Innovative Guide for Interventions

One thing common to both Russians and Americans is the ubiquitous cell phone. More than 90% of adults in both countries use this tiny communication gadget. Furthermore, on a typical day, the average person spends 90 minutes on their phone making calls, checking messages, playing games, and surfing the Internet.

As cell phone use continues to grow, so does the interest among healthcare professionals to use  mobile phone capabilities, such as voicemails, text messages, videos, or apps, as tools for collecting or relaying vital healthcare information – an approach that is commonly known as mobile health or mHealth. A prime example of mHealth is the program called Text4Baby, and its Russian equivalent SMSmame, both of which are mobile text message services for promoting maternal and child health. 

However, so far there has been little effort to adapt mHealth approaches to the specific needs of at-risk women. To fill this gap, the Health and Development Foundation (HDF) in Moscow and Stanley Street Treatment and Resources (SSTAR) in Massachusetts joined forces within the framework of the US-Russia Social Expertise Exchange (SEE) to develop an innovative “Roadmap for mHealth Interventions Targeting At-Risk Women.”

SSTAR brought to the table its specialized knowledge of working with the target population, while HDF provided unique expertise acquired through developing and launching SMSmame in Russia. Together, they produced a comprehensive how-to guide for healthcare professionals, social workers, and project managers on using mHealth technologies as behavioral intervention tools to address the health needs of underserved females. Within this target group are women with a history of substance abuse, commercial sex workers, and women preparing to start or who have recently completed prison terms.

“For these [at-risk women], their primary source of information is their cell phone, which is always by their side and allows them to receive personalized information,” explains Elena Dmitrieva, the CEO of the Health and Development Foundation, speaking to the reason behind the project’s focus on mobile technologies. These technologies, which include modes of communication such as text messages, voicemails, and downloadable apps, can be designed to serve at-risk, disadvantaged women. All of this is made possible by the Roadmap, which addresses every step necessary in understanding, developing, applying, and analyzing said mHealth technologies.

“In this manual, we talk extensively about such things, for example, as how to deal with the issue of attracting program subscribers. We also dealt with issues of confidentiality… [and] how to minimize costs. We talk about how to create content, how to test it, and how to achieve its maximal effectiveness,” according to Sergey Frolov, Program Director of the Health and Development Foundation.  

In June of 2014, Nancy Paull, CEO of SSTAR, and Kimberly Johnson, Co-Deputy Director of Network for the Improvement of Addiction Treatment (NIATx) National Program Office, along with Frolov, traveled to St. Petersburg, Russia to make a presentation about the expected positive impact of the Roadmap on services for at-risk women at the “Psychiatry and Addiction Medicine in the 21st Century” conference. “We’re expecting [the Roadmap] to become a day-to-day part of medical services and a component of medical treatment for at-risk patients,” explained Frolov.

Now that the Roadmap is ready, the next step is distributing it to healthcare professionals and mobile software developers, who can in turn use the proposed strategies and advice to develop concrete mobile tools. To aid in the distribution of the Roadmap and the implementation of the strategies laid out in it, the project partners also produced an informational video designed to be used by healthcare professionals in conjunction with the Roadmap guidebook itself.

This spring the SEE Public Health Working Group plans to use the Roadmap to develop an mHealth pilot targeting people afflicted by drug abuse issues in Fall River, Massachusetts, and St. Petersburg, Russia. “What we’ll be doing is looking at…the existing use of mHealth technologies in both the United States and Russia and globally to try to harness the expertise of our group to really focus those efforts in ways that are most productive for the United States and in Russia.,” explained Judy Twigg, Professor of Political Science at Virginia Commonwealth University, and the US co-chair of the Public Health Working Group.

As mobile health technologies advance in complexity and broaden in scope, the joint efforts of SSTAR and the Health and Development Foundation are sure to lead the way in groundbreaking endeavors for health and behavioral interventions.