The history and future of digital health in the field of behavioral medicine

Danielle Arigo, Danielle E. Jake-Schoffman, Kathleen Wolin, Ellen Beckjord, & Eric B. Hekler
J Behav Med (2019) 42: 67.
https://doi.org/10.1007/s10865-018-9966-z

Abstract

Since its earliest days, the field of behavioral medicine has leveraged technology to increase the reach and effectiveness of its interventions. Here, we highlight key areas of opportunity and recommend next steps to further advance intervention development, evaluation, and commercialization with a focus on three technologies: mobile applications (apps), social media, and wearable devices. Ultimately, we argue that future of digital health behavioral science research lies in finding ways to advance more robust academic-industry partnerships. These include academics consciously working towards preparing and training the work force of the twenty first century for digital health, actively working towards advancing methods that can balance the needs for efficiency in industry with the desire for rigor and reproducibility in academia, and the need to advance common practices and procedures that support more ethical practices for promoting healthy behavior.

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An unknown landscape of privacy and data security

Another relatively new set of challenges centers around the issues of privacy and data security presented by digital health tools. First, some commercially available technologies that were originally produced for purposes other than promoting healthy behavior (e.g., social media) are now being used to study health behavior and deliver interventions. This poses a variety of potential privacy issues depending on the privacy settings used, including the fact that data from non-participants may inadvertently be viewed and collected, and their rights should also be considered as part of study procedures (Arigo et al., 2018).  Privacy may be of particular concern as apps begin to incorporate additional smartphone technologies such as GPS location tracking and cameras (Nebeker et al., 2015).  Second, for commercial products that were originally designed for health behavior change (e.g., apps), researchers need to carefully read and understand the associated privacy and security agreements, be sure that participants understand these agreements, and include a summary of this information in their applications to ethics review boards.