The aim of this study was to evaluate the usability, defined as the effectiveness, efficiency and satisfaction, of the prototype of the DTTSQ for Dutch physical therapy patients with diverse levels of education and experience in using mobile technology.
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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.
Background: Major surgery is associated with negative postoperative outcomes such as complications and delayed or poor recovery. Multimodal prehabilitation can help to reduce the negative effects of major surgery. Offering prehabilitation by means of mobile health (mHealth) could be an effective new approach. Objective: The objectives of this pilot study were to (1) evaluate the usability of the Be Prepared mHealth app prototype for people undergoing major surgery, (2) explore whether the app was capable of bringing about a change in risk behaviors, and (3) estimate a preliminary effect of the app on functional recovery after major surgery. Methods: A mixed-methods pilot randomized controlled trial was conducted in two Dutch academic hospitals. In total, 86 people undergoing major surgery participated. Participants in the intervention group received access to the Be Prepared app, a smartphone app using behavior change techniques to address risk behavior prior to surgery. Both groups received care as usual. Usability (System Usability Scale), change in risk behaviors 3 days prior to surgery, and functional recovery 30 days after discharge from hospital (Patient-Reported Outcomes Measurement Information System physical functioning 8-item short form) were assessed using online questionnaires. Quantitative data were analyzed using descriptive statistics, chi-square tests, and multivariable linear regression. Semistructured interviews about the usability of the app were conducted with 12 participants in the intervention group. Thematic analysis was used to analyze qualitative data. Results: Seventy-nine people—40 in the intervention group and 39 in the control group—were available for further analysis. Participants had a median age of 61 (interquartile range 51.0-68.0) years. The System Usability Scale showed that patients considered the Be Prepared app to have acceptable usability (mean 68.2 [SD 18.4]). Interviews supported the usability of the app. The major point of improvement identified was further personalization of the app. Compared with the control group, the intervention group showed an increase in self-reported physical activity and muscle strengthening activities prior to surgery. Also, 2 of 2 frequent alcohol users in the intervention group versus 1 of 9 in the control group drank less alcohol in the run-up to surgery. No difference was found in change of smoking cessation. Between-group analysis showed no meaningful differences in functional recovery after correction for baseline values (β=–2.4 [95% CI –5.9 to 1.1]). Conclusions: The Be Prepared app prototype shows potential in terms of usability and changing risk behavior prior to major surgery. No preliminary effect of the app on functional recovery was found. Points of improvement have been identified with which the app and future research can be optimized.
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The production, use, disposal and recovery of packaging not only generates massive volumes of waste, it also consumes raw materials, water and energy (Fitzpatrick et al. 2012). Simultaneously, consumers have shown an increasing interest in products incorporating sustainable and social attributes (Kletzan et al., 2006). As a result, environmentally friendly packaging, also called ecofriendly or sustainable packaging, has become mainstream. In this context, packaging is more than just ensuring the product's protection and easing transportation, it is also a communicative tool (Palmer, 2000) and it becomes associated with multiple drivers of the purchasing process. Consequently, companies face pressure to innovate responding to consumer demands, and focusing on sustainable solutions that reduce harmful materials and favour green alternatives for both, the product and the packaging. Although the above has triggered research on consumer choice for sustainable products and alternatives on sustainable packaging, the relation between sustainable packaging and consumer behaviour remains underexplored. This research unpacks this relationship, i.e., empirically verifies which dimensions (recyclability, biodegradability, reusability) of sustainable packaging are perceived and valued by consumers. Put differently, this research investigates consumer behaviour towards the functions of sustainable packaging in terms of product protection, convenience, reliability of information and promotion, and scrutinises the perceived credibility of the associated ethical responsibility claims. It aims to identify those packaging materials and/or sustainability characteristics perceived as more sustainable by consumers as well as the factors influencing actual consumer choice towards sustainable packaged products. We aim to gain more insights in the perceptual frame that different types of consumers apply when exposed to sustainable packaging. To this end, we will make use of revealed preference methods to measure consumer valuations of sustainable packaged products. This game-theoretic approach should provide a more complete depiction of consumers' perceptions and preferences.
Various studies suggest that the fashion and textile industry need to move away from traditional, extractive leadership models. Dreier et al. (2019) show how traditional top-down, hierarchical leadership approaches are not effective in fostering sustainability, and argued that a more collaborative, participative approach is needed to implement true and long-standing change. Moreover, research also shows how fashion and textile designers don’t see themselves as leaders but instead as ‘creators’ who employ others to manage their business and lead the team. This change in leadership is also necessary to achieve the European vision for Industry 5.0 (2022), which places the wellbeing of the worker at the centre of the production process. If we want to find solutions to the problems we face today, we need to change the way we think, lead, and do business. This calls for regenerative leadership which involves not only minimising negative impacts, but also actively working to restore and enhance the social ecological systems in which an industry operates. And since technology has become ubiquitous in every aspect of our lives (including business), it is important to explore its role in helping us become better regenerative leaders. With ReLead, The Hague University of Applied Sciences (THUAS) aims to amplify consortium partner i-did’s social and environmental impact. Since its inception in 2009, i-did has helped more than 400 people become gainfully employed while helping recycle almost 60.000 kgs of textile waste. This has been possible due to the transformation of i-did’s founder (Mireille Geijsen) from a creative designer, into a collaborative and mindful leader. The intended outcome of this project is to create a tech-enabled leadership transformation toolkit and leadership academy that helps creative designers transform into regenerative leaders.
