Despite assumptions that wearable self-care technologies such as smart wristbands and smart watches help users to monitor and self-manage health in daily life, adherence rates are often quite low. In an effort to better understand what determines adherence to wearable self-care technologies, researchers have started to consider the extent to which a technology is perceived as being part of the user (i.e., technology embodiment) and the extent to which users feel they can influence reaching their health goals (i.e., empowerment). Although both concepts are assumed to determine adherence, few studies have empirically validated their influence. Furthermore, the relationships between technology embodiment, empowerment, and adherence to wearable self-care technology have also not been addressed. Drawing upon embodied theory and embodiment cognition theory, this research paper introduces and empirically validates ‘embodied empowerment’ as a predictor of adherence to wearable self-care technology. Using partial least squares structural equation modeling and multigroup analysis on a dataset of 317 wearable self-care technology users, we find empirical evidence of the validity of embodied empowerment as a determinant of adherence. We also discuss the implications for research and practice.
Objectives: To develop an instrument to measure adherence to frequency, intensity, and quality of performance of home-based exercise (HBE) programs recommended by a physical therapist and to evaluate its construct validity and reliability in patients with low back pain. Methods: The Exercise Adherence Scale (EXAS) was developed following a literature search, an expert panel review, and a pilot test. The construct validity of the EXAS was determined based on data from 27 participants through an investigation of the convergent validity between adherence, lack of time to exercise, and lack of motivation to exercise. Associations between adherence, pain, and disability were determined to test divergent validity. The reliability of the EXAS quality of performance score was assessed using video recordings from 50 participants performing four exercises. Results: Correlations between the EXAS and lack of time to exercise, lack of motivation to exercise, pain, and disability were rho = 0.47, rho = 0.48, rho = 0.005, and rho = 0.24, respectively. The intrarater reliability of the quality of performance score was Kappa quadratic weights (Kqw) = 0.87 (95%-CI 0.83–0.92). The interrater reliability was Kqw = 0.36 (95%-CI 0.27–0.45). Conclusions: The EXAS demonstrates acceptable construct validity for the measurement of adherence to HBE programs. Additionally, the EXAS shows excellent intrarater reliability and poor interrater reliability for the quality of performance score and is the first instrument to measure adherence to frequency, intensity, and quality of performance of HBE programs. The EXAS allows researchers and clinicians to better investigate the effects of adherence to HBE programs on the outcomes of interventions and treatments.
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PURPOSE: In this study, we investigated factors associated with program adherence and patient satisfaction with a home-based physical activity program (Onco-Move, N = 77) and a supervised exercise program with a home-based component (OnTrack, N = 76).METHODS: We assessed adherence via self-report (home-based program) and attendance records (supervised program). We used logistic regression analysis to identify sociodemographic, clinical and behavioural variables associated with program adherence. Patient satisfaction was assessed with self-report and is reported descriptively.RESULTS: Fifty-one percent of Onco-Move and 62% of OnTrack participants were adherent to the home-based program, while 59% of OnTrack participants were adherent to the supervised sessions. Higher baseline physical fitness was associated with higher adherence to home-based components. Higher disease stage and having a partner were associated with adherence to OnTrack supervised sessions. Overall satisfaction with the exercise programs was high, but ratings of coaching provided by professionals for the home-based components were low. Patients offered suggestions for improving delivery of the programs.CONCLUSIONS: These findings point to factors relevant to program adherence and suggest ways in which such programs can be improved. Providing additional time and training for health care professionals could improve the quality and hopefully the effectiveness of the interventions. The use of online diaries and smartphone apps may provide additional encouragement to participants. Finally, allowing greater flexibility in the planning and availability of supervised exercise training in order to accommodate the variability in cancer treatment schedules and the (acute) side effects of the treatments could also enhance program adherence.TRIAL REGISTRATION: Netherlands Trial Register, NTR2159. http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2159.
Veel patiënten gebruiken hun medicijnen nog niet optimaal. Ondanks het groeiende aantal interventies en innovaties om de therapietrouw te bevorderen, lukt het maar mondjesmaat om deze ook grootschalig toe te passen in de dagelijkse praktijk. Het Make-It consortium, wat staat voor Medication Adherence Knowledge, Expertise and Implementation Taskforce, houdt zich sinds 1 juli 2019 bezig met de vraag hoe de therapietrouw in de praktijk verbeterd kan worden. Hiertoe begeleidt het consortium proeftuinen die, met subsidie uit de ZonMw STIP ronde laagdrempelige therapietrouw, interventies in de dagelijkse praktijk willen implementeren.Doel Patiënten die chronisch medicatie gebruiken helpen hun medicijnen optimaal te gebruiken. Resultaten Kennis over de implementatie van interventies en innovaties, succesfactoren en knelpunten hiervan, een verbeterde therapietrouw bij patiënten. Looptijd 01 januari 2019 - 01 juli 2025 Aanpak Tijdens het onderzoeksproject worden verschillende interventies, om de therapietrouw in de praktijk te bevorderen, getest. De interventies die succesvol blijken, zullen geïmplementeerd worden in de zorg die geleverd wordt door de deelnemende proeftuinen. Update: Vier proeftuinen hebben in 2020 subsidie gekregen van ZonMw om hun project uit te voeren. De proeftuinen bestaan uit zorgverbanden uit Amsterdam, Almere, Amersfoort en Utrecht. Alle vier zijn zij voorlopers op het gebied van innovatieve zorgprojecten. Momenteel zijn de vier proeftuinen bezig met de afronding van de implementatie van de door hun gekozen interventies. In 2022 hebben vier nieuwe proeftuinen subsidie gekregen voor de laatste ronde van de STIP Call van ZonMw. Dit zijn zorgverbanden uit de Nederlandse Antillen, Friesland, Vleuten en Limburg. Deze proeftuinen zullen in het najaar van 2022 starten met de implementatie van de interventies die zij gekozen hebben.
Make-It 1 en 2: Verbetering van de implementatie van interventies op het gebied van therapietrouw in de eerstelijnszorg. Het Make-It consortium bestaat uit onderzoekers en zorgprofessionals die al vele jaren samenwerken aan het bevorderen van therapietrouw. Het consortium brengt expertise samen op het gebied van farmacie, geneeskunde, gedragswetenschappen, onderzoek in gezondheidszorg, implementatiewetenschap, communicatiewetenschappen en verpleegkunde. Het consortium wordt ondersteund door een patiënten panel en een adviesraad bestaande uit belangrijke belanghebbenden uit de klinische praktijk. Na zes jaar (2019 - 2025) aandacht te hebben besteed aan therapietrouw, breidt het Make-It Consortium sinds 2024 haar reikwijdte uit in Make-It 2.0. Dit tweede deel van het project loopt door tot 2032.
