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mmm-Health

By Steve Draper,   Department of Psychology,   University of Glasgow.

Introduction

This page is to hold some pointers or bookmarks for me about a fuzzy but important area, involving the interaction of three things: increasing people's health and well-being; whether action is done by or to the "patient"; exploiting modern gadgets and ICT (information and communications technology). (By "area" I suppose I mean a place with a rough boundary that delimits the scope of a problem. In problem solving, the most limiting step is usually the initial assumptions made by where you draw the boundary of the problem. If you ask whether a vehicle has a big enough fuel tank, you tend to think about enlarging the tank or making the engine more fuel efficient; but not (as railways do) about whether or not to electrify the route so that its trains need no longer carry around a tank, a diesel engine, and a generator with them.)

It's not an established and defined area nor academic discipline, and so is not in any phone directory. You need networking and contacts. This page is my personal node for this.

One general argument (only one of the possible ones) implies that this IS an area, whether it has a name or not:

If we feel like using the tag "mmmHealth", then "m" stands for all of:

But CompSci use "pervasive health"; and some medics use "e-health".

A possible structure for this area

Here is a possible structure for the area: it could be seen as about all possible combinations of 3 (or 4?, 5?) issues:
  1. The aim: medical cure or life enhancement?
    A clinically diagnosable condition should, when possible, be remediated: thus increasing well-being from negative to zero. But the Positive Psychology attitude is that people who are not diagnosably ill can (should) further increase their well-being from zero to plus. (This means reaching almost everybody: how could this be done?)

    Thus while the disease model divides the population into two parts, sick and healthy; the PosPsy view might be taken to divide the population into three: the sick, the normally unhappy, and those with good well-being. A possible argument is that PosPsy operates in and on the second gap, and that it is largely the re-invention of methods for a secular society that will again restore high well-being, but not raise it above those of highly spiritual people.

    A2. Similarly, in considering what samples of people to study, consider samples of all these groups for a given pathology:

    1. The sick: clinically diagnosed
    2. The average in the population ("near zero")
    3. The exceptionally healthy (well above the clinical threshold), because we may be able to learn from them what are the characteristics, and the standard behaviours, from the unusually healthy and robust.

    A3. Another facet of the same issue is whether to "pathologise" the condition, apply a simplistic medical model to the condition, .. i.e label it as abnormal, less than zero. Issues can be framed (or reframed) as one of these:

    But part of this is whether to separate pathologising (recognising a problem as a problem, a pathology) from the distinct question of who is responsible for (and in control of) the solution. Recognising (admitting to yourself) that you have a problem and what its nature is, is not necessarily identical to having control taken away from you. You can't take control of your own issue until you admit to yourself you have one. Then the control issue (see also [B] below) would be about ...

  2. Agency: Active/passive; who takes the initiative?
    (Interventions) The alternative modes of help are:
  3. Time of intervention:
    This is about the time at which the intervention is made, relative to the condition. E.g.
  4. Delivery mode:
    How can each of the things above be delivered?
  5. Types of (mHealth app) intervention: In the overall field of mHealth, there are at least these kinds of app; and anyone working on a given problem has to think which type of intervention / intrusion might be best. To see why this can be important, consider a project to address a kind of social anxiety where people are unhappy with their own behaviour in social situations (a kind of shyness), and discuss it endlessly but unproductively with their friends afterwards (rumination). Should this be addressed by a) major remedial activity away from both the situation and from friends e.g. by mindfulness, CBT style reflection etc. b) By a "coach in the ear" prompting alternative behaviour in the social situation itself. c) By a "coach in the ear" during ruminative discussion with friends to bring it to a halt. Some helplines have a rule to terminate calls after a fixed time, because generally by that time the conersation is becoming repetitive and unproductive.

Individuals I know personally who are related to this

There is not a single area, profession, career structure, or academic discipline for this area. So I'll begin with people, then mention academic areas you could check out.

Siobhan Lynch: positive effects on education

Passport photo First up, Siobhan Lynch has done important work on Mindfulness training and its direct educational (besides well-being) benefits for learners. I have another whole sketchy page on this.

Rohan Gunatillake: Mindfulness, designing apps, and more

photo
  • About Rohan
  • 21awake
  • Buddhify
  • Buddhist geeks
  • Gunatillake, Rohan (2016) This is Happening. Redesigning mindfulness for our very modern lives (Macmillan)
  • NHS Scotland spiritual care division and report

    Some (more) people

    Passport photo First and most important is Claire McCallum   (dcs page).   (SocSci page). She started (Sept. 2014) a PhD funded for this area. Naturally it is fundamentally interdisciplinary.

    photo Passport photo Lucy Gunatillake worked on Ginsberg in the past. She has just completed an MSc project, which I supervised, on whether people's feelings for their personal device affect how effective mHealth-related apps on it are. (Yes, they can. App designers need to take this into account.)

    photo Cara Wilson (←) has just completed an MSc project (which I supervised) that showed that an app delivering CBT (Cognitive Behavioural Therapy) with proven effectiveness for patients also significantly increases well-being in non-clinical users. She is now moving to postgraduate work at QUT (Queensland University of Technology, Brisbane, Queensland, Australia) with Margot Brereton (→); although she is interested in staying in touch. (Requests for the report to: carawilson21 AT gmail.com)

    photo photo

    photo

  • Ginsberg: a project by the Scottish government to help people improve mental wellbeing.     Use for free

    photo Mel McKendrick lives in Glasgow, works in Edinburgh. Her main connection to this page is that in the past, she founded and ran a support group for the families of the mentally ill, and started research in this area before switching PhD topics.   Action on depression.


    Passport photo Mark Charters has experience with mental health first aid (and shares an office with a mad woman, or so she says).


    Academic subjects

    There is not a single discipline for this area. Here are a few academic areas, each with their own angle on it, which you could check out. For these, you can follow links to people or sites to explore further.

    Computer Science (gadgets for this area)

    Passport photo John Rooksby.   Blog   Eurofit project (Social innovation to improve physical activity and sedentary behaviour through elite European football. His part is about the app.s)   Digital health, CSCW, mobile technologies, ...

    Well-being, Positive Psychology

  • The virtual institute at GU for health and well-being. It is virtual because it has no buildings, and no degree programmes. But it does have a long list of interested people.

    Passport photo Cindy Gray (staff page)     ffit project (football fans in training)

  • UK Network for Mindfulness-Based Teacher Training Organisations

    Passport photo Carol Craig's Centre for confidence and well-being in Glasgow

    Passport photo Passport photo
    Video
    Phil Hanlon's Society, Health, and well-being "Afternow" website   Starter video   Papers

    Passport photo Esther Papies works the School of Psychology, in the field of Health Psychology, particularly in connection with cognitions around eating behaviour.   Her Healthy Cognition Lab.

    Positive psychology; and academic courses on it

    Positive psychology is a (or is a wannabe) sub-area of academic psychology. There are a few university courses on it (and doubtless more arriving).

  • General page of mine on PosPsy.
  • My course (final year undergraduate) on PosPsy at University of Glasgow.
  • Tal D. Ben-Shahar's former Harvard course (first year undergraduate) on PosPsy   His current website
  • UC Berkeley's PosPsy course (module). It is free, open to all, but can count for up to 16 credit hours of CPD for professionals such as therapists.
  • Positive psychology center at University of Pennsylvania (Seligman's base)
  • Links to the UPenn course, and to other universities' courses (postgraduate degree programmes)

    Medicine

  • Mindfulness as a cure.
  • Greenspace effects
  • Gadgets to help deliver multiple things: not only mental health but diet etc.
  • Counselling: this tends to publish entirely separately from academic psychology; to be based on practical experience and concerns, and on case studies not experiments. Thus even when tackling exactly the same topic (what is "well-being"), there are two literatures to check.

    Passport photo Chris Williams.

    photo Michael Smith   profile 2

    The staple cures.

    Forty years ago, a friend of mine training to be a GP remarked that all he really needed to know about was: Aspirin, Penicillin, and Valium. These were interventions that were effective, and each addressed a wide range of common problems.

    In this mHealth area, there are two:

    • Physical exercise
    • Mindfulness training / exercises.

    Both these are even safer than aspirin, penicillin and valium; and are continually being shown to be effective for ever more different problems. Consequently, they are more and more attractive to employ: If they don't do you good for one thing, they will for another.

    NHS, university services, volunteer organisations

    The NHS, university services, volunteer organisations etc. have not been slow in starting to look at this area ....

  • NHS Scotland spiritual care division and report
  • Action on depression.
  • Ginsberg: a project by the Scottish government to help people improve mental wellbeing.     Use for free
  • Glasgow University Counselling & Psychological Services
  • Glasgow Association for Mental Health: community based support.
  • Big White Wall - The support network for emotional health [Support]
  • Mindfulness Scotland
  • Everyday Mindfulness Scotland
  • Scottish Recovery Network: to raise awareness of recovery from mental health problems.
  • Techno Wellness Center Encouraging Balance through Activities [preventative]
  • Self-help for depression [self-help]

    Titles: possible titles for this area and web page

    Public approaches to well-being
    Mental improvement for all
    New mass approaches to health and well-being
    The nameless area
    Mass strategies for coping
    Mind improvements (solo and social; medical and hobbyist; community and professional)
    New tactics for mass health
    Mass, mobile, mental well-being.

    Misc. links: still to be placed somewhere in the above sections

  • Mhealth apps, New Scientist 7 Nov 2015. This touches on: evidence that apps work much less well (for depression) than previous studies suggested; that the prompting and human interaction around therapy and/or apps may be a big part of any effectiveness; mass computer analysis of online text can indicate various mental disorders; social networking applied to support for mental disorders.
  • Simon Gilbody has published evidence that CCBT worked much less well for depression than previous studies indicated.
    However it compared GP treatment for depression with that plus one of two CCBT apps: so it doesn't address the effectiveness of an app alone which might save resources by not involving a qualified human in the treatment. It also doesn't show any preference by patients for a human contact, since all had to use the human contact.
  • James Laurie, Ann Blandford (2016) "Making time for mindfulness" International Journal of Medical Informatics Vol.96 pp.38-50 doi:10.1016/j.ijmedinf.2016.02.010 (http://www.sciencedirect.com/science/article/pii/S1386505616300302) [Blandford study on a mindfulness app] Blog comments on it
  • NHS approved mhealth apps     new NHS Health apps library     old NHS Health apps library
  • Notes on mHealth /digital health workshop at GU, 23-4 July 2015.

  • Call for funding proposals on separate evaluation studies on well-being. Deadline 21 Jan. A pot of money for multiple projects collecting evidence about what works with well-being.     Spec. for the new ESRC centre
  • Positive Technology: article about how PosPsy gives Pos Technology.
  • Positive Technology Just a web development company.
  • New project page? Data science for health.
  • New project page? ATUP

  • "NHS game-changers: Rise of the data-empowered patient" also titled "Wearable technology could revolutionise how we monitor health". A New Scientist article (March 2015). It mentions "data analytics" for scanning data collected for other reasons.
  • This article contains:
    'To get to this point, independent trials will be needed to establish the efficiency of each one. "We need to know what the benefits are of the apps and devices," says Lowe, who wants an app-testing equivalent to the randomised clinical trials used to assess drugs.' [ignoring the writer's mistake, where she meant 'efficacy']

    This of course is a relevant perspective for framing projects and contains the crucial distinction between a project on the user interface's issues and one on the end effect on users.

  • NICE blanket approval of CCBT. (Blay Whitby argues that this is madness: just because one bit of software worked in a trial says nothing about whether another bit of software would.)

  • Funding application call for 6 Oct 2015.

  • Alex Stobart alexATmydex.org www.actionondepression.org/

  • Mel/Gary links.

    Student projects contributing

  • Cara Wilson: see above.
  • Lucy Gunatillake: see above.
  • Hannah Lyall: has shown that exam anxiety can be improved by use of Mindfulness apps (significant pre/post improvement on exam anxiety scale).

    Passport photo Amy McDonald is the chief person in Headtorch: e-learning training for improving attitudes and behaviour at work towards mental health.

  • "Study Protocol on Ecological Momentary Assessment of Health-Related Quality of Life Using a Smartphone Application" Frontiers in psychology doi:10.3389/fpsyg.2016.01086

  • PhD studentships related to digital health, deadline 20 Jan 2017: PhD studentships   related details
    Horizontal menus
    More refs: to ESRC, EPSRC programmes, more NHS ...
    

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