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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Purpose: Breast cancer follow-up (surveillance and aftercare) varies from one-size-fits-all to more personalised approaches. A systematic review was performed to get insight in existing evidence on (cost-)efectiveness of personalised follow-up. Methods: PubMed, Scopus and Cochrane were searched between 01–01-2010 and 10–10-2022 (review registered in PROSPERO:CRD42022375770). The inclusion population comprised nonmetastatic breast cancer patients≥18 years, after completing curative treatment. All intervention-control studies studying personalised surveillance and/or aftercare designed for use during the entire follow-up period were included. All review processes including risk of bias assessment were performed by two reviewers. Characteristics of included studies were described. Results: Overall, 3708 publications were identifed, 64 full-text publications were read and 16 were included for data extraction. One study evaluated personalised surveillance. Various personalised aftercare interventions and outcomes were studied. Most common elements included in personalised aftercare plans were treatment summaries (75%), follow-up guidelines (56%), lists of available supportive care resources (38%) and PROs (25%). Control conditions mostly comprised usual care. Four out of seven (57%) studies reported improvements in quality of life following personalisation. Six studies (38%) found no personalisation efect, for multiple outcomes assessed (e.g. distress, satisfaction). One (6.3%) study was judged as low, four (25%) as high risk of bias and 11 (68.8%) as with concerns. Conclusion: The included studies varied in interventions, measurement instruments and outcomes, making it impossible to draw conclusions on the efectiveness of personalised follow-up. There is a need for a definition of both personalised surveillance and aftercare, whereafter outcomes can be measured according to uniform standards.
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Given the growing number of older people, society as a whole should ideally provide a higher quality of life (QoL) for its ageing citizens through the concept of personalised ageing. Information and communication technologies (ICT) are subject to constant and rapid development, and can contribute to the goal of an improved QoL for older adults. In order to utilise future ICT solutions as a part of an age-friendly smart environment that helps achieve personalised ageing with an increased QoL, one must first determine whether the existing ICT solutions are satisfying the needs of older people. In order to accomplish that, this study contributes in three ways. First, it proposes a framework for the QoL of older adults, in order to provide a systematic review of the state-of-the-art literature and patents in this field. The second contribution is the finding that selected ICT solutions covered by articles and patents are intended for older adults and are validated by them. The third contribution of the study are the six recommendations that are derived from the review of the literature and the patents which would help move the agenda concerning the QoL of older people and personalised ageing with the use of ICT solutions forward. Original article at MDPI; DOI: http://dx.doi.org/10.3390/ijerph17082940 (This article belongs to the Special Issue Feature Papers "Age-Friendly Cities & Communities: State of the Art and Future Perspectives")
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Patients with coronary artery disease (CAD) are more sedentary compared with the general population, but contemporary cardiac rehabilitation (CR) programmes do not specifically target sedentary behaviour (SB). We developed a 12-week, hybrid (centre-based+home-based) Sedentary behaviour IntervenTion as a personaLisEd Secondary prevention Strategy (SIT LESS). The SIT LESS programme is tailored to the needs of patients with CAD, using evidence-based behavioural change methods and an activity tracker connected to an online dashboard to enable self-monitoring and remote coaching. Following the intervention mapping principles, we first identified determinants of SB from literature to adapt theory-based methods and practical applications to target SB and then evaluated the intervention in advisory board meetings with patients and nurse specialists. This resulted in four core components of SIT LESS: (1) patient education, (2) goal setting, (3) motivational interviewing with coping planning, and (4) (tele)monitoring using a pocket-worn activity tracker connected to a smartphone application and providing vibrotactile feedback after prolonged sedentary bouts. We hypothesise that adding SIT LESS to contemporary CR will reduce SB in patients with CAD to a greater extent compared with usual care. Therefore, 212 patients with CAD will be recruited from two Dutch hospitals and randomised to CR (control) or CR+SIT LESS (intervention). Patients will be assessed prior to, immediately after and 3 months after CR. The primary comparison relates to the pre-CR versus post-CR difference in SB (objectively assessed in min/day) between the control and intervention groups. Secondary outcomes include between-group differences in SB characteristics (eg, number of sedentary bouts); change in SB 3 months after CR; changes in light-intensity and moderate-to-vigorous-intensity physical activity; quality of life; and patients’ competencies for self-management. Outcomes of the SIT LESS randomised clinical trial will provide novel insight into the effectiveness of a structured, hybrid and personalised behaviour change intervention to attenuate SB in patients with CAD participating in CR.
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Background A high sedentary time is associated with increased mortality risk. Previous studies indicate that replacement of sedentary time with light- and moderate-to-vigorous physical activity attenuates the risk for adverse outcomes and improves cardiovascular risk factors. Patients with cardiovascular disease are more sedentary compared to the general population, while daily time spent sedentary remains high following contemporary cardiac rehabilitation programmes. This clinical trial investigated the effectiveness of a sedentary behaviour intervention as a personalised secondary prevention strategy (SIT LESS) on changes in sedentary time among patients with coronary artery disease participating in cardiac rehabilitation. Methods Patients were randomised to usual care (n = 104) or SIT LESS (n = 108). Both groups received a comprehensive 12-week centre-based cardiac rehabilitation programme with face-to-face consultations and supervised exercise sessions, whereas SIT LESS participants additionally received a 12-week, nurse-delivered, hybrid behaviour change intervention in combination with a pocket-worn activity tracker connected to a smartphone application to continuously monitor sedentary time. Primary outcome was the change in device-based sedentary time between pre- to post-rehabilitation. Changes in sedentary time characteristics (prevalence of prolonged sedentary bouts and proportion of patients with sedentary time ≥ 9.5 h/day); time spent in light-intensity and moderate-to-vigorous physical activity; step count; quality of life; competencies for self-management; and cardiovascular risk score were assessed as secondary outcomes. Results Patients (77% male) were 63 ± 10 years and primarily diagnosed with myocardial infarction (78%). Sedentary time decreased in SIT LESS (− 1.6 [− 2.1 to − 1.1] hours/day) and controls (− 1.2 [ ─1.7 to − 0.8]), but between group differences did not reach statistical significance (─0.4 [─1.0 to 0.3]) hours/day). The post-rehabilitation proportion of patients with a sedentary time above the upper limit of normal (≥ 9.5 h/day) was significantly lower in SIT LESS versus controls (48% versus 72%, baseline-adjusted odds-ratio 0.4 (0.2–0.8)). No differences were observed in the other predefined secondary outcomes. Conclusions Among patients with coronary artery disease participating in cardiac rehabilitation, SIT LESS did not induce significantly greater reductions in sedentary time compared to controls, but delivery was feasible and a reduced odds of a sedentary time ≥ 9.5 h/day was observed.
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Obesity is a fast-growing societal threat, causingchronic conditions, physical and psychological health problems,as well as sickness absence and heavy healthcare costs. Despitenumerous attempts to promote physical activity and healthydiet, existing interventions do not focus on the commonemotional causes of obesity. There is a need for self-managementsupport of this vulnerable target group: emotional eaters. Thispaper presents the results of the design case study focusing on aholistic design and evaluation of a personalised virtual mHealthcoach that provides self-management training ‘Denk je zèlf!’(Dutch for ‘Develop a wise mind and counsel yourself’). Thetarget group are young adults with an emotional eating disorderand who are obese. The contextual inquiry study was conductedto gain insights into the needs and experiences of the targetusers, including interviews and questionnaires with emotionaleaters, patients undergoing obesity treatment, and healthcarepractitioners. Personas and the use-case scenario were derivedfrom these results and translated into the new ‘Denk je zèlf!’virtual coach, based on Dialectical Behaviour Therapy andexperience sampling measures to capture user experience andemotional state. The main contributions of this paper are: (a)combining holistic eHealth design, behavior chain analysis, anddialectic behaviour therapy in one personalised virtual mHealthcoaching application for emotional eaters; (b) applying emotionenrichedPersonas to guide the design; (c) the results of theinitial user evaluation. Preliminary results suggest that the‘Denk je zèlf!’ virtual coach is useful for helping the targetgroup. Future research will be aimed at further iterative (re)-design and evaluation, as well as development of the dialecticaldialogues for the virtual coach and content for the education andinstruction modules.
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Obesity is a fast growing societal threat, causing chronic conditions, physical and psychological health problems, as well as absenteeism and large healthcare costs. Despite numerous attempts to promote physical activity and healthy diet, existing interventions do not focus on often occurring emotional causes of obesity. There is a need for self-management support of this vulnerable target group: emotional eaters. This paper presents the results of the design case study focusing on a holistic development of a personalised virtual mHealth coach that provides self-management training ‘Denk je zèlf!’ (Dutch for ‘Develop a wise mind and counsel yourself’). Target group are young adults with emotional eating disorder and obesity. The contextual inquiry study was conducted to get insights into the needs and experiences of the target users, including interviews and questionnaires with emotional eaters, obesity treatment patients and healthcare practitioners. Personas and user stories were derived from these results and translated into a new ‘Denk je zèlf!’ virtual coach, based on Dialectical Behaviour Therapy and experience sampling measures to capture user experience and emotional state. This paper makes two main contributions: (a) combining holistic design with behaviour therapy in one virtual mHealth coaching application for emotional eaters; (b) applying Personas to guide the design. Preliminary results suggest that an online self-management training might be useful for the target group. Future research will be aimed at iterative evaluation and further development of the dialectical dialogues for the virtual coach and content for the education and instruction modules.
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In 2004 the physicist Chris Anderson postulated a theory - the long tail - in which he stated that with the emergence of the internet many writers and artists get a chance of success. As a result, greatest hits and bestsellers would have an increasingly relatively smaller share in the totals of artist success. However, the opposite seems to be true! In addition, the often assumed personalized information "bulb" may very well turn out to be a personally packaged globalized tube vision! In: Education Journal, 2018-350 p.21
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