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How Just-in-Time Adaptive Interventions Improve Health Decisions

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joe

CEO @ Affective Health

Affective.health’s guiding purpose is to help patients have better days, regardless of the condition they have been diagnosed with. The power of the Affective.health DXP can be quickly deployed to support patients along their health journey. We do this through the use of common technologies such as mobile phones, tablets, laptops, or personal computers, cloud computing services, and the latest advances in neuroscience.

The cost of a bad decision goes deeper than most realize, and it is the core problem to solve. This is done by measuring underlying behaviors that affect the way a patient acts. When we’re able to understand what is driving a patient’s behavior, interventions can be sent quickly, which both saves resources and increases positive patient outcomes.

The term just-in-time adaptive interventions (JITAIs) (Spruijt-Metz & Nilsen, 2014) is used to describe a suite of interventions that adapt over time to an individual’s time-varying status, with the goal to address the individual’s changing needs for support.

Further, mobile health (mHealth) interventions that provide timely support exist for a wide range of behavioral health issues, such as physical activity (King et al. 2013), alcohol use (Gustafson et al., 2014), smoking cessation (Riley, Obermayer, & Jean-Mary, 2008), obesity (Patrick et al., 2009), and mental illnesses (Ben-Zeev et al., 2014). These interventions are either used as standalone programs or in conjunction with traditional treatments (Price et al., 2014; Ben Zeev et al., 2014).

Rising Costs of Healthcare

Due to the US healthcare system’s massive growth, the cost of the delivery of care has risen to almost \$4 trillion dollars a year. Almost 20% of the U.S economy is spent on health care, which translates to twenty cents of every dollar earned by workers. The cost does not translate to the level of care either; our health is worse than countries that spend half as much of what they earn and comes with the unique risk of healthcare bills triggering bankruptcy.

The US healthcare system is neither desirable nor sustainable. Reimaging healthcare as a system that takes only 10% of our GDP while reducing the years individuals spend managing chronic conditions is an achievable goal when patients are able to make better decisions.

Almost 20% of the U.S economy is spent on health care.

Supporting Chronic Disease Patients

At Affective.health we feel the ability to provide continual support to chronic disease sufferers at low costs is a major step forward in helping to control and improve chronic conditions. Many are not well suited to our current “procedure-based” health care systems that are more focused on large buildings and advanced surgical equipment. An empathetic, human touch is needed.

One of the problems that people who are just diagnosed with chronic conditions have is developing the subconscious behaviors that will keep them from worsening their condition, and in some cases drive it into remission. Development of the new behaviors has two parts; the first, of course, is learning new behaviors to manage the condition. The second, and perhaps more difficult part, is unlearning, or forgetting, the behaviors that are detrimental to achieving positive outcomes.

Methodologies for Positive Behavior Change

Developing habits can be hard, but Affective.health has developed methodologies that can make both parts of the new behavior development easier and quicker to achieve. The design of the Affective.health DXP allows these principles to be effective without being a heavy lift for administrators.

The first theory is Ecological Momentary Assessment (EMA), which is implemented as Ecological Momentary Interventions (EMI) in the Affective.health framework. In our methodology, EMI uses Interval Learning, Influence, and Assessment to retrieve data that populates the state models. The models provide an ongoing understanding of the knowledge and confidence that the individual has in their care plan over-time in different situations and periods of time.

Powerful Results from Digital Interactions

In less than 2 minutes per day of a patient’s time, we can provide ongoing status of a large patient population so that care can be directed more accurately to the needs of each individual. The task is simple so the incentive can be a small set of feedback to the client with an acknowledgment of their successes. Providers can rest assured interventions are received by the patient when and where they are needed and data returns quickly for review.

The future of healthcare needs to shift power to the patient. When we empower and support patients, they are able to make better decisions more often. Those small interactions and daily choices add up to really helping many people have better days.

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