Academic journal article Alcohol Research

Privacy and Security in Mobile Health (mHealth) Research

Academic journal article Alcohol Research

Privacy and Security in Mobile Health (mHealth) Research

Article excerpt

The recent proliferation of wireless and mobile health (mHealth) technologies presents the opportunity for scientists to collect information in the real-world via wearable sensors. When coupled with fixed sensors embedded in the environment, mHealth technologies produce continuous streams of data related to an individual's biology, psychology (attitudes, cognitions, and emotions), behavior and daily environment. These data have the potential to yield new insights into the factors that lead to disease. They also could be analyzed and used in real time to prompt changes in behaviors or environmental exposures that can reduce health risks or optimize health outcomes. This new area of research has the potential to be a transformative force, because it is dynamic, being based on a continuous input and assessment process. Research in mHealth can ensure that important social, behavioral, and environmental data are used to understand the determinants of health and to improve health outcomes and prevent development of alcohol use disorders (AUDs).

Despite its promise, research in mHealth has progressed much more slowly than developments in industry. One reason is that issues of privacy and security remain an ongoing concern for researchers conducting mHealth studies, especially in areas involving sensitive behavior or treatment (e.g., alcohol use). Not only is the sensitivity of the data an issue for privacy and security, but also the amount that can be collected using mobile devices. Because most mobile devices (including phones and sensors) are carried by the person and collecting data throughout the day, researchers are now able to begin thinking about big data at the level of the individual (Estrin 2014). Fusion of streaming biological, physiological, social, behavioral, environmental, and locational data can now dwarf the traditional genetics and electronic health recordsbased datasets of so-called big data. Further, previously underserved groups can now participate in research because of the rapid adoption of mobile devices. In contrast with the Internet digital divide that limited the reach of computerized health behavior interventions for lower socioeconomic groups, mobile phone use has been rapidly and widely adopted among virtually all demographic groups (Pew Research Internet Project 2014). Now, 90 percent of American adults and 78 percent of teenagers have a cell phone, and more than half are smartphones (Pew Research Internet Project 2014).

Many of the strengths of mHealth research (i.e., its ability to reach large and broad samples and collect continuously streaming data on a range of potentially sensitive and possibly illegal behaviors and events) also drive privacy and security concerns. These topics, as well as confidentiality, are all separate yet connected issues that researchers must address in protecting research participants. The National Committee for Vital and Health Statistics describes the differences between and among privacy, confidentiality, and security this way:

"Health information privacy is an individual's right to control the acquisition, uses, or disclosures of his or her identifiable health data. Confidentiality, which is closely related, refers to the obligations of those who receive information to respect the privacy interests of those to whom the data relate. Security is altogether different. It refers to physical, technological, or administrative safeguards or tools used to protect identifiable health data from unwarranted access or disclosure (Cohn 2006)."

These issues are further complicated by Federal regulations governing personal health information, as well as sensitive information concerning alcohol, drug use or mental health. There also are many legal and ethical concerns about mHealth, especially when used to study alcohol, drug use or mental health. Among these issues is safety of participants and liability of researchers if a study participant experiences an emergency during the study (Kramer et al. …

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