Purpose: This is a position paper describing the elements of an international framework for assistive techhnology provision that could guide the development of policies, systems and service delivery procedures across the world. It describes general requirements, quality criteria and possible approaches that may help to enhance the accessibility of affordable and high quality assistive technology solutions. Materials and methods: The paper is based on the experience of the authors, an analysis of the existing literature and the inputs from many colleagues in the field of assistive technology provision. It includes the results of discussions of an earlier version of the paper during an international conference on the topic in August 2017. Results and conclusion: The paper ends with the recommendation to develop an international standard for assistive technology provision. Such a standard can have a major impact on the accessibility of AT for people with disabilities. The paper outlines some the key elements to be included in a standard.
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Background:Children with asthma can decrease the impact of their disease by improving their physical activity (PA). However, health care providers lack interventions for children with asthma that effectively increase their PA levels and achieve behavior change. A technology-supported approach can positively influence PA and physical functioning in children.Objective:The aims of this study were to develop a technology-supported intervention that facilitates health care providers in promoting PA for children (aged 8 to 12 years) with asthma and to systematically describe this developmental process.Methods:Intervention mapping (IM) was applied to develop a blended and technology-supported intervention in cocreation with children with asthma, their parents, and health care providers. In accordance with the IM framework, the following steps were performed: conduct a needs assessment; define the intervention outcome, performance objectives, and change objectives; select theory-based intervention methods and strategies; create components of the intervention and conduct pilot tests; create an implementation plan; and create an evaluation plan.Results:We developed the blended intervention Foxfit that consists of an app with a PA monitor for children (aged 8 to 12 years) with asthma and a web-based dashboard for their health care provider. The intervention focuses on PA in everyday life to improve social participation. Foxfit contains components based on behavior change principles and gamification, including goal setting, rewards, action planning, monitoring, shaping knowledge, a gamified story, personal coaching and feedback, and a tailored approach. An evaluation plan was created to assess the intervention’s usability and feasibility for both children and health care providers.Conclusions:The IM framework was very useful for systematically developing a technology-supported intervention and for describing the translational process from scientific evidence, the needs and wishes of future users, and behavior change principles into this intervention. This has led to the technology-supported intervention Foxfit that facilitates health care providers in promoting PA in children with asthma. The structured description of the development process and functional components shows the way behavior change techniques are incorporated in the intervention.Trial Registration:International Clinical Trial Registry Platform NTR6658; https://tinyurl.com/3rxejksf
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Over the last two decades, institutions for higher education such as universities and colleges have rapidly expanded and as a result have experienced profound changes in processes of research and organization. However, the rapid expansion and change has fuelled concerns about issues such as educators' technology professional development. Despite the educational value of emerging technologies in schools, the introduction has not yet enjoyed much success. Effective use of information and communication technologies requires a substantial change in pedagogical practice. Traditional training and learning approaches cannot cope with the rising demand on educators to make use of innovative technologies in their teaching. As a result, educational institutions as well as the public are more and more aware of the need for adequate technology professional development. The focus of this paper is to look at action research as a qualitative research methodology for studying technology professional development in HE in order to improve teaching and learning with ICTs at the tertiary level. The data discussed in this paper have been drawn from a cross institutional setting at Fontys University of Applied Sciences, The Netherlands. The data were collected and analysed according to a qualitative approach.
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This longitudinal, quantitative study contributes to the debate on technology-based professional development by examining the extent to which a learning (LinkedIn) intervention in a university setting affects an individual’s social media use for professional development, and the extent to which this relates to self-reported employability. In addition, we investigated how this relationship is moderated by an individual’s motivation to communicate through social media (LinkedIn). Based on social capital theory and the conservation of resources theory, we developed a set of hypotheses that were tested based on longitudinal data collected from university employees (N = 101) in middle- and high-level jobs. First, in line with our expectations, social media use for professional development was significantly higher after the learning intervention than before. Second, partially in line with our expectations, social media use for professional development was positively related with the employability dimension anticipation and optimization. Third, contrary to our expectations, motivation to communicate through social media (LinkedIn) did not have a moderating role in this relationship. We concluded that the learning intervention has the potential to foster social media use for professional development, and in turn, can contribute to individuals’ human capital in terms of their employability. Hence, the intervention that forms the core of this empirical research can be a sustainable and promising human resource management (HRM) practice that fits the human capital agenda.
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While traditional crime rates are decreasing, cybercrime is on the rise. As a result, the criminal justice system is increasingly dealing with criminals committing cyber-dependent crimes. However, to date there are no effective interventions to prevent recidivism in this type of offenders. Dutch authorities have developed an intervention program, called Hack_Right. Hack_Right is an alternative criminal justice program for young first-offenders of cyber-dependent crimes. In order to prevent recidivism, this program places participants in organizations where they are taught about ethical hacking, complete (technical) assignments and reflect on their offense. In this study, we have evaluated the Hack_Right program and the pilot interventions carried out thus far. By examining the program theory (program evaluation) and implementation of the intervention (process evaluation), the study adds to the scarce literature about cybercrime interventions. During the study, two qualitative research methods have been applied: 1) document analysis and 2) interviews with intervention developers, imposers, implementers and participants. In addition to the observation that the scientific basis for linking specific criminogenic factors to cybercriminals is still fragile, the article concludes that the theoretical base and program integrity of Hack_Right need to be further developed in order to adhere to principles of effective interventions.
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Advanced technology is a primary solution for the shortage of care professionals and increasing demand for care, and thus acceptance of such technology is paramount. This study investigates factors that increase use of advanced technology during elderly care, focusing on current use of advanced technology, factors that influence its use, and care professionals’ experiences with the use. This study uses a mixed-method design. Logfiles were used (longitudinal design) to determine current use of advanced technology, questionnaires assessed which factors increase such use, and in-depth interviews were administered to retrieve care professionals’ experiences. Findings suggest that 73% of care professionals use advanced technology, such as camera monitoring, and consult clients’ records electronically. Six of nine hypotheses tested in this study were supported, with correlations strongest between performance expectancy and attitudes toward use, attitudes toward use and satisfaction, and effort expectancy and performance expectancy. Suggested improvements for advanced technology include expanding client information, adding report functionality, solving log-in problems, and increasing speed. Moreover, the quickest way to increase acceptance is by improving performance expectancy. Care professionals scored performance expectancy of advanced technology lowest, though it had the strongest effect on attitudes toward the technology.
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Objective: To describe the development of a goal-directed movement intervention in two medical wards, including recommendations for implementation and evaluation. Design: Implementation Research. Setting: Pulmonology and nephrology/gastroenterology wards of the University Medical Centre Utrecht, The Netherlands. Participants: Seven focus groups were executed including 28 nurses, 7 physical therapists and 15 medical specialists. Patients' perceptions were repeatedly assessed during the iterative steps of the intervention development. Intervention: Interventions were targeted to each ward's specific character, following an Intervention Mapping approach using literature and research meetings. Main measures: Intervention components were linked to Behavior Change Techniques and implementation strategies will be selected using the Expert Recommendation Implementing Change tool. Evaluation outcomes like number of patients using the movement intervention will be measured, based on the taxonomy of Proctor. Results: The developed intervention consists of: insight in patients movement behavior (monitoring & feedback), goal setting (goals & planning) and adjustments to the environment (associations & antecedents). The following implementation strategies are recommended: to conduct educational meetings, prepare & identify champions and audit & provide feedback. To measure service and client outcomes, the mean level of physical activity per ward can be evaluated and the Net Promoter Score can be used. Conclusion(s): This study shows the development of a goal-directed movement intervention aligned with the needs of healthcare professionals. This resulted in an intervention consisting of feedback & monitoring of movement behavior, goal setting and adjustments in the environment. Using a step-by-step iterative implementation model to guide development and implementation is recommended.
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Abstract: Background: Chronic obstructive pulmonary disease (COPD) and asthma have a high prevalence and disease burden. Blended self-management interventions, which combine eHealth with face-to-face interventions, can help reduce the disease burden. Objective: This systematic review and meta-analysis aims to examine the effectiveness of blended self-management interventions on health-related effectiveness and process outcomes for people with COPD or asthma. Methods: PubMed, Web of Science, COCHRANE Library, Emcare, and Embase were searched in December 2018 and updated in November 2020. Study quality was assessed using the Cochrane risk of bias (ROB) 2 tool and the Grading of Recommendations, Assessment, Development, and Evaluation. Results: A total of 15 COPD and 7 asthma randomized controlled trials were included in this study. The meta-analysis of COPD studies found that the blended intervention showed a small improvement in exercise capacity (standardized mean difference [SMD] 0.48; 95% CI 0.10-0.85) and a significant improvement in the quality of life (QoL; SMD 0.81; 95% CI 0.11-1.51). Blended intervention also reduced the admission rate (relative ratio [RR] 0.61; 95% CI 0.38-0.97). In the COPD systematic review, regarding the exacerbation frequency, both studies found that the intervention reduced exacerbation frequency (RR 0.38; 95% CI 0.26-0.56). A large effect was found on BMI (d=0.81; 95% CI 0.25-1.34); however, the effect was inconclusive because only 1 study was included. Regarding medication adherence, 2 of 3 studies found a moderate effect (d=0.73; 95% CI 0.50-0.96), and 1 study reported a mixed effect. Regarding self-management ability, 1 study reported a large effect (d=1.15; 95% CI 0.66-1.62), and no effect was reported in that study. No effect was found on other process outcomes. The meta-analysis of asthma studies found that blended intervention had a small improvement in lung function (SMD 0.40; 95% CI 0.18-0.62) and QoL (SMD 0.36; 95% CI 0.21-0.50) and a moderate improvement in asthma control (SMD 0.67; 95% CI 0.40-0.93). A large effect was found on BMI (d=1.42; 95% CI 0.28-2.42) and exercise capacity (d=1.50; 95% CI 0.35-2.50); however, 1 study was included per outcome. There was no effect on other outcomes. Furthermore, the majority of the 22 studies showed some concerns about the ROB, and the quality of evidence varied. Conclusions: In patients with COPD, the blended self-management interventions had mixed effects on health-related outcomes, with the strongest evidence found for exercise capacity, QoL, and admission rate. Furthermore, the review suggested that the interventions resulted in small effects on lung function and QoL and a moderate effect on asthma control in patients with asthma. There is some evidence for the effectiveness of blended self-management interventions for patients with COPD and asthma; however, more research is needed. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42019119894; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=119894
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Objective: Self-management is a core theme within chronic care and several evidence-based interventions (EBIs) exist to promote self-management ability. However, these interventions cannot be adapted in a mere copy-paste manner. The current study describes and demonstrates a planned approach in adapting EBI’s in order to promote self-management in community-dwelling people with chronic conditions. Methods: We used Intervention Mapping (IM) to increase the intervention’s fit with a new context. IM helps researchers to take decisions about whether and what to adapt, while maintaining the working ingredients of existing EBI’s. Results: We present a case study in which we used IM to adapt EBI’s to the Flemish primary care context to promote self-management in people with one or more chronic disease. We present the reader with a contextual analysis, intervention aims, and content, sequence and scope of the resulting intervention. Conclusion: IM provides an excellent framework in providing detailed guidance on intervention adaption to a new context, while preserving the essential working ingredients of EBI’s. Practice Implications: The case study is exemplary for public health researchers and practitioners as a planned approach to seek and find EBI’s, and to make adaptations.
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Creative arts engagement has been shown to be related to maintaining wellbeing in older adulthood (Tymoszuk et al., 2019). For people living with dementia, music can be engaging and rewarding (Baird & Thompson, 2018), and is often presented as a therapeutic activity. It is theorised that music’s capacity to effect change is due to its engaging, emotional, physical, personal, social and persuasive qualities (Brancatisano et al., 2020). However, music itself is a complex intervention (Loui, 2020) and the ‘creative’ in music activities in the small number of studies with people living with dementia is rarely described or critiqued (Creech et al., 2020). Music is often described as passive (receptive)/active to reflect different listening or playing activities. Only a few studies detail opportunities for people living with dementia to exercise creativity (e.g. Zeilig et al., 2019).Technology to assist these musical interactions in dementia falls under distinct categories of listening to music, or playing music, with very little afforded in the way of agency, choice or control (MacRitchie et al., 2023). A few possible explanations could be: i) the musical activity is valued in terms of pre/post cognitive or social changes (Kontos & Grigorovich, 2018) i.e., the activity itself is not particularly critiqued, ii) creativity is assumed to be embedded in the activity and does not need to be enhanced or supported, iii) the locus of creativity is in cognitive processes occurring in the brain, so people living with dementia are often ascribed a passive role in creative musical interactions (Zeilig et al., 2019). We propose a new way of thinking about musical interactions for people living with dementia, building from the enactive, embodied experience of music (Schiavio et al., 2022), and considering a more relational view. Leaving aside the framing where the person with dementia is limited in what creativity they can offer, we propose instead a framework of design where subtle acts of agency and (mini-C) creativity are afforded, supporting a myriad of musical interactions that sit between listening and performing.
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