nudging CHronic disease mANaGemEnt for empowering citizens: the CHANGE project (original) (raw)
Related papers
Mobile applications for chronic disease self-management : building a bridge for behavior change
Frontiers in Public Health, 2016
Mobile applications for chronic disease self-management: building a bridge for behavior change Year 2015 Pages 95 One of the biggest challenges in the future of healthcare is the rising prevalence of chronic, non-communicable diseases. In high-income countries seven out of ten leading risk factor causes of death are caused by the way people eat, drink or move. Health behavior patterns are considered to account for 40 % of early mortality. If nothing changes, from 2011 until 2030 the cost of chronic disease in the whole world will be 47 trillion dollars. It is clear that chronic disease care needs to change. Today people with chronic disease spend less than 0,1 % of their time yearly in direct contact with healthcare and guidance. The rest of the time they are under the influence of family, colleagues, acquaintances, media and all the conflicting information from them. Digital elements are emerging in healthcare. Some of these digital elements emerging are mobile applications. Of all the people in Finland, 70 % own a smartphone. These devices are often in the proximity of their owner; in a pocket or a purse, making them easy and fast to use for various purposes. This is why they can also prove to be useful tools for personal healthcare and chronic disease self-management support, for example for recording diet and exercise related values as well as various disease specific values like blood glucose or blood pressure measurements. They also enable two-way interaction with healthcare professionals and patients in their everyday life. This requires well designed applications that affect the patient's health behavior and are tempting to use. According to research, this is not always the case. This thesis explores the field of chronic disease self-management, mobile applications intended for it, and how they implement known behavior change enhancing features. The purpose of this thesis is to create a new, multiprofessional behavior change intervention tool. This is done by first systematically investigating and quantifying currently available mobile applications suitable for multiple chronic disease self-management, and describing their current usefulness in how they aim to change patient's behavior and maintain it using the Behavior Change Technique taxonomy by Michie et al. and the Gamification taxonomy by Robinson and Bellotti. Secondly, a new framework is created building upon existing information, experience and theory by the principles of constructive research approach using also features from autoethnographic approach. The results impart that the studied applications do not utilize these taxonomies nearly as well as they could. In general, less than 10 % of the possible behavior change techniques were used, and less than 15 % of the possible gamification features were used. This indicates the need for better designed applications that take these features into account. To help in this process, BC-TIP, "the Behavior Change Techniques Intervention Process" framework was developed. This framework will provide visual and narrative guidance amongst the techniques making them easier to be used by professionals from various disciplines, like healthcare and mobile application design.
Improving Wearable Solutions with Nudging Actions in the Chronic Care Management: The SENIOR Project
2024
In order to avoid that many senior citizens with Mild Cognitive Impairment (MCI) could become chronic patients with a low level of functioning in many cognitive, behavioral and emotional domains, some technological solutions have been improved to better enhance less compromised healthy lifestyle, providing real-time clinically-based suggestions and reducing some dysfunctional behaviors. Moreover another critical problem is the overweight and obesity that can affect many people in Western but also Eastern regions. In order to cope with MCI and obesity, mhealth monitoring solutions (smart-watches based and wearable based) have been developed. The major aim of this paper is to show the rationale behind the SENIOR Project, a Cariplo funded project that will develop and deliver wearable monitoring solutions with tailored nudging feedbacks for patients with obesity an MCI. Scientific background, rationale, aims, outcomes measured and innovations are discussed.
User Interaction for people living with a chronic disease
Ambient Intelligence (AmI) allows the intelligent and natural interaction between the context and individuals. This paradigm will facilitate user support through novel medical protocol design for chronic disease treatment, based on the healthy lifestyle promotion. Cardiovascular Diseases (CVD) account for 45% of all deaths in the western world according to the 2004 World Health Organization statistic report. Heart Failure (HF), CVD's primary paradigm, mainly affects people older than 65. The European MyHeart Project's mission is to empower citizens to fight CVD by leading a preventative lifestyle and allowing early diagnosis. This paper presents a model based on contexts to identify the patient interaction and the implementation of this model into a Heart Failure Management solution. Heart Failure Management daily monitors vital body signals, using wearable and mobile technologies, to continuously assess this chronic disease. The methodology applied herein has involved stakeholders in an iterative process: Model validation, feasibility, efficiency, user experience, and acceptance. These carefully designed systems play an important role in motivating people to adopt healthier lifestyles by using technical solutions. These solutions allow patient self-management of their chronic condition.
Towards end-user development for chronic disease management
2018
Although developments in modern medicine continue to reduce premature death from acute illnesses, chronic diseases are now pervading the resultant aging population at a growing rate. Such diseases cannot be cured with drugbased treatment, but can be controlled with patients’ regular monitoring of their symptoms and consequent lifestyle changes. However, this level of sustained engagement outside face-toface appointments places a considerable burden upon patients. Smartphones are suitable platforms to support both patients in engaging with self-management plans, and clinicians in directly monitoring the influence of these plans. Bespoke applications exist for such purposes, yet the diversity in patients’ lifestyles and levels of engagement necessitates many new or personalised applications. One approach, to solve these problems at scale, is with end-user development. This paper reports the findings from interviews with clinicians, and ethnographic observation in chronic disease manag...
Mobile applications that empower people to monitor their personal health
Elektrotechnik Und Informationstechnik, 2006
Researchers have an opportunity to develop assistive applications that empower people to change unhealthy habits through monitoring their behavior. Mobile applications can enhance self-monitoring by providing real-time feedback and employing persuasive technology. The projects presented demonstrate the potential of persuasive, assistive applications for both chronically ill and healthy individuals.
Rethinking Health: ICT-Enabled Services to Empower People to Manage Their Health
IEEE Reviews in Biomedical Engineering, 2011
Lifestyle is a key determinant in the prevention and management of chronic diseases. If we would exercise regularly, eat healthy, control our weight, sleep enough, manage stress, not smoke and use alcohol only moderately, 90% of type II diabetes, 80% of coronary heart disease, and 70% of stroke could be prevented. Health statistics show that lifestyle related diseases are increasing at an alarming rate. Public health promotion campaigns and healthcare together are not effective enough to stop this "tsunami". The solution that is offered is to empower people to manage their health with the assistance of ICT-enabled services. A lot of R&D and engineering effort is being invested in Personal Health Systems. Although some progress has been made, the market for such systems has not yet emerged. The aim of this critical review is to identify the barriers which are holding back the growth of the market. It looks into the theoretical foundations of behavior change support, the maturity of the technologies for behavior change support, and the business context in which behavior change support systems are used.
Frontiers in Public Health, 2022
Introduction: Type 2 diabetes mellitus (T2DM) poses huge burden and cost on the healthcare system. Mobile health (mHealth) interventions that incorporate wearables may be able to improve diabetes self-management. The aim of this randomized controlled trial (RCT) is to investigate the clinical and cost-effectiveness of personalized educational and behavioral interventions delivered through an EMPOWER mobile application (app) among patients with T2DM. Methods: This is a parallel two-arm randomized controlled trial (RCT). Patients with T2DM recruited from primary care will be randomly allocated in a 1:1 ratio to either intervention or control group. The intervention group will receive personalized educational and behavioral interventions through the EMPOWER app in addition to their usual clinical care. The control group will receive the usual clinical care for their T2DM but will not have access to the EMPOWER app. Our primary outcome is patient activation score at 12 months. Secondary outcomes will include HbA1c, physical activity level and diet throughout 12 months; quality of life (QoL), medication adherence, direct healthcare cost and indirect healthcare cost at 6 and 12 months. Discussion: This RCT will provide valuable insights into the effectiveness and implementation of personalized educational and behavioral interventions delivered through mobile application in T2DM management. Findings from this study Kwan et al. Diabetes and Smartphone App can help to achieve sustainable and cost-effective behavioral change in patients with T2DM, and this can be potentially scaled to other chronic diseases such as hypertension and dyslipidemia.
Designing patient-centric applications for chronic disease management
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference, 2011
Chronic diseases such as diabetes and heart disease are the leading causes of disability and death in the developed world. Technological interventions such as mobile applications have the ability to facilitate and motivate patients in chronic disease management, but these types of interventions present considerable design challenges. The primary objective of this paper is to present the challenges arising from the design and implementation of software applications aiming to assist patients in chronic disease management. We also outline preliminary results regarding a self-management application currently under development targeting young adults suffering from type 1 diabetes.
Self-monitoring technologies to promote healthy behavior in the long term
2020
Nowadays, the world is facing two major issues: Non-Communicable Diseases and ageing population. Although committing in healthy behaviors has been shown to be highly beneficial for individual’s health and well-being, the challenge remains in motivating the adoption and the long-term engagement in such behaviors. This thesis focuses on the efficiency of self-monitoring technologies to promote positive change in the long-term on modifiable behaviors, mainly regarding physical activity and nutrition. It sheds light on the opportunities and the limitations of self-monitoring, gamified, social and conversational applications and intends to provide guidelines for designing these technologies for specific population, namely: chronically ill and elderly patients. Overall, the work conducted within this dissertation offers new perspectives on the design of self-monitoring technologies for elderly and chronically-ill patients. It makes several research contributions that are of interest to th...