California State University, Long Beach
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Smartphones Used For Study

Published: December 18, 2013

Grace Reynolds wasn’t exactly sure how well it would work, but it was certainly worth a try.

Reynolds, the associate director for CSULB’s Center for Behavioral Research and Services (CBRS), was able to equip women with smartphones which they then used to record their daily activities. But, these weren’t just any women and not just any activities.

“This study was a daily diary of sexual behavior. This was funded as part of the California HIV research program, so it was focused on sexual risk behavior,” said Reynolds, who headed the two-year study. “The purpose of doing a daily diary over smartphones is to capture event-level information about any and all high-risk sexual encounters.”

Reynolds’ study was funded by the California HIV/AIDS Research Program out of the University of California Office of the President, which over three decades has awarded more than $200 million for more than 2,000 projects.

Using this type of technology to gain immediate feedback, Reynolds noted, avoided the problem of recall bias, where participants try to recall what happened last week or last month.

“This provides what happened in the last 24 hours,” she said. “Most of us can recall that, so I think for certain types of research it’s definitely the way to go.”

“The nice thing about this study is that once they pressed the button, the data were immediately uploaded from the smartphone to the server,” she added. “There was no confidential research data kept on the smartphone so if it was lost or stolen or someone else used it, nothing concerning their research participation was compromised. If you had paper daily diaries being carted around, there could be loss of confidentiality.”

Initially, 200 minority women in the Long Beach area who had previously taken part in CBRS projects were invited to participate. Of that group, 140 agreed to be involved, each actively participating for 12 weeks.

“Getting a smartphone was a big draw because of all the women in the study, none of them have ever owned one before,” said Reynolds. “The fact they got a smartphone and were provided three months of unlimited text, talk and Internet access as part of this study, I’m sure that was a good incentive.” Once the study was completed the women could keep the phone, but were responsible for paying for continued services.

For some, the bridge to this level of technology was too difficult to cross.

“For some of the women the technology was so new and frustrating they did drop out,” said Reynolds. “If we were able to get them through the first two weeks, they generally stuck with the study. Being able to use the phone, to go to the Internet, to log into the app, remembering their participant ID number and pin number and those kinds of things was challenging for many of the women.”

Once underway, every day the women would log in and then answer approximately 50 questions, which could take anywhere from one to three minutes.

The goal of the study was to look at illegal drug use, specifically methamphetamine use, and the role it played in risky sexual behaviors. For example, on a day when one of the women took methamphetamines or some other illegal stimulant drug, was that the day during which she also participated in risky sexual behavior?

“My preliminary analysis of that would be yes,” said Reynolds. “I think we’re going to be able to show days when women used illegal drugs are also the days risky sexual encounters also occurred; they had risky sex acts with risky partners. For example, to the women’s knowledge, has their partner ever been incarcerated, because in some cases that tends to produce a man who has a risky profile and those kinds of things. It’s risky sexual behaviors with risky partners.”

And the study’s growing pains were not just for the women participating, but for Reynolds’ research staff as well. Still, it was well worth it.

“This was a fantastic experience for me, and I think also a very good experience for the women,” she said. “They loved the fact they could experience the smartphone. We learned a lot and I would like to be able to do a similar study in the future.”

Others involved in the study were CBRS’ Director Dennis Fisher, Psychology’s Courtney Ahrens and Stephanie Meyers and graduate students Cameron Shibata and Sarah Sonntag.

Reynolds noted that one benefit of the study will be the ability to help address any new HIV infections, which are disproportionately showing up in heterosexual and minority women.

“I think the cost of prevention is always going to be cheaper than the cost of medical treatment even though we have some very sophisticated, highly active antiretroviral treatments available today,” she said. “Prevention is always better than treatment, and so anything that we can do to get greater insight into some of the behavioral aspects of these women’s lives will benefit others because they are the ones who are most affected by HIV infections these days. I think it is money well spent.”