Understanding pivotal experiences in behavior change for the design of technologies for personal wellbeing.

Most health technologies are designed to support people who have already decided to work toward better health. Thus, there remains an opportunity to design technologies to help motivate people who have not yet decided to make a change. Understanding the experiences of people who have already started to make a health behavior change and how they made a pivotal decision can be useful in understanding how to design such tools. In this paper, we describe results from data collected in 2 phases. Phase 1 consisted of 127 surveys and 13 interviews with adults who have already accomplished behavior change(s). Phase 2 consisted of 117 surveys and 12 interviews with adults who have either already accomplished their behavior change(s) or are currently working toward them. We identified four factors that lead to pivotal experiences: (1) prolonged discontent and desire to change, (2) significant changes that increase fear or hope of future, (3) increased understanding of one's behavior and personal data, and (4) social accountability. We also describe a design space for designing technology-based interventions for encouraging people to decide to make a change to improve their health. Based on feedback from participants, we discuss opportunities for further exploration of the design space for people who are not yet motivated to change and for ethical considerations for this type of intervention.

Efficacy of chemotherapy in epidermal growth factor receptor (EGFR) mutated metastatic pulmonary adenocarcinoma patients who had acquired resistance to first-line EGFR tyrosine kinase inhibitor (TKI).

INTRODUCTION: Salvage chemotherapy is frequently used when tumour epidermal growth factor receptor (EGFR) mutated patients experience disease progression with first-line EGFR-tyrosine kinase inhibitor (TKI) treatment. However, the efficacy of salvage chemotherapy is still unknown. METHODS: We retrospectively reviewed the chart records of our pulmonary adenocarcinoma patients between 2010 and 2013. RESULTS: Five hundred and six of the 1240 stage IV adenocarcinoma patients had an EGFR mutation and 338 received first-line EGFR-TKI treatment. In all, 169 patients in this group received salvage chemotherapy after failure of EGFR-TKI, and 102 patients were eligible for this study. The chemotherapy response rate of these 102 patients was 24.5%, with a median progression-free survival (PFS) of 4.5?months, and median survival time was 14.6?months. Patients who received pemetrexed-based chemotherapy had longer PFS and overall survival (OS), although the extent was statistically insignificant. Progression-free survival and OS were longer for patients who received combination chemotherapy than single-agent chemotherapy. CONCLUSIONS: Pemetrexed-based combination chemotherapy is preferred before a more efficient treatment strategy is found.

Baby Steps Text: Feasibility Study of an SMS-Based Tool for Tracking Children's Developmental Progress.

To help reach populations of children without consistent Internet access or medical care, we designed and implemented Baby Steps Text, an automated text message-based screening tool. We conducted preliminary user research via storyboarding and prototyping with target populations and then developed a fully functional system. In a one-month deployment study, we evaluated the feasibility of Baby Steps Text with fourteen families. During a one-month study, 13 out of 14 participants were able to learn and use the response structure (yielding 2.88% error rate) and complete a child development screener entirely via text messages. All post-study survey respondents agreed Baby Steps Text was understandable and easy to use, which was also confirmed through post-study interviews. Some survey respondents expressed liking Baby Steps Text because it was easy, quick, convenient to use, and delivered helpful, timely information. Our initial deployment study shows text messaging is a feasible tool for supporting parents in tracking and monitoring their child's development.