If I’d Only Known Then What I Know Now (A Letter to Myself)

Katherine Kim, M.P.H., MBA, iN Touch Principal Investigator, San Francisco State University

Dear Kathy,

Three years from now you are going to be finishing the iN Touch project. You’ll have done some things well, made plenty of mistakes, and learned so much. I’m writing this letter to share some of those lessons.

1. You and Christina made the right decision to apply for the Project HealthDesign grant, even though you were worried because those grants from the Robert Wood Johnson Foundation are so competitive.


2. When you start hitting road bumps, lean on your team. Christina, Hali, Judy, Cam-tu, Holly, Ed, Janelle, and Yulia will amaze you with their creativity, optimism, gumption and all-around smarts.


3. The IRB approval process will take twice as long as you expect. The phased IRB that Barbara Massoudi suggests will be the way to go. Submit the application design and testing IRB right away, then work on the intervention IRB which will probably undergo some changes based on the testing. Just-in-time IRB will not be soon enough.


4. Recruitment will take twice as long as you expect. Prototype your recruitment process with the clinicians and staff. Don’t be discouraged by the disconnected phone numbers and no-shows. Remember that life is complicated and messy for the patients. Start recruiting as early as possible.


5. Over-recruit. I just said life is complicated and messy for patients. Even if they want to finish the study, a third of them won’t be able to. Don’t feel bad, this is typical for health and lifestyle studies and those studies with younger and minority participants have even higher dropout rates. You’ll need to recruit more to compensate.


6. Developing attractive, useful reports of ODL data will be harder than you expect. The clinicians won’t know exactly what they want so you’ll have to start out with a mock-up. Recruit a visualization/design expert next time.  Oh yeah, the hospital, clinic, and school will all be on different browsers and versions and they won’t want to update just for you. So make sure to test the reports on multiple browsers.


7. Use multiple communication modes for reminders and scheduling. Paper notes still work!  Deliver them to the classroom to remind youths to come to their appointments. Some of them will want reminders to record ODLs through their iPod Touches, others via text messages to their phones. Forget about email – they never check email.


8. Be ready to educate and evangelize. Hospital, clinic, and school staff members haven’t heard of observations of daily living (ODLs) before and they’re not sure how they feel about mobile technology. You are not just asking them to partner with you on a project, you are asking them to change how they work and engage with patients.


9. The youths who participate in the study will amaze you. They are motivated and excited to use the technology and new strategies to meet their health goals. They’ll teach you a lot about improving health behaviors.

Have a great time with the iN Touch project.

Kathy