Perceptions of factors influencing engagement with health and wellbeing apps: a qualitative study using the COM-B model and Theoretical Domains Framework (Preprint)

2021 ◽  
Author(s):  
Dorothy Szinay ◽  
Olga Perski ◽  
Andy Jones ◽  
Tim Chadborn ◽  
Jamie Brown ◽  
...  
Keyword(s):  
Cognitive Load ◽  
Goal Setting ◽  
Theoretical Domains Framework ◽  
Action Planning ◽  
Care Providers ◽  
Self Monitoring ◽  
Health And Wellbeing ◽  
Multiple Factors ◽  
Wide Range ◽  
User Guidance

BACKGROUND Digital health media, such as health and wellbeing smartphone apps, could offer an accessible and cost-effective way to deliver health and wellbeing interventions. A key component of the effectiveness of these apps is user engagement. However, engagement with health and wellbeing apps is typically sub-optimal. Previous studies have identified multiple factors that influence engagement, however, most of these studies were conducted on specific populations or focused on apps targeting a particular behaviour. Understanding factors that influence engagement with a wide range of health and wellbeing apps can help inform the design and development of more engaging apps. OBJECTIVE The aim of this study was to explore users’ experiences of and reasons for engaging and not engaging with a wide range of health and wellbeing apps. METHODS A sample of adults in the UK (N=17) interested in using a health or wellbeing app took part in a semi-structured interview to explore experiences of engaging and reasons for not engaging with these apps. Participants were recruited via social media platforms. Data were analysed with the framework approach, informed by the Capability, Opportunity, Motivation – Behaviour (COM-B) model and the Theoretical Domains Framework, two widely used frameworks that incorporate a comprehensive set of behavioural influences. RESULTS Factors appearing to influence the capability of participants to engage with health and wellbeing apps included available user guidance, statistical and health information, reduced cognitive load, well-designed reminders, self-monitoring features, features that help to establish a routine, features that allow retaining the app for a potential precipitating event in the future (‘safety netting’) and features that offer a first step in the behaviour change process (‘stepping stone’). Tailoring, peer support and embedded professional support were identified as important factors that appeared to enhance users’ opportunity for engagement with health and wellbeing apps. Feedback, rewards, encouragement, goal setting, action planning, self-confidence and commitment were judged to be motivation factors affecting engagement with health and wellbeing apps. CONCLUSIONS Multiple factors were identified across all components of the COM-B model that may be valuable for enhancing the engagement of health and wellbeing apps. Engagement appears to be influenced primarily by features that provide user guidance, promote minimal cognitive load and support self-monitoring (capability), provide embedded social support (opportunity), and goal setting with action planning (motivation). We provide recommendations for policy makers, industry, health care providers and app developers on how to increase engagement. CLINICALTRIAL Not applicable.

scholarly journals Behavior Change Techniques in Wrist-Worn Wearables to Promote Physical Activity: Content Analysis (Preprint)

2020 ◽  
Author(s):  
Peter Düking ◽  
Marie Tafler ◽  
Birgit Wallmann-Sperlich ◽  
Billy Sperlich ◽  
Sonja Kleih
Keyword(s):  
Physical Activity ◽  
Content Analysis ◽  
Behavior Change ◽  
Goal Setting ◽  
Wearable Sensors ◽  
Action Planning ◽  
Noncommunicable Diseases ◽  
Behavior Change Techniques ◽  
Self Monitoring ◽  
Current Behavior

BACKGROUND Decreasing levels of physical activity (PA) increase the incidences of noncommunicable diseases, obesity, and mortality. To counteract these developments, interventions aiming to increase PA are urgently needed. Mobile health (mHealth) solutions such as wearable sensors (wearables) may assist with an improvement in PA. OBJECTIVE The aim of this study is to examine which behavior change techniques (BCTs) are incorporated in currently available commercial high-end wearables that target users’ PA behavior. METHODS The BCTs incorporated in 5 different high-end wearables (Apple Watch Series 3, Garmin Vívoactive 3, Fitbit Versa, Xiaomi Amazfit Stratos 2, and Polar M600) were assessed by 2 researchers using the BCT Taxonomy version 1 (BCTTv1). Effectiveness of the incorporated BCTs in promoting PA behavior was assessed by a content analysis of the existing literature. RESULTS The most common BCTs were goal setting (behavior), action planning, review behavior goal(s), discrepancy between current behavior and goal, feedback on behavior, self-monitoring of behavior, and biofeedback. Fitbit Versa, Garmin Vívoactive 3, Apple Watch Series 3, Polar M600, and Xiaomi Amazfit Stratos 2 incorporated 17, 16, 12, 11, and 11 BCTs, respectively, which are proven to effectively promote PA. CONCLUSIONS Wearables employ different numbers and combinations of BCTs, which might impact their effectiveness in improving PA. To promote PA by employing wearables, we encourage researchers to develop a taxonomy specifically designed to assess BCTs incorporated in wearables. We also encourage manufacturers to customize BCTs based on the targeted populations.

Intervention Components Targeting Self-Management in Individuals with Multiple Chronic Conditions: An Integrative Review

2020 ◽  
Vol 42 (11) ◽  
pp. 948-962
Author(s):  
Jessica J. Miller ◽  
Bunny J. Pozehl ◽  
Windy Alonso ◽  
Myra Schmaderer ◽  
Christine Eisenhauer
Keyword(s):  
Peer Support ◽  
Goal Setting ◽  
Chronic Conditions ◽  
Descriptive Analysis ◽  
Action Planning ◽  
Conclusive Evidence ◽  
Self Management ◽  
Multiple Chronic Conditions ◽  
Delivery Methods ◽  
Self Monitoring

Multiple chronic conditions (MCC) are becoming increasingly common and self-management (SM) interventions to address MCC are emerging. Prior reviews have broadly examined SM interventions in MCC; however, interventional components were not thoroughly described. Components of SM interventions that have been delivered to individuals with MCC were identified. A review of CINAHL, Cochrane, PubMed, PsycINFO, Scopus, and Embase was completed. This search yielded 13,994 potential studies; 31 studies among those 13,994 studies met inclusion for analysis. The literature is multidisciplinary and describes a wide variety of interventional strategies implementing various combinations of components. A descriptive analysis of the studies’ components, application of the components, delivery methods, and primary outcomes demonstrated clear variations between programs. The most common components noted in the 31 studies were education, action planning/goal setting, self-monitoring, and social/peer support. The variation in SM programs limits conclusive evidence for which components are recommended to improve self-management in individuals with MCC.

scholarly journals Performance Analysis of the OneTouch® UltraVue™ Blood Glucose Monitoring System

2009 ◽  
Vol 3 (5) ◽  
pp. 1158-1165 ◽  
Author(s):  
Anna Chang ◽  
Alice Orth ◽  
Bryan Le ◽  
Perla Menchavez ◽  
Lupe Miller
Keyword(s):  
Blood Glucose ◽  
Health Care Providers ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Care Providers ◽  
Self Monitoring ◽  
Glucose Levels ◽  
Wide Range ◽  
Clinical Action ◽  
Clinical Accuracy

Background: OneTouch® UltraVue™ is a new meter for self-monitoring of blood glucose that includes a color display, used-strip ejector, and no-button interface. The system uses an electrochemical biosensor technology based on glucose oxidase chemistry to detect glucose concentrations from 20 to 600 mg/dl (1.1 to 33.3 mmol/liter). Methods: Accuracy and reproducibility were evaluated over a wide range of glucose concentrations according to standard criteria. Clinical accuracy was assessed by health care providers (HCPs) in two studies and by diabetes patients in the second study. Reference glucose levels were determined by a YSI 2300 analyzer. Same-day reproducibility and day-to-day reproducibility were also evaluated. Results: In the accuracy studies, 99.7% and 98.7% of tests by HCPs and 97.0% of tests by patients were within ±15 mg/dl (±0.8 mmol/liter) of the YSI reference for blood glucose <75 mg/dl (<4.2 mmol/liter), and within ±20% for blood glucose ≥75 mg/dl (≥4.2 mmol/liter), respectively. Consensus error grid analysis showed that 99.7% and 95.3% of tests by HCPs and 97.0% of tests by patients fell within zone A (i.e., has no effect on clinical action); all other results were in zone B (i.e., altered clinical action, little or no effect on clinical outcome). In the reproducibility studies, the standard deviation was <1.5 mg/dl (<0.1 mmol/liter) for glucose concentrations <100 mg/dl (<5.6 mmol/liter), and the coefficient of variation was <2% for concentrations ≥100 mg/dl (≥5.6 mmol/liter). Conclusions: OneTouch UltraVue meets standard acceptability criteria for accuracy and reproducibility across a wide range of glucose concentrations. Its simple interface and lack of contact with used strips make it a viable option for older patients and their caregivers.

scholarly journals Behavior Change Techniques in Wrist-Worn Wearables to Promote Physical Activity: Content Analysis

10.2196/20820 ◽  
2020 ◽  
Vol 8 (11) ◽  
pp. e20820
Author(s):  
Peter Düking ◽  
Marie Tafler ◽  
Birgit Wallmann-Sperlich ◽  
Billy Sperlich ◽  
Sonja Kleih
Keyword(s):  
Physical Activity ◽  
Content Analysis ◽  
Behavior Change ◽  
Goal Setting ◽  
Wearable Sensors ◽  
Action Planning ◽  
Noncommunicable Diseases ◽  
Behavior Change Techniques ◽  
Self Monitoring ◽  
Current Behavior

Background Decreasing levels of physical activity (PA) increase the incidences of noncommunicable diseases, obesity, and mortality. To counteract these developments, interventions aiming to increase PA are urgently needed. Mobile health (mHealth) solutions such as wearable sensors (wearables) may assist with an improvement in PA. Objective The aim of this study is to examine which behavior change techniques (BCTs) are incorporated in currently available commercial high-end wearables that target users’ PA behavior. Methods The BCTs incorporated in 5 different high-end wearables (Apple Watch Series 3, Garmin Vívoactive 3, Fitbit Versa, Xiaomi Amazfit Stratos 2, and Polar M600) were assessed by 2 researchers using the BCT Taxonomy version 1 (BCTTv1). Effectiveness of the incorporated BCTs in promoting PA behavior was assessed by a content analysis of the existing literature. Results The most common BCTs were goal setting (behavior), action planning, review behavior goal(s), discrepancy between current behavior and goal, feedback on behavior, self-monitoring of behavior, and biofeedback. Fitbit Versa, Garmin Vívoactive 3, Apple Watch Series 3, Polar M600, and Xiaomi Amazfit Stratos 2 incorporated 17, 16, 12, 11, and 11 BCTs, respectively, which are proven to effectively promote PA. Conclusions Wearables employ different numbers and combinations of BCTs, which might impact their effectiveness in improving PA. To promote PA by employing wearables, we encourage researchers to develop a taxonomy specifically designed to assess BCTs incorporated in wearables. We also encourage manufacturers to customize BCTs based on the targeted populations.

Urinary tract infections (UTIs); a leaflet for older adults, and carers: the development of a UTI leaflet for older adults and their carers

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X696833 ◽  
Author(s):  
Leah Ffion Jones ◽  
Emily Cooper ◽  
Cliodna McNulty
Keyword(s):  
Older Adults ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Care Home ◽  
Asymptomatic Bacteriuria ◽  
Theoretical Domains Framework ◽  
Antibiotic Use ◽  
Primary Care Providers ◽  
Care Providers ◽  
Tract Infections

BackgroundEscherichia coli bacteraemia rates are rising with highest rates in older adults. Mandatory surveillance identifies previous Urinary Tract Infections (UTI) and catheterisation as risk factors.AimTo help control bacteraemias in older frail patients by developing a patient leaflet around the prevention and self-care of UTIs informed by the Theoretical Domains Framework.MethodFocus groups or interviews were held with care home staff, residents and relatives, GP staff and an out of hours service, public panels and stakeholders. Questions explored diagnosis, management, prevention of UTIs and antibiotic use in older adults. The leaflet was modified iteratively. Discussions were transcribed and analysed using Nvivo.ResultsCarers of older adults reported their important role in identifying when older adults might have a UTI, as they usually flag symptoms to nurses or primary care providers. Information on UTIs needs to be presented so residents can follow; larger text and coloured sections were suggested. Carers were optimistic that the leaflet could impact on the way UTIs are managed. Older adults and relatives liked that it provided new information to them. Staff welcomed that diagnostic guidance for UTIs was being developed in parallel; promoting consistent messages. Participants welcomed and helped to word sections on describing asymptomatic bacteriuria simply, preventing UTIs, causes of confusion and when to contact a doctor or nurseConclusionA final UTI leaflet for older adults has been developed informed by the TDF. See the TARGET website www.RCGP.org.uk/targetantibiotics/

Engagement patterns of users and providers: a study of messaging on app usage in a smartphone app for the treatment of eating disorders (Preprint)

2020 ◽  
Author(s):  
Jane Kim ◽  
Jisung Park ◽  
Jenna Tregarthen
Keyword(s):  
Eating Disorders ◽  
Health Care Providers ◽  
Digital Health ◽  
Communication Styles ◽  
Care Providers ◽  
Digital Tool ◽  
Self Monitoring ◽  
Multiple Phenotypes ◽  
Monitoring Tools ◽  
Level Data

BACKGROUND By offering the ability to immediately communicate with health care providers, digital health apps may significantly bolster the therapeutic relationship. Increasing opportunities of engagement with a digital tool, self-monitoring tools show confer promise in allowing patients to go through periods in between in-clinic visits. Little is known however, regarding the usage of the apps and whether communication between providers and app users in fact encourages usage. OBJECTIVE The objective of this study was to investigate the users of an app for eating disorders and summarize the characteristics of usage, characteristics of communication (i.e. messages sent and received), and assess whether the degree of communication and the degree of app usage (of the main features of the app precluding provider contact) were related. METHODS Users of an app for eating disorders (Tregarthen et al) consented for their de-identified, aggregate level data to be utilized for research. Records of five hundred users were randomly sampled from May 2017 to July 2017. All users in the sampled cohort were linked to a clinician. Raw data included 97,732 observations of meal logs submitted via app across 500 individuals. RESULTS Our data demonstrated a high degree of variability across users in their engagement patterns of the app. Receiving more messages on average had a greater effect on usage than sending messages, implying that being checked in on by clinicians may encourage users to engage more with their app. Data also demonstrated that there were multiple phenotypes in terms of preferences regarding communication – while a portion of users seemed to benefit, a large minority did not demonstrate a change in usage based on the frequency of communication. CONCLUSIONS Understanding usage phenotypes can be instrumental in helping clinician and apps understand who their user is. This work demonstrates that variability among the user population in terms of usage and communication styles, as well as usage and behavior. This information can ultimately be leveraged for guiding effective treatment delivery.

Mobile Applications for Health Management of Older Adults: A Scoping Review (Preprint)

2020 ◽  
Author(s):  
Nurul Asilah Ahmad ◽  
Shahrul Azman Mohd Noah ◽  
Arimi Fitri Mat Ludin ◽  
Suzana Shahar ◽  
Noorlaili Mohd Tohit
Keyword(s):  
Older Adults ◽  
Goal Setting ◽  
Mobile Applications ◽  
Health Management ◽  
Mobile Apps ◽  
Personalized Feedback ◽  
Self Monitoring ◽  
App Store ◽  
Evidenced Based ◽  
Google Play

BACKGROUND Currently, the use of smartphones to deliver health-related content has experienced a rapid growth, with more than 165,000 mobile health (mHealth) applications currently available in the digital marketplace such as iOS store and Google Play. Among these, there are several mobile applications (mobile apps) that offer tools for disease prevention and management among older generations. These mobile apps could potentially promote health behaviors which will reduce or delay the onset of disease. However, no review to date that has focused on the app marketplace specific for older adults and little is known regarding its evidence-based quality towards the health of older adults. OBJECTIVE The aim of this review was to characterize and critically appraise the content and functionality of mobile apps that focuses on health management and/or healthy lifestyle among older adults. METHODS An electronic search was conducted between May 2019 to December 2019 of the official app store for two major smartphone operating systems: iPhone operating system (iTunes App Store) and Android (Google Play Store). Stores were searched separately using predetermined search terms. Two authors screened apps based on information provided in the app description. Metadata from all included apps were abstracted into a standard assessment criteria form. Evidenced based strategies and health care expert involvement of included apps was assessed. Evidenced based strategies included: self-monitoring, goal setting, physical activity support, healthy eating support, weight and/or health assessment, personalized feedback, motivational strategies, cognitive training and social support. Two authors verified the data with reference to the apps and downloaded app themselves. RESULTS A total of 16 apps met the inclusion criteria. Six out of 16 (37.5%) apps were designed exclusively for the iOS platform while ten out of 16 (62.5%) were designed for Android platform exclusively. Physical activity component was the most common feature offered in all the apps (9/16, 56.3%) and followed by cognitive training (8/16, 50.0%). Diet/nutrition (0/16, 0%) feature, however, was not offered on all reviewed mobile apps. Of reviewed apps, 56.3% (9/16) provide education, 37.5% (6/16) provide self-monitoring features, 18.8% (3/16) provide goal setting features, 18.5% (3/16) provide personalized feedback, 6.3% (1/16) provide social support and none of the reviewed apps offers heart rate monitoring and reminder features to the users. CONCLUSIONS All reviewed mobile apps for older adults in managing health did not focused on diet/nutrition component, lack of functional components and lack of health care professional involvement in their development process. There is also a need to carry out scientific testing prior to the development of the app to ensure cost effective and its health benefits to older adults. Collaborative efforts between developers, researchers, health professionals and patients are needed in developing evidence-based, high quality mobile apps in managing health prior they are made available in the app store.

scholarly journals Design and psychometric evaluation of epilepsy-related apathy scale (E-RAS) in adults with epilepsy: a sequential exploratory mixed methods design

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abbas Shamsalinia ◽  
Mozhgan Moradi ◽  
Reza Ebrahimi Rad ◽  
Reza Ghadimi ◽  
Mansoureh Ashghali Farahani ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Mixed Methods ◽  
Care Providers ◽  
Divergent Validity ◽  
Validity And Reliability ◽  
Mixed Methods Design ◽  
Scale Evaluation ◽  
Wide Range ◽  
Epileptic Patients ◽  
Convergent And Divergent Validity

Abstract Background Apathy in patients with epilepsy is associated with a wide range of consequences that reduce the patient’s ability to perform social functions and participate in self-care and rehabilitation programs. Therefore, apathy is one of the important diagnoses of the healthcare team in the process of caring for epileptic patients and its dimensions need to be examined and recognized. Therefore, appropriate instruments with the sociocultural milieu of each community should be provided to health care providers. The aim of the present study was to design and measure epilepsy–related apathy scale (E-RAS) in adults with epilepsy. Methods This study of sequential exploratory mixed methods design was conducted in Iran from April 2019 to December 2019. In the Item generation stage, two inductive (face-to-face and semi-structured interviews with 17 adult epileptic patients) and deductive (literature review) were used. In item reduction, integration of qualitative and literature reviews and scale evaluation were accomplished. For Scale Evaluation, face, content, construct [exploratory factor analysis (EFA) (n = 360) and confirmatory factor analysis (CFA) (n = 200)], convergent and divergent Validity and reliability (internal consistency and stability) were investigated. Results The results of EFA showed that E-RAS has four factors, namely, motivation; self-regulatory; cognition and emotional-effective. These four latent factors accounted for a total of 48.351% of the total variance in the E-RAS construct. The results of CFA showed that the 4-factor model of E-RAS has the highest fit with the data. The results of convergent and divergent validity showed that the values of composite reliability (CR) and average variance extracted (AVE) for the four factors were greater than 0.7 and 0.5, respectively, and the value of AVE for each factor was greater than CR. The Cronbach’s alpha coefficient for the whole scale was obtained 0.815. The results of the test-retest showed that there was a significant agreement between the test and retest scores (P < 0.001). Conclusion E-RAS is a multidimensional construct consisting of 24 items, and has acceptable validity and reliability for the study of epilepsy-related apathy in adult epileptic patients.

WHO European Health Literacy Action Plan

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Sørensen ◽  
A Koylyu ◽  
B Mikkelsen
Keyword(s):  
Health Literacy ◽  
Swot Analysis ◽  
Action Plan ◽  
Action Planning ◽  
Regional Office ◽  
Member States ◽  
Wide Range ◽  
European Health ◽  
Other World ◽  
Action Networks

Abstract Background Grounded in the last decade's health literacy developments; the work of the European health literacy action networks on measurement and NCDs as well as the newly adopted European Health Literacy Roadmap and resolution agreed upon by their 53 Member States in 2019, the WHO European Region continues its investment in health literacy. A WHO European health literacy action plan is under development to be launched in 2021. The action plan implies concrete actions for Member States on how to develop health literate populations and societies. Methods Based on co-creation principles, the development of the action plan is conducted by stakeholders from a wide range of fields and disciplines. Lead by the WHO European Regional Office, the process includes an initial stakeholder meeting, iterative technical consultations with experts and the wider stakeholder community and Member State consultations. The analytical methods integrate a SWOT-analysis, future scenario thinking and long-sight action planning approaches as well as application of health literacy analytics. Results The results of the initial analytical steps will be presented such as the SWOT analysis, the future scenarios and associated recommendations on how to create health literate populations and societies in Europe. Additionally, the outline of the draft of the European health literacy action plan will be open for discussion and input. Conclusions Through an iterative process, the European health literacy action plan is co-produced by multiple actors through a series of consultations facilitating ownership and accountability. The European health literacy action plan can be an inspiration and a model for other world regions.

scholarly journals “What is the actual goal of the pathway?”: examining emergency department physician and nurse perspectives on the implementation of a pediatric concussion pathway using the theoretical domains framework

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anh Ly ◽  
Roger Zemek ◽  
Bruce Wright ◽  
Jennifer Zwicker ◽  
Kathryn Schneider ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Care Providers ◽  
Clinical Pathways ◽  
Theoretical Domains Framework ◽  
Local Context ◽  
Emergency Department Physician ◽  
Evidence Based ◽  
Care Providers ◽  
Structured Interviews ◽  
Pediatric Concussion

Abstract Background Multiple evidence-based clinical practice guidelines (CPGs) exist to guide the management of concussion in children, but few have been translated into clinical pathways (CP), which operationalize guidelines into accessible and actionable algorithms that can be more readily implemented by health care providers. This study aimed to identify the clinical behaviours, attitudinal factors, and environmental contexts that potentially influence the implementation of a clinical pathway for pediatric concussion. Methods Semi-structured interviews were conducted from October 2017 to January 2018 with 42 emergency department clinicians (17 physicians, 25 nurses) at five urban emergency departments in Alberta, Canada. A Theoretical Domains Framework (TDF)-informed interview guide contained open-ended questions intended to gather feedback on the proposed pathway developed for the study, as well as factors that could potentially influence its implementation. Results The original 14 domains of the TDF were collapsed into 6 clusters based on significant overlap between domains in the issues discussed by clinicians: 1) knowledge, skills, and practice; 2) professional roles and identity; 3) attitudes, beliefs, and motivations; 4) goals and priorities; 5) local context and resources; and 6) engagement and collaboration. The 6 clusters identified in the interviews each reflect 2–4 predominant topics that can be condensed into six overarching themes regarding clinicians’ views on the implementation of a concussion CP: 1) standardization in the midst of evolving research; 2) clarifying and communicating goals; 3) knowledge dissemination and alignment of information; 4) a team-oriented approach; 5) site engagement; and 6) streamlining clinical processes. Conclusion Application of a comprehensive, evidence-based, and theory-driven framework in conjunction with an inductive thematic analysis approach enabled six themes to emerge as to how to successfullly implement a concussion CP.

Sign in / Sign up

Export Citation Format

Share Document