The Internet and mobile technology have prompted a new generation of digital health interventions that leverage websites and mobile apps to promote positive health behavior change or to reduce symptoms. Digital health research is being conducted through the Digital Health Program at the Center for Injury Research and Prevention (CIRP), across Children's Hospital of Philadelphia (CHOP) in various departments and programs, and through the Office of Digital Health at CHOP.
It is estimated that over 500,000 mobile health apps are available for download or mobile electronic devices, with functions ranging from health education and self-diagnosis to medication reminders. Yet, limited rigorous, scientific evaluation of these applications provides little evidence of their usage, safety, and effectiveness for providers and patients alike. Our researchers are taking a systematic approach to conduct and foster effective, evidence-based health intervention development and evaluation using the digital health method.
At CIRP, digital health research addresses both improving pediatric health through technology and evaluating eHealth applications to advance the science and promote best practices in pediatric care.
CIRP Projects Involving the Digital Health Research Method
Improving Pediatric Health Through Technology Projects
- iAPP (Integrating Apps Into Pediatric Practice): A CHOP Chair’s Initiative project, this study aims to develop a process to integrate evidence-based and evaluated health apps for families into pediatric care at CHOP in order to improve health outcomes.The major goals of this project are to develop a hospital-wide process to evaluate apps for introduction into clinical care and an evaluation of this process through a proof of concept implementation of a mobile health app for “prescribing” to parents/patients by providers.
Project Team Members: Linda Fleisher, PhD, MPH; Alex Fiks, MD, MSCE; Lindsay Berrigan, MPH; Emily Sykes, BS
Read about the research published in Telemedicine Journal and e-Health.
- Promise of Digital Communication Technology to Advance Car Seat Installation: This study aimed to determine how parents/caregivers use existing materials to install child restraint systems (CRS), examined parent/caregiver perspectives on using smartphones as a tool to improve installation, and developed and user-tested a clickable mobile app. Implemented in four phases, the project included focus groups, a national survey, app prototype development, and prototype user-testing. Based on responses, parents/caregivers value visual, interactive resources for car seat installation beyond the user manual that are available on their everyday mobile devices. Further development and testing of the app prototype will be conducted in coordination with Safekids Worldwide.
Project Team Members: Linda Fleisher, PhD, MPH; Danielle Erkoboni-Wilbur, MD; Katie Halkyard, MPH; Emily Sykes, BS; Marisol Norris, PhD; Laurie Walker; Flaura Winston, MD, PhD.
Read about the research published in the International Journal of Environmental Research and Public Health.
- Implementation of eHealth Child Safety Tools: This study aimed to assess pediatric care providers’ awareness and self-reported use of both print and digital child safety materials created by CIRP. While primary care professionals expressed an interest in using more digital education tools for pediatric injury prevention, there are major barriers to the use of these tools at practice, provider and patient levels, such as lack of time to explain to families how to navigate specified websites and lack of patient access to adequate network connections. To overcome these barriers and to increase adoption, these tools will need to be aligned to the practice environment and patient needs. Future research will explore parent/caretaker perspectives, values, and preferences about using digital health patient education tools for child passenger safety.
Project Team Members: Linda Fleisher, PhD, MPH; Flaura Winston, MD, PhD; Katie Halkyard, MPH
- Exploring Perceptions of Evidence in Digital Health: Perspectives of Developers and Patients: Using a national survey to consumers, this study explored consumers’ perceptions and value of evidence in digital health and how it influences decision-making in using health apps. Over half (60 percent) of consumers have downloaded an app on their mobile device to help track, manage, or find information. Credibility, cost, and ratings from other users were the most influential factors for consumers in the decision to download an app. Other important factors for consumers were the privacy and security of their health information and having a type of regulation or oversight of mobile medical devices and apps.
Project Team Members: Linda Fleisher, PhD, MPH; Wes Hutchinson, PhD (Wharton); Flaura Winston, MD, PhD; Katie Halkyard, MPH; Venk Kandadai, MPH
Access and share an infographic about the research.
Evaluating eHealth Applications Projects
- Reaching Better Health Study: This project seeks to evaluate the effectiveness of a consumer-facing website that was developed for those with chronic diseases to increase their engagement in self-management and medication adherence. The main objective is to determine whether utilization of this website can impact behavioral and clinical outcomes of adults with Type 2 diabetes, one of the most common chronic illnesses among adults in the United States.
Project Team Members: Linda Fleisher, PhD, MPH; Nancy Kassam-Adams, PhD; Flaura Winston, MD, PhD; Nicole Chisholm-Fregene, BS; Emily Sykes, BS; Deanna Brown, BS
- Enabling an Evidence-based Digital Health Revolution Through Do-It-Yourself (DIY) Evaluation: A User-Centered Inferface Design prototype was developed based on previous research (IWEIS) to ensure the functionality of a Do-It-Yourself mHealth evaluation platform that incorporates rigorous research methods and approaches into easy-to-use software for mHealth app developers.
Project Team Members: Linda Fleisher, PhD, MPH; Flaura Winston, MD, PhD; Venk Kandadai, MPH; Katie Halkyard, MPH
- Engineering the Evaluation of Online Health & Wellness Promotion Applications: The Interactive Web-enabled Research System (IWERS) is a software platform for the delivery and evaluation of online applications in disease prevention. This technological breakthrough was commercialized through the development of an Innovation Ecosystem at CIRP.
Project Team Members: Flaura Winston, MD, PhD; Nancy Kassam-Adams, PhD; Linda Fleisher, PhD, MPH; Kristen Kohser, MSW; Venk Kendadai, MPH
Read about CHOP's Commitment to Digital Health Research.