Obesity is a complex problem worldwide. This chronic condition has many different causes. One of them is emotional eating. In about 40% of overweight people, emotional eating plays a major role. Emotional eating is the tendency to (over)eat in response to negative emotions such as stress or irritability. The target group is at a distance from care - due to shame they do not dare to seek help. Within the mental health services there are long waiting lists.The goal of this dissertation is to gain knowledge to support emotional eaters in coping with emotional eating behavior in a self-help setting that is appropriate to the time and context. To achieve this, we need to better understand the needs of emotional eaters in terms of virtual coaching and self-management. We formulated the following research question, "How can virtual coaching facilitate emotional eaters to cope with self-management of their emotional eating behavior?"Knowledge was gathered about their wishes regarding virtual support. Based on this, personas were developed, labeled with emotions, that give shape to the two prototypical problem situations of the emotional eater: 1) experiencing cravings, and 2) giving in to those cravings through binge or overeating.Participants recognized themselves in the problem situations presented, and that there is a need for virtual coaching and for greater understanding of one's own emotions and emotion regulation skills.Research was conducted on the possibilities surrounding the customized delivery of exercises in emotion regulation, which revealed that people mentioned the potential of the exercises, but that their presentation needed improvement.Virtual coaching is potentially successful for this group; participants showed themselves to be accessible and visible; there was openness and outspokenness by the participants about situations presented, etc.; there was goodwill towards digital coaching and doing exercises; the participants also showed themselves to be competent in doing exercises independently.The chance of success with regard to the development of a virtual coach has increased because the target group is open to virtual coaching where future users can work independently with their problems.
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There is a growing number of eHealth interventionsaiming at enhancing lifestyle to address obesity. However, theexisting interventions do not take the emotional aspects ofobesity into account. Forty percent of the overweight populationis an emotional eater. Emotional eaters gain weight because ofpoor emotion regulation, not just due to bad eating habits. Weaim at developing a personalised virtual coach ‘Denk je zèlf!’providing support for self-regulation of emotions for obeseemotional eaters. This paper presents a research study protocolon validating persuasive coaching strategies in emotionregulation, based on Dialectical Behaviour Therapy, ultimatelytargeting behaviour change. Our goal is to design a personalisedeCoaching framework, allowing us to optimally translatesuccessful behaviour change mechanisms and techniques, suchas dialectical strategies, into personalised persuasive coachingstrategies.
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Obesity has become a major societal problem worldwide [1][2]. The main reason for severe overweight is excessive intake of energy, in relation to the individual needs of a human body. Obesity is associated with poor eating habits and/or a sedentary lifestyle. A significant part of the obese population (40%) belongs to a vulnerable target group of emotional eaters, who overeat due to negative emotions [3]. There is a need for self-management support and personalized coaching to enhance emotional eaters in recognising and self-regulating their emotions.Over the last years, coaching systems have been developed for behavior change support, healthy lifestyle, and physical activity support [4]-[9]. Existing virtual coach applications lack systematic evaluation of coaching strategies and usually function as (tele-)monitoring systems. They are limited to giving general feedback to the user on achieved goals and/or accomplished (online) assignments.Dialectical Behavior Therapy (DBT) focuses on getting more control over one’s ownemotions by reinforcing skills in mindfulness, emotion regulation, and stress tolerance [10]. Emotion regulation is about recognizing and acknowledging emotions and accepting the fact that they come and go. The behavior change strategies within DBT are based on validation and dialectics [11]. Dialectics changes the users’ attitude and behavior by creating incongruence between an attitude and behavior since stimuli or the given information contradict with each other.The ultimate goal of the virtual coach is to raise awareness of emotional eaters on their own emotions, and to enhance a positive change of attitude towards accepting the negative emotions they experience. This should result in a decrease of overeating and giving in to binges. We believe that the integration of the dialectical behavior change strategies and persuasive features from the Persuasive System Design Model by Kukkonen and Harjumaa [12] will enhance the personalization of the virtual coach for this vulnerable group. We aim at developing a personalized virtual coach ‘Denk je zèlf!’ (Dutch for ‘Develop a wise mind and counsel yourself’) providing support for self-regulation of emotions for young obese emotional eaters. This poster presents an eCoaching model and a research study protocol aiming at the validation of persuasive coaching strategies based on behavior change techniques using dialectical strategies. Based on the context (e.g., location), emotional state of the user, and natural language processing, the virtual coach application enables tailoring of the real-time feedback to the individual user. Virtual coach application communicates with the user over a chat timeline and provides personal feedback.The research protocol decribes the two weeks field study on validating persuasive coaching strategies for emotional eaters. Participants (N=30), recruited via a Dutch franchise organization of dietitian nutritionists, specialized in treating emotional eating behaviors, will voluntarily participate in this research study. Participants will be presented with short dialogues (existing questions and answers) and will be asked to select the preferred coaching strategy (validating or a dialectical), according to their (current) emotions. To trigger a certain emotion (e.g., the affect that fits best with the chosen coaching strategy), a set of pictures will be shown to the user that evoke respectively sadness, anger, fear, and disgust [13].Participants will be asked to fill out the demographics data ((nick) name, age, gender, weight, length, place of residence) and three questionnaires: • Dutch Eating Behavior Questionnaire (DEBQ) [14],• Five Factor Personality Inventory (FFPI) [15], • Quality of Life Index Questionnaire [16].This research study aims at answering the following research questions: “Which coaching strategies do users with a specific type of emotional eating behavior benefit most from while consulting their personalized virtual coach?; “Which coaching strategies are optimal for which emotions?” and “Which coaching approach do users prefer in which context, e.g. time of the day, before/after a craving?”
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Objectives: Emotional eating is recognized as a potential contributor to weight gain. Emotional eaters often hide their problems because of feelings of shame about their behavior, making it challenging to provide them with the necessary support. The introduction of a virtual coach might offer a potential solution in assisting them. To find out whether emotional eaters are receptive to online personalized coaching, we presented emotional eaters with two essential proto-typical problem situations for emotional eaters: “experiencing cravings” and “after giving in to cravings,” and asked them whether they preferred one of the three coaching strategies presented: Validating, Focus-on-Change and Dialectical.Methods: An experimental vignette study (2 × 3 design) was carried out. The vignettes featured two distinct personas, each representing one of the two common problem scenarios experienced by emotional eaters, along with three distinct coaching strategies for each scenario. To identify potential predictors for recognition of problem situations, questionnaires on emotional eating (DEBQ), personality traits (Big-5), well-being (PANAS), and BMI were administrated.Results: A total of 62% of the respondents identified themselves with “after giving in to cravings” and 47% with “experiencing cravings.” BMI, emotional eating and emotional stability appeared to be predictors in recognizing both the problem situations. In “experiencing cravings,” the participating women preferred Dialectical and the Validation coaching strategies. In the “after giving in to cravings” condition, they revealed a preference for the Dialectical and the Focus-on-Change coaching strategies.Conclusion: Using vignettes allowed a less threatening way of bringing up sensitive topics for emotional eaters. The personas representing the problem situations were reasonably well recognized. To further enhance this recognition, it is important for the design and content of the personas to be even more closely related to the typical problem scenarios of emotional eaters, rather than focusing on physical characteristics or social backgrounds. This way, users may be less distracted by these factors. With the knowledge gained about the predictors that may influence recognition of the problem situations, design for coaching can be more customized. The participants represented individuals with high emotional eating levels, enhancing external validity.
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Background: Around 13% of the world’s population suffers from obesity. More than 40% of people with obesity display emotional eating behaviour (eating in response to negative emotions or distress). It is an alternate to moreeffective coping strategies for negative emotions. Our study explored the opportunities for helping adults with emotional overeating using a virtual coach, aiming to identify preferences for tailored coaching strategies applicable in a personal virtual coach environment. Three different coaching strategies were tested: a validating, a focus-on-change, and a dialectical one – the latter being a synthesis of the first two strategies. Methods: A qualitative study used vignettes reflecting the two most relevant situations for people with emotional eating: 1. experiencing negative emotions, with ensuing food cravings; and 2. after losing control to emotional eating, with ensuing feelings of low self-esteem. Applied design: 2 situations × 3 coaching strategies. Participants: 71 adult women (Mage 44.4/years, range 19–70, SD = 12.86) with high scores on the DEBQ-emotional eating scale (Memo 3.65, range 1.69–4.92, SD = .69) with mean BMI 30.1 (range 18–46, SD = 6.53). They were recruited via dieticians’ practices, were randomly assigned to the conditions and asked how they would face and react to thepresented coaching strategies. Data were transcribed and a thematic analysis was conducted. Results: Qualitative results showed that participants valued both the validating coaching strategy and the focus-onchange strategy, but indicated that a combination of validation and focus-on-change provides both mental supportand practical advice. Data showed that participants differed in their level of awareness of the role that emotions play in their overeating and the need for emotion-regulation skills. Conclusion: The design of the virtual coach should be based on dialectical coaching strategies as preferred by participants with emotional eating behaviour. It should be tailored to the different stages of awareness of their emotions and individual emotion-regulation skills.
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Nowadays, one of the major current health risks is excessive sitting during work hours. Furthermore, the coronavirus disease 2019 (COVID-19) pandemic and the corresponding government state of emergency forced many people to work from home. These constraints carried out an important change in the lifestyle of people; for instance, the proportion of sitting time in front of a computer during working hours has increased considerably worldwide, particularly through the implementation of teleworking.In order to motivate people to lead a less sedentary life, the Hanze University of Applied Sciences Groningen developed an automated recommender system. We investigated the possibility of automated coaching in order to increase physical activity and help people to reach their daily step goal. By monitoring people’s activity level and progress during the day, we predict personalized recommendations. The effect of these recommendations on the individual’s activity level forms the basis for a personalized coaching approach.Step count data is used to train a machine learning algorithm that estimates the hourly probability of the individual achieving the daily steps goal. The outcome of this prediction is combined with the effect of the type recommendation for the individual to deliver the best recommendation for the individual. To show the practical usefulness, we constructed a platform to manage the data, rules, machine learning algorithms and clustering of participants. Results of initial pilots using the platform and app have given insight in the performance of and challenges associated with algorithm selection and personal model generation for the coaching package caused by the nature of the data. Further research will therefore be done in optimizing machine learning algorithms and tuning for human datasets.
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New Virtual Care Centers (VCCs) within hospitals utilize information technology to remotely monitor and support patients with chronic diseases living at home. Nurses play a crucial role by providing remote coaching and guidance to help patients manage their conditions. Currently, there is a growing understanding regarding the evolving roles and responsibilities of nurses in VCCs, however studies have yet to establish connections with educational frameworks, which poses a challenge for nursing education programs to prepare students for this emerging professional role effectively. Our study aimed to provide insights into the evolving roles, tasks, and responsibilities of nurses providing remote care as per the CanMEDS framework. We conducted a qualitative content analysis of 15 interviews. Nursing work within VCCs is represented by the seven CanMEDS roles. Most tasks align with the roles of Leader and Collaborator, while Quality Promotor has the fewest. Our study maps the responsibilities and tasks of VCCs' care delivery to the core roles of nurses.
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In this article, the outcomes of a survey aimed to investigate how aware of and how capable coaches in higher vocational Dutch education perceive themselves to assist students displaying mental health and well-being issues are presented. Additionally, the article explores coaches’ perceptions regarding the frequency, form of help offered, topics to be tackled and the preferred form in which this help should be provided. The author conducted a survey that gathered qualitative and quantitative data from coaches (N 5 82) at a Dutch University of Applied Sciences in the north of the Netherlands. A differentiation in coaches’ number of years of teaching and coaching experience was considered.
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Self-management is widely seen as a viable contribution to sustainable health care as it allows to promote physical and mental well-being. A promising approach to promoting a healthy lifestyle is the deployment of personalized virtual coaches, especially in combination with the latest developments in the fields of Data Science and Artificial Intelligence. This paper presents a framework for a virtual coaching system, as well as a use case in which parts of this framework are applied. The virtual coach in the use case aims to encourage customer contact center employees to protect their mental health. This article outlines one part of the use-case in particular, viz. how to promote employee autonomy and supervisor support by, inter alia, monitoring employees’ levels of emotional exhaustion. Current systems focus on providing users with insight in their health status or behavior, the authors developed the functional architecture for a system that can be implemented for different goals and generates personalized, real-time advice based on the combination of user preferences, motivational success and predicted user behavior.
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One of the main causes of numerous health problemsis a lack of physical activity. To promote a more active lifestyle,the Hanze University started a health promotion program. Participants were motivated to reach their daily goal of physical activityby means of an activity tracker in combination with two-weeklycoaching sessions. Employing the data of the experiment, weinvestigated the manners in which the predictability of physicalactivity of a participant during the day can be improved. Thecollected step count data was used to construct personalisedmachine learning models, by taking into account the differencebetween physical activities during weekdays on the one handand weekends on the other hand. The training of algorithmsper participant in combination with the time-slices weekdays,weekend and the whole week improves the accuracy of theprediction model. The performance of the models improveseven further when the individualised time-sliced models arecombined. More contextual data, like free time and workinghours, might even extend the accuracy. The use of personalisedprediction models, based on machine learning and time slices,could become an addition in preventive personalized eHealthsystems and mobile activity monitoring. For instance, this canconstitute as a viable addition to a virtual coaching system to helpthe participants to reach their daily goal. As the individualisedmodels allow for predictions of the progression of the physicalactivity during the day, they enable the virtual coaching systemto intervene at the appropriate moment in time.
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