Diffusion of mHealth Innovations for Nepali Adolescents: A Pilot Study on Indirect Mental Costs and Cultural Context Considerations
Description
Adolescents are slowly being recognized as a generation, worldwide, that may require different policy approaches to improve their health and wellbeing, including the adoption of mobile based health interventions (e.g. mHealth). While mHealth interventions are growing in popularity, many researchers/policymakers appear to have neglected assessing potential (indirect) costs/negative consequences from their use. Evidence from the developed world shows strong associations between cell phone use and negative mental health outcomes, but such findings are minimal in developing world contexts. Using primary data from a large-scale, school-based survey of 17-19-year-old adolescents in southwestern Nepal, this work investigates such a tension between mobile/smartphone usage as a true mobile health (mHealth) opportunity in Nepal or as a potential problem, introducing deleterious mental health effects from over-use. Analysis, founded in Basic Psychological Needs Theory, examines the mediating role of mobile phone use between the protective and adverse factors of the socio-cultural environment and their subsequent impact on mental health, using structural equation modeling. Additionally, given the endogeneity between mental health and certain cellphone usage types, we include use of instrumental variables techniques from risky behavior literature to attempt to account for this simultaneity concern.
Diffusion of mHealth Innovations for Nepali Adolescents: A Pilot Study on Indirect Mental Costs and Cultural Context Considerations
Adolescents are slowly being recognized as a generation, worldwide, that may require different policy approaches to improve their health and wellbeing, including the adoption of mobile based health interventions (e.g. mHealth). While mHealth interventions are growing in popularity, many researchers/policymakers appear to have neglected assessing potential (indirect) costs/negative consequences from their use. Evidence from the developed world shows strong associations between cell phone use and negative mental health outcomes, but such findings are minimal in developing world contexts. Using primary data from a large-scale, school-based survey of 17-19-year-old adolescents in southwestern Nepal, this work investigates such a tension between mobile/smartphone usage as a true mobile health (mHealth) opportunity in Nepal or as a potential problem, introducing deleterious mental health effects from over-use. Analysis, founded in Basic Psychological Needs Theory, examines the mediating role of mobile phone use between the protective and adverse factors of the socio-cultural environment and their subsequent impact on mental health, using structural equation modeling. Additionally, given the endogeneity between mental health and certain cellphone usage types, we include use of instrumental variables techniques from risky behavior literature to attempt to account for this simultaneity concern.