Personalised nutrition and health

This article is one of a series commissioned by The BMJ. Open access fees for the series were funded by SwissRe, which had no input into the commissioning or peer review of the articles.S

Designing personalised mHealth solutions: An overview

Introduction: Mobile health, or mHealth, is based on mobile information and communication technologies and provides solutions for empowering individuals to participate in healthcare. Personalisation techniques have been used to increase user engagement and adherence to interventions delivered as mHealth solutions. This study aims to explore the current state of personalisation in mHealth, including its current trends and implementation. Materials and Methods: We conducted a review following PRISMA guidelines. Four databases (PubMed, ACM Digital Library, IEEE Xplore, and APA PsycInfo) were searched for studies on mHealth solutions that integrate personalisation. The retrieved papers were assessed for eligibility and useful information regarding integrated personalisation techniques. Results: Out of the 1,139 retrieved studies, 62 were included in the narrative synthesis. Research interest in the personalisation of mHealth solutions has increased since 2020. mHealth solutions were mainly applied to endocrine, nutritional, and metabolic diseases; mental, behavioural, or neurodevelopmental diseases; or the promotion of healthy lifestyle behaviours. Its main purposes are to support disease self- management and promote healthy lifestyle behaviours. Mobile applications are the most prevalent technological solution. Although several design models, such as user-centred and patient-centred designs, were used, no specific frameworks or models for personalisation were followed. These solutions rely on behaviour change theories, use gamification or motivational messages, and personalise the content rather than functionality. A broad range of data is used for personalisation purposes. There is a lack of studies assessing the efficacy of these solutions; therefore, further evidence is needed. Discussion: Personalisation in mHealth has not been well researched. Although several techniques have been integrated, the effects of using a combination of personalisation techniques remain unclear. Although personalisation is considered a persuasive strategy, many mHealth solutions do not employ it. Conclusions: Open research questions concern guidelines for successful personalisation techniques in mHealth, design frameworks, and comprehensive studies on the effects and interactions among multiple personalisation techniques

Priority Hypertension Management Strategies for At-risk African Americans as Perceived by Medical Clinicians and Academic Scholars

African American adults, in the United States (US), bear the greatest burden of high blood pressure (HBP)--a primary risk factor for cardiovascular disease and premature death. Current research does not adequately inform the design of multi-level interventions that work to control HBP in this at-risk population. The purpose of this study was to uncover information about priority strategies recommended for HBP control in African American adults. Research questions are 1) what are factors that reduce or manage HBP in at-risk African Americans and 2) what factors are important to the design and implementation of successful HBP interventions in at-risk African Americans? A qualitative interpretive descriptive design and in-depth interview were used with a purposive sample (n=10) of doctorate-educated healthcare clinicians (i.e., physicians) and academicians (i.e., researchers) based on eligibility criteria: a) experience in treating or conducting research about HBP in African American adults, b) located within the Southern US, and c) consent to participate. Thematic analysis of audio-taped interview transcripts yielded a theoretical framework that consists of three multi-level elements believed to be critical components of interventions that can successfully manage HBP in at-risk African Americans: 1) social support, 2) lifestyle coaching, and 3) personalized medical management. Unique domains within the each element were revealed that ranged from stress management and holism to emotional resonant patient-caregiver partnership and experiential learning. Our findings were consistent with the social ecological model and have the potential to help address racial/ethnic-based health disparities through the design of patient-centered interventions. Findings will also be used to identify parameters available to simulation modelers in the design of models for optimal population level HBP control policy

Designing Personalised mHealth solutions: An overview

Introduction Mobile health, or mHealth, is based on mobile information and communication technologies and provides solutions for empowering individuals to participate in healthcare. Personalisation techniques have been used to increase user engagement and adherence to interventions delivered as mHealth solutions. This study aims to explore the current state of personalisation in mHealth, including its current trends and implementation. Materials and Methods We conducted a review following PRISMA guidelines. Four databases (PubMed, ACM Digital Library, IEEE Xplore, and APA PsycInfo) were searched for studies on mHealth solutions that integrate personalisation. The retrieved papers were assessed for eligibility and useful information regarding integrated personalisation techniques. Results Out of the 1,139 retrieved studies, 62 were included in the narrative synthesis. Research interest in the personalisation of mHealth solutions has increased since 2020. mHealth solutions were mainly applied to endocrine, nutritional, and metabolic diseases; mental, behavioural, or neurodevelopmental diseases; or the promotion of healthy lifestyle behaviours. Its main purposes are to support disease self-management and promote healthy lifestyle behaviours. Mobile applications are the most prevalent technological solution. Although several design models, such as user-centred and patient-centred designs, were used, no specific frameworks or models for personalisation were followed. These solutions rely on behaviour change theories, use gamification or motivational messages, and personalise the content rather than functionality. A broad range of data is used for personalisation purposes. There is a lack of studies assessing the efficacy of these solutions; therefore, further evidence is needed. Discussion Personalisation in mHealth has not been well researched. Although several techniques have been integrated, the effects of using a combination of personalisation techniques remain unclear. Although personalisation is considered a persuasive strategy, many mHealth solutions do not employ it. Conclusions Open research questions concern guidelines for successful personalisation techniques in mHealth, design frameworks, and comprehensive studies on the effects and interactions among multiple personalisation techniques

A case series of an off-the-shelf online health resource with integrated nurse coaching to support self-management in COPD

Background: COPD has significant psychosocial impact. Self-management support improves quality of life, but programs are not universally available. IT-based self-management interventions can provide home-based support, but have mixed results. We conducted a case series of an off-the-shelf Internet-based health-promotion program, The Preventive Plan (TPP), coupled with nurse-coach support, which aimed to increase patient activation and provide self-management benefits. Materials and methods: A total of 19 COPD patients were recruited, and 14 completed 3-month follow-up in two groups: groups 1 and 2 with more and less advanced COPD, respectively. Change in patient activation was determined with paired t-tests and Wilcoxon signed-rank tests. Benefits and user experience were explored in semistructured interviews, analyzed thematically. Results: Only group 1 improved significantly in activation, from a lower baseline than group 2; group 1 also improved significantly in mastery and anxiety. Both groups felt significantly more informed about COPD and reported physical functioning improvements. Group 1 reported improvements in mood and confidence. Overall, group 2 reported fewer benefits than group 1. Both groups valued nurse-coach support; for group 1, it was more important than TPP in building confidence to self-manage. The design of TPP and lack of motivation to use IT were barriers to use, but disease severity and poor IT skills were not. Discussion: Our findings demonstrate the feasibility of combining nurse-coach support aligned to an Internet-based health resource, TPP, in COPD and provide learning about the challenges of such an approach and the importance of the nurse-coach role

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

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HeartCycle: User interaction and patient education

Cardiovascular Diseases are the most prevalent and serious chronic conditions existing nowadays. They are the primary cause of death in the world and generate enormous expenditures to the health systems. Tele-monitoring and personal health systems have proven to be good options for tackling this situation; however they are still lacking many functionalities. It is necessary to find solutions that allow health professionals to follow up patients more closely and efficiently, while reducing the non-adherence of patients to the treatment regime. HeartCycle research project (partially funded by the European Commission) has developed a personal health system for cardiovascular diseases management with the aim to address this problem. This paper describes the Patient Loop of this solution, including the different components, the adopted user interaction, and the implemented patients education and coaching strategy