Joyca Lacroix

Individual differences in persuadability in the health promotion domain

This paper examines the behavioral consequences of individual differences in persuadability in the health promotion domain. We use a 7-item persuadability instrument to determine participants persuadability score. Based on this score two groups are created: the low and high persuadables. Subsequently, we present 2 studies that test the responses to health-related persuasive messages of both low and high persuadables. The results consistently show that high persuadables comply more to messages with a persuasive content as compared to a neutral message than low persuadables. Even more, both studies indicate lower compliance by low persuadables when persuasive messages are employed. Implications of this possible detrimental effect of the use of persuasive messages for low persuadables are discussed.

Understanding user cognitions to guide the tailoring of persuasive technology-based physical activity interventions

The growing number of people with an inactive lifestyle emphasizes the need for highly persuasive physical activity interventions. Modern technological developments bring great promise for the realization of such large-scale persuasive behavior change interventions because they allow for user tailored interaction. For the effective tailoring of technology-based interventions, a profound understanding of the main variables underlying physical activity behavior is required. In this paper, we focus on three cognitive variables that have shown to be crucial for the adoption and maintenance of health behaviors: behavioral regulation, types of motives, and self-efficacy. In particular, we explore the relationship of these cognitive variables with actual levels of daily-life physical activity. Our study differs from related studies in two important ways. First, we consider the entire range of physical activities performed throughout the day while many studies focused on sports and or dedicated exercise. Second, we employ a wearable device for the objective measurement of daily physical activity levels rather than rely on self-report measures. Our results show that active individuals feel higher levels of self-determined behavioral regulation, experience stronger motives to be active (in particular for health and well-being related motives), and have higher levels of self-efficacy for daily-life physical activity than inactive individuals. We argue that tailored technology-based activity interventions should accommodate these cognitive variables and for inactive individuals, aim to gradually induce and internalize the cognitions already experienced by active individuals.

Self-setting of physical activity goals and effects on perceived difficulty, importance and competence

Goal setting can be a powerful method for persuading individuals to adopt an active lifestyle. In order for this to be the case, it is important to set concrete and challenging goals, and to strongly commit to them. In this study, we explored how people set goals for physical activity and how these goals were reflected in self-regulatory mechanisms to drive goal attainment. Our approach is novel in two ways: first, we used an unobtrusive wearable sensor to accurately measure physical activity throughout the day rather than rely on self-report, and second, we provided individuals with feedback about the contribution of their common daily activities (e.g., household activities) to their physical activity level. Our results showed that on the basis of this feedback, participants were able to indicate to what degree they intended to change their behavior. Nevertheless, they failed to set concrete goals that matched their intentions precisely. In particular, we observed that overall the set goals were in accordance with intentions (i.e., goals were set in the desired direction), but we saw a strong tendency to focus on enhancing vigorous activity at the cost of moderate intensity activity. This suggests that many individuals have intentions to change and goal setting support is needed to compose goals that accurately reflect these intentions. Technology-mediated interventions might be ideal to support individuals along that path.

Mindfulness and satisfaction in physical activity: A cross-sectional study in the Dutch population

Both satisfaction and mindfulness relate to sustained physical activity. This study explored their relationship. We conducted a cross-sectional study with 398 Dutch participants who completed measures on trait mindfulness, mindfulness and satisfaction with physical activity, physical activity habits, and physical activity. We performed mediation and moderated mediation. Satisfaction mediated the effect of mindfulness on physical activity. Mindfulness was related to physical activity only when one’s habit was weak. The relation of mindfulness with satisfaction was stronger for weak compared to strong habit. Understanding the relationship between mindfulness and satisfaction can contribute to the development of interventions to sustain physical activity.

Exercising at home: Real-time interaction and experience sharing using avatars

Abstract This paper reports on the design of a vision-based exercise monitoring system. The system aims to promote well-being by making exercise sessions enjoyable experiences, either through real-time interaction and instructions proposed to the user, or via experience sharing or group gaming with peers in a virtual community. The use of avatars is explored as means of representation of the user’s exercise movements or appearance, and the system employs user-centric approaches in visual processing, behavior modeling via history data accumulation, and user feedback to learn the user’s appreciation. A preliminary user survey study has been conducted to explore the avatar appreciations across different types of social contexts.

The relation of trait and state mindfulness with satisfaction and physical activity: A cross-sectional study in 305 Dutch participants.

Previous research has shown that satisfaction mediates the relationship of state mindfulness (i.e. during physical activity) with physical activity. This study aimed to replicate this finding and to explore the role of trait mindfulness with a cross-sectional design. In all, 305 participants completed measures on trait and state mindfulness, satisfaction with physical activity, and physical activity. Mediation analyses were used. Satisfaction mediated the effect of state mindfulness on physical activity. Trait mindfulness related to physical activity via an indirect path, namely through two consecutive mediators, first state mindfulness and then satisfaction. Our results suggest that to enhance satisfaction, both state and trait mindfulness should be considered.

An online survey to study the relationship between patients’ health literacy and coping style and their preferences for self-management-related information

Objective To evaluate patients’ preferences for message features and assess their relationships with health literacy, monitor–blunter coping style, and other patient-dependent characteristics. Methods Patients with coronary heart disease completed an internet-based survey, which assessed health literacy and monitor–blunter coping style, as well as various other patient characteristics such as sociodemographics, disease history, and explicit information preferences. To assess preferences for message features, nine text sets differing in one of nine message features were composed, and participants were asked to state their preferences. Results The survey was completed by 213 patients. For three of the nine text sets, a relationship was found between patient preference and health literacy or monitor–blunter coping style. Patients with low health literacy preferred the text based on patient experience. Patients with a monitoring coping style preferred information on short-term effects of their treatment and mentioning of explicit risks. Various other patient characteristics such as marital status, social support, disease history, and age also showed a strong association. Conclusion Individual differences exist in patients’ preferences for message features, and these preferences relate to patient characteristics such as health literacy and monitor–blunter coping style.

A dual-process view on medication adherence: The role of affect

Medication non-adherence has been recognised as one of the major problems in health care that leads to preventable costs and hospitalisations. This study aimed to assess the role of affect in medication adherence. We propose a dual-process framework of medication adherence based on the reflective–impulsive model, which includes both cognitive and affective processes. We tested this framework in a cross-sectional study (N = 525). The results supported this framework by illustrating the clear role of both cognitive and affective processes.

Assessment of user needs for self-management services in coronary heart disease: a designerly approach

Motivation -- Coronary heart disease (CHD) is a chronic condition with a high prevalence in Western countries. Unless properly managed it leads to life-threatening events, increasing disabilities, and death. Due to the essential role of lifestyle in the development of CHD, patients are in a large part able to self-manage their disease. Internet-based self-management tools and services hold the promise to support patients and their caregivers in this task. Research approach -- This study aims to identify the needs and preferences of CHD patients in daily self-management challenges. An exploratory qualitative research method, originating from the field of product design, will be used to explore self-management needs of CHD patients. As a preparation to this study a literature study, four interviews and a pilot study were executed. Findings/Design -- Based on the literature study and the interviews, two different research tools were designed. These tools were tested in a pilot study. From August to October inclusive the research tools will be adjusted and the study will be executed, resulting in a description of health related self-management needs for patients with CHD. Take away message -- New opportunities for prevention of disease and health self-management arise through internet-based applications. Qualitative research methods involving patients, originating from the field of product design can contribute to the optimal development of such applications.

Effectiveness of a medication-adherence tool: study protocol for a randomized controlled trial

BackgroundResearch shows that more than half of the people taking medication for a chronic condition are non-adherent. Nonadherence hinders disease control with a burden on patient quality of life and healthcare systems. We developed a tool that provides insight into nonadherence risks and barriers for medication-adherence including an intervention strategy to overcome those barriers. This study aims to assess the effectiveness of using this adherence tool in starters with cardiovascular or oral blood glucose-lowering medication to improve medication-adherence.Methods/designIn a cluster-randomized controlled trial 25 pharmacies in the Netherlands will be randomized to the intervention or control arm. Patients registered in a general practice participating in a collaborative can be included when they start cardiovascular or oral blood glucose-lowering medication prescribed by their general practitioner.Participants complete an assessment consisting of measuring nonadherence risk and potential barriers to adherence. For patients with an increased nonadherence risk, a graphic barrier profile is created, showing to what extent eight cognitive, emotional, or practical barriers are present.All patients will fill in the medication-adherence assessment twice: between 1 and 2 weeks after the start of the medication and after 8 months.The intervention strategy consists of discussing this barrier profile to overcome barriers. Pharmacists and assistants of the intervention pharmacies are trained in discussing the profile and to offer a tailored intervention to overcome barriers. In the control arm, patients receive care as usual.The primary outcome is medication-adherence of patients with a high risk of nonadherence at 8 months follow-up.Secondary outcomes include the difference in the percentage of patients with an increased nonadherence risk between intervention and control group after 8 months, the predictive values of the baseline questionnaire in the control group in relation to medication-adherence after 8 months, medication-adherence after 1 year follow-up, and barriers and facilitators in the implementation of the tool.DiscussionThis manuscript presents the protocol for a cluster-randomized clinical trial on the use of an adherence tool to improve medication-adherence. This study will provide insight into the effectiveness of the tool in starters with cardiovascular or oral blood glucose-lowering medication in improvement of medication-adherence.Trial registrationThe Netherlands National Trial Register, NTR5186. Registered on 18 May 2015.