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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
Wireless Penetration: US


CTIA, 2010 Year-end Data

 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


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

Nielsen, 2011
Minority Feature
                                    Preferences

Pew Internet & American Life

Mobile Access, 2010
Underserved SMS


PricewaterhouseCoopers

HRI Consumer Survey, 2010
Wireless Substitution


%	
  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	
  	
  
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)
Ecological Momentary
        “Surveillance”




        IVR
        MMS
        SMS
        Email
        GPS
Prospective Targets


•  Industry?

•  Policy?

•  Advocacy?

•  Smoker Attitudes / Beliefs?

•  Tobacco Product Use Patterns?

•  Smoking Initiation and/or Cessation Milestones?
Rapid Learning Studies


•  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)
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

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Kirchner_CDC OSH 2011

  • 1. 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
  • 2. Wireless Penetration: US CTIA, 2010 Year-end Data 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 Source:  Wireless  Substitution:  International Assoc. for the Wireless Telecommunications Industry (CTIA), 2011  
  • 3. Minority Smartphone Preferences Nielsen, 2011
  • 4. Minority Feature Preferences Pew Internet & American Life Mobile Access, 2010
  • 6. Wireless Substitution %  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    
  • 7. 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)
  • 8.
  • 9. Ecological Momentary Intervention Legacy: Become and EX Mobile (iPhone)
  • 10. Ecological Momentary “Surveillance” IVR MMS SMS Email GPS
  • 11. Prospective Targets •  Industry? •  Policy? •  Advocacy? •  Smoker Attitudes / Beliefs? •  Tobacco Product Use Patterns? •  Smoking Initiation and/or Cessation Milestones?
  • 12. Rapid Learning Studies •  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)
  • 14. Japan
  • 15.
  • 17. 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
  • 18. Challenges •  Privacy •  Platform standards •  Mobile Usage Fees •  Mixed-mode effects •  Reliability / Validity •  Data Processing •  Data Analysis
  • 19. Recommendations •  National Prospective Cohort •  Mobile Platform / Device Independent System Development •  Feature Phone Focus (for now) •  User Preferences Trump Mode Effects •  Mobile + GIS Integration