My Whatsapp advent calendar

After my relatively negative experience with a mobile mental health service I had an idea of my own. Especially after a friend recently opened up about his challenges with mental health. Since it was December 1st I decided to create my own Whatsapp advent calendar*.

Using Whatsapp’s ‘broadcast list’ feature, I sent 16 friends of mine the first post. I only chose 16, because I was worried that more would be too difficult to handle.

Here are the messages I have sent so far.

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December 1st:

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December 2nd:

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Now everyday until the 24th I will come up with a new positive post every day. My plan is for the messages to share happiness, boost confidence and reduce isolation. Giving tips and positive thoughts without being preachy!

This is an experiment. So I will see how the next few weeks go and maybe I could broaden it at a later stage! Learnings to follow!

* I assume the concept of advent calendar is pretty universally understood, but check here if you’re confused.

Send ‘HAPPY’ to 12345

Last weekend I saw an ad on the train about getting free mental health advice via SMS. All I needed to do was to send ‘TIPS’ to a shortcode.  I decided to sign up for two reasons:

1 I am quite a typical A-type neurotic millennial living in the big city. Stressed out is my default.

2 I am interested in mhealth (mobile health) and I was curious about the service itself.

So I texted TIPS.

And then nothing. Nothing happened. I checked my phone 4-5 times within the following hour ( I’m disillusioned about my phone habits, it was probably closer to 20 times). I didn’t get any confirmation that I had signed up. This was Saturday.

Monday morning I receive this text message. In the meantime I had completely forgotten about the whole thing.

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I end up getting a text message every day..

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until Friday I get this one.

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And I’m like…

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This was all a fundraising trick. I thought they were out to help me but instead they sneakily acquired my number, gained my trust but all they wanted was my money!

Don’t get me wrong, giving to charity gets a big thumbs up from me. However, I want to be part of the process. I don’t want to conveniently get something for free and then I am suddenly asked to give money. It’s comparable to the cards, coasters and pens I get from charities before Christmas. They send me free stuff I never asked for and then ask me to donate. Two things happen then:

  • I don’t want to donate anything because I feel blackmailed
  • I feel guilty for not giving and for the waste of stuff on me, but I cannot give into blackmail and now all I remember is that charity making me feel guilty!

When I got the final SMS, I felt tricked and foolish for believing that the service was there to help me.

Overall, I learned two key lessons:

  •  Feedback is not optional. It is essential to any service operating in this day and age, especially in relation to technology. How often do you pay attention to the ticks (Screen Shot 2016-12-04 at 08.33.21.png) on your messenger app ? This kind of feedback makes me feel satisfied and in control.
  • Don’t make an mhealth intervention a gimmick. I seriously believed that these text messages were going to make me feel better. They didn’t really and by Friday I understood why. They were sent by the Marketing department. There is a place for such interventions and when there are real people with real expectations on the other side, it’s dangerous to put it out without a comprehensive plan behind it.

Anyway, at least it encouraged me try my own little mood booster service. More on that later!

How can mobile technology improve health in LMIC? (UCL conference)

Today I attended the first day of the mhealth conference at University College London on ‘How can mobile technology improve health in low and middle income countries?’. Here are just a few thoughts based on the presentations and discussions I heard today!

Some key points from the day

– Account for disabilities in mhealth interventions: they can be easily overlooked, even low eyesight which we may not think of as a disability needs to be addressed in text-based interventions

– Governments and Ministries of Health are key players – especially good if ‘early adopters’ are in charge

– Motivation to get people to use mhealth tools in the long term can be increased through:

  • Incentives (monetary or other)
  • Feeling valued and trusted (e.g. by giving them the mobile device)
  • Regular checks, especially when data shows there is drop in usage
  • Empower some as ‘experts’ or ‘supervisors’ to help others with technical aspects

– We need to get better at describing what exactly interventions do in research papers – and if any of the people who voiced that concern are reading this – could you give examples of studies who do it well?

Further thoughts

Content vs. tech evaluation: There were quite a few questions about the content of some of the mhealth interventions that were presented (e.g. motivational messages for community health workers (CHW) or the maternal health messages for families in Bihar). Both speakers made it clear that their messages had gone through a lot of testing and, for the messages in Bihar, had been approved by a government committee. Sandeep Ghosh from BBC Media Action also made the point that their intervention has shown very positive results, which in a way shows the success of the content. While this is great, and I’m sure that for both projects, they had very capable people (and the budget to get these people on board) where is the learning for other organisations and charities, who want to replicate this type of project? I think that additional research specifically on content would be beneficial.

Health outcomes: Throughout the whole day, it became clear that the focus on health outcomes is crucial in the field of mhealth evidence, as process and usage data only gets us that far. However, I see that if you are a big research institution like UCL, focussing on health outcomes is great. Yet, what can smaller NGOs do when their M&E budget doesn’t allow for a sensible sample size to measure all these health indicators? How can research institutions reach out more to NGOs?

Health communication: I felt that a lot of the discussions were about mhealth as a way to strengthen health systems, while health communication wasn’t center stage. I think it would be interesting to look a bit more at health communication interventions which use mobile devices, and their evidence.