"Being able to access my plan at my fingertips was a huge plus for me," she said. "You can check your meal plan and watch the workout demos right on your phone while at the gym so no need to remember. The instant feedback from the trainer is excellent and it is super easy to document your meals without forgetting because it's all right there in the palm of your hand."

Still, research will continue at Hopkins and elsewhere, said Labrique, also an assistant professor in the international health and epidemiology departments.

But he said already there is some evidence that some types of apps have value: They can help patients adhere to their drug regimens through regular reminders; they can help people change harmful behaviors such as smoking with various messages; and they can aid in weight loss through texts about specific goals and behaviors.

"What they all have in common is they increase how often individuals thinks about their health," Labrique said. "Instead of the occasional interaction with a health provider or system, these apps can serve as a 'guardian angel' in your pocket, reminding you often about your goals and ways to reach them. They can keep us on the straight and narrow and the path to good health."

Labrique said some apps and technologies are getting more advanced than specific reminders and encouragement. There are apps and devices that will be able to monitor your health constantly, including physical activity, sleep stress and even food eaten, and give customized feedback. Others may be able to talk to your network of friends and hook you up for ballgame when your schedules allow.

Some apps are in the works that can make a game out of encouraging healthy behavior in children.

Already, he said some pill bottles are engineered to send you a text message or phone your family when you forget your medicine.

Labrique doesn't endorse specific apps, though researchers from the Global mHealth Initiative have created their own software, including a newly released one designed to educate medical students, doctors and other workers around the globe on how to care for burn victims. The app, created by the director of Hopkins Burn Center and the director of academic computing in the School of Medicine, is called BurnMed and shows through pictures, video and text the steps needed to stabilize a burn victim in the first eight hours, the period critical for survival.

Other apps being developed as part of the initiative aim to train health workers caring for those with HIV and AIDS in Uganda and screen and support victims of domestic abuse in East Baltimore.

Still, Labrique said for an app to work, people have to use the technology and follow the advice.

"There is evidence that suggests some apps can have an impact," he said. "But at the end of the day it comes down to individual behavior and a willingness to be coached."

meredith.cohn@baltsun.com



Mobile Health Apps



There is some evidence that some types of mobile health apps are beneficial, according to Alain Labrique, director of the Johns Hopkins Global Health Initiative, including:

•Those that send reminders to keep patients, such as those with HIV or TB, on their drug regimens.

•Those that send messages to help people change harmful behaviors such as smoking.

•Those that use texts about specific goals and behaviors to aid in weight loss.