Miriam Cabrita

Promoting a healthy lifestyle: Towards an improved personalized feedback approach

Technology supported services for achieving a healthy lifestyle have shown their short term effects and are receiving increasing interest from the research community. However, long term adherence to these services is poor. This paper describes research-in-progress regarding the implementation of automated goal-setting and tailored feedback messages into one such technology supported service, which aims to improve the users physical activity pattern. Tailored feedback messages for several personas were set up based on theories from behavioral science and categorized by experts during an expert workshop. Results indicate reasonable agreement on the matching of motivational messages to four personas. Additional expert input is discussed descriptively. Future research will focus on examining the effectiveness of the new version of the service under investigation.

Healthcare recommendations from the Personalised ICT Supported Service for Independent Living and Active Ageing (PERSSILAA) Study

In the face of demographic ageing European healthcare providers and policy makers are recognising an increasing prevalence of frail, community-dwelling older adults, prone to adverse healthcare outcomes. Prefrailty, before onset of functional decline, is suggested to be reversible but interventions targeting this risk syndrome are limited. No consensus on the definition, diagnosis or management of pre-frailty exists. The PERsonalised ICT Supported Service for Independent Living and Active Ageing (PERSSILAA) project (2013-2016 under Framework Programme 7, grant #610359) developed a comprehensive Information and Communication Technologies (ICT) supported platform to screen, assess, manage and monitor pre-frail community-dwelling older adults in order to address pre-frailty and promote active and healthy ageing. PERSSILAA, a multi-domain ICT service, targets three pre-frailty: nutrition, cognition and physical function. The project produced 42 recommendations across clinical (screening, monitoring and managing of pre-frail older adults) technical (ICT-based innovations) and societal (health literacy in older adults, guidance to healthcare professional, patients, caregivers and policy makers) areas. This paper describes the 25 healthcare related recommendations of PERSSILAA, exploring how they could be used in the development of future European guidelines on the screening and prevention of frailty.

Exploring the relation between positive emotions and the functional status of older adults living independently: a systematic review

ABSTRACT Objectives: Literature suggests that positive emotions positively influence physiological parameters but their relation to functioning in the daily life of older adults living independently remains unclear. The present work aims to investigate the relation between positive emotions and functional status in daily life of older people living independently. Method: A systematic literature review was conducted using the PubMed, PsycINFO and Scopus electronic databases. Included works were peer-reviewed empirical studies that analysed the relation between positive emotions and ability to perform activities of daily living with older adults living independently. Results: After removal of duplicates, 10 out of 963 papers met the inclusion criteria. Cross-sectional studies (n = 6) provided limited evidence about a relation between positive emotions and functioning in daily life. However, longitudinal studies (n = 4) provide significant evidence for an interaction between the two factors, suggesting that time influences this interaction. Conclusion: The variety on the design and samples of the studies included in this review does not allow a cohesive conclusion of the results. Nevertheless, limited evidence suggests that higher frequency in the experience of positive emotions might be associated with lower functional limitations. The issue of causality in emotions-functioning remains unclear from the review. Further observational studies are highly recommended, supported by innovative technologies.

Automated personalized goal-setting in an activity coaching application

The ageing population and the increase in sedentary lifestyles of knowledge workers has led to increasing concerns about the physical activity habits of the European population. Pervasive technologies and theories of behavioral change are being combined in an effort to promote physical activity. The Activity Coach is an example of one such system. Whereas the previous version of the Activity Coach set a fixed and permanent daily goal, in this work we describe the addition of an automatically adaptive goal-setting feature to this existing system. With the new feature, the daily goals for physical activity are set based on the users routine, contributing to the personalization of the system. A technical evaluation was performed to test the systems adaptation to the users routine. Additionally, a conversion factor between a unit of energy expenditure and number of steps was determined. The evaluation indicates that our method of goal-setting provides more challenging but still attainable goals when compared to the previous version. Additional evaluations are recommended to evaluate the users perception and effects on physical activity behavior change of this new feature. The results of this research are implemented in the existing Activity Coach and will be used in future patient evaluations.

Persuasive technology to support active and healthy ageing: An exploration of past, present, and future

The age of the population worldwide is rapidly increasing, bringing social and economic challenges. Persuasive technology can alleviate the burden on traditional healthcare services when used to support healthy behaviors, for instance in the prevention and treatment of chronic diseases. Additionally, healthy behaviors are key factors for active and healthy ageing by delaying or even reversing functional decline. In this manuscript, we present a multi-perspective analysis of technologies that can be used in the support of active and healthy ageing in the daily life. First, we take the perspective of physical and mental health, by focusing on the promotion of physical activity and emotional wellbeing. From a temporal perspective, we look at how technology evolved from past, present and future. The overview of the literature is structured in four main sections: (1) measurement of current behavior (monitoring), (2) analysis of the data gathered to derive meaningful information (analyzing & reasoning), (3) support the individual in the adoption or maintenance of a behavior (coaching), and (4) tools or interfaces that provide the information to the individual to stimulate the desired behavior (applications). Finally, we provide recommendations for the design, development and implementation of future technological innovations to support Active and Healthy Ageing in daily life.

Mobile Technology to Monitor Physical Activity and Wellbeing in Daily Life - Objective and Subjective Experiences of Older Adults.

Older adults are not reaching the recommended guidelines for physical activity. There is growing evidence that physical activity and positive emotions reinforce each other. However, the development of interventions leveraging this knowledge faces several challenges, such as the limited knowledge on the assessment of emotional wellbeing in daily life using technology. In this study, we investigate the experience of older adults regarding the use of mobile technology to coach physical activity and monitor emotional wellbeing during one month. Our results show that the participants became more aware of their daily physical activity and perceived an added value in using the technology in daily life. However, only limited added-value was perceived on monitoring positive emotions in daily life in the way we performed it. The most common argument concerned repetitiveness of the questions being asked every day. Moreover, participants also reported that they were not used to think about their emotions, what affected the way they answered the questions regarding their emotional wellbeing. Our results suggest that, to ensure reliability of the data, it is extremely important to hear the experience of the participants after performing studies in daily life.

ICT-Supported Interventions Targeting Pre-frailty: Healthcare Recommendations from the Personalised ICT Supported Service for Independent Living and Active Ageing (PERSSILAA) Study

As society ages, healthcare systems are preparing for an increasing prevalence of frail, co-morbid and older community-dwellers at risk of adverse outcomes including falls, malnutrition, hospitalisation, institutionalisation and death. Early intervention is desirable and pre-frailty, before onset of functional decline, may represent a suitable transition stage to target, albeit evidence for reversibility and appropriate interventions are limited. No consensus on the definition, diagnosis or management of pre-frailty exists. This work describes 25 healthcare related findings from the recently completed PERsonalised ICT Supported Service for Independent Living and Active Ageing (PERSSILAA) project, funded under the 2013–2016 European Union Framework Programme 7 (grant #610359). PERSSILAA developed a comprehensive Information and Communication Technologies (ICT)-supported platform to screen, assess, intervene and then monitor community-dwellers in two regions (Enschede in the Netherlands and Campania in Italy) in order to address pre-frailty and promote active and healthy ageing, targeting three important pre-frailty subdomains: nutrition, cognition and physical function. Proposed definitions of pre-frailty, ICT-based approaches to screen and monitor for the onset of frailty and targeted management strategies employing technology across these domains are described. The potential of these 25 healthcare recommendations in the development of future European guidelines on the screening and prevention of frailty is explored.

Dinner is ready!: Virtual Reality Assisted Training for Chronic Pain Rehabilitation

Gamified environments in Virtual Reality (VR) have shown promising results for acute pain and behavioral health. The potential for rehabilitation of chronic pain has yet to be explored. In this paper, we present a Virtual Reality game to improve the training of chronic pain both in the clinical and home settings. The prototype was designed in strong collaboration with therapists and patients to meet specific needs of this clinical population. With this approach, we are able to translate clinical guidelines into the VR environment to facilitate future implementation in the care path. User evaluations show that the game tasks meet the aim of simulating activities performed in clinical practice and provide indications for future improvements. The proof of concept will be finalized end-2017. We expect that VR-assisted training for chronic pain rehabilitation can provide added value in terms of motivation, engagement and facilitating rehabilitation achievements to daily life.

Technology based interventions to promote Healthy and Active Ageing: the role of positive emotions and physical activity

An active lifestyle is of utmost importance for the quality of life of the older adults. With active lifestyle is meant not only physically active, but also engaged with the social environment. Although some individuals can achieve a desired level of physical activity and engagement by themselves, others seem to be in need of an external motivation. Technology based interventions show promising results promoting healthy behaviours, namely physical activity, in daily life. However, to the best of our knowledge, the promotion of an active lifestyle has been less explored. We intend to bring technology-based interventions beyond the state of the art by designing tailored strategies to motivate people to be physically active through engagement in pleasurable activities, thereby promoting healthy and active ageing. Our approach is to look at how the experience of positive emotions relate to physical activity in the daily lives of older adults and, based on that, design tailored strategies to support older adults in becoming more active. Therefore we define two objectives: (1) to increase understanding on the relationship between positive emotions and physical health in daily lives of older adults living independently and (2) to investigate how technology can support in monitoring and coaching towards active ageing in daily life. To achieve these objectives we perform a systematic literature review and two observational studies. We hypothesize that the experience of positive emotions in daily life is highly personal, with our studies focusing on a deep understanding in an individual level, making use of wearable technology and experience sampling on a smartphone. The results of the literature and observational studies are used to define the parameters and relations of a model to be implemented in a mobile system to promote active ageing in daily life. The literature review is concluded as well as the data acquisition of one observational study. This PhD trajectory is expected to be concluded by the end of 2016.

User Interaction Concepts in Smart Caring Homes for Elderly with Chronic Conditions

This article addresses the design and implementation of user interaction concepts for smart caring homes. Elderly suffering from age related frailty or chronic diseases, such as chronic obstructive pulmonary disease and mild dementia are the targeted primary users. Their informal and formal caregivers are regarded as secondary users. The current smart home approach to user interaction is either too intrusive or too unobtrusive. This article proposes an alternative that implements both concepts in complementary interaction paradigms, using multiple types of feedback devices.