Health Promotion? Yeah, There Are Apps for That!

Most clinicians who work with children or teenagers already know that the best way to reach them is through a computer screen. As Baby Boomers reach retirement age, this advice now applies to older patients as well. NPs and PAs are seeing more 70-year-olds who spend an hour on Facebook every day, surf the Web, and text with the best of them.

As a result, more clinicians are turning to high-tech devices, such as iPhone apps, video games, and streaming videos, as an effective way to deliver their health promotion messages. Read on to see how providers across the country are tapping into this trend.

Web-Based “Dramas” Promote Safe Sex
Rachel Jones, PhD, RN, FAAN, an associate professor at Rutgers University College of Nursing, hit a roadblock while promoting safe sexual practices with her patients in an urban New Jersey clinic.

“I was seeing these smart, together women and men,” Jones says. “I would talk to them about STDs and HIV, but they were still having unprotected sex.”

Jones realized that the rational, knowledge-based approach to prevention doesn’t really work when it comes to sexual health. “Cognitive-based knowledge is not enough,” she says. “These are intense emotional and relationship issues.”

Once, after having an exam interrupted—yet again!—by a patient taking a cell phone call, Jones realized the phone could be a powerful prevention tool.

She had already been in the midst of making HIV prevention videos, but now will make these compelling dramas available via streaming video on phones with 3G and 4G network service. “We wanted to boost the message between clinic visits, in the comfort of patients’ homes,” Jones says. “We wanted it to be confidential and private.”

To create the story lines for her HIV prevention soap ­operas, Jones brought real women from the community into the studio for focus groups. As a result, her videos are true to life—and very popular. Once patients watch the first video in the series, called “Toni, Mike, and Valerie,” they get hooked and want to continue watching other episodes to find out what happens to the main characters.

“We have found a lot of women carrying both their own phone and our phone,” says Jones, who with grant money was actually able to purchase compatible cell phones and hand them out to patients. “There’s a high interest in the story—it’s not a hard sell.”

The message is built into the story, but it is woven through in a subtle way. The drama includes what Jones calls low-power and high-power women. The low-power women give in to pressure to have unprotected sex as a way to show they’ll do anything for their man, and they trust him completely. The higher-power women, on the other hand, would never even think of having sex without first asking the man to have an HIV test.

“Those women are our heroines,” Jones says. “Strong, powerful women can serve to mentor other women—that’s really what we’re doing with our shows.” When patients identify with the characters emotionally, they understand the consequences of their behavior, and they start to emulate the stronger women, Jones says.

Jones also made a series called “Love, Sex and Choices.” Jones received grants from the National Institutes of Health and the Health Care Foundation of New Jersey, among other sources, to make her prevention videos. Next, she plans to make a video series for men and to market her videos through social media.

“There is tremendous power in this modality,” Jones says.

Her goal is to change attitudes about condoms, so both women and men see them as a symbol of love and protection. “We could completely eradicate HIV in women by using condoms,” Jones says. She hopes more nurses and physician assistants will embrace this multimedia educational approach as an important prevention tool.

As other providers hear about Jones’ videos, requests for copies of the program on DVD (another option, besides the streaming video that can be accessed via Web-capable cell phones) have been pouring in from all over the United States and overseas. Many practitioners are showing the videos while patients sit in the waiting room. They are available at www.stophiv.newark .rutgers.edu.

“Not everybody can go out and make their own movies,” Jones says. “Our goal is to distribute them widely so we can share them with our fellow clinicians.”

Video Games Help Diabetic Kids
Pediatric diabetes is another hot area for high-tech prevention. Several companies have produced interactive video games that educate kids with type 1 diabetes about insulin shots and avoiding sugary foods.

The insulin pump manufacturer Medtronic offers a popular iPhone app starring a cuddly character named Larry the Lion. He helps diabetic children count their carbs to keep their glycemic index in the right zone.

“Larry the Lion is very cute,” says Lois Gilmer, a diabetes educator at the University of Colorado’s Barbara Davis Center for Childhood Diabetes. Since kids like Larry, the app makes eating right a fun game instead of an exercise in self-denial.

Gilmer says the iPhone apps are very popular with their diabetic patients. “A lot of clients I work with do use apps on their Smartphones—that’s useful and we encourage it,” she says.

Other companies, such as Game Equals Life in Norman, Oklahoma, and Bayer, also offer video games that are uniquely tailored to children with diabetes.

Beating Stress and Staying Heart-Healthy
Meanwhile, in Cleveland, prevention experts are using social media and free iPhone apps to appeal to sports fans and reduce their cardiac disease risk. The Cleveland Clinic recently launched a campaign called Let’s Move It!

The Let’s Move It! app, which works with iPhone and iPod Touch, includes a pedometer that helps users keep track of their individual progress. The app also challenges users to participate in different sports-related community walks. For example, they can try to walk the equivalent mileage between Cleveland Browns Stadium and Paul Brown Stadium in Cincinnati. As they participate in the challenge, fellow walkers can cheer them on through Facebook and Twitter. The app even tells them how many steps they would have to take to work off a hot dog, beer, and fries at the stadium.

“Physical inactivity is one of the factors contributing to the escalating chronic disease rate in America,” said Michael Roizen, MD, Chairman of the Cleveland Clinic Wellness Institute, in a statement. “The Let’s Move It! app makes exercise fun by creating friendly competitions among users. Research has shown that people who have access to an interactive, social exercise environment are more likely to actually exercise.”

In other areas of the country, cardiologists are turning their patients on to iPhone apps that help them watch for trends in their blood pressure readings and calculate their risk for a heart attack.

Stress is another factor in heart disease, as well as a host of other conditions, from depression and dementia to fibromyalgia. So the Cleveland Clinic Wellness Institute also offers a free app that leads users through guided meditations. These relaxation apps help people relax their muscles, let go of their anger, and practice mindfulness.

Cleveland Clinic has its own health information Web site. The site, at 360-5.com, is similar to MayoClinic.com, but is more interactive and also sells wellness products. As part of its offerings, it includes an online application that goes with the iPhone app called Stress Free Now. Clinicians at Cleveland Clinic have access to the program for any patient. Others can pay for it for $40 per person. To preview Stress Free Now, visit www.360-5.com/promos.

Thomas Morledge, MD, medical director of the Cleveland Clinic’s Wellness Enterprise, created the eight-week Stress Free Now program and the app. Patients log on daily to read motivational messages from Morledge. Then, they can download an MP3 with breathing techniques, relaxation methods, and positive affirmations. They must set aside about 30 minutes, several times a week, to see results.

“There’s a lot of literature to support these techniques,” Morledge says. “It can help with chronic pain, such as fibromyalgia, and cut down on inflammation. It can reduce the risk of stroke and dementia.” The Cleveland Clinic program is based a great deal on the work of mindfulness expert and University of Massachusetts medical professor Jon Kabat-Zinn.

The clinic currently is enrolling 600 patients in a clinical trial to test the effectiveness of the online program, but so far, anecdotal evidence says it is working. “When people use it, you can see there’s been a change—their color improves, they sleep better, and they have more energy,” Morledge says.

So far, it is the NPs and PAs who have referred the most patients to the Stress Free Now program, he adds. “They seem to have better peripheral vision,” he says. “They have a very patient-centered approach to their care.”

Stress remains an overlooked component of health, even though, as Morledge says, “The impact of stress is probably as great as [that of] obesity.”

By reaching out to patients with MP3s, iPhone apps, and online coaching, Cleveland Clinic is on the leading edge of an important trend in prevention. Programs like Stress Free Now can help spread the word to thousands of people—more than any single clinician could reach from a typical medical office.

Most clinicians who work with children or teenagers already know that the best way to reach them is through a computer screen. As Baby Boomers reach retirement age, this advice now applies to older patients as well. NPs and PAs are seeing more 70-year-olds who spend an hour on Facebook every day, surf the Web, and text with the best of them.

As a result, more clinicians are turning to high-tech devices, such as iPhone apps, video games, and streaming videos, as an effective way to deliver their health promotion messages. Read on to see how providers across the country are tapping into this trend.

Web-Based “Dramas” Promote Safe Sex
Rachel Jones, PhD, RN, FAAN, an associate professor at Rutgers University College of Nursing, hit a roadblock while promoting safe sexual practices with her patients in an urban New Jersey clinic.

“I was seeing these smart, together women and men,” Jones says. “I would talk to them about STDs and HIV, but they were still having unprotected sex.”

Jones realized that the rational, knowledge-based approach to prevention doesn’t really work when it comes to sexual health. “Cognitive-based knowledge is not enough,” she says. “These are intense emotional and relationship issues.”

Once, after having an exam interrupted—yet again!—by a patient taking a cell phone call, Jones realized the phone could be a powerful prevention tool.

She had already been in the midst of making HIV prevention videos, but now will make these compelling dramas available via streaming video on phones with 3G and 4G network service. “We wanted to boost the message between clinic visits, in the comfort of patients’ homes,” Jones says. “We wanted it to be confidential and private.”

To create the story lines for her HIV prevention soap ­operas, Jones brought real women from the community into the studio for focus groups. As a result, her videos are true to life—and very popular. Once patients watch the first video in the series, called “Toni, Mike, and Valerie,” they get hooked and want to continue watching other episodes to find out what happens to the main characters.

“We have found a lot of women carrying both their own phone and our phone,” says Jones, who with grant money was actually able to purchase compatible cell phones and hand them out to patients. “There’s a high interest in the story—it’s not a hard sell.”

The message is built into the story, but it is woven through in a subtle way. The drama includes what Jones calls low-power and high-power women. The low-power women give in to pressure to have unprotected sex as a way to show they’ll do anything for their man, and they trust him completely. The higher-power women, on the other hand, would never even think of having sex without first asking the man to have an HIV test.

“Those women are our heroines,” Jones says. “Strong, powerful women can serve to mentor other women—that’s really what we’re doing with our shows.” When patients identify with the characters emotionally, they understand the consequences of their behavior, and they start to emulate the stronger women, Jones says.

Jones also made a series called “Love, Sex and Choices.” Jones received grants from the National Institutes of Health and the Health Care Foundation of New Jersey, among other sources, to make her prevention videos. Next, she plans to make a video series for men and to market her videos through social media.

“There is tremendous power in this modality,” Jones says.

Her goal is to change attitudes about condoms, so both women and men see them as a symbol of love and protection. “We could completely eradicate HIV in women by using condoms,” Jones says. She hopes more nurses and physician assistants will embrace this multimedia educational approach as an important prevention tool.

As other providers hear about Jones’ videos, requests for copies of the program on DVD (another option, besides the streaming video that can be accessed via Web-capable cell phones) have been pouring in from all over the United States and overseas. Many practitioners are showing the videos while patients sit in the waiting room. They are available at www.stophiv.newark .rutgers.edu.

“Not everybody can go out and make their own movies,” Jones says. “Our goal is to distribute them widely so we can share them with our fellow clinicians.”

Video Games Help Diabetic Kids
Pediatric diabetes is another hot area for high-tech prevention. Several companies have produced interactive video games that educate kids with type 1 diabetes about insulin shots and avoiding sugary foods.

The insulin pump manufacturer Medtronic offers a popular iPhone app starring a cuddly character named Larry the Lion. He helps diabetic children count their carbs to keep their glycemic index in the right zone.

“Larry the Lion is very cute,” says Lois Gilmer, a diabetes educator at the University of Colorado’s Barbara Davis Center for Childhood Diabetes. Since kids like Larry, the app makes eating right a fun game instead of an exercise in self-denial.

Gilmer says the iPhone apps are very popular with their diabetic patients. “A lot of clients I work with do use apps on their Smartphones—that’s useful and we encourage it,” she says.

Other companies, such as Game Equals Life in Norman, Oklahoma, and Bayer, also offer video games that are uniquely tailored to children with diabetes.

Beating Stress and Staying Heart-Healthy
Meanwhile, in Cleveland, prevention experts are using social media and free iPhone apps to appeal to sports fans and reduce their cardiac disease risk. The Cleveland Clinic recently launched a campaign called Let’s Move It!

The Let’s Move It! app, which works with iPhone and iPod Touch, includes a pedometer that helps users keep track of their individual progress. The app also challenges users to participate in different sports-related community walks. For example, they can try to walk the equivalent mileage between Cleveland Browns Stadium and Paul Brown Stadium in Cincinnati. As they participate in the challenge, fellow walkers can cheer them on through Facebook and Twitter. The app even tells them how many steps they would have to take to work off a hot dog, beer, and fries at the stadium.

“Physical inactivity is one of the factors contributing to the escalating chronic disease rate in America,” said Michael Roizen, MD, Chairman of the Cleveland Clinic Wellness Institute, in a statement. “The Let’s Move It! app makes exercise fun by creating friendly competitions among users. Research has shown that people who have access to an interactive, social exercise environment are more likely to actually exercise.”

In other areas of the country, cardiologists are turning their patients on to iPhone apps that help them watch for trends in their blood pressure readings and calculate their risk for a heart attack.

Stress is another factor in heart disease, as well as a host of other conditions, from depression and dementia to fibromyalgia. So the Cleveland Clinic Wellness Institute also offers a free app that leads users through guided meditations. These relaxation apps help people relax their muscles, let go of their anger, and practice mindfulness.

Cleveland Clinic has its own health information Web site. The site, at 360-5.com, is similar to MayoClinic.com, but is more interactive and also sells wellness products. As part of its offerings, it includes an online application that goes with the iPhone app called Stress Free Now. Clinicians at Cleveland Clinic have access to the program for any patient. Others can pay for it for $40 per person. To preview Stress Free Now, visit www.360-5.com/promos.

Thomas Morledge, MD, medical director of the Cleveland Clinic’s Wellness Enterprise, created the eight-week Stress Free Now program and the app. Patients log on daily to read motivational messages from Morledge. Then, they can download an MP3 with breathing techniques, relaxation methods, and positive affirmations. They must set aside about 30 minutes, several times a week, to see results.

“There’s a lot of literature to support these techniques,” Morledge says. “It can help with chronic pain, such as fibromyalgia, and cut down on inflammation. It can reduce the risk of stroke and dementia.” The Cleveland Clinic program is based a great deal on the work of mindfulness expert and University of Massachusetts medical professor Jon Kabat-Zinn.

The clinic currently is enrolling 600 patients in a clinical trial to test the effectiveness of the online program, but so far, anecdotal evidence says it is working. “When people use it, you can see there’s been a change—their color improves, they sleep better, and they have more energy,” Morledge says.

So far, it is the NPs and PAs who have referred the most patients to the Stress Free Now program, he adds. “They seem to have better peripheral vision,” he says. “They have a very patient-centered approach to their care.”

Stress remains an overlooked component of health, even though, as Morledge says, “The impact of stress is probably as great as [that of] obesity.”

By reaching out to patients with MP3s, iPhone apps, and online coaching, Cleveland Clinic is on the leading edge of an important trend in prevention. Programs like Stress Free Now can help spread the word to thousands of people—more than any single clinician could reach from a typical medical office.

Most clinicians who work with children or teenagers already know that the best way to reach them is through a computer screen. As Baby Boomers reach retirement age, this advice now applies to older patients as well. NPs and PAs are seeing more 70-year-olds who spend an hour on Facebook every day, surf the Web, and text with the best of them.

As a result, more clinicians are turning to high-tech devices, such as iPhone apps, video games, and streaming videos, as an effective way to deliver their health promotion messages. Read on to see how providers across the country are tapping into this trend.

Web-Based “Dramas” Promote Safe Sex
Rachel Jones, PhD, RN, FAAN, an associate professor at Rutgers University College of Nursing, hit a roadblock while promoting safe sexual practices with her patients in an urban New Jersey clinic.

“I was seeing these smart, together women and men,” Jones says. “I would talk to them about STDs and HIV, but they were still having unprotected sex.”

Jones realized that the rational, knowledge-based approach to prevention doesn’t really work when it comes to sexual health. “Cognitive-based knowledge is not enough,” she says. “These are intense emotional and relationship issues.”

Once, after having an exam interrupted—yet again!—by a patient taking a cell phone call, Jones realized the phone could be a powerful prevention tool.

She had already been in the midst of making HIV prevention videos, but now will make these compelling dramas available via streaming video on phones with 3G and 4G network service. “We wanted to boost the message between clinic visits, in the comfort of patients’ homes,” Jones says. “We wanted it to be confidential and private.”

To create the story lines for her HIV prevention soap ­operas, Jones brought real women from the community into the studio for focus groups. As a result, her videos are true to life—and very popular. Once patients watch the first video in the series, called “Toni, Mike, and Valerie,” they get hooked and want to continue watching other episodes to find out what happens to the main characters.

“We have found a lot of women carrying both their own phone and our phone,” says Jones, who with grant money was actually able to purchase compatible cell phones and hand them out to patients. “There’s a high interest in the story—it’s not a hard sell.”

The message is built into the story, but it is woven through in a subtle way. The drama includes what Jones calls low-power and high-power women. The low-power women give in to pressure to have unprotected sex as a way to show they’ll do anything for their man, and they trust him completely. The higher-power women, on the other hand, would never even think of having sex without first asking the man to have an HIV test.

“Those women are our heroines,” Jones says. “Strong, powerful women can serve to mentor other women—that’s really what we’re doing with our shows.” When patients identify with the characters emotionally, they understand the consequences of their behavior, and they start to emulate the stronger women, Jones says.

Jones also made a series called “Love, Sex and Choices.” Jones received grants from the National Institutes of Health and the Health Care Foundation of New Jersey, among other sources, to make her prevention videos. Next, she plans to make a video series for men and to market her videos through social media.

“There is tremendous power in this modality,” Jones says.

Her goal is to change attitudes about condoms, so both women and men see them as a symbol of love and protection. “We could completely eradicate HIV in women by using condoms,” Jones says. She hopes more nurses and physician assistants will embrace this multimedia educational approach as an important prevention tool.

As other providers hear about Jones’ videos, requests for copies of the program on DVD (another option, besides the streaming video that can be accessed via Web-capable cell phones) have been pouring in from all over the United States and overseas. Many practitioners are showing the videos while patients sit in the waiting room. They are available at www.stophiv.newark .rutgers.edu.

“Not everybody can go out and make their own movies,” Jones says. “Our goal is to distribute them widely so we can share them with our fellow clinicians.”

Video Games Help Diabetic Kids
Pediatric diabetes is another hot area for high-tech prevention. Several companies have produced interactive video games that educate kids with type 1 diabetes about insulin shots and avoiding sugary foods.

The insulin pump manufacturer Medtronic offers a popular iPhone app starring a cuddly character named Larry the Lion. He helps diabetic children count their carbs to keep their glycemic index in the right zone.

“Larry the Lion is very cute,” says Lois Gilmer, a diabetes educator at the University of Colorado’s Barbara Davis Center for Childhood Diabetes. Since kids like Larry, the app makes eating right a fun game instead of an exercise in self-denial.

Gilmer says the iPhone apps are very popular with their diabetic patients. “A lot of clients I work with do use apps on their Smartphones—that’s useful and we encourage it,” she says.

Other companies, such as Game Equals Life in Norman, Oklahoma, and Bayer, also offer video games that are uniquely tailored to children with diabetes.

Beating Stress and Staying Heart-Healthy
Meanwhile, in Cleveland, prevention experts are using social media and free iPhone apps to appeal to sports fans and reduce their cardiac disease risk. The Cleveland Clinic recently launched a campaign called Let’s Move It!

The Let’s Move It! app, which works with iPhone and iPod Touch, includes a pedometer that helps users keep track of their individual progress. The app also challenges users to participate in different sports-related community walks. For example, they can try to walk the equivalent mileage between Cleveland Browns Stadium and Paul Brown Stadium in Cincinnati. As they participate in the challenge, fellow walkers can cheer them on through Facebook and Twitter. The app even tells them how many steps they would have to take to work off a hot dog, beer, and fries at the stadium.

“Physical inactivity is one of the factors contributing to the escalating chronic disease rate in America,” said Michael Roizen, MD, Chairman of the Cleveland Clinic Wellness Institute, in a statement. “The Let’s Move It! app makes exercise fun by creating friendly competitions among users. Research has shown that people who have access to an interactive, social exercise environment are more likely to actually exercise.”

In other areas of the country, cardiologists are turning their patients on to iPhone apps that help them watch for trends in their blood pressure readings and calculate their risk for a heart attack.

Stress is another factor in heart disease, as well as a host of other conditions, from depression and dementia to fibromyalgia. So the Cleveland Clinic Wellness Institute also offers a free app that leads users through guided meditations. These relaxation apps help people relax their muscles, let go of their anger, and practice mindfulness.

Cleveland Clinic has its own health information Web site. The site, at 360-5.com, is similar to MayoClinic.com, but is more interactive and also sells wellness products. As part of its offerings, it includes an online application that goes with the iPhone app called Stress Free Now. Clinicians at Cleveland Clinic have access to the program for any patient. Others can pay for it for $40 per person. To preview Stress Free Now, visit www.360-5.com/promos.

Thomas Morledge, MD, medical director of the Cleveland Clinic’s Wellness Enterprise, created the eight-week Stress Free Now program and the app. Patients log on daily to read motivational messages from Morledge. Then, they can download an MP3 with breathing techniques, relaxation methods, and positive affirmations. They must set aside about 30 minutes, several times a week, to see results.

“There’s a lot of literature to support these techniques,” Morledge says. “It can help with chronic pain, such as fibromyalgia, and cut down on inflammation. It can reduce the risk of stroke and dementia.” The Cleveland Clinic program is based a great deal on the work of mindfulness expert and University of Massachusetts medical professor Jon Kabat-Zinn.

The clinic currently is enrolling 600 patients in a clinical trial to test the effectiveness of the online program, but so far, anecdotal evidence says it is working. “When people use it, you can see there’s been a change—their color improves, they sleep better, and they have more energy,” Morledge says.

So far, it is the NPs and PAs who have referred the most patients to the Stress Free Now program, he adds. “They seem to have better peripheral vision,” he says. “They have a very patient-centered approach to their care.”

Stress remains an overlooked component of health, even though, as Morledge says, “The impact of stress is probably as great as [that of] obesity.”

By reaching out to patients with MP3s, iPhone apps, and online coaching, Cleveland Clinic is on the leading edge of an important trend in prevention. Programs like Stress Free Now can help spread the word to thousands of people—more than any single clinician could reach from a typical medical office.