BackgroundPhysical activity can prevent or delay age-related impairments and prolong the ability of older adults to live independently. Community-based programs typically offer classes where older adults can exercise only once a week under the guidance of an instructor. The health benefits of such programs vary. Exercise frequency and the duration of the program play a key role in realizing effectiveness. An auxiliary home-based exercise program can provide older adults the opportunity to exercise more regularly over a prolonged period of time in the convenience of their own homes. Furthermore, mobile electronic devices can be used to motivate and remotely guide older adults to exercise in a safe manner. Such a blended intervention, where technology is combined with personal guidance, needs to incorporate behavior change principles to ensure effectiveness.ObjectiveThe aim of this study was to identify theory-based components of a blended intervention that supports older adults to exercise at home.MethodsThe Medical Research Council framework was used to develop the blended intervention. Insights from focus group, expert panels, and literature were combined into leading design considerations.ResultsA client-server system had been developed that combined a tablet app with a database in the cloud and a Web-based dashboard that can be used by a personal coach to remotely monitor and guide older adults. The app contains several components that facilitate behavior change—an interactive module for goal setting, the ability to draw up a personal training schedule from a library containing over 50 exercise videos, progress monitoring, and possibilities to receive remote feedback and guidance of a personal coach.ConclusionsAn evidence-based blended intervention was designed to promote physical activity among older adults. The underlying design choices were underpinned by behavior change techniques that are rooted in self-regulation. Key components of the tablet-supported intervention were a tailored program that accommodates individual needs, demonstrations of functional exercises, monitoring, and remote feedback. The blended approach combines the convenience of a home-based exercise program for older adults with the strengths of mobile health and personal guidance.
Rationale To improve the quality of exercise-based cardiac rehabilitation (CR) in patients with chronic heart failure (CHF) a practice guideline from the Dutch Royal Society for Physiotherapy (KNGF) has been developed. Guideline development A systematic literature search was performed to formulate conclusions on the efficacy of exercise-based intervention during all CR phases in patients with CHF. Evidence was graded (1–4) according the Dutch evidence-based guideline development criteria. Clinical and research recommendations Recommendations for exercise-based CR were formulated covering the following topics: mobilisation and treatment of pulmonary symptoms (if necessary) during the clinical phase, aerobic exercise, strength training (inspiratory muscle training and peripheral muscle training) and relaxation therapy during the outpatient CR phase, and adoption and monitoring training after outpatient CR. Applicability and implementation issues This guideline provides the physiotherapist with an evidence-based instrument to assist in clinical decision-making regarding patients with CHF. The implementation of the guideline in clinical practice needs further evaluation. Conclusion This guideline outlines best practice standards for physiotherapists concerning exercise-based CR in CHF patients. Research is needed on strategies to improve monitoring and follow-up of the maintenance of a physical active lifestyle after supervised CR.
In 2017, I introduced a new theoretical framework in Archival Science, that of the ‘Archive–as–Is’. This framework proposes a theoretical foundation for Enterprise Information Management (EIM) in World 2.0, the virtual, interactive, and hyper connected platform that is developing around us. This framework should allow EIM to end the existing ‘information chaos’, to computerize information management, to improve the organizational ability to reach business objectives, and to define business strategies. The concepts of records and archives are crucial for those endeavours. The framework of the ‘Archive–as–Is’ is an organization–oriented archival theory, consisting of five components, namely: [1] four dimensions of information, [2] two archival principles, [3] five requirements of information accessibility, [4] the information value chain; and [5] organizational behaviour. In this paper, the subject of research is component 5 of the framework: organizational behaviour. Behaviour of employees (including archivists) is one of the most complicated aspects within organizations when creating, processing, managing, and preserving information, records, and archives. There is an almost universal ‘sound of silence’ in scholarly literature from archival and information studies although this subject and its effects on information management are studied extensively in many other disciplines, like psychology, sociology, anthropology, and organization science. In this paper, I want to study how and why employees behave as they do when they are working with records and archives and how EIM is influenced by this behaviour.
