Usability and access reflect fundamental challenges faced in mobile phone usage for health care. In this context, design approaches are needed to extend the usefulness of mobile phones to the entire population [ 8].

Design

Conceptually, with the use of interactive technologies, efforts are needed to understand if the same theories and mediating constructs guide behavior change in e-health programs as in traditionally delivered programs [ 2]. Moreover, there is a need for designers and researchers to look beyond HIV specific research to other health care issues (e.g. weight management, diabetes management, smoking cessation, etc.) and like arenas (e.g. sustainability, Dan Lockton’s efforts at the Cleaner Electronics Research Group at Brunel University, personal finance, etc.) to identify potentially promising new techniques for technology-enabled intervention efforts [ 9]. Interactive technologies and mobile phones, specifically, offer unique means for tailoring content and its delivery and these means should be leveraged in the design of technology-enabled interventions. Ways of tailoring the technology to the target age group should be examined. For example, using a video-based intervention design for adults who are familiar with movies [ 9]. In addition, a greater understanding of “tailoring to,” assessing individual characteristics, and tailoring content at the individual is warranted [ 5]. Design and research efforts are also needed to understand the optimal uses of tailored information–is targeted and/or generic information adequate to foster certain behavior changes in particular populations [ 2]. Fundamentally, a central question is what is (are) the optimal way(s) to tailor health communication messages and strategies [10]. Because tailoring is a core strength of technology-enabled interventions, there is a need to actively explore the potential of tailored design strategies across more HIV vulnerable populations. Specific to MSM, HIV behavioral interventions must continue to evolve to address the challenges in this population. One way this can be accomplished is by considering and incorporating technologic innovations and social changes in HIV transmission [ 11].

Notification Systems

Text messaging (SMS) should be used as a tool to affect HIV prevention behavior change. For example by leveraging the evolving function/feature set of the mobile phone, tailored messages could be sent to one’s mobile phone on-demand or at self-identified higher risk periods or locales [ 9]. In addition, design and research efforts are needed to understand other roles of notification mechanisms in potentially enhancing the use of accessible/available behavioral interventions. [ 2]

Evaluation

November + December 2009

There is a dearth of studies that explore the feasibility of mobile phone–based HIV-prevention approaches for the full gamut of impacted populations, e.g., adolescents and older adults [ 9]. General to leveraging interactive technologies in the delivery of HIV-prevention behavioral interventions, little research has been conducted to compare the delivery efficacy of differing stimulus formats or input modalities [10]. In addition, work is needed to discern, conceptually, what measures, capture understanding, depth, and benefits at each session (e.g. What is the optimal interval between log-ons? What is the optimal length of engagement at each log-on? What is the optimal number of log-ons?) [ 2]. From an evaluative perspective, effectiveness demonstrations are needed to show if these sorts of technology enable intervention work under everyday, real-world conditions with unmotivated patients and when introduced by busy staff with many other patient care responsibilities” [10]. Work is especially needed in support of HIV vulnerable populations. What remains to be determined for MSM populations is the identification of technology-based intervention components considered to be most effective, least effective, and cost effective. Further design and research efforts are necessary to determine what works best, in what context, and with whom [ 11]. Though not specific—however important—to MSM populations, future work is needed that evaluates behavioral interventions in high-risk venues [ 11].

interactions

providers. The October 2009 conference features tracks that highlight the “role of technology in living with a health condition and making the healthcare system more consumer-cen-tric.” There is also the United Nation’s mHealth Alliance that is systemically examining the

use of mobile technologies in facilitating global delivery innovations, along with addressing behavioral change.

The HCI community is part of this discourse. Several HCI-oriented events, including the recent Persuasive 2009 Conference and the upcoming

Ubinutrituion 2009 (The Second International Symposium on Ubiquitous Computing Technologies for Nutrition and Public Health), featured or will feature dedicated sessions related to the design of technologies for engendering health-related behavioral change.