Am I taking a student in 2016?

It’s that time of year again. I’m a faculty member in the clinical psychology program at Duke. Clinical psychology programs are kind of competitive.  During application season, I get lots of questions about whether I’m taking a graduate student, as well as what I’m looking for.

Back when I applied to graduate programs in clinical psychology, I had an entire kitchen table full of brochures, letters, and file folders for each university. We didn’t apply electronically, so I had an assembly line with stacks of printed personal statements, letters of recommendation in sealed envelopes, and special sections for schools — like Duke at the time — that required extra stuff.

Some things change, some things stay the same. Then, as now, I remember wondering whether individual faculty would be taking students in my application year. I really appreciated those faculty who were transparent about their plans, so I aim to do the same. Therefore:

tl;dr: Yes, we are [probably] taking a student next year.

Now, a few pieces of totally presumptuous advice:

As most of you know, clinical psychology programs that adopt the scientist-practitioner model operate along a continuum from clinical-heavy to research-heavy emphasis. Duke’s clinical program resides at the research-heavy end of the continuum. Duke offers absolutely splendid clinical training. We have outstanding clinical supervisors and a diverse set of training settings. Our alums become very strong clinicians. But we remain a research-heavy graduate program. If you are primarily interested in becoming a clinician or are not sure about your research interests, then I would strongly consider whether a research-heavy program is right for you. My opinion: they’re probably not.

Next, when it comes to evaluating potential research mentors, fit should be your primary consideration. I cannot emphasize this enough. For better or worse, many graduate programs still use an apprentice training model. This means that you will spend at least the next four years working very closely with a research mentor to develop the skills necessary to pursue an independent research career.

Here is a universal truth about graduate study:

If the fit with your mentor stinks, your graduate experience will too. -Me

Look, we know that there are lots of good reasons to pursue graduate studies at Duke. We are one of the best research institutions in the country. We have the country’s most beautiful campus. We have the best men’s and women’s basketball teams in the nation. Our faculty actually play basketball. We have will soon have the best football team in the country. We have the best food and food trucks in the country. We have the best dance festival in the country. We have the prettiest gardens and forests in the country. We have the best weather in the country. We have the best college chapel in the country (I was married there). We have the most spirited undergrads in the country. Did I mention that I am an alumnus? Duke is an amazing place, but if the fit with your research mentor stinks, very little of this will matter.

In that spirit, here’s what I’m looking for. First, know that my team designs, tests, and disseminates interventions for obesity treatment in medically vulnerable populations. This means a few things:

  • We’re looking for those who want to learn how to develop interventions.
  • We work in real-world settings with medically vulnerable populations; for obesity this means socioeconomically disadvantaged, rural, older aged, and racial/ethnic minority groups. We’re less in determining what works for obesity treatment in highly motivated populations. We work in busy primary care settings, often far from campus.
  • We use digital health approaches. We don’t use paper, pencils, workbooks, food models, or in-person individual or group treatments.
  • Although psychology is an individual discipline, our research program is heavily invested in population health.
  • We work on the public health challenge of adult obesity. We don’t work in eating disorders (although Duke has great faculty in this space). We’re getting more interested in work with kids, and will probably start with families.
  • Finally, when evaluating a graduate application, I’m looking for those who have demonstrated an ability to think big, articulate focused research questions, work independently, execute in the field, meet deadlines, work well with colleagues, and communicate effectively – all while knowing how to have fun.

Good luck and Go Duke!

ResearchKit is flawed [just like most research studies]

(Apologies for this week’s hyper-geeky posts. I’m about to double-down now. In fact, let’s call this part of an ongoing series on the promises and perils of ResearchKit for digital health science. How’s that?)

It seems like Research Kit is a winner out of the gates. Nevertheless, in the reaction to last Monday’s announcement, a number of reports have identified a common concern: limited generalizability.

The idea here is that people who own iPhones differ from the general population (particularly from those who pocket the Android). That’s true. TL; DR: iPhone users are more educated, higher income, and less likely to be males and racial/ethnic minorities, compared to Android users.

(Note: I’ve seen lots of blogs calling this selection bias. Selection bias is a potential issue with ResearchKit, and there are lots of potential selection biases depending on what kind of study you’re conducting. However, what seems to concern people most is limited generalizability).

This is a problem. From a research perspective, it means that what we learn from ResearchKit studies will only apply to iPhone users. But, here’s the thing: most studies have this problem.

Psychological research is based on studies of undergraduates — clear generalizability issues. Our most important research fundings about health risk factors come from big studies that are rife with generalizability issues. Nurse’s Health Study recruited nurses, in part because they are knowledgeable about health, and because they are extraordinarily conscientious about research participation. Framingham Heart Study recruited patients from a single city in the Northeast (an area that is far healthier than the rest of the country). We could go on all day like this.

That said (with widespread use), I think we can mitigate some of these concerns. Here’s how:

  • Recruit large sample sizes. This creates more variability (difference) in your study sample. With recruitment potential at a global scale, this is an area in which ResarchKit can really excel.
  • Expand ResearchKit to Android (and Windows). This would expand the pool of potential study participants to non-iPhone users. If Apple handles the open-sourcing appropriately (and there’s little reason to suspect otherwise), this shouldn’t be a major problem.This one is critical for another reason. Some historically disconnected populations are not only more likely to own smartphones, but they use their phone’s advanced data-related features (e.g., text messaging, watching videos, playing games, taking pictures) more than other groups. I think this might also extend to ResearchKit apps, when they’re properly designed.
  • Targeting specific populations. There is certainly merit in ResearchKit’s ability to recruit huge samples, but there’s also potential for micro-targeting specific groups. We’ll know more in a few weeks, but I suspect that many ResearchKit apps will be distributed using Apple’s enterprise features which allow one to [largely] bypass the App Store. This might allow us to identify folks who meet particular criteria (via social media, in clinic, Mturk) and screen in/out potential participants. I’m particularly bullish on the potential of ResearchKit to help us reach people with rare diseases — this has been a persistent challenge for the research world.

Look — I’m not minimizing the challenge here and the presence of biases in existing research studies is no excuse for introducing them into new studies. Indeed, we will have to be very careful about interpreting data from ResearchKit studies — at least in the short term.

ResearchKit looks like a winner [right now]

Here’s a researchers dream: Wake up one morning and find that 11,000 people have signed up for your latest study.

“To get 10,000 people enrolled in a medical study normally, it would take a year and 50 medical centers around the country,” said Alan Yeung, medical director of Stanford Cardiovascular Health. “That’s the power of the phone.”

Here’s a researchers nightmare: Losing 80% of those 11,000.

Out of the gate, ResearchKit appears to be a smashing success. However, there’s a problem — with most mobile apps (particularly those that are commercialized by the download or rewarded for large user bases), the crucial question is “if you build it will they come?

The problem is that with research, particularly longitudinal research studies, there’s another [much more important] question: “if you build it, will they stay?

Come work with us

teamwork-606818_1920

I’m excited to announce that our center — Duke Digital Health — is recruiting a postdoctoral fellow, to start this summer/next fall. We’re looking for innovators who want create digital health interventions that work, scale, and serve high risk patients. Questions? Bug me.

Here’s the announcement [sorry it’s so dry — blame the lawyers]:

Postdoctoral Fellow
The newly established Duke Global Digital Health Science Center is seeking a full-time postdoctoral fellow. Founded in 2014, the Duke Digital Health is the first of its kind — an integrated research program for the discovery, evaluation, and dissemination of digital health interventions for medically vulnerable populations. Our mission is to close health disparities using digital health.

We are seeking a full-time postdoctoral fellow. This fellow will work for up to two years, while being mentored by Center faculty. We are open to applicants with expertise using any type of digital health intervention to address any health outcome. We invite applicants from a range of disciplinary backgrounds and varying levels of technical expertise. Ideally, the fellowship will begin in Fall 2015. The annual salary floor will be based on NIH guidelines. Successful applicants will have an earned doctorate (e.g., Ph.D., Sc.D., MD/MPH), with some training in quantitative methods. U.S. citizenship or permanent resident status is necessary due to funding requirements.

Working with his/her mentors, the fellow will be expected to contribute to the Center’s ongoing efforts, while pursuing independent research activities. The fellow will be provided with professional development funds and will have access to the Center’s software engineering team.

Application instructions:
Review of applications will begin by March 15 and will continue until the position is filled. Please include a cover letter with a statement of research interests, curriculum vitae, 1-2 sample publications, and two reference letters including one from the training director or doctoral committee chairperson/advisor.

Submit applications (as one PDF) to postdoc@dukedigitalhealth.org

Questions may be addressed to postdoc@dukedigitalhealth.org

DGHI/Duke University is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual’s age, color, disability, genetic information, gender, gender identity, national origin, race, religion, sexual orientation, or veteran status.

Am I taking a student in 2015?

It’s that time of year again. I’m a faculty member in the clinical psychology program at Duke. During application season, I get lots of questions about whether I’m taking a graduate student, as well as who (and what) I’m looking for.

Back when I applied to graduate programs in clinical psychology, I had an entire kitchen table full of brochures, letters, and file folders for each university. We didn’t apply electronically, so I had an assembly line with stacks of printed personal statements, letters of recommendation in sealed envelopes, and special sections for schools — like Duke at the time — that required extra stuff.

Some things change, some things stay the same. Then, as now, I remember wondering whether individual faculty would be taking students in my application year. I really appreciated those faculty who were transparent about their plans, so I aim to do the same. Therefore:

tl;dr: Yes, we are [probably] taking a student next year.

Now, a few pieces of totally presumptuous advice:

As most of you know, clinical psychology programs that adopt the scientist-practitioner model operate along a continuum from clinical-heavy to research-heavy emphasis. Duke’s clinical program resides at the research-heavy end of the continuum. Duke offers absolutely splendid clinical training. We have outstanding clinical supervisors and a diverse set of training settings. Our alums become very strong clinicians. But we remain a research-heavy graduate program. If you are primarily interested in becoming a clinician or are not sure about your research interests, then I would strongly consider whether a research-heavy program is right for you. My opinion: they’re probably not.

Next, when it comes to evaluating potential research mentors, fit should be your primary consideration. I cannot emphasize this enough. For better or worse, many graduate programs still use an apprentice training model. This means that you will spend at least the next four years working very closely with a research mentor to develop the skills necessary to pursue an independent research career.

Here is a universal truth about graduate study:

If the fit with your mentor stinks, your graduate experience will too. -Me

Look, we know that there are lots of good reasons to pursue graduate studies at Duke. We are one of the best research institutions in the country. We have the country’s most beautiful campus. We have the best men’s and women’s basketball teams in the nation. Our faculty actually play basketball. We have will soon have the best football team in the country. We have the best food and food trucks in the country. We have the best dance festival in the country. We have the prettiest gardens and forests in the country. We have the best weather in the country. We have the best chapel in the country. We have the most spirited undergrads in the country. Did I mention that I am an alumnus? Duke is an amazing place, but if the fit with your research mentor stinks, very little of this will matter.

In that spirit, here’s what I’m looking for. First, know that my team designs, tests, and disseminates interventions for obesity treatment in high risk populations. This means a few things:

  • We’re looking for those who want to learn how to develop interventions. We’re less of a fit if you’re interested in the causes or psychological consequences of obesity.
  • We work in real-world settings with high risk populations; for obesity this means socioeconomically disadvantaged and racial/ethnic minority groups. We’re less in determining what works for obesity treatment in highly motivated populations. We work in busy primary care settings, often far from campus.
  • We use digital health approaches. We don’t use paper, pencils, workbooks, food models, or in-person individual or group treatments.
  • Although psychology is an individual discipline, our research program is heavily invested in population health. Thus, I’m looking for those with strong interests, training, or work experience in public/global health.
  • We work on the public health challenge of adult obesity. We don’t work in eating disorders (although Duke has great faculty in this space). We’re getting more interested in work with kids, but will probably start with families.
  • Finally, when evaluating a graduate application, I’m looking for those who have demonstrated an ability to think big, articulate focused research questions, work independently, execute in the field, meet deadlines, work well with colleagues, and communicate effectively – all while knowing how to have fun.

Good luck and Go Duke!

Get your grant tips here

OLYMPUS DIGITAL CAMERA

I decided to accept the call, serve the field and my country by joining an NIH study section. Since many of you academic readers are preparing June grants, I thought that I’d list my top grantwriting tips. There are lots of good places to get good, comprehensive information on grantspersonship. What I’ll mention are some quick thoughts that emerge after reading what feels like hundreds of applications this round.

1. Imagine me. Not me and you. Just me. Sitting here, reading your grant. It’s late. It’s early. My kids just went to sleep. They’re about to wake up. I’m on my couch. I’m on the porch. It’s been a long day. It’s going to be a long day. I’m tired. I just woke up. I’m having a glass of wine. I’m about to make my kid’s lunch. I just fell asleep. Again.

Get the picture?

Most of us can’t fit our reviews into the normal workday, but we fit the reviews in. In weird places, at strange times, amidst our lives.

So make it easy! Kill the jargon. It doesn’t make the grant sound better. It makes reading difficult. Use whitespace. Lots of it. Be declarative. Use active voice. Use pictures. Be persuasive. Shorten your sentences. Make them painfully short. See what I mean? This works wonders at 11:27pm.

2. Abbreviations are absolutely horrible (AH). Why are they AH? Because they mean very little (VL) to me, so half-way through your grant, I remember VL about the terms. So now it’s 6:30 am, my kids are almost awake, I’m feeling AH, and you’re requiring me to flip back to the front of this 150 page PDF to find the first mention of this term. I know that you have VL space, but using non-standard (to me, not you) abbreviations is AH for the reviewer.

3. Be creative. Initially, I was most surprised by the huge amount of variability in the structure of individual proposals. I think people feel very bound to the structure that they learned when first writing grants. But you have license to make your grant stand out [positively]. No, you don’t need to use arcane heading structures (e.g., A.1., A.1.a., A.1.a.ii — really I’ve seen these out to four decimals). Use good figures, color, and reasonable images to get my attention!

4. Bold judiciously. I like a little hyperbole (stop laughing, everyone I’ve ever met). I get that you want me to notice your point. But you can stop bolding at the period (or even before if you like). The whole paragraph doesn’t need to be bold, because it becomes kind of like crying wolf. Oh, and pick something: bold, underline, or maybe even bold underline. But don’t do all of them, simultaneously.

5. Make your first sentence sing. There’s a reason that people get excited by the first lines of books. They matter. So make yours matter. I know that rates are rising, that disparities are prevalent, that gaps exist. Give me the gist, capture my attention, tell me why this matters, why your approach is golden, make me put this glass of wine down — all in a [short] initial sentence.

Last one [for now] — tell me why I should care. Really, I care about you, the field, and science more generally. I know that we have a horrible funding situation right now and trust that I’m in your corner. But, the sheer number of grants (which are about to increase) means that I can’t help but be … judicious. For this to work, I will need to advocate for you. I have to argue your case. I’ll need to stare down my fellow colleagues and argue why your idea matters. Inspire me to do that and I will. Promise.

Think twice before listening to your users

Back in the old days when I was learning how to develop behavior change interventions, everyone started the same way: with the focus group.

However, of late, I’ve been seeing more and more scientists applying the same rules to their digital health interventions. When designing a digital health intervention, I think you have to be very judicious about when to use focus groups and how much weight to give the findings.

Why?

Two reasons:
1) Users don’t know what they want.
2) Users can’t comprehend the tradeoffs.

John Gruber just posted an anecdote that nicely captures the challenge (BTW — yes, it’s that Marissa. From way back in 2006.

Marissa started [her talk] with a story about a user test they did. They asked a group of Google searchers how many search results they wanted to see. Users asked for more, more than the ten results Google normally shows. More is more, they said. So, Marissa ran an experiment where Google increased the number of search results to thirty. Traffic and revenue from Google searchers in the experimental group dropped by 20%. Ouch. Why? Why, when users had asked for this, did they seem to hate it? After a bit of looking, Marissa explained that they found an uncontrolled variable. The page with 10 results took .4 seconds to generate. The page with 30 results took .9 seconds. Half a second delay caused a 20% drop in traffic. Half a second delay killed user satisfaction…

The lesson, Marissa said, is that speed matters. People do not like to wait.

Now, I suspect that focus group users could’ve articulated that they like speedy web pages. No one likes watching webpages load (even if we were more tolerant of slower speeds back in 2006). But, what if we asked those users how they prioritized speed? I think most would’ve said, “I’ll happily wait a bit longer for more/better results.”

The lesson?

Base your designs on what users do, not what they say.