Hilbrand Oldenhuis

Key components in ehealth interventions combining self-tracking and persuasive ecoaching to promote a healthier lifestyle: a scoping review

Background The combination of self-tracking and persuasive eCoaching in automated interventions is a new and promising approach for healthy lifestyle management. Objective The aim of this study was to identify key components of self-tracking and persuasive eCoaching in automated healthy lifestyle interventions that contribute to their effectiveness on health outcomes, usability, and adherence. A secondary aim was to identify the way in which these key components should be designed to contribute to improved health outcomes, usability, and adherence. Methods The scoping review methodology proposed by Arskey and O’Malley was applied. Scopus, EMBASE, PsycINFO, and PubMed were searched for publications dated from January 1, 2013 to January 31, 2016 that included (1) self-tracking, (2) persuasive eCoaching, and (3) healthy lifestyle intervention. Results The search resulted in 32 publications, 17 of which provided results regarding the effect on health outcomes, 27 of which provided results regarding usability, and 13 of which provided results regarding adherence. Among the 32 publications, 27 described an intervention. The most commonly applied persuasive eCoaching components in the described interventions were personalization (n=24), suggestion (n=19), goal-setting (n=17), simulation (n=17), and reminders (n=15). As for self-tracking components, most interventions utilized an accelerometer to measure steps (n=11). Furthermore, the medium through which the user could access the intervention was usually a mobile phone (n=10). The following key components and their specific design seem to influence both health outcomes and usability in a positive way: reduction by setting short-term goals to eventually reach long-term goals, personalization of goals, praise messages, reminders to input self-tracking data into the technology, use of validity-tested devices, integration of self-tracking and persuasive eCoaching, and provision of face-to-face instructions during implementation. In addition, health outcomes or usability were not negatively affected when more effort was requested from participants to input data into the technology. The data extracted from the included publications provided limited ability to identify key components for adherence. However, one key component was identified for both usability and adherence, namely the provision of personalized content. Conclusions This scoping review provides a first overview of the key components in automated healthy lifestyle interventions combining self-tracking and persuasive eCoaching that can be utilized during the development of such interventions. Future studies should focus on the identification of key components for effects on adherence, as adherence is a prerequisite for an intervention to be effective.

Knowledge and preferences regarding cardiopulmonary resuscitation: A survey among older patients

OBJECTIVE Survival rates following cardiopulmonary resuscitation (CPR) are low for older people, and are associated with a high risk of neurological damage. This study investigated the relationship between the preferences, knowledge of survival chances, and characteristics among older people regarding CPR. METHODS A cross-sectional, self-administrated survey was distributed by researchers to 600 patients aged at least 50 years. The 14-question survey tool was used to collect basic demographic data, knowledge about CPR, and preference for CPR. We performed binary logistic regression analysis to predict whether patients wanted to receive CPR or not. RESULTS The response rate was 48%. Most respondents (84%) predicted the estimated survival rate to be higher than the actual rate. Patients were significantly less likely to want to receive CPR if they correctly estimated the survival rate, had ever contemplated CPR, were older, or female. Discussing CPR with a doctor had no influence on patient preference for CPR. CONCLUSION Older patients choose to receive CPR based on incorrect knowledge. PRACTICE IMPLICATIONS Doctors should be aware of the impact of knowing the true chances of survival on patient preference for CPR. Knowledge and skills need to be updated to provide this information to patients.

The Values of Self-tracking and Persuasive eCoaching According to Employees and Human Resource Advisors for a Workplace Stress Management Application: A Qualitative Study

Self-tracking and automated persuasive eCoaching combined in a smartphone application may enhance stress management among employees at an early stage. For the application to be persuasive and create impact, we need to achieve a fit between the design and end-users’ and important stakeholders’ values. Semi-structured interviews were conducted among 8 employees and 8 human resource advisors to identify values of self-tracking, persuasive eCoaching, and preconditions (e.g., privacy and implementation) for a stress management application, using the value proposition design by Osterwalder et al. Results suggest essential features and functionalities that the application should possess. In general, respondents see potential in combining self-tracking and persuasive eCoaching for stress management via a smartphone application. Future design of the application should mainly focus on gaining awareness about the level of stress and causes of stress. In addition, the application should possess a positive approach besides solely the focus on negative aspects of stress.

Jongeren met beperkingen en arbeidsvermogen op de arbeidsmarkt

SamenvattingWerkloze jongeren met beperkingen en arbeidsvermogen vallen vanaf 2015 onder de Participatiewet en onder verantwoordelijkheid van gemeenten. Een deel van hen heeft in het verleden een aanvraag voor de Wajong gedaan. In dit onderzoek is een groep van 44 afgewezen Wajong-aanvragers tot twee jaar na afwijzing gevolgd. Tijdens hun aanvraag en ruim een jaar na de Wajong-aanvraag is hun arbeidsmarktpositie, ervaren gezondheid, werkmotivatie en zelfinzicht in kaart gebracht. Uit de resultaten blijkt dat de Wajong-aanvragers zich ruim een jaar na afwijzing gezonder voelen, gemotiveerder zijn om te werken en meer zelfinzicht hebben dan tijdens hun aanvraag. Het blijkt echter ook dat slechts 9% van hen erin slaagt om binnen twee jaar een vaste baan te bemachtigen en dat bijna de helft ofwel uit beeld van UWV en gemeente is verdwenen, ofwel niet of nauwelijks ondersteund wordt in het vinden van werk. De groep van afgewezen Wajong-aanvragers blijft een kwetsbare groep op de arbeidsmarkt, ondanks dat zij aangeven zich gezond te voelen, gemotiveerd te zijn en over voldoende zelfinzicht te beschikken. Ondersteuning voor deze groep is daarom van groot belang, ook in het kader van de Participatiewet.AbstractYoung adults with disabilities and capacity to work at the labor market. A study on work participation, perceived general health and psychological factors of young adults who unsuccessfully applied for a disability benefit. Due to the Participation Act, municipalities are responsible for jobless young adults with disabilities and capacity to work since 2015. In this longitudinal study 44 people were followed for two years after their unsuccessful application for the Invalidity Insurance Act for Young Disabled Persons. At baseline and more than one year later their labor market position, perceived general health, work motivation and self-knowledge was measured. Results show that they reported a better health status, more motivation to work and more self-knowledge one year after their application than at the time of their application. However, only 9% had a stable job after two years and almost half of them was completely out of sight of the Social Security Institute and the municipality and/or received no substantial support in trying to find a job. Hence, this group remains very vulnerable on the labor market, in spite of their relatively high levels of perceived general health, work motivation and self-knowledge. Support for this group to find and retain work is therefore of utmost importance, also under the Participation Act.