What patients want: Relevant health information technology for diabetes self-management.

Health information technology has great potential to promote efficiency in patient care and increase patient-provider communication, and patient engagement in their treatment. This paper explored qualitatively what patients with type 2 diabetes want from electronic resources that are designed to support their diabetes self-management. Data were collected via interviews and focus groups from managed care patients who had completed participation in either a web-based (MyPath) or in-person group-based (¡Viva Bien!) longitudinal diabetes self-management study. Content analysis identified common themes that highlighted participant interest in virtual and electronic programs to support diabetes self-management goals, and their desired content and features. Eighteen ¡Viva Bien! participants completed telephone interviews and 30 MyPath participants attended seven focus groups in 2010-2011. All participants expressed a preference for face-to-face contact; however, most participants were also interested in using technology as a tool to support daily diabetes self-management decisions and to receive tailored information. Choice of technology, personalized instruction on how to use program features, and the ability to exchange information with their healthcare team were desired by all participants. Participants were divided on whether virtual social support networks should be closed to friends and family, should include other program members (peers), or should be open to anyone with diabetes. Participants aged 65 and older stressed the desire for technical support. What patients wanted from technology is real-time assistance with daily behavioral decision-making, ability to share information with their healthcare team, connections with others for support, and choice.Ye

The Effects Of Personalized Dietary Education On Glycosylated Hemoglobin Levels In Adult Diabetic Patients

Diabetes mellitus is a complex and multifactorial disease process with numerous debilitating outcomes if improperly managed. This chronic illness requires continuing medical care and education to prevent acute exacerbations and to reduce the risk of long-term complications. The primary manifestation, hyperglycemia, can be the result of various elements. One major cause of hyperglycemia is inappropriate dietary intake which results in detrimental short- and long­ term effects. A glycosylated hemoglobin measurement can be utilized as a marker in monitoring long-term glycémie control. This quasi-experimental study examined the effect of personalized dietary education on glycosylated hemoglobin levels in adult diabetic patients. The study was guided by the null hypothesis : There will be no difference in glycosylated hemoglobin levels in adult diabetic patients before and after a personalized dietary teaching intervention program. Pender\u27s Health Promotion Model provided the theoretical framework in interpreting dietary teaching\u27s effect on glycémie management. The sample 111 consisted of adult diabetic patients in rural Mississippi primary care facilities. Data were compiled using a demographic survey and the results of glycosylated hemoglobin testing obtained at baseline and two to three month post-intervention. Data were analyzed using descriptive statistics and the dependent t-test. Results indicated no significant reduction in the mean difference of the post-intervention glycosylated hemoglobin levels (p = 0.853). Additional findings were brought out by researcher analyzed demographic questionnaires. Recommendations for future research included replication of this study with a larger sample utilizing different geographical areas and different health care providers. Conduction of a similar study over a longer period of time utilizing multiple dietary educational interventions and several glycosylated hemoglobin measurements as determinants of long-term dietary compliance was further recommended

DriveSafe DriveAware: A systematic review

Objectives: Driving is an activity of daily living that significantly affects independence, and driving cessation is associated with poor health, lower quality of life, cognitive decline and early entry into care facilities. There is no consensus regarding the best off-road tool to assess driving safety. Therefore, this review explored the diagnostic accuracy, reliability and clinical utility of DriveSafe DriveAware (DSDA) compared with an on-road driving assessment. Methods: This review adhered to the PRISMA guidelines. Electronic databases for all English language articles published prior to December 2021 were searched. Studies were assessed for methodological quality and results were synthesised using a narrative descriptive approach. Results: Six studies were reviewed, consisting of 1332 participants. Four studies assessed diagnostic accuracy, two studies assessed reliability and three were relevant to clinical utility since they used DSDA as a standalone tool. Some studies demonstrated high levels of diagnostic accuracy, with specificity and sensitivity above 90% for those who fall into the safe and unsafe categories (50% of those assessed). Inter-rater reliability showed substantial agreement, and test–retest reliability was demonstrated for all age groups. DSDA was assessed as having high clinical utility (as a standalone tool) based on time taken to conduct, cost effectiveness and equipment required to complete the assessment. Conclusions: DriveSafe DriveAware appears to be an ideal tool for the subacute setting; however, at present, inadequate evidence exists to support its use as a standalone tool for directing driving decisions. Further research is required

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

Description des interventions visant une perte de poids chez les femmes traitées pour un cancer du sein à l'aide de la Behaviour Change Technique Taxonomy version 1 (BCTTv1): travail de Bachelor

Introduction : La qualité des descriptions des études d’intervention visant un changement de comportement est très variable. Par conséquent, ces interventions sont difficilement implantables dans la pratique professionnelle. Dans le cadre du cancer du sein, les femmes ont une tendance à prendre du poids suite aux traitements. Il n’y pas de recommandation pour la prise en charge du poids de ces patientes. Cela est principalement dû à un manque de preuves solides, malgré qu’une perte de poids soit réalisable. Les composantes efficaces des interventions réalisées ne sont pas connues. Le but de ce travail est d’identifier les ingrédients actifs des interventions visant une perte de poids chez les femmes traitées pour un cancer du sein à l’aide de la taxonomie Behaviour Change Technique Taxonomy version 1 (BCTTv1). Méthodes : 24 études d’intervention visant une perte de poids chez les femmes traitées pour un cancer du sein ont été analysées. Une analyse descriptive des interventions menées a été effectuée sur la base du fondement de l’intervention, du type d’intervention auto-déclaré par les auteurs, de la description de l’intervention, du public cible de l’intervention, des modalités d’intervention et des ressources matérielles et humaines. Les 24 interventions ont également été codées à l’aide de la taxonomie BCTTv1 afin d’en dégager les ingrédients actifs. Résultats : Dix-huit études sur vingt-quatre ont une composante alimentaire ainsi qu’une composante d’activité physique. Six études ont également une composante de soutien social. Les descriptions des études inclues sont très variables dans la précision et dans le vocabulaire utilisé pour les qualifier, malgré que les interventions soient très similaires. Les modalités d’interventions ainsi que les ressources matérielles et humaines ne sont pas toujours explicitées de manière claire. Nous avons pu identifier 25% des labels BCT possibles. Les labels les plus fréquents sont Goal setting (behavior) (1.1), Social support (unspecified) (3.1), Instruction on how to perform the behavior (4.1) et Goal setting (outcome) (1.3) par ordre décroissant. Conclusion : Nos résultats ont montré la variabilité des descriptions pour des interventions qui sont finalement semblables. Le faible nombre de labels BCT trouvé montre le manque de précision dans les descriptions pour que l’ingrédient actif soit clairement identifié. Nos résultats montrent l’importance de l’utilisation d’un langage commun afin que ces interventions puissent être comparées beaucoup plus facilement et de ce fait, apporter encore plus de poids aux résultats de toutes les études portant sur le sujet des femmes atteintes d’un cancer du sein. Ce travail est une première étape vers la compréhension des mécanismes de perte de poids dans le cadre du cancer du sein. Il est important, dans les futures études, que les interventions soient décrites de manière structurée et avec un langage commun. Ceci dans le but de les rendre plus systématiques et d’augmenter les preuves quant au bénéfice d’une prise en charge du surpoids et de l’obésité chez les femmes traitées pour un cancer du sein, avec un objectif de changement de comportement à long terme

Nutrition Enhancement in Early Psychosis (Neep): A Feasibility Trial of Enhanced Nutrition with Text Messaging and a Dietary Tracking Mobile Application

Indiana University-Purdue University Indianapolis (IUPUI)Background. People with psychotic disorders tend to die earlier than the general population, primarily due to preventable cardiovascular disease. Behavioral risk factors, such as poor diet, have been identified as major contributors. Given the importance of prevention, the early stages of psychosis have been described as a “critical” time to intervene on health behaviors. As such, a mobile-based intervention, Nutrition Enhancement in Early Psychosis (NEEP) was created to improve diet quality in persons with early psychosis. This study has three aims: (1) assess the feasibility of the intervention, (2) examine preliminary outcomes, and (3) investigate mechanisms associated with dietary change. Methods. NEEP incorporates a combination of nutrition education, goal setting, and mobile technology (i.e., a mobile application for dietary tracking, as well both automated and personalized text-messages). Given the pilot nature of the study, all participants (N=15) received the intervention. Feasibility was assessed through different metrics related to recruitment and adherence to the dietary tracking application, as well as self-report responses regarding acceptability. Preliminary outcomes (i.e., two measures of diet quality) and potential mechanisms of change (i.e., self-efficacy and motivation) were also evaluated using paired sample t-tests. Qualitative interviews were conducted following study participation. Given the emphasis on feasibility with a small sample, all significance tests were set at p <.10, and Hedges g was used to examine effects over time. Results. 15 participants were enrolled in the study and 12 participants completed follow-up assessments. Evaluative measures of feasibility suggest that the majority of those who were screened enrolled in this intervention and regularly engaged with the mobile tracking device to record their dietary consumption. In addition, participants enjoyed the intervention and found it to be useful in improving their diet. Preliminary evidence also suggests this intervention may improve diet quality. As such, one indicator of improvement in diet quality was considered significant (Rapid Eating Assessment for Participants- Shortened; p=.084), and both measures of diet quality suggested improvement in diet at the end of the 28-day intervention with small to medium effect sizes (REAP-S g=.44; Heathy Eating Index-2015 g=.69). Contrary to hypotheses, self-efficacy significantly decreased after the intervention (p=.028) and motivation remained relatively stable. Conclusion. Results suggest that NEEP is feasible as a low-cost, low-resource mobile intervention that is well-tolerated and may improve diet quality in people with early psychosis; however, mechanisms of change require further exploration

Nutritional management and recommendations for hospital users and medical inpatients

Dissertação de mestrado em Engenharia InformáticaNutrition is fundamental to human well-being and health, especially when applied to patients who need special health care. In these cases, it is crucial that each patient has adequate nutrition to meet their needs, in order to accelerate their recovery process. Recommender systems make it possible to offer suggestions to users, adapted to their preferences and to previously obtained information about them. Food recommender systems are recommender systems applied to nutrition and diet. They are usually implemented feeding plans recommendation platforms based on food and the person using it. In this sense, the existing gap in the use of these recommendation systems applied to nutrition in health care is notorious. This is mainly due to the difficulty in associating the nutritional value of each food with the needs of patients. The main objective of this project is to fill the existing void, through the development and implementation of a platform that will allow the planning of meals taking into account the nutritional plan of the food and the specific needs associated with the users of the Vila Verde Social Canteen. The use of machine learning algorithms will allow us to identify how the connection between food and patient requirements can be made, making this task possible, which is complex due to the wide domain associated with it. This platform will be used for the generation of kitchen meal plans, which shall be produced using the algorithms developed after a bibliographic study and an investigation of the existing work, in order to understand how they can be implemented and which are the most adequate to the nutritional recommendations system.A nutrição é fundamental no bem-estar e na saúde do ser humano, principalmente quando aplicada a pacientes que necessitam de cuidados de saúde especiais. Nestes casos, é fulcral que cada paciente tenha uma nutrição adequada às suas necessidades, de forma a acelerar o seu processo de recuperação. Os sistemas de recomendação permitem oferecer sugestões aos utilizadores, adequados às suas preferências e às informações previamente obtidas acerca dos mesmos. Os sis-temas de recomendação de alimentos são sistemas de recomendação aplicados à nutrição e alimentação. Estes são usualmente implementados em plataformas de recomendações de receitas e planos de alimentação tendo como base a comida e a pessoa. Neste sentido, é notória a falha atual no que diz respeito à utilização destes sistemas de recomendação aplicados à nutrição em cuidados de saúde. Isto deve-se maioritariamente à dificuldade na associação entre o valor nutricional de cada alimento e as necessidades dos pacientes. Este projeto tem como principal objetivo preencher a lacuna existente, através do desen-volvimento e implementação de uma plataforma que irá permitir o planeamento de refeições tendo em conta o plano nutricional dos alimentos e as necessidades específicas associadas aos utentes da Cantina Social de Vila Verde. A utilização de algoritmos de machine learning permitirá perceber como pode ser feita a conexão entre os alimentos e os requisitos dos pacientes, tornando possível esta tarefa, que é complexa devido ao largo domínio associado à mesma. Esta plataforma será utilizada para a geração de planos de refeições da cozinha, sendo estes produzidos utilizando os algoritmos desenvolvidos após um estudo bibliográfico e uma investigação ao trabalho existente com o objetivo de perceber como poderão ser implementados e quais os mais adequados ao sistema de recomendações nutricional

SMARTPHONE TECHNOLOGY AND TEXT MESSAGING TO PROMOTE WEIGHT LOSS IN YOUNG ADULTS

Background: Overweight and obesity are a major public health problem for young adults in the United States. Current research suggests that young adults gain weight due to poor food choices, convenience eating, increases in alcohol consumption, decreases in fruit and vegetable consumption, and decreased physical activity. Behavioral interventions that can be easily integrated into the lives of young adults are needed. Utilizing a technology like Smartphone applications and text messaging may provide a good platform for delivering an intervention to this population. Methods: This study was a two-part study, beginning with a focus group study followed by a randomized controlled trial to test the effectiveness of a Smartphone application + text messaging on weight. Participants in both studies were young adults aged 18-25 years. Participants were conveniently sampled from an area in and around a college campus. Focus group results were analyzed using a process of thematic analysis. Randomized controlled trial results were analyzed utilizing Wilcoxin rank-sum tests and chi-squared or Fisher’s Exact test for group differences in baseline characteristics. A completers analysis was performed using generalized linear models, which were used to test for group differences, time effects, and interactions between group*time. Results: Participants from the focus group confirmed that utilizing a Smartphone application and text messaging would be of interest to them in a weight loss study. The randomized controlled trial contained 62 participants, 71% female and 33.8% Asian. Participants randomized to the intervention group lost significantly more weight (p=0.026), significantly reduced their body mass index (p<0.01), and significantly reduced their waist circumference (p<0.01) when compared to participants in the control group. Conclusions: Smartphone applications are easily integrated into the lives of young adults. When used as part of a behavioral intervention, Smartphone applications plus text messaging can be a successful tool for helping overweight and obese young adults lose weight

“My wellbeing-their wellbeing “– An eHealth intervention for managing obesity in early care and education: Protocol for the Go NAPSACC Cares cluster randomized control trial

Background To fully leverage the potential of the early care and education (ECE) setting for childhood obesity prevention, initiatives must not intervene solely at the organizational level, but rather they should also address the health needs of the ECE workers. Workers suffer disproportionately high rates of obesity, and have reported low confidence in modeling and promoting healthy eating and activity behaviors. However, information regarding the effectiveness of improving ECE workers’ health behaviors or whether such improvements elicit meaningful change in the ECE environment and/or the children in their care is limited. Method The proposed study will integrate a staff wellness intervention into a nationally recognized, ECE obesity prevention initiative (Go NAPSACC). Go NAPSACC+ Staff Wellness program will be assessed using a clustered randomized controlled trial including 84 ECE centers, 168 workers, and 672 2–5-year-old children. Centers will be randomly assigned to 1) standard “Go NAPSACC” or 2) Go NAPSACC+ Staff Wellness. Outcome measures will assess impact on dietary intake and PA behaviors of 2-5-year-old children at 6 months (primary aim) and 12 months. Secondarily, we will compare the impact of the intervention on centers’ implementation of healthy weight practices and the effect on ECE workers’ diet quality and PA at 6- and 12 months. Discussion This trial expects to increase our understanding of how ECE worker’s personal health behaviors impact the health behaviors of the children in their care and the ECE environment. Trial registration ClinicalTrials.gov: NCT05656807, registered on 19 December 2022. Protocol version 1.0, 22 March 2023