Designing a Just-in-time Adaptive Intervention (Group Project 3)

Abstract

Today, we face the challenge of chronic conditions. Personal coaching approaches are neither scalable nor financially sustainable. The question arises therefore to which degree Digital Health Interventions (DHIs) are appropriate to address this challenge. In this CAS module, students will design, implement and evaluate a DHI, esp. a just-in-time adaptive intervention.

Objective

After this module, participants will be able to… 1. understand the importance of just-in-time adaptive interventions (JITAIs), esp. for the prevention of NCDs 2. understand the design, implementation and evaluation of smartphone‐based and chatbot‐delivered JITAIs 3. discuss opportunities and challenges of JITAIs

Content

Can medical Alexas make us more healthy? (The New York Times, April 2021), Wearables as a tool for measuring therapeutic adherence in behavioral health (npj Digital Medicine, May 2021), Improving community healthcare screenings with smartphone-based AI technologies (The Lancet Digital Health, May 2021), Predictive analytics and tailored interventions improve clinical outcomes (npj Digital Medicine, June 2021), H1 2021 secured $14.7B in digital health funding, already surpassing all of 2020ʹs funding (Rock Health, 2021) What are the implications and rationale behind the recent developments in the field of digital health? Digital Health is the use of information and communication technology for the prevention and treatment of diseases in the everyday life of individuals. It is thus linked to topics such as digital health interventions, digital biomarkers, digital coaches and healthcare chatbots, telemedicine, mobile and wearable computing, self‐tracking, personalized medicine, connected health, smart homes, or smart cars. In the 20th century, healthcare systems specialized in acute care. In the 21st century, we now face the challenge of dealing with the specific characteristics of non‐communicable diseases (NCDs). NCDs are now responsible for around 70% of all deaths worldwide and 85% of all deaths in Europe and are associated with an estimated economic loss of $7 trillion between 2011 and 2025. NCDs are characterized in particular by the fact that they require an intervention paradigm that focuses on prevention and lifestyle change. Lifestyle (e.g., diet, physical activity, tobacco, or alcohol consumption) can reduce the risk of suffering from a chronic condition or, if already present, can reduce its burden. A corresponding change in lifestyle is, however, only implemented by a fraction of those affected, partly because of missing or inadequate interventions or health literacy, partly due to socio‐cultural influences. Individual personal coaching of these individuals is neither scalable nor financially sustainable. To this end, the question arises on how to develop evidence‐based digital health interventions (DHIs) that allow medical doctors and other caregivers to scale and tailor long‐term treatments to individuals in need at sustainable costs. At the intersection of health economics, behavioral medicine, information systems research, and computer science, this CAS module has the objective to help participants interested in the multi‐disciplinary field of digital health to better understand the need, design, implementation, and assessment of DHIs, esp. just-in-time adaptive interventions (JITAIs). After this module, participants will be able to… 1. understand the importance of JITAIs, esp. for the prevention of NCDs 2. understand the design, implementation and evaluation of smartphone‐based and chatbot‐delivered JITAIs 3. discuss opportunities and challenges of JITAIs The CAS module is structured in two parts and follows the concept of a blended treatment consisting of live sessions and complementary online material. In the live sessions, participants will learn relevant topics. Complementary learning material (e.g., video clips), multiple‐choice questions, and exercises are provided via the online learning platform. In the second part, participants work in teams and will use their knowledge from the first part of the module to develop a smartphone‐based and chatbot‐delivered JITAI with MobileCoach (www.mobile‐coach.eu), an open-source software platform for the development of digital biomarker and digital health interventions. Each team will then present and discuss the resulting JITAI and evaluation results with their colleagues who will provide peer reviews. Additional live coaching sessions are offered to support the teams with the design and evaluation of their JITAIs, and with the preparation of the final group project presentations.

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