BACKGROUND: Maintaining a healthy lifestyle is important for wheelchair users' well-being, as it can have a major impact on their daily functioning. Mobile health (mHealth) apps can support a healthy lifestyle; however, these apps are not necessarily suitable for wheelchair users with spinal cord injury or lower limb amputation. Therefore, a new mHealth app (WHEELS) was developed to promote a healthy lifestyle for this population.OBJECTIVE: The objectives of this study were to develop the WHEELS mHealth app, and explore its usability, feasibility, and effectiveness.METHODS: The WHEELS app was developed using the intervention mapping framework. Intervention goals were determined based on a needs assessment, after which behavior change strategies were selected to achieve these goals. These were applied in an app that was pretested on ease of use and satisfaction, followed by minor adjustments. Subsequently, a 12-week pre-post pilot study was performed to explore usability, feasibility, and effectiveness of the app. Participants received either a remote-guided or stand-alone intervention. Responses to semistructured interviews were analyzed using content analysis, and questionnaires (System Usability Score [SUS], and Usefulness, Satisfaction, and Ease) were administered to investigate usability and feasibility. Effectiveness was determined by measuring outcomes on physical activity, nutrition, sleep quality (Pittsburgh Sleep Quality Index), body composition, and other secondary outcomes pre and post intervention, and by calculating effect sizes (Hedges g).RESULTS: Sixteen behavior change strategies were built into an app to change the physical activity, dietary, sleep, and relaxation behaviors of wheelchair users. Of the 21 participants included in the pilot study, 14 participants completed the study. The interviews and questionnaires showed a varied user experience. Participants scored a mean of 58.6 (SD 25.2) on the SUS questionnaire, 5.4 (SD 3.1) on ease of use, 5.2 (SD 3.1) on satisfaction, and 5.9 (3.7) on ease of learning. Positive developments in body composition were found on waist circumference (P=.02, g=0.76), fat mass percentage (P=.004, g=0.97), and fat-free mass percentage (P=.004, g=0.97). Positive trends were found in body mass (P=.09, g=0.49), BMI (P=.07, g=0.53), daily grams of fat consumed (P=.07, g=0.56), and sleep quality score (P=.06, g=0.57).CONCLUSIONS: The WHEELS mHealth app was successfully developed. The interview outcomes and usability scores are reasonable. Although there is room for improvement, the current app showed promising results and seems feasible to deploy on a larger scale.
Objectives In two randomised controlled trials, the Plants for Joints (PFJ) multidisciplinary lifestyle intervention reduced signs and symptoms of rheumatoid arthritis (RA), or metabolic syndrome-associated hip or knee osteoarthritis (MSOA) compared with usual care. The current study investigated long-term outcomes.Methods After completion of two 16-week trials in people with (1) RA or (2) MSOA, control groups switched to the active PFJ intervention. At the end of the intervention, all participants were followed up in a 1-year observational extension study. Primary outcomes were 28-joint Disease Activity Score (DAS28) (RA) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (MSOA). Secondary outcomes included body composition, metabolic outcomes, medication changes and intervention adherence. An intention-to-treat analysis with a linear mixed model was used to analyse within-group changes.Results 65 (84%) of 77 RA participants and 49 (77%) of 64 MSOA participants completed the extension study. The effects of the PFJ intervention were replicated in the original control groups and sustained within the RA group a year after intervention completion (mean DAS28 –0.9 points; p<0.001), while in the MSOA group mean WOMAC increased towards but remained well under the starting value (–7.8 points, p<0.001). Improvements in C-reactive protein, waist circumference (RA and MSOA); low-density lipoprotein cholesterol (RA); and weight, haemoglobin A1c, blood pressure (MSOA) were also sustained. Participants had a net decrease of medication, and intervention adherence was largely sustained.Conclusions A year after the PFJ lifestyle intervention, improvements of disease activity and metabolic outcomes within RA and MSOA groups were largely sustained and related to sustained adherence, with a net decrease of medication.Trial registration numbers NL7800, NL7801.
MULTIFILE
Objective: To evaluate the implementation of a multicomponent lifestyle intervention at two different worksites. Methods: Data on eight process components were collected by means of questionnaires and interviews. Data on the effectiveness were collected using questionnaires. Results: The program was implemented partly as planned, and 84.0% (max 25) and 85.7% (max 14) of all planned interventions were delivered at the university and hospital, respectively. Employees showed high reach (96.6%) and overall participation (75.1%) but moderate overall satisfaction rates (6.8 ± 1.1). Significant intervention effects were found for days of fruit consumption (β = 0.44 days/week, 95% CI: 0.02 to 0.85) in favor of the intervention group. Conclusions: The study showed successful reach, dose, and maintenance but moderate fidelity and satisfaction. Mainly relatively simple and easily implemented interventions were chosen, which were effective only in improving employees’ days of fruit consumption.
The livability of the cities and attractiveness of our environment can be improved by smarter choices for mobility products and travel modes. A change from current car-dependent lifestyles towards the use of healthier and less polluted transport modes, such as cycling, is needed. With awareness campaigns, cycling facilities and cycle infrastructure, the use of the bicycle will be stimulated. But which campaigns are effective? Can we stimulate cycling by adding cycling facilities along the cycle path? How can we design the best cycle infrastructure for a region? And what impact does good cycle infrastructure have on the increase of cycling?To find answers for these questions and come up with a future approach to stimulate bicycle use, BUas is participating in the InterReg V NWE-project CHIPS; Cycle Highways Innovation for smarter People transport and Spatial planning. Together with the city of Tilburg and other partners from The Netherlands, Belgium, Germany and United Kingdom we explore and demonstrate infrastructural improvements and tackle crucial elements related to engaging users and successful promotion of cycle highways. BUas is responsible for the monitoring and evaluation of the project. To measure the impact and effectiveness of cycle highway innovations we use Cyclespex and Cycleprint.With Cyclespex a virtual living lab is created which we will use to test several readability and wayfinding measures for cycle infrastructure. Cyclespex gives us the opportunity to test different scenario’s in virtual reality that will help us to make decisions about the final solution that will be realized on the cycle highway. Cycleprint will be used to develop a monitoring dashboard where municipalities of cities can easily monitor and evaluate the local bicycle use.
Receiving the first “Rijbewijs” is always an exciting moment for any teenager, but, this also comes with considerable risks. In the Netherlands, the fatality rate of young novice drivers is five times higher than that of drivers between the ages of 30 and 59 years. These risks are mainly because of age-related factors and lack of experience which manifests in inadequate higher-order skills required for hazard perception and successful interventions to react to risks on the road. Although risk assessment and driving attitude is included in the drivers’ training and examination process, the accident statistics show that it only has limited influence on the development factors such as attitudes, motivations, lifestyles, self-assessment and risk acceptance that play a significant role in post-licensing driving. This negatively impacts traffic safety. “How could novice drivers receive critical feedback on their driving behaviour and traffic safety? ” is, therefore, an important question. Due to major advancements in domains such as ICT, sensors, big data, and Artificial Intelligence (AI), in-vehicle data is being extensively used for monitoring driver behaviour, driving style identification and driver modelling. However, use of such techniques in pre-license driver training and assessment has not been extensively explored. EIDETIC aims at developing a novel approach by fusing multiple data sources such as in-vehicle sensors/data (to trace the vehicle trajectory), eye-tracking glasses (to monitor viewing behaviour) and cameras (to monitor the surroundings) for providing quantifiable and understandable feedback to novice drivers. Furthermore, this new knowledge could also support driving instructors and examiners in ensuring safe drivers. This project will also generate necessary knowledge that would serve as a foundation for facilitating the transition to the training and assessment for drivers of automated vehicles.
With the help of sensors that made data collection and processing possible, many products around us have become “smarter”. The situation that our car, refrigerator, or umbrella communicating with us and each other is no longer a future scenario; it is increasingly a shared reality. There are good examples of such connectedness such as lifestyle monitoring of elderly persons or waste management in a smart city. Yet, many other smart products are designed just for the sake of embedding a chip in something without thinking through what kind of value they add everyday life. In other words, the design of these systems have mainly been driven by technology until now and little studies have been carried out on how the design of such systems helps citizens to improve or maintain the quality of their individual and collective lives. The CREATE-IT research center creates new solutions and methodologies in “digital design” that contribute to the quality of life of citizens. Correspondingly, this proposal focuses on one type of digital design—smart products—and investigate the concept of empowerment in relation to the design of smart products. In particular, the proposal aims to develop a model with its supplementary tools and methods for designing such products better. By following a research-through-design methodology, the proposal intends to offer a critical understanding on designing smart products. Along with its theoretical contribution, the proposal will also aid the students of ICT and design, and professionals such as designers and engineers to create smart products that will empower people and the industry to develop products grounded in a clear user experience and business model.
