Wearable Computing for Health and Fitness: Exploring the Relationship between Data and Human Behaviour

Health and fitness wearable technology has recently advanced, making it easier for an individual to monitor their behaviours. Previously self generated data interacts with the user to motivate positive behaviour change, but issues arise when relating this to long term mention of wearable devices. Previous studies within this area are discussed. We also consider a new approach where data is used to support instead of motivate, through monitoring and logging to encourage reflection. Based on issues highlighted, we then make recommendations on the direction in which future work could be most beneficial

Using socio-ecological model to inform the design of persuasive applications

Diverse persuasive applications that aim for behavioural changes have been developed. However, the method in which particular persuasive design principles are chosen over others remains unclear. Meanwhile, the use of socio-ecological model has been widely utilized in clinical research, as a basis to understand the factors in the entire ecological system that influences behavioural patterns. Because persuasive technology aims to change the behaviour and attitudes of users, we believe that the use of socio- ecological model would be beneficial to inform the design of persuasive applications. Accordingly, in this paper, we attempt to demonstrate the mapping of the socio-ecological factors and persuasive design principles by conducting interviews and expert reviews. Based on our approach, 12 socio-ecological factors that influence physical activity behaviour, and corresponding relevant persuasive design principles to deal with these factors, are identified

Reporting health data in waiting rooms with mobile technology: Patient expectation and confirmation

Objectives: Hospitals and medical staff use digital devices such as mobile phones and tablets to treat patients. Prior research has examined patient-reported outcomes, and the use of medical devices to do diagnosis and prognosis of patients, but not whether patients like using, and intend to use in future, mobile devices to self-report medical data. We address this research gap by developing a theoretical model based on the expectancy confirmation model (ECM) and testing it in an empirical study of patients using mobile technology to self-report data. Design: This study adopts a non-interventional cross-sectional research design. Randomly-selected patients provided data via survey and physical measurements. The target population comprises adults visiting a healthcare laboratory to get their blood drawn. Materials and methods: We surveyed 190 randomly-selected patients waiting for treatment in the clinic. They were surveyed at two points in time - before and after their blood was drawn - on their demographic characteristics, research variables concerning their use of mobile devices to provide medical information, and perceived clinical data (blood pressure, height and weight). The research model was tested using structural equation modeling. Results: The study found strong support for the research model, with seven of eight hypotheses being supported. Both self-disclosure effort and feedback expectation positively affect both perceived feedback quality and confirmation. Contrary to expectations, perceived feedback quality was not found to affect confirmation. Perceived feedback quality, along with confirmation, was found to positively affect satisfaction, which was found to affect intention to disclose medical data through mobile technology. Conclusions: The study\u27s findings support the proposed path from feedback expectation and self-disclosure effort to confirmation to satisfaction to disclosure intention. Although perceived feedback does not affect confirmation, it affects satisfaction. Overall, we believe the results provide novel insights to both scientific research community and practitioners about using mobile technologies for self-reporting medical data

Improving quality of summative eHealth evaluations

Summative evaluation, which is conducted at the end of an eHealth trial or implementation,assesses outcomes, produces evidence, and advances knowledge of eHealth implementationsin healthcare provisions. Therefore, its high quality is essential in order to reap the benefits ofthe results generated by evaluation studies. Quality is achieved in eHealth evaluation throughcontextual sensitivity, adequate research design, adherence to standards, a mixed-methodresearch approach, and ethical handling of data. However, insufficient quality in eHealthevaluation studies leads to decision makers and other potential users disregarding their results,which leads to the resources and effort involved in conducting an evaluation being wasted.The purpose of this thesis is to study how summative eHealth evaluations can be improved tosupport the determination of eHealth value in a specific context as well as the use of evidenceproduced during eHealth interventions. This thesis is built on a single case study of a summativeeHealth evaluation of an eHealth implementation project within different healthcare contexts.The thesis focuses on the different phases of evaluation process, assesses adequacy of standards,explores value that the eHealth intervention delivered in different contexts, and studies howevidence from evaluation is further used.The thesis extends knowledge on eHealth evaluation quality by providing deeper insights intothe problems in the existing quality criteria and by introducing two new criteria for quality ineHealth evaluations: capturing value of an eHealth solution and involving healthcareprofessionals in the intervention and its evaluation. The thesis reveals that meeting some of thecriteria is not always practical, and that evaluators might make trade-offs among the criteria.The findings point to a need to improve methodologies for eHealth evaluations by providingbetter guidance to evaluators and validating evaluation standards in different locations. Thethesis also suggests viewing value of an eHealth solution as a holistic view of the createdmonetary and nonmonetary benefits of eHealth that require monetary and nonmonetarysacrifices in a particular context. In addition, the thesis proposes a model for assessing value ofan eHealth solution

Action Research : the first steps to start up a pilot experiment in heritage education

Peer-reviewedLes relacions entre els museus i les escoles canvien amb l'ús d'internet. Volem analitzar com aquestes noves relacions tenen lloc a una escala nacional. És important analitzar aquestes noves relacions possibles, que són producte de canvis socials i tecnològics, ja que permeten noves interaccions i participació, al mateix temps que demanen canvis en les formes d'organització, la gestió de recursos web i els models d'ensenyament i aprenentatge. Concretament, les xarxes d'aprenentatge poden establir una nova forma de relació entre els museus i les escoles, i els recursos educatius en línia amb contingut sobre patrimoni cultural poden oferir oportunitats d'aprenentatge i recursos de coneixement més enllà dels límits de l'ensenyament formal. Tanmateix, calen projectes experimentals per a efectuar proves i veure com aquests tipus de pràctiques d'ensenyament i aprenentatge funcionaran en un context social i cultural concret. Així, doncs, la recerca activa pot contribuir al desenvolupament d'una experiència d'aprenentatge, basat en la reflexió i l'acció. L'objectiu d'aquesta experimentació és obtenir un model de treball i millors pràctiques per a aprendre i ensenyar en xarxes d'aprenentatge formades per gestors, professors i estudiants de patrimoni en què els membres produeixin i utilitzin recursos educatius en línia amb contingut de patrimoni cultural. Els resultats d'aquest projecte empíric seran comprovats amb resultats de la primera part metodològica de la tesi doctoral per a obtenir un model que es pugui exportar a altres contextos.Las relaciones entre los museos y las escuelas cambian con el uso de internet. Queremos analizar cómo estas nuevas relaciones tienen lugar a una escala nacional. Es importante analizar estas posibles nuevas relaciones, que son producto de cambios sociales y tecnológicos, ya que permiten nuevas interacciones y participación, a la vez que requieren cambios en las formas de organización, la gestión de recursos web y los modelos de enseñanza y aprendizaje. Concretamente, las redes de aprendizaje pueden establecer una nueva forma de relación entre los museos y las escuelas, y los recursos educativos en línea con contenido de patrimonio cultural pueden ofrecer oportunidades de aprendizaje y recursos de conocimiento más allá de los límites de la enseñanza formal. No obstante, existe una necesidad de proyectos experimentales para realizar pruebas para ver cómo estos tipos de prácticas de enseñanza y aprendizaje funcionarán en un contexto social y cultural concreto. Así pues, la investigación-acción puede contribuir al desarrollo de una experiencia de aprendizaje, basado en la reflexión y las acciones. El objetivo de esta experimentación es obtener un modelo de trabajo y mejores prácticas para el aprendizaje y la enseñanza en redes de aprendizaje formadas por gestores, profesores y estudiantes del patrimonio en las que los miembros produzcan y utilicen recursos en línea con contenido de patrimonio cultural. Los resultados de este proyecto de investigación empírico serán comparados con los resultados de la primera parte metodológica de la tesis doctoral para obtener un modelo que pueda ser exportado a otros contextos.The relationships between museums and schools are changing through the use of internet. We want to analyse how these new relationships occur at a national level. It is important to analyse these possible new relationships, which are the product of social and technological changes. They allow for new interactions and participation whilst requiring changes in the forms of organisation, web resource management, and teaching and learning models. Specifically, learning networks can establish a new form of relationship between museums and schools and educational online resources with cultural heritage content can offer learning opportunities and knowledge resources beyond the boundaries of formal education. However, there is a need for experimental projects to test the evidence and to see how these kinds of teaching and learning practices will work within a concrete social and cultural context. Thus, Action Research can contribute to the development of a learning experience, based on reflection and actions. The aim of this experimentation is to obtain a working model and best practices for learning and teaching in learning networks shaped by heritage managers, teachers and students where the members produce and use educational online resources with cultural heritage content. The results of this empirical research project will be compared with results from the first methodological part of the PhD thesis to obtain a model that can be exported to other contexts

The usability, acceptability, and satisfaction of a digital mental health tool for patients with breast and prostate cancer

The impact and use of digital health tools vary considerably among individuals dealing with somatic illnesses, such as cancer. This variability can be attributed to several factors, such as sociodemographic characteristics, baseline mental health, perception of the intervention’s usefulness, ease of use, and early engagement with the system. In this thesis, we aimed to examine the influence and interaction among these indicators on the usability, acceptability, satisfaction, and clinical effectiveness of a digital health tool in individuals with breast and prostate cancer. All studies were based on data from the NEVERMIND trial, a clinical randomized controlled trial that included patients with five different somatic illnesses. Our study included 255 participants (at baseline) who were diagnosed with breast or prostate cancer. Half of the participants (n=129) were allocated to the NEVERMIND system, whereas the other half (n=125) were allocated to the treatment as usual (control) group. Those in the NEVERMIND system group were involved in the use of the NEVERMIND digital health tool, comprising a mobile app and sensorized shirt (shirt), over a 12-week period. Data from baseline assessments and follow-ups at four and 12 weeks were used. The aim was to assess the usability, acceptability, and satisfaction of the NEVERMIND system, as well as the factors associated with these dimensions. This Ph.D. project also examined how usability and acceptability impacted the clinical effectiveness of the NEVERMIND system on depressive and stress symptoms. Study I. We investigated the association between baseline sociodemographic characteristics and usability assessed at four and 12 weeks of using the NEVERMIND system among 108 patients with breast and prostate cancer who received and used the system. The NEVERMIND system had good usability according to the usability questionnaires. Higher favourability of the mobile app was observed among women (breast cancer patients) compared to men (prostate cancer patients); however, men had significantly higher use of the overall system. Study II. The relationships between sex, education, baseline depressive and stress symptoms, perceived ease of use, perceived usefulness, and system usage at various stages were examined using Bayesian Structural Equation Modelling in a path analysis of 129 patients with breast and prostate cancer. Higher perceived usefulness and initial usage were associated with a higher level of usage at 12 weeks. The results indicated that a better understanding of the system’s benefits and early engagement were key drivers of its sustained use and clinical effectiveness in improving mental health outcomes. Study III. In a sample of 255 patients with breast and prostate cancer, we examined the relationship between the clinical effectiveness, usability, and acceptability of the NEVERMIND system when treating depressive and stress symptoms in patients with breast and prostate cancer. The results showed that patients in the NEVERMIND group had a greater reduction in depressive symptoms than those in the control group at the 12-week follow-up. The findings also showed that users who utilized the system for more than six weeks experienced a statistically significant decrease in both depressive symptoms and stress symptoms compared to those who used it for less than two weeks. Study IV. This study looked at the overall satisfaction of users (68 with breast cancer and 39 with prostate cancer) with the NEVERMIND system. Satisfaction was measured at four and 12 weeks using a one-item questionnaire with two open-ended follow-up questions about user experiences. An inductive and deductive thematic analysis was conducted by using the NEVERMIND system’s components as a sensitizing concept which was then refined and interpreted through the lens of Information Systems (IS) success model. The findings show that 68.24% of users rated the system as good or excellent at four weeks, with a slight decrease to 65.42% at 12 weeks. Three themes emerged from the thematic analysis: (1) Fostering Personal Agency and Motivation, (2) Engagement and Interaction Experiences, and (3) Content Quality and Relevance. Gender differences emerged in the prioritization of emotional support among female users and self-awareness among male users. The satisfaction and challenges faced by users underscore the importance of a user-centric approach that focuses on holistic well-being, user engagement, personalized content, and technical stability. This study also contributes to the broader literature by utilizing IS success model as a framework for interpreting user satisfaction. Conclusions. Higher levels of usability, acceptability, and satisfaction in the NEVERMIND system may contribute to improving the mental health outcomes of patients with breast and prostate cancer, both independently from each other, and even more so when high levels of engagement, acceptance, use, and satisfaction coexist. They emphasize the importance of perceived usefulness, initial engagement, and user-centric design in different components of the NEVERMIND system and confirms the multidimensionality of successful digital health tools implementation. Moreover, the notable differences in usability and preference between genders indicate that tailored and personalized strategies might serve as effective means to address diverse user needs. Taken together, these insights strengthen scientific evidence for healthcare experts and digital health innovators and developers, guiding them towards creating and designing digital health tools through user-centric and multi-domain approaches

Using Mobile Apps to Support the Implementation of Coping-relevant Behaviour Change Techniques for Self-management of Stress

Mobile apps have shown potential in early stress self-management interventions, yet they remain less beneficial than face-to-face therapies. One of the most effective ways people can cope with stress is to identify what their stressors are and take action in managing them. Coping-relevant behaviour change techniques (BCTs), such as self-monitoring, goal setting, and action planning, have the potential to support this process. Nevertheless, there is little guidance on how to incorporate such techniques into stress management apps. Drawing on mixed methods research, this thesis provides two contributions. First, it improves our understanding of how existing stress management apps support coping-relevant BCTs and suggests areas for improvements. An app functionality review and follow-up 3-week intervention using Welltory stress monitoring and Coach.me goal setting apps revealed that existing apps do not support users’ efforts with coping-relevant BCTs. Participants reported that Welltory did not yield sufficient data to gain insights into the factors affecting their stress. Relatedly, the way in which these apps implemented coping-relevant BCTs diminished peoples’ sense of autonomy and competence. Drawing on peoples’ experiences with existing apps and principles of positive computing, the second contribution of this thesis is the design and evaluation of Reffy - a chatbot prototype that integrates coping-relevant BCTs in a way that meets people’s stress management needs. Based on findings from a field evaluation study, we identify specific benefits and challenges of using a stress self-management chatbot. We find that chatbot-based reflective questioning helps people identify how factors impact their stress during early stages of self-tracking. Likewise, adding features that promote users’ sense of autonomy and competence improves Welltory’s ability to support coping strategies. This thesis advances our understanding of how behaviour change and stress coping techniques can be incorporated into mobile apps to effectively support stress self-management