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Kuru H. Identifying Behavior Change Techniques in an Artificial Intelligence-Based Fitness App: A Content Analysis. HEALTH EDUCATION & BEHAVIOR 2024; 51:636-647. [PMID: 38054236 DOI: 10.1177/10901981231213586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
In the field of artificial intelligence-based fitness apps, the effective integration of behavior change techniques (BCTs) is critical for promoting physical activity and improving health outcomes. However, the specific BCTs employed by apps and their impact on user engagement and behavior change are not explored sufficiently. This study investigates the Freeletics fitness app through a mixed-methods approach to evaluate the use of BCTs. In the quantitative analysis, fifteen unique BCTs were identified based on the Behavior Change Technique Taxonomy (V1). In the qualitative analysis, user reviews (n=400) were examined to understand perspectives on the app's effectiveness in promoting behavior change. Goal setting, action planning, self-monitoring of behavior, and social support were among the most prevalent BCTs identified in the Freeletics app, and their effectiveness in enhancing user engagement and promoting behavior change was also highlighted by user reviews. Among the areas of improvement identified in the study were the need for simplifying personalization options and addressing user concerns regarding the specificity of feedback. The study underscores the importance of integrating BCTs effectively within AI-based fitness apps to drive user engagement and facilitate behavior change. It contributes valuable insights into the design and implementation of BCTs in fitness apps and offers recommendations for developers, emphasizing the significance of goal setting, feedback mechanisms, self-monitoring, and social support. By understanding the impact of specific BCTs on user behavior and addressing user concerns, developers can create more effective fitness apps, ultimately promoting healthier lifestyles and positive behavior change.
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Affiliation(s)
- Hakan Kuru
- İstanbul Rumeli University, İstanbul, Turkey
- Middle East Technical University, Ankara, Turkey
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Zhou YL, Chen CL, Chang SJ, Wu BS. Home-Based Intelligent Exercise System for Seniors' Healthcare: The Example of Golf Croquet. Sports (Basel) 2023; 11:207. [PMID: 37999424 PMCID: PMC10674598 DOI: 10.3390/sports11110207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 09/14/2023] [Accepted: 10/24/2023] [Indexed: 11/25/2023] Open
Abstract
In 2020, the world experienced the threat of the COVID-19 epidemic, and seniors and chronic disease patients generally reduced their exercise and social activities to avoid increasing the risk of infection, which could lead to increased loneliness and even many diseases. Combining golf croquet games with a mobile application (App) and AIoT companion robots, this research constructs a home-based intelligent exercise system, uses the technology acceptance model (TAM), deduces users' intention to use this system based on perceived usefulness and perceived ease of use, and adds the needs of love and belonging, esteem, cognitive, aesthetic, and self-actualization in Maslow's hierarchy of needs theory (HNT) to conduct an analysis of system needs. This study collected empirical data, totaling 320 participants including seniors and their caregivers, from elderly care centers in northern Taiwan using a cross-sectional survey and purposive sampling. Based on regression and variance analysis, the results show that participants have a high level of acceptance of this system, believing that it is easy to learn and operate and can increase interaction with others, improve self-confirmation, satisfy the thirst for knowledge, increase the feeling of happiness, and fulfill self-actualization needs. In the future, by collecting and recording the process of seniors using the App, so as to find out their health problems as soon as possible, expand their daily life through this exercise, and achieve the goal of happy living and better healthcare.
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Affiliation(s)
- Yu-Li Zhou
- Taiwan Economy and Industry Association, Taipei 100008, Taiwan;
| | - Chia-Li Chen
- Department of Information Management, Lunghwa University of Science and Technology, Taoyuan 333326, Taiwan; (C.-L.C.); (B.-S.W.)
| | - Shih-Jui Chang
- Center for Professional Competency Certification, Lunghwa University of Science and Technology, Taoyuan 333326, Taiwan
| | - Bo-Sheng Wu
- Department of Information Management, Lunghwa University of Science and Technology, Taoyuan 333326, Taiwan; (C.-L.C.); (B.-S.W.)
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3
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Wu S, Li G, Du L, Chen S, Zhang X, He Q. The effectiveness of wearable activity trackers for increasing physical activity and reducing sedentary time in older adults: A systematic review and meta-analysis. Digit Health 2023; 9:20552076231176705. [PMID: 37252261 PMCID: PMC10214103 DOI: 10.1177/20552076231176705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 05/02/2023] [Indexed: 05/31/2023] Open
Abstract
Background Traditional interventions such as education and counseling are successful in increasing physical activity (PA) participation, but are usually labor and resource intensive. Wearable activity trackers can objectively record PA and provide feedback to help users to achieve activity goals and are an increasingly popular tool among adults used to facilitate self-monitoring of PA. However, no reviews systematically explored the roles of wearable activity trackers in older populations. Methods We searched PubMed, Web of Science, Google Scholar, Embase, Cochrane Library, and Scopus from inception to September 10, 2022. Randomized controlled trials were included. Two reviewers independently conducted study selection, data extraction, risk of bias, and certainty of evidence assessment. A random-effects model was used to evaluate the effect size. Results A total of 45 studies with 7144 participants were included. A wearable activity tracker was effective in increasing daily steps (standard mean differences (SMD) = 0.59, 95% confidence interval (CI) (0.44, 0.75)), weekly moderate-to-vigorous PA (MVPA) (SMD = 0.54, 95% CI (0.36, 0.72)), and total daily PA (SMD = 0.21, 95% CI (0.01, 0.40)) and reducing sedentary time (SMD = -0.10, 95% CI (-0.19, -0.01)). Subgroup analysis showed that the effectiveness of wearable activity trackers for daily steps was not influenced by participants and intervention features. However, wearable activity trackers seemed more effective in promoting MVPA of participant's age <70 than participant's age ≥70. In addition, wearable activity trackers incorporated with traditional intervention components (e.g. telephone counseling, goal setting, and self-monitoring) could better promote MVPA than alone use. Short-term interventions potentially achieve better MVPA increase than long-term. Conclusion This review showed that wearable activity trackers are an effective tool to increase PA for the old population and also favor reducing sedentary time. When used together with other interventions, wearable activity trackers can achieve better MVPA increase, especially in the short term. However, how to more effectively improve the effectiveness of wearable activity trackers is an important direction of future research.
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Affiliation(s)
- Shuang Wu
- School of Physical Education, Shandong University, Jinan, China
| | - Guangkai Li
- School of Physical Education, Shandong University, Jinan, China
| | - Litao Du
- School of Physical Education, Shandong University, Jinan, China
| | - Si Chen
- School of Nursing and Rehabilitation,
Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xianliang Zhang
- School of Physical Education, Shandong University, Jinan, China
| | - Qiang He
- School of Physical Education, Shandong University, Jinan, China
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Das S, Chaudhury P, Kumar Tripathy H. Employing Machine Learning Techniques to Categorize users in a Fitness Application. 2022 INTERNATIONAL CONFERENCE ON ADVANCEMENTS IN SMART, SECURE AND INTELLIGENT COMPUTING (ASSIC) 2022. [DOI: 10.1109/assic55218.2022.10088294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2023]
Affiliation(s)
- Shyamali Das
- Sillicon Institute of Technology Bhubaneswar,Department of Computer Science and Engineering,Odisha,India
| | - Pamela Chaudhury
- Sillicon Institute of Technology Bhubaneswar,Department of Computer Science and Engineering,Odisha,India
| | - Hrudaya Kumar Tripathy
- School of Computer Engineering, Kalinga Institute of Industrial Technology, Bhubaneswar,Odisha,India
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Mavragani A, Meshesha LZ, E Blevins C, Battle CL, Lindsay C, Marsh E, Feltus S, Buman M, Agu E, Stein M. A Smartphone Physical Activity App for Patients in Alcohol Treatment: Single-Arm Feasibility Trial. JMIR Form Res 2022; 6:e35926. [PMID: 36260381 PMCID: PMC9631169 DOI: 10.2196/35926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Alcohol use disorder (AUD) is a significant public health concern worldwide. Alcohol consumption is a leading cause of death in the United States and has a significant negative impact on individuals and society. Relapse following treatment is common, and adjunct intervention approaches to improve alcohol outcomes during early recovery continue to be critical. Interventions focused on increasing physical activity (PA) may improve AUD treatment outcomes. Given the ubiquity of smartphones and activity trackers, integrating this technology into a mobile app may be a feasible, acceptable, and scalable approach for increasing PA in individuals with AUD. OBJECTIVE This study aims to test the Fit&Sober app developed for patients with AUD. The goals of the app were to facilitate self-monitoring of PA engagement and daily mood and alcohol cravings, increase awareness of immediate benefits of PA on mood and cravings, encourage setting and adjusting PA goals, provide resources and increase knowledge for increasing PA, and serve as a resource for alcohol relapse prevention strategies. METHODS To preliminarily test the Fit&Sober app, we conducted an open pilot trial of patients with AUD in early recovery (N=22; 13/22, 59% women; mean age 43.6, SD 11.6 years). At the time of hospital admission, participants drank 72% of the days in the last 3 months, averaging 9 drinks per drinking day. The extent to which the Fit&Sober app was feasible and acceptable among patients with AUD during early recovery was examined. Changes in alcohol consumption, PA, anxiety, depression, alcohol craving, and quality of life were also examined after 12 weeks of app use. RESULTS Participants reported high levels of satisfaction with the Fit&Sober app. App metadata suggested that participants were still using the app approximately 2.5 days per week by the end of the intervention. Pre-post analyses revealed small-to-moderate effects on increase in PA, from a mean of 5784 (SD 2511) steps per day at baseline to 7236 (SD 3130) steps per day at 12 weeks (Cohen d=0.35). Moderate-to-large effects were observed for increases in percentage of abstinent days (Cohen d=2.17) and quality of life (Cohen d=0.58) as well as decreases in anxiety (Cohen d=-0.71) and depression symptoms (Cohen d=-0.58). CONCLUSIONS The Fit&Sober app is an acceptable and feasible approach for increasing PA in patients with AUD during early recovery. A future randomized controlled trial is necessary to determine the efficacy of the Fit&Sober app for long-term maintenance of PA, ancillary mental health, and alcohol outcomes. If the efficacy of the Fit&Sober app could be established, patients with AUD would have a valuable adjunct to traditional alcohol treatment that can be delivered in any setting and at any time, thereby improving the overall health and well-being of this population. TRIAL REGISTRATION ClinicalTrials.gov NCT02958280; https://www.clinicaltrials.gov/ct2/show/NCT02958280.
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Affiliation(s)
| | - Lidia Z Meshesha
- Department of Psychology, University of Central Florida, Orlando, FL, United States
| | - Claire E Blevins
- Butler Hospital, Providence, RI, United States.,Alpert Medical School of Brown University, Providence, RI, United States
| | - Cynthia L Battle
- Butler Hospital, Providence, RI, United States.,Alpert Medical School of Brown University, Providence, RI, United States
| | | | - Eliza Marsh
- Butler Hospital, Providence, RI, United States
| | - Sage Feltus
- Butler Hospital, Providence, RI, United States
| | - Matthew Buman
- Arizona State University, Tempe, AZ, United States.,Worcester Polytechnic Institute, Worcester, MA, United States
| | - Emmanuel Agu
- Worcester Polytechnic Institute, Worcester, MA, United States
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Radhakrishnan K, DeMain AS, Julien C, Leggio K, O'Hair M, Hebért Arsers ET, Lee G, Baranowski T. A Sensor-Controlled Digital Game for Heart Failure Self-Care Based on Behavioral Change Frameworks. SEGAH ... IEEE ... INTERNATIONAL CONFERENCE ON SERIOUS GAMES AND APPLICATIONS FOR HEALTH : BOOK OF PROCEEDINGS. IEEE INTERNATIONAL CONFERENCE ON SERIOUS GAMES AND APPLICATIONS FOR HEALTH 2022; 2022:10.1109/segah54908.2022.9978594. [PMID: 37817860 PMCID: PMC10564567 DOI: 10.1109/segah54908.2022.9978594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
Self-care behaviors are critical to manage the adverse impact of heart failure disease. However, engaging in self-care behaviors such as physical activity or daily weight-monitoring can be difficult due to lack of knowledge or motivation. Digital games can serve as an alternative to traditional patient education to provide information and motivate engagement in critical self-care behaviors. In this paper, we describe a sensor-controlled digital game (SCDG) in which game play is driven by the player's real life self-care behaviors. We also present the design and development of the next iteration of the SCDG based on playtesting results and behavioral theoretical frameworks.
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Affiliation(s)
| | | | - Christine Julien
- Cockrell School of Engineering, The University of Texas-Austin, Austin, USA
| | - Katelyn Leggio
- School of Nursing, The University of Texas-Austin, Austin, USA
| | | | | | - Grace Lee
- Cockrell School of Engineering, The University of Texas-Austin, Austin, USA
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7
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A Comparative Utility Score for Digital Health Tools. J Med Syst 2022; 46:34. [PMID: 35511408 PMCID: PMC9069219 DOI: 10.1007/s10916-022-01821-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/19/2022] [Indexed: 11/25/2022]
Abstract
Digital health tools (DHT) are increasingly poised to change healthcare delivery given the Coronavirus Disease 2019 (COVID-19) pandemic and the drive to telehealth. Establishing the potential utility of a given DHT could aid in identifying how it could be best used and further opportunities for healthcare improvement. We propose a metric, a Utility Factor Score, which quantifies the benefits of a DHT by explicitly defining adherence and linking it directly to satisfaction and health goals met. To provide data for how the comparative utility score can or should work, we illustrate in detail the application of our metrics across four DHTs with two simulated users. The Utility Factor Score can potentially facilitate integration of DHTs into various healthcare settings and should be evaluated within a clinical study.
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Chaudhari S, Ghanvatkar S, Kankanhalli A. Personalization of Intervention Timing for Physical Activity: Scoping Review. JMIR Mhealth Uhealth 2022; 10:e31327. [PMID: 35225811 PMCID: PMC8922140 DOI: 10.2196/31327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/21/2021] [Accepted: 01/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background The use of sensors in smartphones, smartwatches, and wearable devices has facilitated the personalization of interventions to increase users’ physical activity (PA). Recent research has focused on evaluating the effects of personalized interventions in improving PA among users. However, it is critical to deliver the intervention at an appropriate time to each user to increase the likelihood of adoption of the intervention. Earlier review studies have not focused on the personalization of intervention timing for increasing PA. Objective This review aims to examine studies of information technology–based PA interventions with personalized intervention timing (PIT); identify inputs (eg, user location) used by the system for generating the PIT, the techniques and methods used for generating the PIT, the content of the PA intervention, and delivery mode of the intervention; and identify gaps in existing literature and suggest future research directions. Methods A scoping review was undertaken using PsycINFO, PubMed, Scopus, and Web of Science databases based on a structured search query. The main inclusion criteria were as follows: the study aimed to promote PA, included some form of PIT, and used some form of information technology for delivery of the intervention to the user. If deemed relevant, articles were included in this review after removing duplicates and examining the title, abstract, and full text of the shortlisted articles. Results The literature search resulted in 18 eligible studies. In this review, 72% (13/18) of the studies focused on increasing PA as the primary objective, whereas it was the secondary focus in the remaining studies. The inputs used to generate the PIT were categorized as user preference, activity level, schedule, location, and predicted patterns. On the basis of the intervention technique, studies were classified as manual, semiautomated, or automated. Of these, the automated interventions were either knowledge based (based on rules or guidelines) or data driven. Of the 18 studies, only 6 (33%) evaluated the effectiveness of the intervention and reported positive outcomes. Conclusions This work reviewed studies on PIT for PA interventions and identified several aspects of the interventions, that is, inputs, techniques, contents, and delivery mode. The reviewed studies evaluated PIT in conjunction with other personalization approaches such as activity recommendation, with no study evaluating the effectiveness of PIT alone. On the basis of the findings, several important directions for future research are also highlighted in this review.
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Affiliation(s)
- Saurabh Chaudhari
- Department of Information Systems and Analytics, School of Computing, National University of Singapore, Singapore, Singapore
| | - Suparna Ghanvatkar
- Department of Information Systems and Analytics, School of Computing, National University of Singapore, Singapore, Singapore
| | - Atreyi Kankanhalli
- Department of Information Systems and Analytics, School of Computing, National University of Singapore, Singapore, Singapore
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9
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User Engagement and Abandonment of mHealth: A Cross-Sectional Survey. Healthcare (Basel) 2022; 10:healthcare10020221. [PMID: 35206837 PMCID: PMC8872344 DOI: 10.3390/healthcare10020221] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/03/2021] [Accepted: 12/14/2021] [Indexed: 02/04/2023] Open
Abstract
Mobile health (mHealth) apps have great potential to improve health outcomes. Given that mHealth apps have become ubiquitous, there is limited focus on their abandonment. Data concerning crucial metrics, including reasons for adoption and discontinued use, are limited. This study aims to gain broad insights into utilization of mHealth and game-like features promoting user engagement. We conducted a cross-sectional survey of 209 mHealth users worldwide. The 17-item survey assessed sociodemographics, as well as the key motivators for mHealth uptake and discontinued use. Our findings show that sports and fitness activity tracking were the most common categories of health apps, with most users engaging with them at least several times a week. Interestingly, the most downloaded mHealth apps among younger adults include MyFitnessPal, Fitbit, Nike Run Club, and Samsung Health. Critical drivers of abandonment of mHealth apps were amotivation, loss of interest, and experimenting with different apps to identify the most suitable tool. Additionally, the financial cost of mHealth apps is crucial, with most participants advocating for free or more affordable apps. The study findings suggest that while many individuals utilize mHealth, several factors drive their abandonment. Moreover, data indicate that mHealth developers need to consider gamification strategies to sustain user commitment, as well as psychological variables, such as intrinsic motivation.
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Radhakrishnan K, Julien C, Baranowski T, O'Hair M, Lee G, Sagna De Main A, Allen C, Viswanathan B, Thomaz E, Kim M. Feasibility of a Sensor-Controlled Digital Game for Heart Failure Self-management: Randomized Controlled Trial. JMIR Serious Games 2021; 9:e29044. [PMID: 34747701 PMCID: PMC8663490 DOI: 10.2196/29044] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/03/2021] [Accepted: 06/28/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Poor self-management of heart failure (HF) contributes to devastating health consequences. Our innovative sensor-controlled digital game (SCDG) integrates data from sensors to trigger game rewards, progress, and feedback based on the real-time behaviors of individuals with HF. OBJECTIVE The aim of this study is to compare daily weight monitoring and physical activity behavior adherence by older adults using an SCDG intervention versus a sensors-only intervention in a feasibility randomized controlled trial. METHODS English-speaking adults with HF aged 55 years or older who owned a smartphone and could walk unassisted were recruited from Texas and Oklahoma from November 2019 to August 2020. Both groups were given activity trackers and smart weighing scales to track behaviors for 12 weeks. The feasibility outcomes of recruitment, retention, intervention engagement, and satisfaction were assessed. In addition to daily weight monitoring and physical activity adherence, the participants' knowledge, functional status, quality of life, self-reported HF behaviors, motivation to engage in behaviors, and HF-related hospitalization were also compared between the groups at baseline and at 6, 12, and 24 weeks. RESULTS A total of 38 participants with HF-intervention group (IG; 19/38, 50%) and control group (CG; 19/38, 50%)-were enrolled in the study. Of the 38 participants, 18 (47%) were women, 18 (47%) were aged 65 years or older, 21 (55%) had been hospitalized with HF in the past 6 months, and 29 (76%) were White. Furthermore, of these 38 participants, 31 (82%)-IG (15/19, 79%) and CG (16/19, 84%)-had both weight monitoring and physical activity data at the end of 12 weeks, and 27 (71%)-IG (14/19, 74%) and CG (13/19, 68%)-participated in follow-up assessments at 24 weeks. For the IG participants who installed the SCDG app (15/19, 79%), the number of days each player opened the game app was strongly associated with the number of days the player engaged in weight monitoring (r=0.72; P=.04) and the number of days with physical activity step data (r=0.9; P<.001). The IG participants who completed the satisfaction survey (13/19, 68%) reported that the SCDG was easy to use. Trends of improvement in daily weight monitoring and physical activity in the IG, as well as within-group improvements in HF functional status, quality of life, knowledge, self-efficacy, and HF hospitalization in both groups, were observed in this feasibility trial. CONCLUSIONS Playing an SCDG on smartphones was feasible and acceptable for older adults with HF for motivating daily weight monitoring and physical activity. A larger efficacy trial of the SCDG intervention will be needed to validate trends of improvement in daily weight monitoring and physical activity behaviors. TRIAL REGISTRATION ClinicalTrials.gov NCT03947983; https://clinicaltrials.gov/ct2/show/NCT03947983.
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Affiliation(s)
| | - Christine Julien
- Department of Electrical and Computer Engineering, Cockrell School of Engineering, The University of Texas Austin, Austin, TX, United States
| | | | | | - Grace Lee
- Department of Electrical and Computer Engineering, Cockrell School of Engineering, The University of Texas Austin, Austin, TX, United States
| | - Atami Sagna De Main
- School of Nursing, The University of Texas Austin, Austin, TX, United States
| | - Catherine Allen
- School of Nursing, The University of Texas Austin, Austin, TX, United States
| | - Bindu Viswanathan
- Department of Statistics and Data Sciences, The University of Texas Austin, Austin, TX, United States
| | - Edison Thomaz
- Department of Electrical and Computer Engineering, Cockrell School of Engineering, The University of Texas Austin, Austin, TX, United States
| | - Miyong Kim
- School of Nursing, The University of Texas Austin, Austin, TX, United States
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11
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Identifying the Antecedents of University Students’ Usage Behaviour of Fitness Apps. SUSTAINABILITY 2021. [DOI: 10.3390/su13169043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of the study is to explore the antecedents of university students’ fitness application usage behaviours by combining the theory of planned behaviour and the technology acceptance model. An anonymous questionnaire survey was adopted to address the objectives of the study. Purposive and snowball sampling was used to select eligible students from six universities in Zhanjiang City. An online survey was used to collect data from 634 eligible subjects, and partial least squares structural equation modelling was used to analyse the collected data. The results indicated that the students’ perceived usefulness (β = 0.17, p < 0.05) and perceived ease of use (β = 0.32, p < 0.05) concerning the application and their attitude (β = 0.31, p < 0.05) toward it significantly influenced their usage intentions. Furthermore, perceived usefulness (β = 0.11, p < 0.05) and perceived ease of use (β = 0.38, p < 0.05) fully mediated the relationship between subjective norms and usage intentions. However, subjective norms and perceived behavioural control did not enhance the students’ intentions to use fitness applications. That is, students’ attitudes and fitness application design are the determinants of usage intention. Accordingly, improving students’ fitness applications usage intention requires strategies that involve customised services, social networking, and collaboration with schools; this would further increase students’ engagement in physical exercise.
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12
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Domin A, Spruijt-Metz D, Theisen D, Ouzzahra Y, Vögele C. Smartphone-Based Interventions for Physical Activity Promotion: Scoping Review of the Evidence Over the Last 10 Years. JMIR Mhealth Uhealth 2021; 9:e24308. [PMID: 34287209 PMCID: PMC8339983 DOI: 10.2196/24308] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 02/12/2021] [Accepted: 04/16/2021] [Indexed: 01/19/2023] Open
Abstract
Background Several reviews of mobile health (mHealth) physical activity (PA) interventions suggest their beneficial effects on behavior change in adolescents and adults. Owing to the ubiquitous presence of smartphones, their use in mHealth PA interventions seems obvious; nevertheless, there are gaps in the literature on the evaluation reporting processes and best practices of such interventions. Objective The primary objective of this review is to analyze the development and evaluation trajectory of smartphone-based mHealth PA interventions and to review systematic theory- and evidence-based practices and methods that are implemented along this trajectory. The secondary objective is to identify the range of evidence (both quantitative and qualitative) available on smartphone-based mHealth PA interventions to provide a comprehensive tabular and narrative review of the available literature in terms of its nature, features, and volume. Methods We conducted a scoping review of qualitative and quantitative studies examining smartphone-based PA interventions published between 2008 and 2018. In line with scoping review guidelines, studies were not rejected based on their research design or quality. This review, therefore, includes experimental and descriptive studies, as well as reviews addressing smartphone-based mHealth interventions aimed at promoting PA in all age groups (with a subanalysis conducted for adolescents). Two groups of studies were additionally included: reviews or content analyses of PA trackers and meta-analyses exploring behavior change techniques and their efficacy. Results Included articles (N=148) were categorized into 10 groups: commercial smartphone app content analyses, smartphone-based intervention review studies, activity tracker content analyses, activity tracker review studies, meta-analyses of PA intervention studies, smartphone-based intervention studies, qualitative formative studies, app development descriptive studies, qualitative follow-up studies, and other related articles. Only 24 articles targeted children or adolescents (age range: 5-19 years). There is no agreed evaluation framework or taxonomy to code or report smartphone-based PA interventions. Researchers did not state the coding method, used various evaluation frameworks, or used different versions of behavior change technique taxonomies. In addition, there is no consensus on the best behavior change theory or model that should be used in smartphone-based interventions for PA promotion. Commonly reported systematic practices and methods have been successfully identified. They include PA recommendations, trial designs (randomized controlled trials, experimental trials, and rapid design trials), mixed methods data collection (surveys, questionnaires, interviews, and focus group discussions), scales to assess app quality, and industry-recognized reporting guidelines. Conclusions Smartphone-based mHealth interventions aimed at promoting PA showed promising results for behavior change. Although there is a plethora of published studies on the adult target group, the number of studies and consequently the evidence base for adolescents is limited. Overall, the efficacy of smartphone-based mHealth PA interventions can be considerably improved through a more systematic approach of developing, reporting, and coding of the interventions.
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Affiliation(s)
- Alex Domin
- Research Group: Self-Regulation and Health, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Donna Spruijt-Metz
- USC mHealth Collaboratory, Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States
| | - Daniel Theisen
- ALAN - Maladies Rares Luxembourg, Kockelscheuer, Luxembourg
| | - Yacine Ouzzahra
- Research Support Department, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Claus Vögele
- Research Group: Self-Regulation and Health, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
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13
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Jaschinski C, Ben Allouch S, Peters O, Cachucho R, van Dijk JAGM. Acceptance of Technologies for Aging in Place: A Conceptual Model. J Med Internet Res 2021; 23:e22613. [PMID: 33787505 PMCID: PMC8047804 DOI: 10.2196/22613] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/06/2020] [Accepted: 01/17/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Older adults want to preserve their health and autonomy and stay in their own home environment for as long as possible. This is also of interest to policy makers who try to cope with growing staff shortages and increasing health care expenses. Ambient assisted living (AAL) technologies can support the desire for independence and aging in place. However, the implementation of these technologies is much slower than expected. This has been attributed to the lack of focus on user acceptance and user needs. OBJECTIVE The aim of this study is to develop a theoretically grounded understanding of the acceptance of AAL technologies among older adults and to compare the relative importance of different acceptance factors. METHODS A conceptual model of AAL acceptance was developed using the theory of planned behavior as a theoretical starting point. A web-based survey of 1296 older adults was conducted in the Netherlands to validate the theoretical model. Structural equation modeling was used to analyze the hypothesized relationships. RESULTS Our conceptual model showed a good fit with the observed data (root mean square error of approximation 0.04; standardized root mean square residual 0.06; comparative fit index 0.93; Tucker-Lewis index 0.92) and explained 69% of the variance in intention to use. All but 2 of the hypothesized paths were significant at the P<.001 level. Overall, older adults were relatively open to the idea of using AAL technologies in the future (mean 3.34, SD 0.73). CONCLUSIONS This study contributes to a more user-centered and theoretically grounded discourse in AAL research. Understanding the underlying behavioral, normative, and control beliefs that contribute to the decision to use or reject AAL technologies helps developers to make informed design decisions based on users' needs and concerns. These insights on acceptance factors can be valuable for the broader field of eHealth development and implementation.
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Affiliation(s)
- Christina Jaschinski
- Research Group Technology, Health & Care, Saxion University of Applied Sciences, Enschede, Netherlands
| | - Somaya Ben Allouch
- Digital Life, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Oscar Peters
- Saxion University of Applied Sciences, Enschede, Netherlands
| | - Ricardo Cachucho
- Leiden Institute of Advanced Computer Science (LIACS), Leiden University, Leiden, Netherlands
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Marchant G, Bonaiuto F, Bonaiuto M, Guillet Descas E. Exercise and Physical Activity eHealth in COVID-19 Pandemic: A Cross-Sectional Study of Effects on Motivations, Behavior Change Mechanisms, and Behavior. Front Psychol 2021; 12:618362. [PMID: 33692722 PMCID: PMC7937732 DOI: 10.3389/fpsyg.2021.618362] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 01/12/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES The aims of this research were (1) to compare the levels of physical activity of eHealth users and non-users, (2) to determine the effects of these technologies on motivations, and (3) to establish the relationship that could exist between psychological constructs and physical activity behaviors. METHODS This cross-sectional study involved 569 adults who responded to an online questionnaire during confinement in France. The questions assessed demographics, usage of eHealth for exercise and physical activity, and behavioral levels. The questionnaire also measured the constructs of Social Cognitive Theory, the Theory of Planned Behavior, and automaticity facets toward eHealth for exercise and physical activity. RESULTS Participants who were users of eHealth for exercise and physical activity presented significantly higher levels of vigorous physical activity and total physical activity per week than non-users (p < 0.001). The chi-square test showed significant interactions between psychological constructs toward eHealth (i.e., self-efficacy, behavioral attitudes, intentions, and automaticity) and physical activity levels (all interactions were p < 0.05). Self-efficacy was significantly and negatively correlated with walking time per week. Concerning the automaticity facets, efficiency was positive and significantly correlated with vigorous physical activity levels per week (p < 0.05). Then, regressions analyses showed that self-efficacy and automaticity efficiency explained 5% of the variance of walking minutes per week (ß = -0.27, p < 0.01) and vigorous physical activity per week (ß = 0.20, p < 0.05), respectively. CONCLUSION This study has shown that people during confinement looked for ways to stay active through eHealth. However, we must put any technological solution into perspective. The eHealth offers possibilities to stay active, however its benefits and the psychological mechanisms affected by it remains to be demonstrated: eHealth could be adapted to each person and context.
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Affiliation(s)
- Gonzalo Marchant
- Laboratory of Vulnerabilities and Innovation in Sport, UFR STAPS, Claude Bernard University Lyon 1, Lyon, France
| | | | - Marino Bonaiuto
- CIRPA – Interuniversity Research Centre in Environmental Psychology, Department of Psychology of Developmental and Socialization Processes, Sapienza University of Rome, Rome, Italy
| | - Emma Guillet Descas
- Laboratory of Vulnerabilities and Innovation in Sport, UFR STAPS, Claude Bernard University Lyon 1, Lyon, France
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Eysenbach G, Buis L, Scheel-Sailer A, Brach M, Rubinelli S. Opportunities and Challenges of a Self-Management App to Support People With Spinal Cord Injury in the Prevention of Pressure Injuries: Qualitative Study. JMIR Mhealth Uhealth 2020; 8:e22452. [PMID: 33295876 PMCID: PMC7758166 DOI: 10.2196/22452] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/14/2020] [Accepted: 10/09/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Mobile health applications can offer tailored self-management support to individuals living with chronic health conditions. However, there are several challenges to the adoption of these technologies in practice. Co-design is a promising approach to overcoming some of these challenges by enabling the development of solutions that meet the actual needs and preferences of the relevant stakeholder groups. OBJECTIVE Taking spinal cord injury as a case in point, the overall objectives of this study were to identify the perceived benefits of a co-designed self-management app that could promote its uptake and to explore the factors that may impede adoption. METHODS We adopted a qualitative research approach guided by the Technology Acceptance Model. Data were collected through semistructured interviews with individuals with spinal cord injury (n=15) and two focus groups with health care professionals specialized in spinal cord injury (n=7, n=5). Prior to the interviews and focus groups, study participants were given time to explore the app prototype. All interviews were transcribed verbatim and analyzed using inductive thematic analysis. RESULTS Findings of our analysis indicate that study participants perceived the app prototype as potentially useful for supporting individuals with spinal cord injury in preventing pressure injuries. In particular, we identified three concrete use cases highlighting the benefits of the app for different audiences: (1) a companion for newly injured individuals, (2) an emergency kit and motivational support, and 3) a guide for informal caregivers and family members. We also uncovered several challenges that might impede the adoption of the self-management app in practice, including (1) challenges in motivating individuals to use the app, (2) concerns about the misuse and abuse of the app, and (3) organizational and maintenance challenges. CONCLUSIONS This study adds to a growing body of research that investigates individuals' adoption and nonadoption behavior regarding mobile health solutions. Building on earlier work, we make recommendations on how to address the barriers to the adoption of mobile health solutions identified by this study. In particular, there is a need to foster trust in mobile health among prospective users, including both patients and health care professionals. Moreover, increasing personal relevance of mobile health solutions through personalization may be a promising approach to promote uptake. Last but not least, organizational support also plays an instrumental role in mobile health adoption. We conclude that even though co-design is promoted as a promising approach to develop self-management tools, co-design does not guarantee adoption. More research is needed to identify the most promising strategies to promote the adoption of evidence-based mobile health solutions in practice.
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Affiliation(s)
| | | | - Anke Scheel-Sailer
- Swiss Paraplegic Center, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Mirjam Brach
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Sara Rubinelli
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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The Effect of the ERVE Smartphone App on Physical Activity, Quality of Life, Self-Efficacy, and Exercise Motivation for Inactive People: A Randomized Controlled Trial. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2020.101198] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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17
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Li I, Bui T, Phan HT, Llado A, King C, Scrivener K. App-based supplemental exercise in rehabilitation, adherence, and effect on outcomes: a randomized controlled trial. Clin Rehabil 2020; 34:1083-1093. [PMID: 32508183 DOI: 10.1177/0269215520928119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
QUESTION To determine the uptake of an app-based supplemental exercise programme in a rehabilitation setting and the effect of such a programme on length of stay and function compared to usual care physiotherapy. DESIGN Randomized controlled trial with random allocation and assessor blinding. PARTICIPANTS A total of 144 individuals with mixed diagnoses (orthopaedic, neurological, reconditioning) admitted for inpatient sub-acute rehabilitation. INTERVENTIONS Participants were randomly allocated to usual care physiotherapy (control group) or usual care physiotherapy with the addition of an app-based supplemental exercise programme (intervention group). OUTCOME MEASURES The primary measure of interest was total supplementary exercise dosage completed by the intervention group. The primary between-group outcome measure was length of stay with secondary measures including walking endurance (Six-Minute Walk Test), walking speed (10-Metre Walk Test), functional mobility (Timed Up and Go Test) and level of disability (Functional Independence Measure). RESULTS Participants in the intervention group performed 7 minutes (SD: 9) or 49 repetitions (SD: 48) of supplementary exercise using the app each day. There were no differences between the groups for length of stay (mean difference (MD): -0.5 days, 95% confidence interval (CI): -3.2 to 2.2) or change in any secondary functional outcome measures, including walking speed (MD: -0.1 m/s, 95% CI: -0.2 to 0.0) and disability (MD: -0.9, 95% CI: -3.6 to 1.8). CONCLUSION A small supplementary exercise dose was achieved by participants in the intervention group. However, such a programme did not affect length of stay or functional outcomes when compared to usual care.
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Affiliation(s)
- Ingrid Li
- Department of Health Professions, Macquarie University, Sydney, NSW, Australia
| | - Tram Bui
- Royal Rehab, Sydney, NSW, Australia
| | - Hoang T Phan
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | | | | | - Katharine Scrivener
- Department of Health Professions, Macquarie University, Sydney, NSW, Australia
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Lee BC, Xie J, Ajisafe T, Kim SH. How Are Wearable Activity Trackers Adopted in Older Adults? Comparison between Subjective Adoption Attitudes and Physical Activity Performance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103461. [PMID: 32429258 PMCID: PMC7277188 DOI: 10.3390/ijerph17103461] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/11/2020] [Accepted: 05/13/2020] [Indexed: 12/29/2022]
Abstract
Wearable activity trackers can motivate older adults to engage in the recommended daily amount of physical activity (PA). However, individuals may not maintain their use of the trackers over a longer period. To investigate the attitudes of activity tracker adoption and their effects on actual PA performance, we conducted a three-month study. We gave activity trackers to 16 older adults and assessed attitudes on activity tracker adoption through a survey during the study period. We extracted participants’ PA measures, step counts, and moderate and vigorous physical activity (MVPA) times. We observed significant differences in adoption attitudes during the three different periods (χ2(2, 48) = 6.27, p < 0.05), and PA measures followed similar decreasing patterns (F(83, 1357) = 12.56, 13.94, p < 0.00001). However, the Pearson correlation analysis (r = 0.268, p = 0.284) and a Bland–Altman plot indicated a bias between two PA measures. Positive attitudes at the initial stage did not persist through the study period, and both step counts and length of MVPA time showed waning patterns in the study period. The longitudinal results from both measures demonstrated the patterns of old adults’ long-term use and adoption. Considering the accuracy of the activity tracker and older adults’ athletic ability, MVPA times are more likely to be a reliable measure of older adults’ long-term use and successful adoption of activity trackers than step counts. The results support the development of better activity tracker design guidelines that would facilitate long-term adoption among older adults.
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Affiliation(s)
- Byung Cheol Lee
- Department of Engineering, Texas A&M University-Corpus Christi, Corpus Christi, TX 78412, USA;
| | - Junfei Xie
- Department of Electrical and Computer Engineering, San Diego State University, San Diego, CA 92182, USA;
| | - Toyin Ajisafe
- Department of Kinesiology, Texas A&M University-Corpus Christi, Corpus Christi, TX 78412, USA;
| | - Sung-Hee Kim
- Industrial ICT Engineering, Dong-eui University, Busan 47340, Korea
- Correspondence: ; Tel.: +82-51-890-2366
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Yang X, Ma L, Zhao X, Kankanhalli A. Factors influencing user's adherence to physical activity applications: A scoping literature review and future directions. Int J Med Inform 2019; 134:104039. [PMID: 31865054 DOI: 10.1016/j.ijmedinf.2019.104039] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 11/12/2019] [Accepted: 11/29/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although mobile app-delivered physical activity (PA) interventions have the potential to promote exercise, poor adherence to these apps is a common issue impeding their effectiveness. Gaining insights into the factors that influence PA app adherence is an important priority for app developers and intervention designers. OBJECTIVE The objective of this study is to perform a literature review to synthesize the factors influencing PA app adherence and to identify directions for future research in this area. METHODS A scoping review of prior research was conducted to uncover the factors influencing PA app adherence. Seven online journal databases were searched for relevant articles published from January 1, 2014, to December 31, 2018. The initial search identified 5,572 articles. After a screening and eligibility check based on inclusion criteria, 24 articles were finally selected. The definition of PA app adherence in this review could be categorized along four dimensions derived from previous studies: i.e., frequency of PA app usage, intention/motivation to sustain use of the PA app, degree of function use within the PA app, and the duration of PA app usage. RESULTS Of the 24 included studies (both qualitative and quantitative), 12 studies were conducted in the U.S. The methods and study designs varied considerably, with the study durations ranging from 2 weeks to 24 months. The synthesized evidence indicates that 89 distinct factors influenced PA app adherence, and these could be classified into three categories: Personal Factors (n = 28), Technology Features (n = 53), and Contextual Factors (n = 8). Nine more detailed sub-categories were also compiled. Factors in sub-categories, such as psychological factors, health-related factors and predefined goals, are essential for physical activity behavior change experts to implement interventions. Factors in technology features, including PA tracking, PA goal setting and customization of exercise, are specifically useful for PA app developers or PA intervention designers. Overall, evidence of causal factors was limited. Only 5 of the 24 articles explored causal factors that affect PA app adherence. Furthermore, longitudinal studies with long durations were also limited. CONCLUSIONS Uncovering the factors influencing PA app adherence is critical as it can expand our current knowledge and provide guidance for app-delivered PA interventions, as well as the design of PA apps. This scoping review identified and categorized factors that influence PA app adherence in prior studies. Based on the evidence synthesized, users are paying more attention to the "playfulness" and personalized features of PA apps, in addition to basic functional requirements. Also, app glitches are the most common factors found to negatively influence app adherence. Several important directions for future research are highlighted in this review, especially the design of studies to explore causality.
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Affiliation(s)
- Xiaotian Yang
- School of Management, Xi'an Jiaotong University, Xi'an 710049, China.
| | - Lin Ma
- School of Management, Xi'an Jiaotong University, Xi'an 710049, China.
| | - Xi Zhao
- School of Management, Xi'an Jiaotong University, Xi'an 710049, China; The Key Lab of the Ministry of Education for process control & Efficiency Engineering, Xi'an 710049, China.
| | - Atreyi Kankanhalli
- Department of Information Systems and Analytics, National University of Singapore, Singapore.
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Lifestyle E-Coaching for Physical Activity Level Improvement: Short-Term and Long-Term Effectivity in Low Socioeconomic Status Groups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224427. [PMID: 31726649 PMCID: PMC6888441 DOI: 10.3390/ijerph16224427] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/04/2019] [Accepted: 11/08/2019] [Indexed: 12/22/2022]
Abstract
E-coaching applications can improve people's lifestyles; however, their impact on people from a lower socioeconomic status (low SES) is unknown. This study investigated the effectiveness of a lifestyle e-coaching application in encouraging people facing low SES disadvantages to engage in a more active lifestyle over a course of 19 weeks. In this bicountry study, 95 people with low activity level (GR: 50, NL: 45) used a mobile application linked to a wearable activity tracker. At the start and after 6 and 19 weeks, self-reported physical activity levels, attitudes, and intention towards increasing activity levels, perceived behavioral control, and wellbeing were measured. Results indicated that participants using the lifestyle e-coaching application reported significantly more often an increase in activity levels than a parallel control group. Additionally, the people using the application also more often reported increased levels of wellbeing and perceived behavioral control. Therefore, lifestyle e-coaching applications could be a cost-effective solution for promoting healthier lifestyles in low-SES populations.
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Finkenflügel RN, Hoornenborg E, Achterbergh RC, Marra E, Davidovich U, de Vries HJ, Prins M, Schim van der Loeff MF. A Mobile Application to Collect Daily Data on Preexposure Prophylaxis Adherence and Sexual Behavior Among Men Who Have Sex With Men: Use Over Time and Comparability With Conventional Data Collection. Sex Transm Dis 2019; 46:400-406. [PMID: 30882717 PMCID: PMC6553988 DOI: 10.1097/olq.0000000000000999] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 02/17/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND We studied the use of a mobile application (app) to measure human immunodeficiency virus (HIV) preexposure prophylaxis (PrEP) adherence and sexual behavior, assessed determinants of app use, and we compared data in app and questionnaires. METHODS Men who have sex with men participating in the Amsterdam PrEP project (AMPrEP) on daily or event-driven PrEP at the Public Health Service of Amsterdam completed the data on sexual risk behavior and PrEP adherence through a standard questionnaire every 3 months and on a daily basis using the project's app. Regression analyses were used to assess factors associated with app use. Among those who reported 90% or greater of data in the app, the number of PrEP pills taken and number of unknown casual sex partners were compared between the app and the questionnaires by Wilcoxon signed-rank test. RESULTS Of all participants (n = 374), 94% (352 of 374) reported data in the app at least once; 72% (261 of 362) reported data ≥90% of the days in the sixth month and 62% (222 of 359) in the 12th month following PrEP initiation.Factors associated with reporting data in the app were using daily PrEP and recent initiation of PrEP. The reported numbers of pills taken and unknown sexual partners were comparable between app and questionnaires. CONCLUSIONS The AMPrEP app was used frequently, especially by those using a daily PrEP regimen. Data collected by app regarding adherence and sexual risk behavior were consistent with questionnaire data among those who used the app consistently. An app is a promising tool to measure PrEP adherence and sexual risk behavior.
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Affiliation(s)
| | - Elske Hoornenborg
- From the Department of Infectious Diseases, Research and Prevention
- Department of Infectious Diseases, STI Outpatient Clinic, Public Health Service of Amsterdam
| | - Roel C.A. Achterbergh
- Department of Infectious Diseases, STI Outpatient Clinic, Public Health Service of Amsterdam
| | - Elske Marra
- From the Department of Infectious Diseases, Research and Prevention
| | - Udi Davidovich
- From the Department of Infectious Diseases, Research and Prevention
- Department of Infectious Diseases, Amsterdam Infectious and Immunity Institute
| | - Henry J.C. de Vries
- Department of Infectious Diseases, STI Outpatient Clinic, Public Health Service of Amsterdam
- Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam; and
- National Institute of Public Health and the Environment, Center for Infectious Disease Control, Bilthoven, the Netherlands
| | - Maria Prins
- From the Department of Infectious Diseases, Research and Prevention
- Department of Infectious Diseases, Amsterdam Infectious and Immunity Institute
| | - Maarten F. Schim van der Loeff
- From the Department of Infectious Diseases, Research and Prevention
- Department of Infectious Diseases, Amsterdam Infectious and Immunity Institute
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Harst L, Lantzsch H, Scheibe M. Theories Predicting End-User Acceptance of Telemedicine Use: Systematic Review. J Med Internet Res 2019; 21:e13117. [PMID: 31115340 PMCID: PMC6547771 DOI: 10.2196/13117] [Citation(s) in RCA: 152] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 03/08/2019] [Accepted: 03/29/2019] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Only a few telemedicine applications have made their way into regular care. One reason is the lack of acceptance of telemedicine by potential end users. OBJECTIVE The aim of this systematic review was to identify theoretical predictors that influence the acceptance of telemedicine. METHODS An electronic search was conducted in PubMed and PsycINFO in June 2018 and supplemented by a hand search. Articles were identified using predefined inclusion and exclusion criteria. In total, two reviewers independently assessed the title, abstract, and full-text screening and then individually performed a quality assessment of all included studies. RESULTS Out of 5917 potentially relevant titles (duplicates excluded), 24 studies were included. The Axis Tool for quality assessment of cross-sectional studies revealed a high risk of bias for all studies except for one study. The most commonly used models were the Technology Acceptance Model (n=11) and the Unified Theory of Acceptance and Use of Technology (n=9). The main significant predictors of acceptance were perceived usefulness (n=11), social influences (n=6), and attitude (n=6). The results show a superiority of technology acceptance versus original behavioral models. CONCLUSIONS The main finding of this review is the applicability of technology acceptance models and theories on telemedicine adoption. Characteristics of the technology, such as its usefulness, as well as attributes of the individual, such as his or her need for social support, inform end-user acceptance. Therefore, in the future, requirements of the target group and the group's social environment should already be taken into account when planning telemedicine applications. The results support the importance of theory-guided user-centered design approaches to telemedicine development.
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Affiliation(s)
- Lorenz Harst
- Research Association Public Health, Center of Evidence-based Healthcare, University Clinic Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Hendrikje Lantzsch
- Master Program Health Sciences / Public Health, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Madlen Scheibe
- Center for Evidence-Based Healthcare, University Clinic Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Kanstrup AM, Bertelsen P, Jensen MB. Contradictions in digital health engagement: An activity tracker's ambiguous influence on vulnerable young adults' engagement in own health. Digit Health 2018; 4:2055207618775192. [PMID: 29942636 PMCID: PMC6016565 DOI: 10.1177/2055207618775192] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 04/14/2018] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Activity trackers are designed to support individuals in monitoring and increasing their physical activity. The use of activity trackers among individuals diagnosed with depression and anxiety has not yet been examined. This pilot study investigates how this target group engages with an activity tracker during a 10-week health intervention aimed to increase their physical activity level and improve their physical and mental health. METHODS Two groups of 11 young adults (aged 18-29 years) diagnosed with depression or anxiety participated in the digital health intervention. The study used mixed methods to investigate the research question. Quantitative health data were used to assess the intervention's influence on the participants' health and qualitative data provided insights into the participants' digital health experience. RESULTS The study demonstrated an ambiguous influence from the use of an activity tracker with positive physical and mental health results, but a fading and even negative digital health engagement and counterproductive competition. CONCLUSIONS The ambiguous results identify a need for (1) developing strategies for health professionals to provide supervised use of activity trackers and support the target groups' abilities to convert health information about physical activity into positive health strategies, and (2) designing alternatives for health promoting IT targeted users who face challenges and need motivation beyond self-tracking and competition.
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Affiliation(s)
| | | | - Martin B Jensen
- Research Unit for General Practice in Aalborg, Department of Clinical Medicine, Aalborg University, Denmark
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