Background: Alcohol use is associated with an automatic tendency to approach alcohol, and the retraining of this tendency (cognitive bias modification [CBM]) shows therapeutic promise in clinical settings. To improve access to training and to enhance participant engagement, a mobile version of alcohol avoidance training was developed.Objective: The aims of this pilot study were to assess (1) adherence to a mobile health (mHealth) app; (2) changes in weekly alcohol use from before to after training; and (3) user experience with regard to the mHealth app.Methods: A self-selected nonclinical sample of 1082 participants, who were experiencing problems associated with alcohol, signed up to use the alcohol avoidance training app Breindebaas for 3 weeks with at least two training sessions per week. In each training session, 100 pictures (50 of alcoholic beverages and 50 of nonalcoholic beverages) were presented consecutively in a random order at the center of a touchscreen. Alcoholic beverages were swiped upward (away from the body), whereas nonalcoholic beverages were swiped downward (toward the body). During approach responses, the picture size increased to mimic an approach movement, and conversely, during avoidance responses, the picture size decreased to mimic avoidance. At baseline, we assessed sociodemographic characteristics, alcohol consumption, alcohol-related problems, use of other substances, self-efficacy, and craving. After 3 weeks, 37.89% (410/1082) of the participants (posttest responders) completed an online questionnaire evaluating adherence, alcohol consumption, and user satisfaction. Three months later, 19.03% (206/1082) of the participants (follow-up responders) filled in a follow-up questionnaire examining adherence and alcohol consumption.Results: The 410 posttest responders were older, were more commonly female, and had a higher education as compared with posttest dropouts. Among those who completed the study, 79.0% (324/410) were considered adherent as they completed four or more sessions, whereas 58.0% (238/410) performed the advised six or more training sessions. The study identified a significant reduction in alcohol consumption of 7.8 units per week after 3 weeks (95% CI 6.2-9.4, P<.001; n=410) and another reduction of 6.2 units at 3 months for follow-up responders (95% CI 3.7-8.7, P<.001; n=206). Posttest responders provided positive feedback regarding the fast-working, simple, and user-friendly design of the app. Almost half of the posttest responders reported gaining more control over their alcohol use. The repetitious and nonpersonalized nature of the intervention was suggested as a point for improvement.Conclusions: This is one of the first studies to employ alcohol avoidance training in a mobile app for problem drinkers. Preliminary findings suggest that a mobile CBM app fulfils a need for problem drinkers and may contribute to a reduction in alcohol use. Replicating these findings in a controlled study is warranted.
Abstract Background: With the growing shortage of nurses, labor-saving technology has become more important. In health care practice, however, the fit with innovations is not easy. The aim of this study is to analyze the development of a mobile input device for electronic medical records (MEMR), a potentially labor-saving application supported by nurses, that failed to meet the needs of nurses after development. Method: In a case study, we used an axiomatic design framework as an evaluation tool to visualize the mismatches between customer needs and the design parameters of the MEMR, and trace these mismatches back to (preliminary) decisions in the development process. We applied a mixed-method research design that consisted of analyzing of 118 external and internal files and working documents, 29 interviews and shorter inquiries, a user test, and an observation of use. By factoring and grouping the findings, we analyzed the relevant categories of mismatches. Results: The involvement of nurses during the development was extensive, but not all feedback was, or could not be, used effectively to improve the MEMR. The mismatches with the most impact were found to be: (1) suboptimal supportive technology, (2) limited functionality of the app and input device, and (3) disruption of nurses’ workflow. Most mismatches were known by the IT department when the MEMR was offered to the units as a product. Development of the MEMR came to a halt because of limited use. Conclusion: Choices for design parameters, made during the development of labor-saving technology for nurses, may conflict with the customer needs of nurses. Even though the causes of mismatches were mentioned by the IT department, the nurse managers acquired the MEMR based on the idea behind the app. The effects of the chosen design parameters should not only be compared to the customer needs, but also be assessed with nurses and nurse managers for the expected effect on the workflow.
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Background: To facilitate adherence to adaptive pain management behaviors after interdisciplinary multimodal pain treatment, we developed a mobile health app (AGRIPPA app) that contains two behavior regulation strategies. Objective: The aims of this project are (1) to test the effectiveness of the AGRIPPA app on pain disability; (2) to determine the cost-effectiveness; and (3) to explore the levels of engagement and usability of app users. Methods: We will perform a multicenter randomized controlled trial with two parallel groups. Within the 12-month inclusion period, we plan to recruit 158 adult patients with chronic pain during the initial stage of their interdisciplinary treatment program in one of the 6 participating centers. Participants will be randomly assigned to the standard treatment condition or to the enhanced treatment condition in which they will receive the AGRIPPA app. Patients will be monitored from the start of the treatment program until 12 months posttreatment. In our primary analysis, we will evaluate the difference over time of pain-related disability between the two conditions. Other outcome measures will include health-related quality of life, illness perceptions, pain self-efficacy, app system usage data, productivity loss, and health care expenses. Results: The study was approved by the local Medical Research Ethics Committee in October 2019. As of March 20, 2020, we have recruited 88 patients. Conclusions: This study will be the first step in systematically evaluating the effectiveness and efficiency of the AGRIPPA app. After 3 years of development and feasibility testing, this formal evaluation will help determine to what extent the app will influence the maintenance of treatment gains over time. The outcomes of this trial will guide future decisions regarding uptake in clinical practice.
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Veel patiënten binnen de GGZ kampen met chronische pijn en depressie. Het bevorderen van een gezond beweegpatroon speelt een belangrijke rol in hun behandeling. Deze patiënten kunnen echter door emoties en veranderde prikkelverwerking signalen van het lichaam niet goed inschatten. Daarbij zijn hun klachten belemmerend in hun activiteiten waardoor motivatie vaak afwezig is. GGZ-professionals gebruiken zorgstandaarden waarbij uitgegaan wordt van 'one-size-fits-all' behandelprogramma's. Deze sluiten onvoldoende aan bij de behoefte aan gepersonaliseerde interventies uitgaande van zelfmanagement van de individuele patiënt. Dit pleit voor een instrument dat professionals helpt objectief inzicht te krijgen in het beweegpatroon van hun patiënten, dat gepersonaliseerde feedback geeft en ondersteunt bij de verdere individueel passende begeleiding van de patiënt. Zelfmeettechnologie ('activity trackers') lijkt hier goed te passen. De mogelijkheden om zelfmeettechnologie als basis voor de behandeling van deze patiënten te gebruiken zijn echter bij GGZ-professionals veelal onbekend. Daarnaast is het inzetten van alleen zelfmeettechnologie waarschijnlijk onvoldoende en is niet goed bekend hoe deze patiënten gemotiveerd kunnen worden om deze technologie te (blijven) gebruiken. In dit project willen de Hanzehogeschool Groningen, Inter-Psy, Transcare en MobileCare samen met professionals en patiënten en andere nog te betrekken partners (o.a. het Rob Giel Onderzoekscentrum als trekker van het eHealth netwerk Noord-Nederland heeft aangegeven een bijdrage te willen leveren) ontdekken hoe op een goede manier aan de bovenbeschreven behoefte van GGZ-professionals kan worden bijgedragen. Beoogd wordt om met deze subsidie een proof of concept te leveren van een digitaal instrument dat op basis van zelfmeettechnologie meerwaarde biedt in de behandeling van patiënten met chronische pijn en depressie. Deze proof of concept vormt de basis voor een te schrijven subsidievoorstel om dit verder te ontwikkelen.
Structural colour (SC) is created by light interacting with regular nanostructures in angle-dependent ways resulting in vivid hues. This form of intense colouration offers commercial and industrial benefits over dyes and other pigments. Advantages include durability, efficient use of light, anti-fade properties and the potential to be created from low cost materials (e.g. cellulose fibres). SC is widely found in nature, examples include butterflies, squid, beetles, plants and even bacteria. Flavobacterium IR1 is a Gram-negative, gliding bacterium isolated from Rotterdam harbour. IR1 is able to rapidly self-assemble into a 2D photonic crystal (a form of SC) on hydrated surfaces. Colonies of IR1 are able to display intense, angle-dependent colours when illuminated with white light. The process of assembly from a disordered structure to intense hues, that reflect the ordering of the cells, is possible within 10-20 minutes. This bacterium can be stored long-term by freeze drying and then rapidly activated by hydration. We see these properties as suiting a cellular reporter system quite distinct from those on the market, SC is intended to be “the new Green Fluorescent Protein”. The ability to understand the genomics and genetics of SC is the unique selling point to be exploited in product development. We propose exploiting SC in IR1 to create microbial biosensors to detect, in the first instance, volatile compounds that are damaging to health and the environment over the long term. Examples include petroleum or plastic derivatives that cause cancer, birth defects and allergies, indicate explosives or other insidious hazards. Hoekmine, working with staff and students within the Hogeschool Utrecht and iLab, has developed the tools to do these tasks. We intend to create a freeze-dried disposable product (disposables) that, when rehydrated, allow IR1 strains to sense and report multiple hazardous vapours alerting industries and individuals to threats. The data, visible as brightly coloured patches of bacteria, will be captured and quantified by mobile phone creating a system that can be used in any location by any user without prior training. Access to advice, assay results and other information will be via a custom designed APP. This work will be performed in parallel with the creation of a business plan and market/IP investigation to prepare the ground for seed investment. The vision is to make a widely usable series of tests to allow robust environmental monitoring for all to improve the quality of life. In the future, this technology will be applied to other areas of diagnostics.
A world where technology is ubiquitous and embedded in our daily lives is becoming increasingly likely. To prepare our students to live and work in such a future, we propose to turn Saxion’s Epy-Drost building into a living lab environment. This will entail setting up and drafting the proper infrastructure and agreements to collect people’s location and building data (e.g. temperature, humidity) in Epy-Drost, and making the data appropriately available to student and research projects within Saxion. With regards to this project’s effect on education, we envision the proposal of several derived student projects which will provide students the opportunity to work with huge amounts of data and state-of-the-art natural interaction interfaces. Through these projects, students will acquire skills and knowledge that are necessary in the current and future labor-market, as well as get experience in working with topics of great importance now and in the near future. This is not only aligned with the Creative Media and Game Technologies (CMGT) study program’s new vision and focus on interactive technology, but also with many other education programs within Saxion. In terms of research, the candidate Postdoc will study if and how the data, together with the building’s infrastructure, can be leveraged to promote healthy behavior through playful strategies. In other words, whether we can persuade people in the building to be more physically active and engage more in social interactions through data-based gamification and building actuation. This fits very well with the Ambient Intelligence (AmI) research group’s agenda in Augmented Interaction, and CMGT’s User Experience line. Overall, this project will help spark and solidify lasting collaboration links between AmI and CMGT, give body to AmI’s new Augmented Interaction line, and increase Saxion’s level of education through the dissemination of knowledge between researchers, teachers and students.
