Complex multiple risk intervention topromote healthy behaviours in peoplebetween 45 to 75 years attended inprimary health care (EIRA study): study protocol for a hybrid trial

Background:Health promotion is a key process of current health systems. Primary Health Care (PHC) is the idealsetting for health promotion but multifaceted barriers make its integration difficult in the usual care. The majority ofthe adult population engages two or more risk behaviours, that is why a multiple intervention might be moreeffective and efficient. The primary objectives are to evaluate the effectiveness, the cost-effectiveness andan implementation strategy of a complex multiple risk intervention to promote healthy behaviours in peoplebetween 45 to 75 years attended in PHC.Methods:This study is a cluster randomised controlled hybrid type 2 trial with two parallel groups comparing acomplex multiple risk behaviour intervention with usual care. It will be carried out in 26 PHC centres in Spain. Thestudy focuses on people between 45 and 75 years who carry out two or more of the following unhealthybehaviours: tobacco use, low adherence to the Mediterranean dietary pattern or insufficient physical activity level.The intervention is based on the Transtheoretical Model and it will be made by physicians and nurses in theroutine care of PHC practices according to the conceptual framework of the“5A’s”. It will have a maximum durationof 12 months and it will be carried out to three different levels (individual, group and community). Incremental costper quality-adjusted life year gained measured by the tariffs of the EuroQol-5D questionnaire will be estimated. Theimplementation strategy is based on the“Consolidated Framework for Implementation Research”, a set of discreteimplementation strategies and an evaluation framework. Discussion:EIRA study will determine the effectiveness and cost-effectiveness of a complex multiple riskintervention and will provide a better understanding of implementation processes of health promotioninterventions in PHC setting. It may contribute to increase knowledge about the individual and structural barriersthat affect implementation of these interventions and to quantify the contextual factors that moderate theeffectiveness of implementation

A Comprehensive User Modeling Framework and a Recommender System for Personalizing Well-Being Related Behavior Change Interventions: Development and Evaluation

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Automatic Generation of Personalized Recommendations in eCoaching

Denne avhandlingen omhandler eCoaching for personlig livsstilsstøtte i sanntid ved bruk av informasjons- og kommunikasjonsteknologi. Utfordringen er å designe, utvikle og teknisk evaluere en prototyp av en intelligent eCoach som automatisk genererer personlige og evidensbaserte anbefalinger til en bedre livsstil. Den utviklede løsningen er fokusert på forbedring av fysisk aktivitet. Prototypen bruker bærbare medisinske aktivitetssensorer. De innsamlede data blir semantisk representert og kunstig intelligente algoritmer genererer automatisk meningsfulle, personlige og kontekstbaserte anbefalinger for mindre stillesittende tid. Oppgaven bruker den veletablerte designvitenskapelige forskningsmetodikken for å utvikle teoretiske grunnlag og praktiske implementeringer. Samlet sett fokuserer denne forskningen på teknologisk verifisering snarere enn klinisk evaluering.publishedVersio

DEVELOPMENT OF A COMMUNITY-BASED PLAN FOR AN EFFECTIVE BEHAVIORAL INTERVENTION TO REDUCE CHILDHOOD OBESITY IN A RURAL APPALACHIAN COMMUNITY

Rural children experience increased rates of obesity and reduced access to specialized weight management facilities, which makes receiving the recommended frequency of care difficult. Clinical-community partnerships, recommended by the American Academy of Pediatrics (AAP) to expand access, have been shown to be a feasible strategy of care delivery. Examination of literature and stakeholder interviews were used to inform the development of a collaborative pediatric weight management program in a rural, Appalachian community. Screening articles as well as intervention articles were reviewed. Outcomes of screening articles reviewed included BMI measures (3), screening practices (7), and referral practices (4). Common outcomes of intervention articles included BMI (24), parent BMI (7), diet (17), physical activity (16), quality of life (9), and sleep/sleep quality (7). Key results from these outcomes varied in each article. Clinical referral was seen in 23 studies and family-centeredness was seen in 25 of the 32 intervention articles reviewed. The majority of intervention studies that reported improved outcomes included both clinical referral and family-centered interventions. Interview guides were developed using the Consolidated Framework for Implementation Research (CFIR). Structured stakeholder interviews were conducted among implementation partners (n=4), community partners (n=1), and individuals (parents/caregivers) (n=1). Interviews were transcribed and a thematic analysis was conducted. Themes that emerged during thematic analysis included Barriers, Facilitators, Need for Intervention, Incentives, Receptivity, Setting Characteristics, and Implementation Considerations. Barrier sub-themes included transportation, childcare, adherence, time, and financial barriers. Facilitators sub-theme included complementary programs and processes. Incentives were grouped into monetary and non-monetary incentives sub-themes. Receptivity included community and organizational receptivity sub-themes. Setting characteristics included community and organizational setting characteristics sub-themes. Community site considerations (spaciousness, access, and familiarity); overlapping financial and adherence barriers; provision of program-specific incentives; and positive program framing to improve receptivity and participation were notable characteristics examined among themes and should be considered in future program development. Preliminary research, establishing factors that may influence implementation within the specified community, is of great importance to ensure efficacy; thus, the findings of this study will present critical information for program development and delivery

INTEGRATION OF INTERNET OF THINGS AND HEALTH RECOMMENDER SYSTEMS

The Internet of Things (IoT) has become a part of our lives and has provided many enhancements to day-to-day living. In this project, IoT in healthcare is reviewed. IoT-based healthcare is utilized in remote health monitoring, observing chronic diseases, individual fitness programs, helping the elderly, and many other healthcare fields. There are three main architectures of smart IoT healthcare: Three-Layer Architecture, Service-Oriented Based Architecture (SoA), and The Middleware-Based IoT Architecture. Depending on the required services, different IoT architecture are being used. In addition, IoT healthcare services, IoT healthcare service enablers, IoT healthcare applications, and IoT healthcare services focusing on Smartwatch are presented in this research. Along with IoT in smart healthcare, Health Recommender Systems integration with IoT is important. Main Recommender Systems including Content-based filtering, Collaborative-based filtering, Knowledge-based filtering, and Hybrid filtering with machine learning algorithms are described for the Health Recommender Systems. In this study, a framework is presented for the IoT-based Health Recommender Systems. Also, a case is investigated on how different algorithms can be used for Recommender Systems and their accuracy levels are presented. Such a framework can help with the health issues, for example, risk of going to see the doctor during pandemic, taking quick actions in any health emergencies, affordability of healthcare services, and enhancing the personal lifestyle using recommendations in non-critical conditions. The proposed framework can necessitate further development of IoT-based Health Recommender Systems so that people can mitigate their medical emergencies and live a healthy life

Innovative food recommendation systems: a machine learning approach

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University LondonRecommendation systems employ users history data records to predict their preference, and have been widely used in diverse fields including biology, e-commerce, and healthcare. Traditional recommendation techniques include content-based, collaborative-based and hybrid methods but not all real-world problems can be best addressed by these classical recommendation techniques. Food recommendation is one such challenging problem where there is an urgent need to use novel recommendation systems in assisting people to select healthy, balanced and personalized food plans. In this thesis, we make several advances in food recommendation systems using innovative machine learning methods. First, a novel recommendation approach is proposed by transforming an original recommendation problem into a many-objective optimisation one that contains several different objectives resulting in more balanced recommendations. Second, a unified approach to designing sequence-based personalised food recommendation systems is investigated to accommodate dynamic user behaviours. Third, a new food recommendation approach is developed with a temporal dependent graph neural network and data augmentation techniques leading to more accurate and robust recommendations. The experimental results show that these proposed approaches have not only provided a more balanced and accurate way of recommending food than the traditional methods but also led to promising areas for future research

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Policies for the prevention and control of Noncommunicable diseases in the WHO European Region: the example of salt

Trabalho complementar (Monografia) realizado no âmbito da Unidade Curricular Estágio da Licenciatura em Ciências da Nutrição da Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, sob orientação de Prof. Doutor João Joaquim Rodrigues da Silva Breda (Organização Mundial de Saúde, Delegação Europa)Resumo da tese: As doenças não transmissíveis são responsáveis por mais de 80% das mortes na Região Europeia da Organização Mundial de Saúde. Dietas não saudáveis são um dos factores de risco mais relevantes e a redução do consumo excessivo de sal é uma das intervenções prioritárias na prevenção e controlo das doenças não transmissíveis. A implementação de políticas para a redução do consumo de sal nas populações, apesar de não estar no topo da agenda governamental, apresenta um custo-benefício e uma efectividade que deve ser tomada em consideração para melhorar o bem-estar e a qualidade de vida das populações. O envolvimento de parceiros, como a indústria alimentar e os media, com os diferentes organismos e associações nacionais e um correcto sistema de monitorização são a chave para o sucesso de uma política nacional de redução do consumo de sal, a fim de reduzir a ingestão de sal para 5g/dia, de acordo com a recomendação da Organização Mundial de Saúde. Um olhar atento nos diferentes sucessos das políticias na Região Europeia da Organização Mundial de Saúde poderá ajudar os países da Região, a implementar políticas nacionais bem estruturadas e eficazes com resultados benéficos para a Saúde.Thesis abstract: Noncommunicable diseases are responsible for more than 80% of deaths in the Member States of the World Health Organization European Region. Unhealthy diets are one of the most relevant risk factors and the reduction of excessive salt intake is a priority intervention in the prevention and control of noncommunicable diseases. The implementation of policies to reduce salt intake in populations, although not always a top priority on a government agenda, present a cost-beneficial and effective approach that must be taken into account to improve the welfare and quality of life of people. The involvement of partners such as the food industry and media, along with different agencies and national associations and a proper monitoring system is the key to the success of a national policy to reduce salt intake to 5g/day, the World Health Organization recommendation. A closer look at the different political successes in the World Health Organization European Region will help the countries across the Region to implement a well-structured and effective national policy with beneficial results to health