ashley walton
research & publications


Developing mobile health (mHealth) interventions 


My work in Susan Murphy’s Statistics Reinforcement Learning Lab is focused on experimental designs for developing mHealth interventions, specifically the Micro-randomized Trial (MRT) for optimizing adaptive mobile health interventions.

The clinical problem I have focused on is detecting pain experience using sensor technologies in order to develop interventions that support chronic and acute pain management. I have worked with adolescents with sickle cell disease (SCD), as part of a long-term collaboration with Lori Crosby at Cincinnati Children’s Hospital Medical Center.


Key publications & presentations

• Walton, A., Nahum‐Shani, I., Crosby, L., Klasnja, P., & Murphy, S. (2018). Optimizing Digital Integrated Care via Micro‐Randomized Trials. Clinical Pharmacology & Therapeutics, 104 (1), 53-58. http://doi.org/10.1002/cpt.1079

• Walton, A., Quiroz, J., Crosby L., Richardson, M., Kiefer, A., Chemero, A. & Murphy, S. (2018, April). Multi-scaled measurements of pain experience in young adults with sickle cell disease. Poster presented at the Annual Society of Behavioral Medicine Meeting, New Orleans, LA. (download)

• Crosby, L. E., Ware, R. E., Goldstein, A., Walton, A., Joffe, N. E., Vogel, C., & Britto, M. T. (2016). Development and evaluation of iManage: A self‐management app co‐designed by adolescents with sickle cell disease. Pediatric blood & cancer, 64(1), 139-145. (download)



Research Components


1. Developing mobile health interventions for pain management.
As part of my dissertation research, I ran a pilot study evaluating the use of mobile sensors that record information including heart rate, skin conductance, and movement to identify levels of pain intensity in adolescents with SCD. This serves as an initial step towards designing health interventions that can be adaptive to what support patients need and when, throughout the course of their daily lives. I’ve presented this work in collaboration with Dr. Susan Murphy as a poster at the fourth annual Mobile Data to Knowledge (MD2K) meeting in October, 2017.



Poster presented at Fourth Annual Mobile Data to Knowledge (MD2K) Meeting, October, 2017.




2. Design and development of mHealth application to support social interaction and self-management for SCD. 

iManage is an iPad application I designed and developed that is integrated with a weekly self-management class for adolescents and young adults (AYA) with SCD. It is part of an NIH funded clinical trial that has recently concluded, and is in the early stage of evaluation.

Key components of the application, identified in the research and co-design phase (see below), include a diary for recording daily pain and mood, visual tracking of progress towards self-management goals, and facilitating social interaction and support from other AYA with SCD.

Future directions will focus on adapting the application so patients can download it on their personal mobile phone, sustaining engagement and patient interaction after the conclusion of the self-management course, and leveraging other mobile sensing capabilities (heart rate, movement) to provide adaptive support for pain management outside the clinical setting.




 

Snapshots of the design and development of iManage, an iPad application for AYA with SCD.



Development & Co-design process with SCD patients. The need for iManage was determined through a series of participatory design research projects in collaboration with adolescents with SCD. The phases of this research and what barriers and needs were identified are displayed in the diagram of insights included below and are described in detail in Development and evaluation of iManage: A self‐management app co‐designed by adolescents with sickle cell disease in Pediatric Blood & Cancer (Crosby et al., 2016).


Diagram of study insights from Crosby et al. (2017)


Initial prototypes of mobile tools to support self-management in SCD adolescents were presented at the 2013 National Institutes of Health Pain Consortium in Bethesda, MD.


Poster presented at the 2013 National Institutes of Health Pain Consortium in Bethesda, MD.


Publications

Crosby, L. E., Walton, A., Shook, L. M., Ware, R. E., Treadwell, M., Saving, K. L., Britto, M., Peugh, J., McTate, E., Oyeku, S., Nwankwo, C., & Brinkman, W. B. (2018, June 13), Development of a Hydroxyurea Decision Aid for Parents of Children with Sickle Cell Anemia. Journal of Pediatric Hematology/Oncology, 17-348R2.

Walton, A.E., Crosby, L., Kiefer, A., Chemero, A., Murphy, S., Richardson, M. (forthcoming). Mulit-scaled assessment for predicting pain experience in adolescents with Sickle Cell Disease. (doctoral dissertation). University of Cincinnati, Cincinnati, OH.

Crosby, L. E., Ware, R. E., Goldstein, A., Walton, A., Joffe, N. E., Vogel, C., & Britto, M. T. (2016). Development and evaluation of iManage: A self‐management app co‐designed by adolescents with sickle cell disease. Pediatric blood & cancer, 64(1), 139-145.


Posters & Presentations

Walton, A., Quiroz, J., Crosby L., Richardson, M., Kiefer, A., Chemero, A. & Murphy, S. (2018, April). Multi-scaled measurements of pain experience in young adults with sickle cell disease. Poster session presented at the Annual Society of Behavioral Medicine Meeting, New Orleans, LA.

Nwankwo, C., BA, Kidwell, K., Joffe, N., Walton. A.E., Hughes, M., Burks, J., Edwards, S. & Crosby, L.E. (2018, April). Evaluation of iManage: an App Developed with Adolescents with Sickle Cell Disease. Poster presentation at Society of Pediatric Psychology Annual Conference, Orlando, FL.

Walton, A.E., Crosby, L., Kiefer, A., Chemero, A., Murphy, S., Richardson, M. (2017, October). Multi-scaled assessment for predicting pain experience in adolescents with Sickle Cell Disease. Poster presentation at the Fourth Annual Mobile Data to Knowledge (MD2K) Meeting, Memphis, TN.

Crosby, Lori E., Joffe N., Walton, A. & Kalinyak, K. (2013, May). An Innovative Approach to Pain Assessment and Management in Pediatric Sickle Cell. Poster presented at the National Institutes of Health Pain Consortium, Bethesda, MD.

Crosby, L., Walton, A. (2013, April). An Innovative Approach to Enhancing the Transition to Adult Care in Sickle Cell Disease. Paper presentation at the Sickle Cell Disease Research and Educational Symposium, Miami, FL.

Walton, A. (2012, August). Adherence Promotion & Self Management in Sickle Cell Disease. Paper presented at the Adherence Center Seminar Series, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH.

*PDF files linked to this site are intended for personal use only.

Copyright © 2018 Ashley Walton