Mobile Health Tool for Lung Cancer: Mitigate Lung Cancer Stigma and Promote Self-Management

Lung cancer is the leading cause of cancer deaths in the US. It is unique because of racial disparity, persistent mortality rate, and social stigma. Lung Cancer Stigma (LCS) is based on the belief that one caused their own cancer and is associated with increases in psychological and physical symptom severity and diminished quality of life. LCS is a significant barrier to patient-clinician communication and self-management. Stigma-reduction interventions are effective in other diseases; no interventions are available to decrease LCS. Purposes of this paper are to: present development processes of a mobile Health (mHealth) application; provide feasibility/usability data; and recommend directions for future research. The mHealth Tool for Lung Cancer (mHealth TLC), an immersive 3-dimensional (3-D) “game”, integrates avatar scenarios with clinical pathways relevant to lung cancer and LCS. In “virtual visits” mHealth TLC can improve communication and self-management. Virtual intervention advantages include: new possibilities for cost-effective broad-based care, incorporation of ethnic and culturally sensitive material, access to hard-to-reach populations, and interactive opportunities for patients to receive positive feedback for behavior change. mHealth TLC development consisted of three major components: 1) emPATH, designed to execute care pathways in mobile-based UCSF clinical trials; 2) The Unity 3D gaming system (for avatar design), the most popular commercial 3D iPad game engine on the market; and 3) a SalesForce Customer Relationship Management (CRM) system modified for cloud-based patient data monitoring . mHealth TLC allows patients to develop and practice communication skills in a safe environment, reduce LCS and access support for self-management skills.