ANGELES — Qiana Sago knew she had a problem.
years ago, at age 30, she weighed 269 pounds. She was taking
pills for high blood pressure. Her triglycerides were
"the highest you can have," she said.
as an LAX airport custodian, she was surrounded by fast food,
which became a daily staple. "You ate (it) when you got
to work, you ate it again midday," she said. "Then I’d
get off work and eat more."
partly because she was provided access to unique fitness
technology, the Inglewood, Calif., resident has turned things
around — losing more than 40 pounds and working toward the
day she can stop taking blood pressure medication.
39 other young African-American women at Faithful Central
Bible Church recently participated in a UCBC-backed clinical
trial that used a smartphone app to track their eating and
activity and teach them healthful diet and exercise habits.
such mobile health, or "m-health," programs are in
their infancy. But researchers and advocates for underserved,
hard-to-reach patient groups hope they soon will contribute to
major advances in the treatment of diabetes, heart disease and
other chronic conditions.
provide unprecedented, low-cost access to patients, experts
say, because the technology is so widely used and the
socioeconomic digital divide is shrinking. The Pew Research
Internet Project reported earlier this year that 84 percent of
U.S. adults with incomes below $30,000 a year had cellphones;
47 percent had smartphones.
phones — not home-based broadband connections — are the
gateway to the Internet for all Americans.
that you’re doing online, that you want to extend to a
low-income population, the way they’re most likely to access
it is through mobile," said Margaret Laws of the
California Health Care Foundation in Oakland. Laws runs a
program that hopes to use technology to help at-risk groups.
has a phone, even if it’s a throwaway," added UCLA
psychologist and researcher Vickie Mays.
who leads a center that focuses on addressing health
disparities, collaborates with the university’s Wireless
Health Institute, which backed the Inglewood study. Mobile
technology offers a powerful tool to assist people seeking to
change bad eating and lifestyle habits, she said, because it
can reinforce medical advice after a patient leaves the doctor’s
disease among young black women — a long-recognized problem
— appeared to be an ideal condition to target with m-health
programs, said Jo-Ann Eastwood, a nurse practitioner and
associate professor at UCLA’s School of Nursing who ran the
church group study.
was tired of seeing women come in at 55 years old and they’ve
already had a heart attack," she said. "Their
illness hadn’t been picked up early enough. That’s what
drew me to this population: Where could I do the most
the other women selected for the study all were between 25 and
45 at the time and had at least two risk factors for heart
disease. They knew that they needed to eat well and exercise.
But many said they were too busy caring for their children and
parents — and working long hours — to find time to care
for themselves. They also needed help understanding nutrition
taught the women about healthy-heart lifestyles and stress
reduction in four diet-and-exercise classes before handing out
custom-configured Android phones.
devices were disabled for voice calls but could be used to
text others in the study group. The phones were loaded with an
app, developed at UCLA, that interacted with the women,
sending daily and weekly questions — "Did you eat five
to six servings of fruit today?" — and tracking how
much exercise they got via built-in accelerometers.
participants were supposed to wear the smartphones whenever
they were awake. They also had to measure their blood pressure
on Sunday nights, using Bluetooth-equipped blood-pressure
cuffs that sent readings to the phones, which then streamed
the data to the researchers.
time to make the system work as planned, said Nabil Alshurafa,
a PhD candidate who spent many days at Faithful Central
tweaking the phone app. One challenge was figuring out a
comfortable way for the women to wear the phones during waking
hours. He and Eastwood ultimately opted for passport pouches
worn around the waist.
most of the women got used to lugging around the phones, which
logged movement data several times a second.
readings spiked after the Fourth of July, the researchers
noticed — a holiday when the women had loaded up on salty
foods. Due to signal and data variations, Alshurafa could also
tell when one participant faked her workouts by shaking the
phone in her hand instead of taking walks.
unusual patterns of data were spotted, a nurse would give the
subject a call, which at wavering moments reinforced the idea
that someone was watching and that the diet and exercise goals
were important, Alshurafa said.
results from the study have been promising. Compared with a
control group, the church women had significant improvements
in blood pressure and cholesterol levels, lower levels of
anxiety and stress and improved eating and exercise habits.
The UCLA team reported their findings last month at an
American Heart Assn. scientific meeting in Chicago.
changed things that are very important for heart
disease," Eastwood said, adding that many participants
said the program had made them and their families healthier.
now 33 and a full-time student, cut red meat out of her diet
and loaded up on vegetables. In addition to losing weight, she
significantly improved her blood pressure and triglycerides.
smartphone helped keep her honest.
lies to themselves," she said. "But when you use the
phone, you can’t really lie. You can’t cheat. The phone
showed that you did the work. It kept track every time you
phones appear to have been key in prompting transformations
like Sago’s, Eastwood said.
like to be connected," she said. "This was a good
way for them to have some social support ... someone to cheer
them on and keep them on the right track."
will continue analyzing results in the coming months and hopes
to revisit the women in a year and see how they’ve fared.
Jackie Russell, Faithful Central Bible Church’s director of
community services and an early champion of the UCLA project,
said such programs won’t help everyone. But she thinks that
if a cellphone app gets even a few of the 3,000 who come to
the church each Sunday to improve how they eat or increase
their exercise, it will be a success.
we throw a wide net, we expect to catch some," she said.