is there, to sit there and coach the patient. That‟s the

way I would use it.”

Tenacity

“I think the way that they talk to you too because a

lot of the time when I go to the doctor, I feel like I‟m

getting interrogated. Like they go through a list of

everything they need to ask you and I‟m just like

“duh, duh, duh, duh” and I‟m like what about my

feelings (laughter) or like you know what about, how

do I… like kind of check-in on a more personal

level, „cause like having more of a conversation versus

like an interrogation.”

What does it mean?• Health coaches may be invaluable

o More sustainable – less $$

o Teen patients may identify more with health coach

• “Judgment” and Face concerns can impede the

care process

• Use of mobile technology may benefit youth with

obesity and depressiono Needs to be quick and easy

o Needs to be reviewed by a trusted provider (health coach)

o Needs to be digested and reported efficiently