BACKGROUND: A lack of physical activity is considered to cause 6% of deaths globally. Feedback from wearables such as activity trackers has the potential to encourage daily physical activity. To date, little research is available on the natural development of adherence to activity trackers or on potential factors that predict which users manage to keep using their activity tracker during the first year (and thereby increasing the chance of healthy behavior change) and which users discontinue using their trackers after a short time.OBJECTIVE: The aim of this study was to identify the determinants for sustained use in the first year after purchase. Specifically, we look at the relative importance of demographic and socioeconomic, psychological, health-related, goal-related, technological, user experience-related, and social predictors of feedback device use. Furthermore, this study tests the effect of these predictors on physical activity.METHODS: A total of 711 participants from four urban areas in France received an activity tracker (Fitbit Zip) and gave permission to use their logged data. Participants filled out three Web-based questionnaires: at start, after 98 days, and after 232 days to measure the aforementioned determinants. Furthermore, for each participant, we collected activity data tracked by their Fitbit tracker for 320 days. We determined the relative importance of all included predictors by using Random Forest, a machine learning analysis technique.RESULTS: The data showed a slow exponential decay in Fitbit use, with 73.9% (526/711) of participants still tracking after 100 days and 16.0% (114/711) of participants tracking after 320 days. On average, participants used the tracker for 129 days. Most important reasons to quit tracking were technical issues such as empty batteries and broken trackers or lost trackers (21.5% of all Q3 respondents, 130/601). Random Forest analysis of predictors revealed that the most influential determinants were age, user experience-related factors, mobile phone type, household type, perceived effect of the Fitbit tracker, and goal-related factors. We explore the role of those predictors that show meaningful differences in the number of days the tracker was worn.CONCLUSIONS: This study offers an overview of the natural development of the use of an activity tracker, as well as the relative importance of a range of determinants from literature. Decay is exponential but slower than may be expected from existing literature. Many factors have a small contribution to sustained use. The most important determinants are technical condition, age, user experience, and goal-related factors. This finding suggests that activity tracking is potentially beneficial for a broad range of target groups, but more attention should be paid to technical and user experience-related aspects of activity trackers.
Purpose – The purpose of this paper is to develop a model on how business managers perceive that an employee’s psychological contract influences his or her attitude toward an organizational change. More specifically, it aims to provide insight into the managerial views on: first, the affective, behavioral and cognitive responses of employees toward organizational change; second, the pre-change and change antecedents of these responses; and third, the role of the psychological contract as a pre-change antecedent. Design/methodology/approach – Data were collected from in-depth interviews with 39 human resource directors, change managers and management consultants in eight European countries. Based on detailed grounded theory-driven analyses of the qualitative data, a conceptual model was developed. Findings – Based on the grounded theory analysis, a model emerged that positions the individual change perception and individual answer to the “what’s in it for me?” question as central determinants of an employee’s attitude toward change. Moreover, the model distinguishes between “influencing” variables that shape the employees’ change perception, and “overruling” variables that can potentially reverse the change perceptions. Practical implications – A strong emphasis on managing the employment relationship by fulfilling mutual obligations and by creating trust will yield more constructive responses to organizational change than focussing on managing an organizational change as an independent event. Originality/value – As one of the first in its field, this study provides insight in the sense-making processes during organizational change, while adopting a managerial perspective. A grounded theory approach by means of interviewing, serves as a first step toward better understanding of the development of employees’ affective, behavioral and cognitive responses to organizational change.
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Abstract: Background: Little is known about frailty among patients hospitalized with heart failure (HF). To date, the limited information on frailty in HF is based on a unidimensional view of frailty, in which only physical aspects are considered when determining frailty. The aims of this study were to study different dimensions of frailty (physical, psychological and social) in patients with HF and the effect of different dimensions of frailty on the incidence of heart failure. Methods: The study used a cross-sectional design and included 965 patients hospitalized for heart failure and 164 healthy controls. HF was defined according to the ESC guidelines. The Tilburg Frailty Indicator (TFI) was used to assess frailty. Probit regression analyses and chi-square statistics were used to examine associations between the occurrence of heart failure and TFI domains of frailty. Results: Patients diagnosed with frailty were 15.3% more likely to develop HF compared to those not diagnosed with frailty (p < 0.001). An increase in physical, psychological and social frailty corresponded to an increased risk of HF of 2.9% (p < 0.001), 4.4% (p < 0.001) and 6.6% (p < 0.001), respectively. Conclusions: We found evidence of the association between different dimensions of frailty and incidence of HF.
Ready, Set, Go for Health (ReSetGo) The UN declared health as a fundamental right for all. Due to the exponential rise of healthcare costs and the greying of the European population, the current healthcare system is unsustainable. This has major negative individual and population consequences making health a priority on the EU-agenda. To change this for the better, a sustainable transition from the current healthcare system, primarily focusing on cure and care, towards health as a capability is needed. Health is influenced by many determinants and involves an interaction of psychological, environmental (social/physical) and political factors. This systemic view means that health is not only an individual responsibility. Rather, we need to create communities that strengthen the ability to optimize health. What becomes clear from the reflections of the (health)professionals in the context of Eemsdelta, is that a transition towards health is needed and that support and a critical amount of capacity is a prerequisite. But is a community ready and is there enough capacity to start the health transition towards healthy living? In order to be able to map this health transition readiness and capacity at each stage of the transition process a monitor needs to developed. Based on interaction with the practical field and our experiences, Hanze (NL) feels the need to further facilitate this health transition and developed ReSetGo together with consortium partners IPB (PT), Metropolia (FI) and Thrive (NL). ReSetGo has two goals: 1) develop and test a health transition readiness and capacity monitor in existing communities in FI, PT and NL; 2) extend our international network and prepare a Marie Skłodowska-Curie/Doctoral Network proposal on this health transition theme.
