Wants to improve eHealth interventions
When Holter worked at the Quit-line at the Norwegian Directorate of Health she experienced that the combination of physical, psychological and social addiction together with the tobacco companies' persistent attempts to keep their customers, made it very difficult for many people to quit on their own. When she heard about the project of a fully automated program that would give people the necessary support to be able to quit, she found that idea intriguing.
- On an overarching level, my research is on how to improve the quality of eHealth interventions; i.e. applications that can help you live healthier and take better care of yourself, via web or mobile, she says.
There are now countless programs to help people lose weight, quit smoking, reduce stress and reduce their alcohol intake, among others. Some of these programs show better effect in making people change their behavior than other programs do. But although there are many different applications, and many studies showing the effectiveness of these programs, little is still known about why some programs work better than others.
- To gain more knowledge about this is the primary objective of my doctorate degree, Holter says.
An automatic conversation with the users
Holter has been heavily involved in the development of a smoking cessation program called "Endre” (Change). This she has done as part of her doctoral degree at SERAF. "Endre" is a completely automatic program and there are no people involved in the contact with the users, but the program still maintains a form of "conversation" over time with the individual user.
- We have some ideas on how such a "conversation" may be most effective, and we have tried to implement these ideas into the program, she says.
Researcher Håvar Brendryen at SERAF, who is Holter’s main supervisor and the leader of the research project, will put one of these ideas to the test in an RCT, while Holter herself will explore another with a qualitative study as part of her degree.
The user-friendliness and trust as important aspects
According to Holter there are many people who need help and support in order to free themselves from the personal issues that weigh them down. EHealth applications can be a cost-effective, easily accessible and evidence-based way of providing this support. But if one doesn’t have the knowledge of what separates effective programs from those that are less effective, it is difficult to know how to create applications that people like to use, that they trust and that will help them.
- It's like handing out medications without knowing what the effective substances are, or to engage in psychotherapy without knowing what has the potential to help the client, she says.
- In other words, a bit directionless.
Holter's dream is that researchers in the field will be better at describing what they think are the important elements of their eHealth programs, so that other developers might use the same elements in their programs. This will provide a better basis for large meta-analyzes that could provide proper answers to what really works and what does not.
- In ten years’ time I hope the field has come further along in identifying elements of eHealth applications that might potentially be effective, says Holter.
A balancing act
During her first year as a PhD candidate at SERAF, Marianne Holter has learned that a good researcher preferably should be able to think big, but at the same time be able to do laborious work to Reach your goals.
- I think that you must find a balance between not letting yourself be limited by the existing research when thinking, but find a way to adapt your thoughts to the real world to make the research feasible and the results relevant, she says.
She points out that it is important to find a balance in life between research, family, friends and interests, both to gain energy and to discover interesting angles in your work.
- In addition, I think a good researcher will support other researchers and grow on their resources and ideas rather than feel threatened by them. But I'm still only learning to become a researcher.
Holter is in her element as a PhD candidate at SERAF. But what if she wanted to do something completely different?
- In secret, I am a singer-song-writer and would like to have recorded and released my own music and done concerts. Maybe I would have traveled around with my music to those who cannot go to concerts - to nursing homes, refugee centers and hospitals. That would have been meaningful and nice, she concludes.