ents’ eating and/or exercise behaviors. Similarly, after leveraging successes from an initial pilot program that explored the use of SMS messaging to remind patients with diabetes of their regular blood tests, Delaware Physicians Care, Inc. (DPCI) is now piloting an SMS system for pregnant patients. Through this system, enrolled patients receive reminders of their pre- and postnatal appointments along with messages that provide educational information. Early evidence reflecting the efficacy of this more novel use of the SMS medium, reported by DPCI, shows improved patient compliance with clinical guidelines that could eventually lead to better health outcomes, lower health care costs, and an enhanced quality of life for the patient.

Efforts by Intel Research have spawned the development of the UbiFit Garden. Part of the Everyday Behavioral Monitoring Project, the application is designed to foster regular physical activity through the use of mobile displays, on-body sensing, and journaling. As an individual performs physical activities, the UbiFit Garden application displays a blooming garden on the mobile phone screen. The number of flowers represents the user’s activity level for the week; the type of flowers displayed represents variations in routine; and if goals are met, butterflies appear on screen. The user wears a device that detects physical activity; the information is then manually added and edited using a journal application integrated into the

“HIV prevention is critical to control the epidemic.…Between 75 and 85 of every 100 HIV-positive adults have been infected through unprotected sexual inter- course.… Recent evidence shows that sustained, intensive behaviour change programmes promoting increased use of condoms, delayed sexual initiation and fewer sexual partners are reducing HIV incidence.” —United Nations Millennium “Development Goals (MDGs) Fact Sheet (Goal 6) “We must also commit our- selves to fighting the HIV/AIDS epidemic by both reducing the number of HIV infections and providing care and support services to people living with HIV/AIDS across the United States.”

—President Barack Obama, LGBT Pride Month, 2009 Proclamation

”

“As I said earlier, when it comes to HIV/AIDS in the US we have a choice. We can choose to get used to HIV/AIDS…to accept that it is a permanent feature of society...to be satisfied with lengthening lives instead of saving them. The President has taken the other path—to work to lower HIV incidence, to work to get all people living with HIV into care and improve their health outcomes and to work to end HIV-related health disparities.”

—Kathleen Sebelius, U.S. Secretary of Health and Human Services

“In this country, we are doing a lot of things right, so we’re not starting from a point of failure. But we want to bring attention back to the domestic epidemic.”

—Jeff Crowley, Director of the Office of National AIDS Policy at the White House

like-minded apps in producing routines for the sedentary and obese, possibly improving health and driving down medical costs.

Although the empirical work in this area is in its infancy, the time is ripe for further exploration, which beckons for more active HCI involvement. The Society of Behavioral Medicine, in an effort to advance work in this area, has established the Behavioral Informatics Special Interest Group (SIG). As defined by the SIG, behavioral informatics is “the study of the use of technologies by patients and health care providers as well as the design, implementation, and evaluation of behavior change interventions delivered through advanced technologies.” Other venues, including the Health 2.0: User-Generated Healthcare Conference, are also catapulting this use of advanced technologies in connecting patients and

mobile phone [ 3]. Results from field studies have demonstrated UbiFit Garden’s effectiveness in helping people maintain a more physically active lifestyle, and provide evidence validating the usefulness of design in supporting behavioral change [ 4].

Furthermore, as numerous mobile applications to support health-related behavioral change emerge, so is a cottage industry of sorts. The Apple i Tunes mobile applications store now features a dedicated health care and fitness page, and many of the offered apps are designed to engender and/ or promote healthful behaviors. Several of which were recently detailed in a September 10, 2009 New York Times article, “Training Apps That Help You Sweat the Details.” While apps can help an athlete achieve their personal best, the article notes that some physicians see the potential of these and

[ 3] Intel Labs Seattle. “Everyday Behavioral Monitoring.” http:// seattle.intel-research. net/ projects.php#ebm

[ 4] Consolvo, S., McDonald, D. W., and Landay, J. A. “ Theory-driven Design Strategies for Technologies that Support Behavior Change in Everyday Life.” In Proceedings of ACM CHI 2009 Conference on Human Factors in Computing Systems (2009): 405- 414. Available online.

November + December 2009