As stroke incidence increases, therapists' time is under pressure. Technology-supported rehabilitation may offer new opportunities. The objective of this study was to evaluate patient motivation for ...and the feasibility and effects of a new technology-supported task-oriented arm training regime (T-TOAT). Nine chronic stroke patients performed T-TOAT (2 × 30 min/day, four days/week) during eight weeks. A system including movement tracking sensors, exercise board, and software-based toolkit was used for skill training. Measures were recorded at baseline, after four and eight weeks of training, and six months posttraining. T-TOAT improved arm-hand performance significantly on Fugl-Meyer, Action Research Arm Test, and Motor Activity Log. Training effects lasted at least six months posttraining. Health-related-quality-of-life had improved significantly after eight weeks of T-TOAT with regard to perceived physical health, but not to perceived mental health (SF-36). None of the EuroQol-5D components showed significant differences before and after training. Participants were intrinsically motivated and felt competent to use the system. Furthermore, system usability was rated very good. However, exercise challenge as perceived by participants decreased significantly over eight weeks of training. The results of this study indicate that T-TOAT is feasible. Despite the small number of stroke patients tested, significant and clinically relevant improvements in skilled arm-hand performance were found.
Aim
Suboptimal self‐management with controller inhalation therapy in asthma and COPD is frequently observed with poor treatment outcomes. The developed ‘Respiratory Adherence Care Enhancer’ (RACE) ...instrument identifies and addresses individual barriers to self‐management with a theoretical underpinning. This study investigates the feasibility of pharmaceutical support with this instrument.
Methods
An implementation trial was conducted with asthma and COPD patients in 5 community pharmacies in the Netherlands. Patients were allocated to standard care or add‐on support with the RACE instrument. Patients were invited to complete the RACE questionnaire at baseline, 5‐week and 10‐week follow‐up. Barrier profiles were accessible for the intervention group with subsequent consultations at baseline and 5‐weeks. Experiences were collected from patients and consultants with a questionnaire and reported findings. Primary endpoints focused on the acceptability, practicality and implementation process. Secondary endpoints included between‐group differences in barrier and disease control outcomes from baseline at 10‐weeks follow‐up.
Results
In total, 84 patients were included; 48 were assigned to intervention and 36 to standard care. Patient satisfaction of support with the RACE instrument was high (71%). Patients felt motivated, reassured and more confident about their disease management. Consultants reported an increase in awareness of patient barriers. Patient recognition of barrier profiles was 83.9% (±12.9%). The barrier inhaler techniques decreased significantly for the intervention group at follow‐up with odds ratio 0.30 (95% confidence interval, 0.10–0.91). No significant differences were observed for changes in number of barriers and disease control.
Conclusion
Self‐management support with the RACE instrument is feasible and appreciated, facilitating behaviour change with patient‐centred pharmaceutical care in asthma and COPD.
This paper examines the behavioral consequences of individual differences in persuadability in the health promotion domain. We use a 7-item persuadability instrument to determine participants ...persuadability score. Based on this score two groups are created: the low and high persuadables. Subsequently, we present 2 studies that test the responses to health-related persuasive messages of both low and high persuadables. The results consistently show that high persuadables comply more to messages with a persuasive content as compared to a neutral message than low persuadables. Even more, both studies indicate lower compliance by low persuadables when persuasive messages are employed. Implications of this possible detrimental effect of the use of persuasive messages for low persuadables are discussed.
This paper reports an exploration of the concept of social intelligence in the context of designing home dialogue systems for an Ambient Intelligence home. It describes a Wizard of Oz experiment ...involving a robotic interface capable of simulating several human social behaviours. Our results show that endowing a home dialogue system with some social intelligence will: (a) create a positive bias in the user's perception of technology in the home environment, (b) enhance user acceptance for the home dialogue system, and (c) trigger social behaviours by the user in relation to the home dialogue system.
Parents looking to foster more energy sufficient behaviours in their children struggle to have their child maintain these behaviours unsupervised. Our research indicates that in order for the child ...to maintain these behaviours, s/he must perceive him/herself as an eco conscious individual. We propose that increasing a child’s ability to firstly recognise eco-friendly behaviours and secondly, recollect them, is likely to yield a greater affinity for habitual energy sufficient behaviours. This paper describes a first prototype game, whose interface employs availability heuristics and other persuasive design elements to achieve this goal.
The Kitten Scanner is an educational scanner that can be used to playfully prepare children for an MRI or CT scan. The current paper describes a re-design of the Kitten Scanner to increase its ...educational value and prepare a diverse group of patients for a diverse range of scan types. Learning goals were created that are applicable to both MRI and CT. Based on these learning goals, storylines were developed for 3 different characters, with each character showcasing a different scan and emotional response.
This paper reports an exploration of the concept of social intelligence in the context of home dialogue systems for an Ambient Intelligence home. It reports a Wizard of Oz experiment involving a ...robotic interface capable of displaying several human social behaviors. Our results show that endowing a home dialogue system with some social intelligence can (a) create a positive bias in user’s perception of technology in the environment, (b) increase user acceptance for the home dialogue system, and (c) trigger social behaviors of the user towards the home dialogue system.
Goal setting can be a powerful method for persuading individuals to adopt an active lifestyle. In order for this to be the case, it is important to set concrete and challenging goals, and to strongly ...commit to them. In this study, we explored how people set goals for physical activity and how these goals were reflected in self-regulatory mechanisms to drive goal attainment. Our approach is novel in two ways: first, we used an unobtrusive wearable sensor to accurately measure physical activity throughout the day rather than rely on self-report, and second, we provided individuals with feedback about the contribution of their common daily activities (e.g., household activities) to their physical activity level. Our results showed that on the basis of this feedback, participants were able to indicate to what degree they intended to change their behavior. Nevertheless, they failed to set concrete goals that matched their intentions precisely. In particular, we observed that overall the set goals were in accordance with intentions (i.e., goals were set in the desired direction), but we saw a strong tendency to focus on enhancing vigorous activity at the cost of moderate intensity activity. This suggests that many individuals have intentions to change and goal setting support is needed to compose goals that accurately reflect these intentions. Technology-mediated interventions might be ideal to support individuals along that path.
The growing number of people with an inactive lifestyle emphasizes the need for highly persuasive physical activity interventions. Modern technological developments bring great promise for the ...realization of such large-scale persuasive behavior change interventions because they allow for user tailored interaction. For the effective tailoring of technology-based interventions, a profound understanding of the main variables underlying physical activity behavior is required. In this paper, we focus on three cognitive variables that have shown to be crucial for the adoption and maintenance of health behaviors: behavioral regulation, types of motives, and self-efficacy. In particular, we explore the relationship of these cognitive variables with actual levels of daily-life physical activity. Our study differs from related studies in two important ways. First, we consider the entire range of physical activities performed throughout the day while many studies focused on sports and or dedicated exercise. Second, we employ a wearable device for the objective measurement of daily physical activity levels rather than rely on self-report measures. Our results show that active individuals feel higher levels of self-determined behavioral regulation, experience stronger motives to be active (in particular for health and well-being related motives), and have higher levels of self-efficacy for daily-life physical activity than inactive individuals. We argue that tailored technology-based activity interventions should accommodate these cognitive variables and for inactive individuals, aim to gradually induce and internalize the cognitions already experienced by active individuals.
This paper addresses the relationship between goal difficulty and performance within the context of an ongoing activity intervention program called New Wellness Solutions (NWS). The NWS program ...employs a mobile device to enable moment-to-moment monitoring and progress feedback. In order to assess the relationship between goal difficulty and physical performance, we analyzed the data of a recently completed NWS program test. We found a significant positive linear relationship between goal difficulty and performance for individuals with an inactive lifestyle. No significant relationship was found for individuals with an active lifestyle. This may be explained by the active participants' low level of commitment to the assigned goals. We conclude that sufficiently difficult goals combined with timely progress feedback are effective in increasing activity levels of inactive people. Future studies should address the effect of additional mobile persuasion techniques to further improve physical activity patterns of inactive individuals and to enhance goal commitment of active individuals.
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