Design considerations for integrating video into tablet-based mHealth interventions addressing HIV and substance use

Abstract

Aims: To improve the reach and effectiveness of tablet-based mHealth interventions. Methods:mHealth interventions via tablet computer can reach patients who might otherwise be missed, and video may be especially effective with low literacy populations. However, tablets may not readily accommodate video. Understanding technical limitations, and how to address them, can potentially lead to more effective mHealth tools. The following considerations apply to interventions addressingHIV, druguse, andother behavioral health issues. Consider the Internet connection. Many tablets require Internet connections to play video. Older iPads could cache, or store video, after an initial Internet connection. This meant they could play video offline beyond the reach of WIFI or mobile broadband. Newer iPads and Android tablets do not play video without an active Internet connection. This may limit the locations in which they can be used for mHealth. Tablets that use the Windows operating system can play video from removable media, i.e. an SD card, so they can be used in locations where Internet access is not available. Develop a hybrid design. Flexible mHealth interventions can be created to work in situations where Internet connections may available sporadically or not at all. Interventions that can play videowithout a connection and then transmit data asynchronously when an Internet connection is available (possibly in another location) may address barriers to access. Think about scale. Successful mHealth interventions canbe offered simultaneously inmany locations. Designing for multiple contingencies may facilitate wider adoption. Evaluate using mixed methods. Examining howmany participants complete an intervention, and whether participants stop at the same point, may provide measures of feasibility. Qualitative interviews with participants and staff may informmore successful future interventions. Conclusions: Technology issues that could otherwise emerge as barriers can be used to optimize designs for a specific setting, population, or behavioral health issue. Financial support: NIDA R34DA037129; P30 DA011041.