scholarly journals Effects of Incentives on Adherence to a Web-Based Intervention Promoting Physical Activity: Naturalistic Study

10.2196/18338 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e18338
Author(s):  
Ramona Wurst ◽  
Anja Maliezefski ◽  
Christina Ramsenthaler ◽  
Judith Brame ◽  
Reinhard Fuchs
Keyword(s):  
Physical Activity ◽  
Health Care Providers ◽  
Financial Incentives ◽  
Real Life ◽  
Naturalistic Study ◽  
Care Providers ◽  
Web Based ◽  
Incentive Group ◽  
Incentive Program ◽  
Usage Data

Background Despite many advantages of web-based health behavior interventions such as wide accessibility or low costs, these interventions are often accompanied by high attrition rates, particularly in usage under real-life conditions. It would therefore be helpful to implement strategies such as the use of financial incentives to motivate program participation and increase adherence. Objective This naturalistic study examined real-life usage data of a 12-week web-based physical activity (PA) intervention (Fitness Coach) among insurants who participated in an additional incentive program (incentive group) and those who did not (nonincentive group). Users in the incentive group had the perspective of receiving €30 (about US $33) cash back at the end of the intervention. Methods Registration and real-life usage data as part of routine data management and evaluation of the Fitness Coach were analyzed between September 2016 and June 2018. Depending on the duration of use and the weekly recording of tasks, 4 adherence groups (low, occasional, strong, and complete adherence) were defined. Demographic characteristics were collected by a self-reported questionnaire at registration. We analyzed baseline predictors and moderators of complete adherence such as participation in the program, age, gender, and BMI using binary logistic regressions. Results A total of 18,613 eligible persons registered for the intervention. Of these, 15,482 users chose to participate in the incentive program (incentive group): mean age 42.4 (SD 14.4) years, mean BMI 24.5 (SD 4.0) kg/m2, median (IQR) BMI 23.8 (21.7-26.4) kg/m2; 65.12% (10,082/15,482) female; and 3131 users decided not to use the incentive program (nonincentive group): mean age 40.7 (SD 13.4) years, mean BMI 26.2 (SD 5.0) kg/m2, median BMI 25.3 (IQR 22.6-28.7) kg/m2; 72.18% (2260/3131) female. At the end of the intervention, participants in the incentive program group showed 4.8 times higher complete adherence rates than those in the nonincentive program group (39.2% vs 8.1%), also yielding significantly higher odds to complete the intervention (odds ratio [OR] 12.638) for the incentive program group. Gender significantly moderated the effect with men in the incentive group showing higher odds to be completely adherent than women overall and men in the nonincentive group (OR 1.761). Furthermore, older age and male gender were significant predictors of complete adherence for all participants, whereas BMI did not predict intervention completion. Conclusions This is the first naturalistic study in the field of web-based PA interventions that shows the potential of even small financial incentives to increase program adherence. Male users, in particular, seem to be strongly motivated by incentives to complete the intervention. Based on these findings, health care providers can use differentiated incentive systems to increase regular participation in web-based PA interventions.

scholarly journals Effects of Incentives on Adherence to a Web-Based Intervention Promoting Physical Activity: Naturalistic Study (Preprint)

2020 ◽  
Author(s):  
Ramona Wurst ◽  
Anja Maliezefski ◽  
Christina Ramsenthaler ◽  
Judith Brame ◽  
Reinhard Fuchs
Keyword(s):  
Physical Activity ◽  
Health Care Providers ◽  
Financial Incentives ◽  
Real Life ◽  
Naturalistic Study ◽  
Care Providers ◽  
Web Based ◽  
Incentive Group ◽  
Incentive Program ◽  
Usage Data

BACKGROUND Despite many advantages of web-based health behavior interventions such as wide accessibility or low costs, these interventions are often accompanied by high attrition rates, particularly in usage under real-life conditions. It would therefore be helpful to implement strategies such as the use of financial incentives to motivate program participation and increase adherence. OBJECTIVE This naturalistic study examined real-life usage data of a 12-week web-based physical activity (PA) intervention (Fitness Coach) among insurants who participated in an additional incentive program (incentive group) and those who did not (nonincentive group). Users in the incentive group had the perspective of receiving €30 (about US $33) cash back at the end of the intervention. METHODS Registration and real-life usage data as part of routine data management and evaluation of the Fitness Coach were analyzed between September 2016 and June 2018. Depending on the duration of use and the weekly recording of tasks, 4 adherence groups (low, occasional, strong, and complete adherence) were defined. Demographic characteristics were collected by a self-reported questionnaire at registration. We analyzed baseline predictors and moderators of complete adherence such as participation in the program, age, gender, and BMI using binary logistic regressions. RESULTS A total of 18,613 eligible persons registered for the intervention. Of these, 15,482 users chose to participate in the incentive program (incentive group): mean age 42.4 (SD 14.4) years, mean BMI 24.5 (SD 4.0) kg/m<sup>2</sup>, median (IQR) BMI 23.8 (21.7-26.4) kg/m<sup>2</sup>; 65.12% (10,082/15,482) female; and 3131 users decided not to use the incentive program (nonincentive group): mean age 40.7 (SD 13.4) years, mean BMI 26.2 (SD 5.0) kg/m<sup>2</sup>, median BMI 25.3 (IQR 22.6-28.7) kg/m<sup>2</sup>; 72.18% (2260/3131) female. At the end of the intervention, participants in the incentive program group showed 4.8 times higher complete adherence rates than those in the nonincentive program group (39.2% vs 8.1%), also yielding significantly higher odds to complete the intervention (odds ratio [OR] 12.638) for the incentive program group. Gender significantly moderated the effect with men in the incentive group showing higher odds to be completely adherent than women overall and men in the nonincentive group (OR 1.761). Furthermore, older age and male gender were significant predictors of complete adherence for all participants, whereas BMI did not predict intervention completion. CONCLUSIONS This is the first naturalistic study in the field of web-based PA interventions that shows the potential of even small financial incentives to increase program adherence. Male users, in particular, seem to be strongly motivated by incentives to complete the intervention. Based on these findings, health care providers can use differentiated incentive systems to increase regular participation in web-based PA interventions.

scholarly journals Evaluation and Implementation of ListeningTime: A Web-Based Preparatory Communication Tool for Elderly Patients With Cancer and Their Health Care Providers (Preprint)

2018 ◽  
Author(s):  
Janneke Noordman ◽  
Jeanine A Driesenaar ◽  
Inge R. van Bruinessen ◽  
Johanneke E.A. Portielje ◽  
Sandra van Dulmen
Keyword(s):  
Health Care ◽  
Elderly Patients ◽  
Cancer Survivors ◽  
Health Care Providers ◽  
Real Life ◽  
Perceived Usefulness ◽  
Care Providers ◽  
Communication Tool ◽  
Web Based ◽  
Patients With Cancer

BACKGROUND Effective patient-provider communication is an important condition to deliver optimal care and it supports patients in coping with their disease. The complex and emotionally loaded setting of oncology care challenges both health care providers (HCPs) and patients in reaching effective communication. ListeningTime is developed for elderly patients with cancer and their oncological HCPs to help them (better) prepare the clinical encounter and overcome communication barriers. ListeningTime is a Web-based preparatory communication tool including modeling videos and has an audio-facility to listen back to recorded encounters. OBJECTIVE This study aims to evaluate the usability, perceived usefulness, and actual use of ListeningTime, through the eyes of elderly patients with cancer and their oncological HCPs. If highly rated, the ultimate goal is to make ListeningTime publicly available. METHODS First, members of a panel of elderly cancer survivors and patients (age ≥65 years) were approached to evaluate ListeningTime through a Web-based questionnaire. The usability and perceived usefulness were assessed. Second, ListeningTime was evaluated in real-life practice through a pilot study in 3 Dutch hospitals. In these hospitals, elderly patients with cancer and their oncological HCPs were approached to evaluate ListeningTime through a similar Web-based questionnaire, measuring the perceived usefulness. In addition, we examined log files and user statistics to get insight into how the program was used. RESULTS A total of 30 cancer survivors or patients from the patient panel, and 17 patients and 8 HCPs from the hospitals, evaluated ListeningTime. Overall, both panel members and hospital patients were positive about the ListeningTime website, audio-facility, and video fragments. Some patients suggested improvements with respect to the actors’ performances in the video fragments and believed that ListeningTime is mainly suitable for non experienced patients. HCPs were also positive about ListeningTime; they valued the video fragments for patients and the audio-facility for patients and themselves. However, providers did not relisten their own recorded encounters. Patients did use the audio-facility to relisten their encounters. CONCLUSIONS ListeningTime was highly rated, both by patients and their oncological HCPs. As a result, the video fragments of ListeningTime are now made publicly available for elderly patients with cancer through the Dutch website “kanker.nl.”

scholarly journals Obesity in Children and Adolescents during COVID-19 Pandemic

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 135
Author(s):  
Androniki Stavridou ◽  
Evangelia Kapsali ◽  
Eleni Panagouli ◽  
Athanasios Thirios ◽  
Konstantinos Polychronis ◽  
...  
Keyword(s):  
Physical Activity ◽  
Young Adults ◽  
Health Care Providers ◽  
Eating Behaviors ◽  
Adolescents And Young Adults ◽  
Care Providers ◽  
Weight Changes ◽  
Sugary Drinks ◽  
Precautionary Measures ◽  
Obesity In Children

Background: The COVID-19 pandemic has led to special circumstances and changes to everyday life due to the worldwide measures that were imposed such as lockdowns. This review aims to evaluate obesity in children, adolescents and young adults during the COVID-19 pandemic. Methods: A literature search was conducted to evaluate pertinent studies up to 10 November 2020. Results: A total of 15 articles were eligible; 9 identified 17,028,111 children, adolescents and young adults from 5–25 years old, 5 pertained to studies with an age admixture (n = 20,521) and one study included parents with children 5–18 years old (n = 584). During the COVID-19 era, children, adolescents and young adults gained weight. Changes in dietary behaviors, increased food intake and unhealthy food choices including potatoes, meat and sugary drinks were noted during the ongoing COVID-19 pandemic. Food insecurity associated with financial reasons represents another concern. Moreover, as the restrictions imposed reduced movements out of the house, physical activity was limited, representing another risk factor for weight gain. Conclusions: COVID-19 restrictions disrupted the everyday routine of children, adolescents and young adults and elicited changes in their eating behaviors and physical activity. To protect them, health care providers should highlight the risk of obesity and provide prevention strategies, ensuring also parental participation. Worldwide policies, guidelines and precautionary measures should ideally be established.

Nutrition for the Healthy Adult

2018 ◽  
Author(s):  
Marijane G. Staniec
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Weight Gain ◽  
Chronic Diseases ◽  
Health Care Providers ◽  
Primary Care Providers ◽  
Healthy Adults ◽  
Dietary Guidelines ◽  
Care Providers ◽  
Added Sugars

Many of today’s healthy adults will be plagued by chronic diseases, such as obesity, hypertension, heart disease, and diabetes, and be robbed of the quality of life they desire. According to the 2015–2020 Dietary Guidelines for Americans, about half of all American adults have one or more diet-related chronic diseases. The question, “What should healthy adults eat to stay healthy?” may seem simple. However, many primary care providers feel vulnerable answering questions about nutrition. This review serves as a summary of the most up-to-date guidelines about added sugars, sodium, types of fat, and cholesterol for healthy adults and a refresher for health care providers caring for them. Other important related issues, such as the latest recommendations for physical activity, the problem of adult weight gain, the need for adiposity screening, the powerful role of the primary care provider, and suggestions nutrition-focused primary care, are discussed. This review contains 5 Figures, 5 Tables and 137 references Key words: weight gain, cholesterol, Dietary Guidelines, sugar-sweetened beverages, adiposity, added sugar, hydrogenated oils, physical activity, waist-to-height ratio, nutrition-focused, Primary Care

scholarly journals The Issue of Aversion in Lifestyle Treatments

2016 ◽  
Vol 11 (2) ◽  
pp. 119-121 ◽  
Author(s):  
Katherine R. Arlinghaus ◽  
John P. Foreyt ◽  
Craig A. Johnston
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Health Care Providers ◽  
Bone Health ◽  
Self Efficacy ◽  
Vigorous Physical Activity ◽  
Care Providers ◽  
Behavior Adjustment

Increasing evidence suggests that vigorous physical activity (PA) is more beneficial than moderate PA for reducing adiposity and improving bone health in youth. However, beginning a vigorous PA program is not an easy behavior adjustment and the change is likely to be aversive for some individuals. In order to benefit from vigorous PA, health care providers need to help individuals increase self-efficacy.

scholarly journals Use and Effects of Patient Access to Medical Records in General Practice Through a Personal Health Record in the Netherlands: Protocol for a Mixed-Methods Study

10.2196/10193 ◽  
2018 ◽  
Vol 7 (9) ◽  
pp. e10193 ◽  
Author(s):  
Maria MT Vreugdenhil ◽  
Rudolf B Kool ◽  
Kees van Boven ◽  
Willem JJ Assendelft ◽  
Jan AM Kremer
Keyword(s):  
Health Care ◽  
General Practice ◽  
Health Care Providers ◽  
Personal Health Record ◽  
Mixed Methods Study ◽  
Personal Health ◽  
Care Providers ◽  
Group Discussions ◽  
Web Based ◽  
Staff Level

Background In the Dutch health care system, general practitioners hold a central position. They store information from all health care providers who are involved with their patients in their electronic health records. Web-based access to the summary record in general practice through a personal health record (PHR) may increase patients’ insight into their medical conditions and help them to be involved in their care. Objective We describe the protocol that we will use to investigate the utilization of patients’ digital access to the summary of their medical records in general practice through a PHR and its effects on the involvement of patients in their care. Methods We will conduct a multilevel mixed-methods study in which the PHR and Web-based access to the summary record will be offered for 6 months to a random sample of 500 polypharmacy patients, 500 parents of children aged <4 years, and 500 adults who do not belong to the former two groups. At the patient level, a controlled before-after study will be conducted using surveys, and concurrently, qualitative data will be collected from focus group discussions, think-aloud observations, and semistructured interviews. At the general practice staff (GP staff) level, focus group discussions will be conducted at baseline and Q-methodology inquiries at the end of the study period. The primary outcomes at the patient level are barriers and facilitators for using the PHR and summary records and changes in taking an active role in decision making and care management and medication adherence. Outcomes at the GP staff level are attitudes before and opinions after the implementation of the intervention. Patient characteristics and changes in outcomes related to patient involvement during the study period will be compared between the users and nonusers of the intervention using chi-square tests and t tests. A thematic content analysis of the qualitative data will be performed, and the results will be used to interpret quantitative findings. Results Enrollment was completed in May 2017 and the possibility to view GP records through the PHR was implemented in December 2017. Data analysis is currently underway and the first results are expected to be submitted for publication in autumn 2019. Conclusions We expect that the findings of this study will be useful to health care providers and health care organizations that consider introducing the use of PHR and Web-based access to records and to those who have recently started using these. Trial Registration Netherlands Trial Registry NTR6395; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6395 (Archived by WebCite at http://www.webcitation.org/71nc8jzwM) Registered Report Identifier RR1-10.2196/10193

scholarly journals Development of a tool to assess health applications for healthcare providers: A Delphi Expert Panel Study (Preprint)

2020 ◽  
Author(s):  
Immaculada Grau-Corral ◽  
Percy Efran Pantoja ◽  
Francisco J. Grajales III ◽  
Belchin Kostov ◽  
Valentí Aragunde ◽  
...  
Keyword(s):  
Literature Review ◽  
Health Care Providers ◽  
Expert Panel ◽  
Panel Study ◽  
Healthcare Providers ◽  
Care Providers ◽  
Web Based ◽  
Health Apps ◽  
Agreement Assessment ◽  
Health Applications

BACKGROUND The presence of the mobile phone and devices is generating knowledge about the use of applications to support patient care, but there are few recommendations for apps dedicated to healthcare professionals OBJECTIVE To establish a validated scale to assess healthcare mobile applications is the most efficient step for health care providers and systems. The main goal is to create and validate a tool to evaluate health apps destined to be used by health professionals. METHODS A five steps simplified methodology to assess of the scale was followed. The first step consists of building a scale for professionals based on a literature review. Next step would be an expert panel validation by a Delphi method, rating web-based questionnaires to evaluate inclusion and weight of the indicators. It was agreed to carry out, as many iterations as necessary, to reach a consensus of 75%. Finally, a pilot of the score was developed to evaluate the reliability of the scale. For the inter-rater agreement assessment during the pilot, the Cohen Kappa was used. RESULTS After the literature review, a first scale draft was developed. Two rounds of interactions of the local investigation group and the external panel of experts were needed to select final indicators. Seventeen indicators were included in the score. For the pilot test, 280 apps were evaluated and 66 meet the criteria. The interrater agreement was strong (higher than 82% with significant kappa >0.72 per app and item). CONCLUSIONS We have developed, with a reproducible methodology, a tool that allows us to evaluate health applications for clinical, surgical and general medical providers. The ISYScore-PRO scale to be reliable and reproducible. The assessment permitted to consolidate every step of the methodology. We were able to reach consensus on the dimensions and items on the scale with only two rounds. The process of validation included two robust methodologies. The ISYScore-PRO scale is reliable and reproducible.

scholarly journals Perceptions, Facilitators And Barriers of Physical Activity Among People Living With HIV: A Qualitative Study

2021 ◽  
Author(s):  
Brenda Kitilya ◽  
Erica Sanga ◽  
George PrayGod ◽  
Robert Peck ◽  
Bazil B Kavishe ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Care Providers ◽  
Gender Stereotypes ◽  
Ecological Model ◽  
People Living With Hiv ◽  
Activity Levels ◽  
Care Providers ◽  
Middle Income ◽  
Facilitators And Barriers ◽  
Living With Hiv

Abstract BackgroundPeople Living with HIV (PLWH) have low levels of physical activity. Understanding of perceptions, facilitators and barriers of physical activity in this population is of importance for future perspectives in developing contextual based intervention to improve physical activity in PLWH. MethodThis study explored perceptions, facilitators and barriers of physical activity in PLWH using sixteen in-depth interviews and three focus group discussions conducted in Mwanza, Tanzania. The interviews and discussions were audio recorded, transcribed and translated into English. Transcripts were coded and analysed deductively using thematic content analysis. The themes were interpreted and presented using the social ecological model. ResultsForty-three PLWH age 23-61 years old participated in this study. The findings showed that, PLWH perceived physical activity was beneficial to their health and that their perceptions and practices were rooted within the existing gender stereotypes and roles in the community. In addition to that, house-chores and income generating activities were perceived as sufficient physical activity to achieve adequate levels of physical activity. As facilitators, social support and interactions from family and friends were appraised positively as motivating factors of physical activity in this population. Indeed, at individual to community/environmental levels, PLWH reported barriers of physical activity were lack of time, money, and availability of facilities, as well as lack of social groups participating in physical activity in the communities and inadequate information on physical activity from health care providers at ART clinics. HIV disease was not reported as a main barrier of physical activity but rather stipulated from family members as a reason not to support physical activity in PLWH. ConclusionThe findings demonstrated differing perceptions, facilitators and barriers of physical activity among PLWH. Interventions addressing physical activity awareness, gender stereotypes and roles relating to physical activity performances from individual to community level, building supportive environment and infrastructures are needed to elevate physical activity levels in PLWH particularly in low and -middle income countries.

Level of physical activity and its correlates among health care workers in Ethiopia, 2019

2019 ◽  
Author(s):  
Tigist Demssew Adane ◽  
Birhan Gebresillassie Gebregiorgis ◽  
Elda Mekonnen Nigussie ◽  
Abate Dargie Wubetu
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Workers ◽  
Health Professionals ◽  
Associated Factors ◽  
P Value ◽  
Care Providers ◽  
Care Workers ◽  
Study Participants

Abstract Background These days, engaging at sufficient regular physical activity strongly recommended for good health and physical functioning. Physical activity can increase the self-confidence of the health professionals and they would become fit for daily activities with patients. Knowing the level of physical activity can help health care professionals to plan for physical activity programs. This study aimed to measure the level of physical activity and associated factors among adult health professionals at Tirunesh Beijing general hospital.Objective The aim of this study was to assess the level of physical activity and associated factors among health care workers in Ethiopia, 2019.Methods Institution based cross-sectional study conducted level of physical activity and associated factors among health care workers in Ethiopia, 2019. Two hundred nighty seven adult health professionals were participated, which was a 97.4% response rate. The global physical activity questionnaire used to measure the level of physical activity. Descriptive statistics and binary logistic regression analyses was done to affirm the variables characteristics. A predictor variable with a p-value of less than 0.2 exported to multivariate analysis. During multivariate analysis, statistical significance declared at a p-value of < 0.05.Results In general, the majority of the study participants, 89.2% (95% CI: 85.9-92.6) were achieved recommended levels of physical activity. Regarding the intensity of the physical activity, the overall mean time score was 518.4 mints per week or 2352.6 MET/week. For moderate-intensity physical activity, 83.5% of the study participants were physically active, (≥150 minutes/week). In the case of vigorous activity, about 32.7% of the study participants were physically active and engaged in vigorous physical activity (≥75 minutes /week). The study participants, who had self-motivation for physical activity, had a BMI of less than 25 kg/m2 and aged < 40 years were physically active.Conclusions Health care providers’ habit of physical activity improved as compared with the previous studies. However, the current level of physical activity of health professionals is not adequate. Health care providers’ age, body mass index and self-motivation attribute to physical activity. The level of physical activity can increase by enhancing staff motivation towards physical activity.

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