Background Total laryngectomy with or without adjuvant (chemo)radiation often induces speech, swallowing and neck and shoulder problems. Speech, swallowing and shoulder exercises may prevent or diminish these problems. The aim of the present paper is to describe the study, which is designed to investigate the effectiveness and cost-utility of a guided self-help exercise program built into the application “In Tune without Cords” among patients treated with total laryngectomy. Methods/design Patients, up to 5 years earlier treated with total laryngectomy with or without (chemo)radiation will be recruited for participation in this study. Patients willing to participate will be randomized to the intervention or control group (1:1). Patients in the intervention group will be provided access to a guided self-help exercise program and a self-care education program built into the application “In Tune without Cords”. Patients in the control group will only be provided access to the self-care education program. The primary outcome is the difference in swallowing quality (SWAL-QOL) between the intervention and control group. Secondary outcome measures address speech problems (SHI), shoulder disability (SDQ), quality of life (EORTC QLQ-C30, QLQ-H&N35 and EQ-5D), direct and indirect costs (adjusted iMCQ and iPCQ measures) and self-management (PAM). Patients will be asked to complete these outcome measures at baseline, immediately after the intervention or control period (i.e. at 3 months follow-up) and at 6 months follow-up. Discussion This randomized controlled trial will provide knowledge on the effectiveness of a guided self-help exercise program for patients treated with total laryngectomy. In addition, information on the value for money of such an exercise program will be provided. If this guided self-help program is (cost)effective for patients treated with total laryngectomy, the next step will be to implement this exercise program in current clinical practice.
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This paper investigates how management accounting and control systems (operationalized by using Simons’ (1995a) levers of control framework) can be used as devices to support public value creation and as such it contributes to the literature on public value accounting. Using a mixed methods case study approach, including documentary analysis and semi-structured interviews, we found diverging uses of control systems in the Dutch university of applied sciences we investigated. While belief and interactive control systems are used intensively for strategy change and implementation, diagnostic controls were used mainly at the decentral level and seen as devices to make sure that operational and financial boundaries were not crossed. Therefore, belief and interactive control systems lay the foundation for the implementation of a new strategy, in which concepts of public value play a large role, using diagnostic controls to constrain actions at the operational level. We also found that whereas the institution wanted to have interaction with the external stakeholders, in daily practice this takes place only at the phase of strategy formulation, but not in the phase of intermediate strategy evaluation.
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Smart speakers are heralded to make everyday life more convenient in households around the world. These voice-activated devices have become part of intimate domestic contexts in which users interact with platforms.This chapter presents a dualstudy investigating the privacy perceptions of smart speaker users and non-users. Data collected in in-depth interviews and focus groups with Dutch users and non-users show that they make sense of privacy risks through imagined sociotechnical affordances. Imagined affordances emerge with the interplay between user expectations, technologies, and designer intentions. Affordances like controllability, assistance, conversation, linkability, recordability, and locatability are associated with privacy considerations. Viewing this observation in the light of privacy calculus theory, we provide insights into how users’ positive experiences of the control over and assistance in the home offered by smart speakers outweighs privacy concerns. On the contrary, non-users reject the devices because of fears that recordability and locatability would breach the privacy of their homes by tapping data to platform companies. Our findings emphasize the dynamic nature of privacy calculus considerations and how these interact with imagined affordances; establishing a contrast between rational and emotional responses relating to smart speaker use.Emotions play a pivotal role in adoption considerations whereby respondents balance fears of unknown malicious actors against trust in platform companies.This study paves the way for further research that examines how surveillance in the home is becoming increasingly normalized by smart technologies.
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Background: To experience external objects in such a way that they are perceived as an integral part of one's own body is called embodiment. Wearable technology is a category of objects, which, due to its intrinsic properties (eg, close to the body, inviting frequent interaction, and access to personal information), is likely to be embodied. This phenomenon, which is referred to in this paper as wearable technology embodiment, has led to extensive conceptual considerations in various research fields. These considerations and further possibilities with regard to quantifying wearable technology embodiment are of particular value to the mobile health (mHealth) field. For example, the ability to predict the effectiveness of mHealth interventions and knowing the extent to which people embody the technology might be crucial for improving mHealth adherence. To facilitate examining wearable technology embodiment, we developed a measurement scale for this construct. Objective: This study aimed to conceptualize wearable technology embodiment, create an instrument to measure it, and test the predictive validity of the scale using well-known constructs related to technology adoption. The introduced instrument has 3 dimensions and includes 9 measurement items. The items are distributed evenly between the 3 dimensions, which include body extension, cognitive extension, and self-extension.Methods: Data were collected through a vignette-based survey (n=182). Each respondent was given 3 different vignettes, describing a hypothetical situation using a different type of wearable technology (a smart phone, a smart wristband, or a smart watch) with the purpose of tracking daily activities. Scale dimensions and item reliability were tested for their validity and Goodness of Fit Index (GFI). Results: Convergent validity of the 3 dimensions and their reliability were established as confirmatory factor analysis factor loadings45 (>0.70), average variance extracted values40 (>0.50), and minimum item to total correlations50 (>0.40) exceeded established threshold values. The reliability of the dimensions was also confirmed as Cronbach alpha and composite reliability exceeded 0.70. GFI testing confirmed that the 3 dimensions function as intercorrelated first-order factors. Predictive validity testing showed that these dimensions significantly add to multiple constructs associated with predicting the adoption of new technologies (ie, trust, perceived usefulness, involvement, attitude, and continuous intention). Conclusions: The wearable technology embodiment measurement instrument has shown promise as a tool to measure the extension of an individual's body, cognition, and self, as well as predict certain aspects of technology adoption. This 3-dimensional instrument can be applied to mixed method research and used by wearable technology developers to improve future versions through such things as fit, improved accuracy of biofeedback data, and customizable features or fashion to connect to the users' personal identity. Further research is recommended to apply this measurement instrument to multiple scenarios and technologies, and more diverse user groups.
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Background:Physical activity can prolong the ability of older adults to live independently. Home-based exercises can help achieve the recommended physical activity levels. A blended intervention was developed to support older adults in performing home-based exercises. A tablet and a personal coach were provided to facilitate the self-regulation of exercise behavior.Objective:In line with the Medical Research Council framework, this study aimed to carry out process evaluation of a blended intervention. The objectives were (1) to assess the long-term usability of the tablet adopted in the blended intervention and (2) to explore how the tablet, in conjunction with a personal coach, supported older adults in performing home-based exercises.Methods:The process evaluation was conducted with a mixed-methods approach. At baseline, older adults participating in the blended intervention were asked to fill out a questionnaire about their general experience with information and communication technology (ICT) devices and rate their own skill level. After 6 months, participants filled out the Usefulness, Satisfaction, and Ease of use (USE) questionnaire to assess the usefulness, satisfaction, and ease of use of the tablet. With a random selection of participants, in-depth interviews were held to explore how the tablet and coach supported the self-regulation. The interviews were double coded and analyzed with the directed content analysis method.Results:At baseline, 29% (65/224) of participants who started the intervention (mean age 72 years) filled out the ICT survey and 36% (37/103) of participants who used the tablet for 6 months (mean age 71 years) filled out the USE questionnaire. Furthermore, with 17% (18/103) of participants (mean age 73 years), follow-up interviews were held. The results of the baseline questionnaire showed that the large majority of participants already had experience with a tablet, used it regularly, and reported being skillful in operating ICT devices. After 6 months of use, the participants rated the usefulness, satisfaction, and ease of use of the tablet on average as 3.8, 4.2, and 4.1, respectively, on a 5-point scale. The analysis of the interviews showed that the participants felt that the tablet supported action planning, behavior execution, and self-monitoring. On the other hand, especially during the first few months, the personal coach added value during the goal setting, behavior execution, and evaluation phases of self-regulation.Conclusions:The results of the process evaluation showed that older adults who participated in the study were positive about the blended intervention that was designed to support them in performing home-based exercises. Participants reported that the tablet helped them to perform the exercises better, more frequently, and safely. It supported them in various phases of self-regulation. The availability of a personal coach was nevertheless crucial. To support physical activity in older adults, a blended approach is promising.
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This investigation explores relations between 1) a theory of human cognition, called Embodied Cognition, 2) the design of interactive systems and 3) the practice of ‘creative group meetings’ (of which the so-called ‘brainstorm’ is perhaps the best-known example). The investigation is one of Research-through-Design (Overbeeke et al., 2006). This means that, together with students and external stakeholders, I designed two interactive prototypes. Both systems contain a ‘mix’ of both physical and digital forms. Both are designed to be tools in creative meeting sessions, or brainstorms. The tools are meant to form a natural, element in the physical meeting space. The function of these devices is to support the formation of shared insight: that is, the tools should support the process by which participants together, during the activity, get a better grip on the design challenge that they are faced with. Over a series of iterations I reflected on the design process and outcome, and investigated how users interacted with the prototypes.
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Background: Impaired upper extremity function due to muscle paresis or paralysis has a major impact on independent living and quality of life (QoL). Assistive technology (AT) for upper extremity function (i.e. dynamic arm supports and robotic arms) can increase a client’s independence. Previous studies revealed that clients often use AT not to their full potential, due to suboptimal provision of these devices in usual care. Objective: To optimize the process of providing AT for impaired upper extremity function and to evaluate its (cost-)effectiveness compared with care as usual. Methods: Development of a protocol to guide the AT provision process in an optimized way according to generic Dutch guidelines; a quasi-experimental study with non-randomized, consecutive inclusion of a control group (n = 48) receiving care as usual and of an intervention group (optimized provision process) (n = 48); and a cost-effectiveness and cost-utility analysis from societal perspective will be performed. The primary outcome is clients’ satisfaction with the AT and related services, measured with the Quebec User Evaluation of Satisfaction with AT (Dutch version; D-QUEST). Secondary outcomes comprise complaints of the upper extremity, restrictions in activities, QoL, medical consumption and societal cost. Measurements are taken at baseline and at 3, 6 and 9 months follow-up.
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More people voted in 2024 than any other year in human history, while often relying on the internet for political information. This combination resulted in critical challenges for democracy. To address these concerns, we designed an exhibition that applied interactive experiences to help visitors understand the impact of digitization on democracy. This late-breaking work addresses the research questions: 1) What do participants, exposed to playful interventions, think about these topics? and 2) How do people estimate their skills and knowledge about countering misinformation? We collected data in 5 countries through showcases held within weeks of relevant 2024 elections. During visits, participants completed a survey detailing their experiences and emotional responses. Participants expressed high levels of self-confidence regarding the detection of misinformation and spotting AI-generated content. This paper contributes to addressing digital literacy needs by fostering engaging interactions with AI and politically relevant issues surrounding campaigning and misinformation.
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This thesis aims to develop and validate a comprehensive and adaptable activity monitoring system that quantifies physical behaviours in children with and without developmental disabilities, including those utilizing assistive devices. This system seeks to overcome the current limitations in the accuracy and feasibility of existing monitoring devices by providing robust measurements in real-world settings.
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Background: Self-management of exacerbations in COPD patients is important to reduce exacerbation impact. There is a need for more comprehensive and individualized interventions to improve exacerbation-related selfmanagement behavior. The use of mobile health (mHealth) could help to achieve a wide variety of behavioral goals. Understanding of patients and health care providers perspectives towards using mHealth in promoting selfmanagement will greatly enhance the development of solutions with optimal usability and feasibility. Therefore, the aim of this study was to explore perceptions of COPD patients and their health care providers towards using mHealth for self-management of exacerbations. Methods: A qualitative study using focus group interviews with COPD patients (n = 13) and health care providers (HCPs) (n = 6) was performed to explore perceptions towards using mHealth to support exacerbation-related selfmanagement. Data were analyzed by a thematic analysis. Results: COPD patients and HCPs perceived mostly similar benefits and barriers of using mHealth for exacerbationrelated self-management. These perceived benefits and barriers seem to be important drivers in the willingness to use mHealth. Both patients and HCPs strengthen the need for a multi-component and tailored mHealth intervention that improves patients’ exacerbation-related self-management by determining their health status and providing adequate information, decision support and feedback on self-management behavior. Most importantly, patients and HCPs considered an mHealth intervention as support to improve self-management and emphasized that it should never replace patients’ own feelings nor undermine their own decisions. In addition, the intervention should be complementary to regular contact with HCPs, as personal contact with a HCP was considered to be very important. To optimize engagement with mHealth, patients should have a positive attitude toward using mHealth and an mHealth intervention should be attractive, rewarding and safe. Conclusions: This study provided insight into perceptions of COPD patients and their HCPs towards using mHealth for self-management of exacerbations. This study points out that future mHealth interventions should focus on developing self-management skills over time by providing adequate information, decision support and feedback on self-management behavior and that mHealth should complement regular care. To optimize engagement, mHealth interventions should be attractive, rewarding, safe and tailored to the patient needs.
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