Technology is an amazing thing. Back in the 90’s, I remember that my dad had a cell phone which was the size of a brick. He would only keep it in the car, because it was too bulky to carry around. In the early 2000’s, I got my first cell phone, which was a 3rd-hand Nokia 3210. It had a green and black screen (like an original Gameboy). The only game I had on it was Snake. When I got into college, I got an iPod touch, which was my first introduction to mobile apps. I thought back then, “why would you need that? I have my computer for applications, my iPod is for music, not games, and all this other stuff.” It’s been about 7 years since then and boy was I wrong.
For this week, the guiding question is “how can mobile apps be useful in primary care?” The assignment is to propose a new mobile app concept for a primary health care scenario. Primary health care, defined by the International Conference on Primary Health Care Alma-Ata of 1978:
"is essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination."
Primary health care focuses on sociocultural, economic, and political factors and how they affect health at the community level. It deals with health issues not just through curative means, but also through promotive and preventive methods as well.
Health-related mobile apps aren’t anything new. Aside from the personal health records I mentioned previously, there are many other kinds of apps promoting a healthy lifestyle. These can be considered as mobile apps that are useful in a primary health care setting. Examples include diet-related apps (calories, carbohydrates, vitamins/mineral intake measurer), exercise-related apps (regimen scheduler, activity measurer), health awareness apps (health electronic news, disaster and outbreak reporting), and vital signs recording apps.
Availability of all these apps however, is still a problem. Mobile apps are only available in certain types of cellular phones - smartphones. Here in the Philippines, not that many people have smartphones. As of last year, only 15% of cell phones used by Filipinos are smartphones. While the projected smartphone penetration is estimated to rise to 50% by the end of this year, that’s still only half of the population. While there are no figures on the distribution of ownership, it is more likely that people in urban areas make up most of the smartphone user base. The community is the core of primary health care. For those communities that have less individuals owning smartphones, mobile apps are pretty useless. Still, if the rate of smartphone penetration is to be believed (from 15% to 50% in a year is crazy), then there is some serious potential that can be harnessed here.
So for my app, I decided to go with something simple - something that anyone can use. It should be about a health issue that could be addressed through information or prevention. It should be something that the population of smartphone users could be dealing with. Those individuals are mostly people living in the metro and under the age of 34.
During my brainstorming, I asked a few people for health issues that they were having. Two people mentioned osteoporosis. Okay, not exactly something the target age is known for having. However thinking back to my knowledge of preventive measures - strengthening your bones and reaching peak bone density (which is around the age of 30) before it starts to decrease at old age, it fits pretty well.
One way of doing this is through proper nutrition. Calcium-rich foods are the target here, but this is already covered by some apps I’ve seen before. How about vitamin D? It helps in intestinal calcium absorption (I won’t go into the physiologic details here as it’s not the focus). While I’ve also seen apps on vitamin D-rich foods, I haven’t seen an app that focuses on another important source - sunlight. Without going into the more physiologic details, ultraviolet light is absorbed by the skin, which transforms precursors into the active form of vitamin D and releases it into circulation. Sunlight exposure meets 90% of vitamin D requirements of most people.
The Philippine College of Occupational Medicine (PCOM) and Philippine Neurological Association (PNA) state that vitamin D deficiency is becoming an unnoticed health issue, especially for office workers. It’s ironic, considering that our country has pretty good amounts of sunlight exposure all year round. However, staying indoors for most of the day, wearing full-body covering clothes and other cultural factors make it understandable. I’ll be honest, I hate being under the sun. I’m a sweaty individual, and the heat makes it worse. I try to avoid the sun as much as possible. Also, knowing the sunlight double-edged-sword nature (extended sunlight exposure can increase risk of skin cancer) makes me weary of being in the sun for too long. Still, the suggested safe period of sunlight exposure a day isn’t that long, being 15 to 30 minutes during 10 am to 3 pm.
So for my proposed app, I suggest an app that helps office workers get their needed daily amount of sunlight. The person can set what time they can go out to get some sun and the app alarms them when it’s time. The person also inputs how long they stayed in the sun and the app can keep track of daily sun exposure. Weather reports can be used by the app so that it can warn the person if their allotted time won’t get them enough sunlight (like cloudy and stormy weather). The app can have a sharing option, where you can post the amount of sunlight you had in your social media. This helps increase awareness of the issue as well.
If the app will be used worldwide however, it gets more complicated as more factors come into play with vitamin D production. Indicating the person’s location is important, as UV radiation needed from the sun decreases as you go further from the equator and seasons can affect the amount of sun these places get. Their skin color also comes into play, as darker skin requires longer time under the sun to produce the same amount of vitamin D compared to lighter skin. These things have to inputted by the user before setting their schedule. This way, the app can take these factors into account when determining if the person is getting the right amount of sunlight.
This kind of app is super simple, but I believe that these types of apps are the kinds that people can easily get into. Accessibility is one of mobile’s greatest strengths. Overall, I think mobile apps have a future in helping people keep healthy, which is one of the goals of primary healthcare.
References:
- All About Vitamin D. (2015). Retrieved from the Philippine Daily Inquirer website: http://lifestyle.inquirer.net/190412/all-about-vitamin-d.
- Declaration of Alma-Ata International Conference on Primary Primary Health Care, Alma-Ata, USSR. (1978). Retrieved from the World Health Organization International website: http://www.who.int/publications/almaata_declaration_en.pdf.
- CC Chante. Vitamin D deficiency. (2014). Retrieved from The Philippine Star website: http://www.philstar.com/opinion/2014/12/28/1407096/vitamin-d-deficiency.
- S Crisostomo. Most Pinoys found to have Vitamin D deficiency. (2014). Retrieved from The Philippine Star website: http://www.philstar.com:8080/headlines/2014/03/23/1304055/most-pinoys-found-have-vitamin-d-deficiency.
- MF Holick. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular diseases. (2004). Am J Clin Nutr 2004:1678S-88S. Retrieved from The American Journal of Clinical Nutrition website: http://ajcn.nutrition.org/content/80/6/1678S.full.pdf+html.
- A Sweeney. The Philippines mobile internet crowd: young, affluent, and growing fast. (2014). Retrieved from On Device Research website: https://ondeviceresearch.com/blog/philippines-mobile-internet-trends.
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