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Lifestyle management is the cornerstone of both primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD) and the importance of lifestyle management is emphasised by all major guidelines. Despite this, actual implementation of lifestyle management is poor. Lifestyle modification includes smoking cessation, weight loss, dietary change, increasing physical inactivity, and stress management. This review summarises evidence-based opportunities and challenges for healthcare professionals to promote healthy lifestyles at an individual level for the prevention of ASCVD.
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Background: The combination of self-tracking and persuasive eCoaching in automated interventions is a new and promising approach for healthy lifestyle management. Objective: The aim of this study was to identify key components of self-tracking and persuasive eCoaching in automated healthy lifestyle interventions that contribute to their effectiveness on health outcomes, usability, and adherence. A secondary aim was to identify the way in which these key components should be designed to contribute to improved health outcomes, usability, and adherence. Methods: The scoping review methodology proposed by Arskey and O'Malley was applied. Scopus, EMBASE, PsycINFO, and PubMed were searched for publications dated from January 1, 2013 to January 31, 2016 that included (1) self-tracking, (2) persuasive eCoaching, and (3) healthy lifestyle intervention. Results: The search resulted in 32 publications, 17 of which provided results regarding the effect on health outcomes, 27 of which provided results regarding usability, and 13 of which provided results regarding adherence. Among the 32 publications, 27 described an intervention. The most commonly applied persuasive eCoaching components in the described interventions were personalization (n=24), suggestion (n=19), goal-setting (n=17), simulation (n=17), and reminders (n=15). As for self-tracking components, most interventions utilized an accelerometer to measure steps (n=11). Furthermore, the medium through which the user could access the intervention was usually a mobile phone (n=10). The following key components and their specific design seem to influence both health outcomes and usability in a positive way: reduction by setting short-term goals to eventually reach long-term goals, personalization of goals, praise messages, reminders to input self-tracking data into the technology, use of validity-tested devices, integration of self-tracking and persuasive eCoaching, and provision of face-to-face instructions during implementation. In addition, health outcomes or usability were not negatively affected when more effort was requested from participants to input data into the technology. The data extracted from the included publications provided limited ability to identify key components for adherence. However, one key component was identified for both usability and adherence, namely the provision of personalized content. Conclusions: This scoping review provides a first overview of the key components in automated healthy lifestyle interventions combining self-tracking and persuasive eCoaching that can be utilized during the development of such interventions. Future studies should focus on the identification of key components for effects on adherence, as adherence is a prerequisite for an intervention to be effective.
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This book presents the results of the international research project CODALoop: Community Data Loop for Energy Conscious Lifestyles. It dissects the energy practices that make urban households demanding energy in their daily life and reveals the pathway towards reducing this energy demand.
To unpack energy practices, the authors of this volume move away from efficiency problems studying the interaction between human and new technologies. Instead, they use a repertoire of different analytical instruments to study how interaction between humans, and between humans and data, change the social norms that shape energy needs.
The volume offers a synthesis of a cross-disciplinary study of energy reduction carried out in three different countries through multiple methodological approaches. The project at the source of the book was funded under the Joint Program Initiative 'Urban Europe' and the ERA-net framework.
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While the beneficial effects of secondary prevention of cardiovascular disease are undisputed, implementation remains challenging. A gap between guideline-mandated risk factor targets and clinical reality was documented as early as the 1990s. To address this issue, research groups in the Netherlands have performed several major projects. These projects address innovative, multidisciplinary strategies to improve medication adherence and to stimulate healthy lifestyles, both in the setting of cardiac rehabilitation and at dedicated outpatient clinics. The findings of these projects have led to changes in prevention and rehabilitation guidelines.
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The high prevalence and burden of cardiovascular diseases (CVD) is largely attributable to unhealthy lifestyle factors such as smoking, alcohol consumption, physical inactivity and unhealthy food habits. Prevention of CVD, through the promotion of healthy lifestyles, appears to be a Sisyphean task for healthcare professionals, as the root causes of an unhealthy lifestyle lie largely outside their scope. Since most lifestyle choices are habitual and a response to environmental cues, rather than rational and deliberate choices, nationwide policies targeting the context in which lifestyle behaviours occur may be highly effective in the prevention of CVD. In this point-of-view article, we emphasise the need for government policies beyond those mentioned in the National Prevention Agreement in the Netherlands to effectively reduce the CVD risk, and we address the commonly raised concerns regarding ‘paternalism’.
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The Knowledge Alliance for Communities of Practice for Healthy Lifestyle (COP4HL) aimed at developing and sustaining communities of practice (COP) in order to stimulate innovation and socio-economic development in the area of Healthy Ageing. Promoting Healthy Ageing, and specifically an Active & Healthy Lifestyle, is one of the biggest societal and economical challenges the EU is facing. A paradigm shift from health care and cure to prevention is essential since the traditional ways have proven to be insufficient to solve this complex problem. An impact-driven multi-sector approach is necessary to develop innovative products and services to change this for the better. The KA was composed of higher education institutes and businesses, supported by public authorities and non-for-profits, who are accepting the need of co-creating knowledge to stimulate innovation for an Active & Healthy Lifestyle. A local needs and assets mapping procedure, that assessed the national and local status quo in the area of Healthy Ageing/Healthy Lifestyles, served as starting point of the development of five communities or practice the communities of Groningen (the Netherlands), Odense (Denmark), Malaga (Spain), Kaunas (Lithuania) and Cascais (Portugal) plus an additional COP in Alcobaca (Portugal). These COP were focused on a common goal that was collectively decided in the local COP.
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Post-war urban neighbourhoods in industrialised countries have been shown to negatively affect the lifestyles of their residents due to their design. This study aims at developing an empirical procedure to select locations to be redesigned and the determinants of health at stake in these locations, with involvement of residents’ perspectives as core issue. We addressed a post-war neighbourhood in the city of Groningen, the Netherlands. We collected data from three perspectives: spatial analyses by urban designers, interviews with experts in local health and social care (n = 11) and online questionnaires filled in by residents (n = 99). These data provided input for the selection of locations to be redesigned by a multidisciplinary team (n = 16). The procedure yielded the following types of locations (and determinants): An area adjacent to a central shopping mall (social interaction, traffic safety, physical activity), a park (experiencing green, physical activity, social safety, social interaction) and a block of low-rise row houses around a public square (social safety, social interaction, traffic safety). We developed an empirical procedure for the selection of locations and determinants to be addressed, with addressing residents’ perspectives. This procedure is potentially applicable to similar neighbourhoods internationally.
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Globally, coastal areas can be seen as the most popular tourist-recreational destinations. Consequently, these destinations generate major visitor flows. Furthermore, they are interpreted differently by every visitor, for example depending on lifestyles and age. These two problems, or maybe chances, are the central focus in this article. More specifically, this conceptual paper examines what the typical coastal experience consists of and in which ways the producers of the tourist-recreational coastal product can anticipate this. After explaining the principles of visitor management, as defined by Ennen, a theoretical framework is presented that tries to capture the total coastal experience. Then, two existing coastal areas are projected onto this framework. Finally, some conclusions are drawn.
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