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.
BackgroundIt has been demonstrated that people with dementia’s wellbeing can improve by using touchscreen technology. The FindMyApps program is a training and web-based selection-tool to help people with dementia and their caregivers find suitable apps that can improve their self-management and engagement in meaningful activities. As part of an exploratory RCT into FindMyApps a process evaluation was conducted according to the MRC Framework for process evaluation. Contextual, implementation and mechanisms of impact factors which may influence trial outcomes were evaluated.MethodA mixed methods design was used, in which quantitative and qualitative data were collected by semi-structured interviews (SSI) with stakeholders The SSI comprised closed and open questions, designed specifically for this study. Twenty people with mild dementia (MMSE >17; GDS 3-4) or Mild Cognitive Impairment (MCI) and twenty informal caregivers in both experimental and control groups, as well as 3 other stakeholders (researchers, technical helpdesk person) involved in the implementation of the intervention, were interviewed. Participants were recruited in the Netherlands. Exclusion criteria: moderate to severe dementia or severe sight problems. All participant dyads were provided a tablet computer for the three months intervention period. In the experimental group, people with dementia and caregivers were trained to use the tablet and FindMyApps after which the caregivers guided the persons with dementia to learn to use FindMyApps and find, and use, suitable apps for self-management and meaningful activities. In the control group, dyads only received general instruction in tablet use and a list of websites where to find potentially useful apps.ResultRegarding contextual factors, it was found that some technical problems might have influenced the intervention. Regarding implementation, participants noted that the training in the use of FindMyApps was of variable quality. Regarding mechanisms of impact it was found that dyads usually used the apps they found through FindMyApps regularly and enjoyed them, but they did not use FindMyApps itself regularly.ConclusionFindMyApps was experienced as a useful tool by most people with dementia/MCI and informal caregivers. Several adaptations to the trial protocol are recommended, to ensure robust outcomes in a definitive trial into its effectiveness.
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Anne4Care is een virtuele assistent ontwikkeld door Virtual Assistant BV. Zij biedt ondersteuning aan mensen met cognitieve problemen bij het behouden van dagstructuur, het onderhouden van sociale contacten en uitvoeren van betekenisvolle dagactiviteiten. De instructiematerialen zijn in de Nederlandse taal beschikbaar en gericht op gebruikers met een Nederlandse achtergrond. Anne4Care wordt op dit moment geïmplementeerd bij een dagbesteding van IMEAN Care in Almelo voor migrantenouderen. IT-professionals van Anne4Care en de zorgprofessionals van de dagbesteding van IMEAN hebben behoefte aan instructiematerialen en leermethoden die aansluiten op de behoeften van de groep migrantenouderen. Met als doel de introductie, acceptatie en het gebruik van Anne4Care zo optimaal mogelijk te laten verlopen. Dit zal resulteren in een betere ondersteuning van migrantenouderen en daarmee sociale inclusie en zinvolle dagbesteding bevorderen. Het consortium bestaat uit mbk-partners IMEAN Care (praktijk) en Virtual Assistant BV (technologieontwikkelaar) en de lectoraten Technology, Health & Care en Verpleegkunde van hogeschool Saxion. Samen met eindgebruikers (migrantenouderenouderen, hun mantelzorgers en zorgprofessionals) worden instructiematerialen en leermethoden ontwikkeld voor het gebruik van Anne4Care. Op basis van (1) observationeel en (2) literatuuronderzoek wordt een programma van eisen opgesteld. Vervolgens worden in co-creatie met eindgebruikers de instructiematerialen en leermethoden ontwikkeld en geëvalueerd. Tot slot zal virtuele assistent Anne4Care zelf een rol krijgen als instructrice waarbij een onboarding faciliteit wordt gecreëerd. De resultaten van dit project zijn: - Programma van eisen waaraan de instructiematerialen en leermethoden aan moeten voldoen - Instructiematerialen en leermethoden passend bij de wensen en behoeften van migrantenouderen, hun mantelzorgers en zorgprofessionals - Onboarding faciliteit op de tablet: Anne4Care als ‘instructrice’ in eigen (Turkse) taal - Inzicht in het gebruik en het gemak van Anne4Care en de instructiematerialen - Inzicht in de invloed van de instructiematerialen en leermethoden op het gebruik van Anne4Care.
Alcoholgebruiksstoornis (AUD) is een groot probleem. Alleen al in de USA zijn er 15 miljoen mensen met een AUD en meer dan 950.000 Nederlanders drinkt overmatig. Wereldwijd is 3-8% van het aantal sterfgevallen en 5% van alle ziektes en letsels toe te schrijven aan AUD. Zorg staat voor uitdagingen. Zo krijgt meer dan de helft van de AUD-patiënten binnen een jaar na behandeling een terugval. Een oplossing hiervoor is de inzet van Cue-Exposure-Therapy (CET). Daarbij worden cliënten blootgesteld aan triggers d.m.v. objecten, mensen en omgevingen die zucht opwekken. Om op een realistische, veilige en gepersonaliseerde manier deze triggers te ervaren, wordt Virtual Reality ingezet (VRET). Op die manier worden coping-vaardigheden getraind om verlangen naar alcohol tegen te gaan. De effectiviteit van VRET is (klinisch) bewezen. De komst van AR-technologieën roept echter de vraag op om mogelijkheden van Augmented-Reality-Exposure-Therapy (ARET) te onderzoeken. ARET geniet dezelfde voordelen als VRET (zoals een realistische veilige ervaring). Maar omdat AR virtuele-componenten in de echte omgeving integreert, waarbij het lichaam zichtbaar is, roept het vermoedelijk een ander type ervaring op. Dit kan de ecologische validiteit van CET in de behandeling vergroten. Daarnaast is ARET goedkoper te ontwikkelen (minder virtuele elementen) en hebben cliënten/klinieken gemakkelijker toegang tot AR (via smartphone/tablet). Bovendien worden nieuwe AR-brillen ontwikkeld, die nadelen zoals een te klein smartphone-scherm oplossen. Ondanks de vraag vanuit behandelaars, is ARET nog nooit ontwikkeld en onderzocht rondom verslaving. In dit project wordt het eerste ARET-prototype ontwikkeld rondom AUD in de behandeling van alcoholverslaving. Het prototype wordt ontwikkeld op basis van Volumetric-Captured-Digital-Humans en toegankelijk gemaakt voor AR-brillen, tablets en smartphones. Het prototype wordt gebaseerd op RECOVRY, een door het consortium ontwikkelde VRET rondom AUD. Een prototype-test onder (ex)AUD-cliënten zal inzicht geven in behoeften en verbeterpunten vanuit patiënt en zorgverlener en in het effect van ARET in vergelijk met VRET.
Alcohol use disorder (AUD) is a major problem. In the USA alone there are 15 million people with an AUD and more than 950,000 Dutch people drink excessively. Worldwide, 3-8% of all deaths and 5% of all illnesses and injuries are attributable to AUD. Care faces challenges. For example, more than half of AUD patients relapse within a year of treatment. A solution for this is the use of Cue-Exposure-Therapy (CET). Clients are exposed to triggers through objects, people and environments that arouse craving. Virtual Reality (VRET) is used to experience these triggers in a realistic, safe, and personalized way. In this way, coping skills are trained to counteract alcohol cravings. The effectiveness of VRET has been (clinically) proven. However, the advent of AR technologies raises the question of exploring possibilities of Augmented-Reality-Exposure-Therapy (ARET). ARET enjoys the same benefits as VRET (such as a realistic safe experience). But because AR integrates virtual components into the real environment, with the body visible, it presumably evokes a different type of experience. This may increase the ecological validity of CET in treatment. In addition, ARET is cheaper to develop (fewer virtual elements) and clients/clinics have easier access to AR (via smartphone/tablet). In addition, new AR glasses are being developed, which solve disadvantages such as a smartphone screen that is too small. Despite the demand from practitioners, ARET has never been developed and researched around addiction. In this project, the first ARET prototype is developed around AUD in the treatment of alcohol addiction. The prototype is being developed based on Volumetric-Captured-Digital-Humans and made accessible for AR glasses, tablets and smartphones. The prototype will be based on RECOVRY, a VRET around AUD developed by the consortium. A prototype test among (ex)AUD clients will provide insight into needs and points for improvement from patient and care provider and into the effect of ARET compared to VRET.
