Evaluating Patient Engagement and User Experience of a Positive Technology Intervention: The H-CIM Case

The present chapter will provide an example of an intervention evaluation from the joint viewpoints of patient engagement and user experience. The authors evaluated H-CIM, a technological platform for the intelligent monitoring of physiological data of elderly patients performing physiotherapy exercises. Descriptive quantitative measures, behavioral observation, and qualitative interviews are integrated to evaluate H-CIM ability in (1) guaranteeing a positive experience to its users and (2) supporting them in advancing through a patient engagement development. This contribution would constitute a practical example of how these fundamental factors should be considered and evaluated when implementing positive technology for healthcare

Sequential simulation (SqS) of clinical pathways: a tool for public and patient engagement in point-of-care diagnostics

Objectives: Public and patient engagement (PPE) is fundamental to healthcare research. To facilitate effective engagement in novel point-of-care tests (POCTs), the test and downstream consequences of the result need to be considered. Sequential simulation (SqS) is a tool to represent patient journeys and the effects of intervention at each and subsequent stages. This case study presents a process evaluation of SqS as a tool for PPE in the development of a volatile organic compound-based breath test POCT for the diagnosis of oesophagogastric (OG) cancer. Setting: Three 3-hour workshops in central London. Participants: 38 members of public attended a workshop, 26 (68%) had no prior experience of the OG cancer diagnostic pathway. Interventions: Clinical pathway SqS was developed from a storyboard of a patient, played by an actor, noticing symptoms of oesophageal cancer and following a typical diagnostic pathway. The proposed breath testing strategy was then introduced and incorporated into a second SqS to demonstrate pathway impact. Facilitated group discussions followed each SqS. Primary and secondary outcome measures: Evaluation was conducted through pre-event and postevent questionnaires, field notes and analysis of audiovisual recordings. Results: 38 participants attended a workshop. All participants agreed they were able to contribute to discussions and like the idea of an OG cancer breath test. Five themes emerged related to the proposed new breath test including awareness of OG cancer, barriers to testing and diagnosis, design of new test device, new clinical pathway and placement of test device. 3 themes emerged related to the use of SqS: participatory engagement, simulation and empathetic engagement, and why participants attended. Conclusions: SqS facilitated a shared immersive experience for participants and researchers that led to the coconstruction of knowledge that will guide future research activities and be of value to stakeholders concerned with the invention and adoption of POCT

Managing chronic pathologies with a stepped mHealth-based approach in clinical psychology and medicine

Chronic diseases and conditions typically require long-term monitoring and treatment protocols both in traditional settings and in out-patient frameworks. The economic burden of chronic conditions is a key challenge and new and mobile technologies could offer good solutions. mHealth could be considered an evolution of eHealth and could be defined as the practice of medicine and public health supported by mobile communication devices. mHealth approach could overcome limitations linked with the traditional, restricted, and highly expensive in-patient treatment of many chronic pathologies. Possible applications include stepped mHealth approach, where patients can be monitored and treated in their everyday contexts. Unfortunately, many barriers for the spread of mHealth are still present. Due the significant impact of psychosocial factors on disease evolution, psychotherapies have to be included into the chronic disease protocols. Existing psychological theories of health behavior change have to be adapted to the new technological contexts and requirements. In conclusion, clinical psychology and medicine have to face the "chronic care management" challenge in both traditional and mHealth settings

A mixed methods study to explore the effects of program design elements and participant characteristics on parents' engagement with an mHealth program to promote healthy infant feeding: The growing healthy program

Copyright © 2019 Taki, Russell, Lymer, Laws, Campbell, Appleton, Ong and Denney-Wilson. Purpose: Mobile health (mHealth) interventions have great potential to promote health. To increase consumer engagement in mHealth interventions it is necessary to address factors that influence the target demographic. The Growing healthy (GH) program is the first obesity prevention program delivered via a smartphone app and website offering evidence-based information on infant feeding from birth until 9 months of age. This sub-study aimed to explore how the design features, quality of the app and participant characteristics influenced parents' engagement with the GH app. Methods: A sequential mixed methods design was used. The GH app participants (225/301) were considered for this sub-study. Participant app engagement was measured through a purpose-built Engagement Index (EI) using app metrics. Participants were categorized as low, moderately or highly engaged based on their EI score upon completing the 9 months program and were then invited to participate in semi-structured telephone interviews. Participants who used the app program, given an EI score and expressed interest to participate in these interviews were eligible. The interviews explored factors that influenced app engagement including delivery features and quality. Thematic analysis networks was used for analysis. Results: 108/225 expressed interest and 18 interviews were conducted from low (n = 3), moderately (n = 7), or highly (n = 8) engaged participants based on purposeful sampling. Participants defined as highly engaged were likely to be a first-time parent, felt the app content to be trustworthy and the app design facilitated easy navigation and regularly opened the push notifications. Participants defined as having low or moderate engagement were likely to have experience from previous children, felt they had sufficient knowledge on infant feeding and the app did not provide further information, or experienced technological issues including app dysfunction due to system upgrades. Conclusions/Implications: This study demonstrated a novel approach to comprehensively analyse engagement in an mHealth intervention through quantitative (Engagement Index) and qualitative (interviews) methods. It provides an insight on maximizing data collected from these programs for measuring effectiveness and to understand users of various engagement levels interaction with program features. Measuring this can determine efficacy and refine programs to meet user requirements

Measuring patient activation in Italy: Translation, adaptation and validation of the Italian version of the patient activation measure 13

Background: The Patient Activation Measure (PAM13) is an instrument that assesses patient knowledge, skills, and confidence for disease self-management. This cross-sectional study was aimed to validate a culturally-adapted Italian Patient Activation Measure (PAM13-I) for patients with chronic conditions. Methods: 519 chronic patients were involved in the Italian validation study and responded to PAM13-I. The PAM 13 was translated into Italian by a standardized forward-backward translation. Data quality was assessed by mean, median, item response, missing values, floor and ceiling effects, internal consistency (Cronbach's alpha and average inter-item correlation), item-rest correlations. Rasch Model and differential item functioning assessed scale properties. Results: Mean PAM13-I score was 66.2. Rasch analysis showed that the PAM13-I is a good measure of patient activation. The level of internal consistency was good (a\u3b1 = 0.88). For all items, the distribution of answers was left-skewed, with a small floor effect (range 1.7-4.5 %) and a moderate ceiling effect (range 27.6-55.0 %). The Italian version formed a unidimensional, probabilistic Guttman-like scale explaining 41 % of the variance. Conclusion: The PAM13-I has been demonstrated to be a valid and reliable measure of patient activation and the present study suggests its applicability to the Italian-speaking chronic patient population. The measure has good psychometric properties and appears to be consistent with the developmental nature of the patient activation phenomenon, although it presents a different ranking order of the items comparing to the American versio

Pozitivna tehnologija

Pozitivna psihologija je znanstvena disciplina unutar psihologije koja je usmjerena na činitelje potrebne za postizanje optimalnog djelovanja i razvoja pojedinca i zajednice. Nastala je kao pobuna protiv područja djelovanja prethodnih razdoblja unutar psihologije koja su uglavnom bila usmjerena na neugodne i patološke činitelje ljudskog djelovanja i doživljavanja. Sukladno razvoju tehnologije, pojavila se potreba za razvojem područja unutar psihologije koje će se baviti proučavanjem psiholoških fenomena nastalih kao rezultat interakcije djelovanja čovjeka i tehnologije. Takvo područje rada se naziva kibernetička psihologija, a obuhvaća širok raspon interesa (npr. internetska psihologija, virtualna stvarnost, umjetna inteligencija, amplifikacija inteligencije i drugo). Kibernetička psihologija ima brojna usmjerenja, no ovdje ćemo se osvrnuti samo na dva, i to na terapiju u digitalnom okruženju i pozitivnu tehnologiju. Oba usmjerenja u nekoj mjeri koriste iste metode, ali razlikuju se s obzirom na aspekte ljudskog djelovanja kojima su posvećeni. Za razliku od terapije u digitalnom okruženju, koja je usmjerena na rješavanje ili smanjivanje postojećih problema (npr. rad s pacijentima u psihijatrijskoj bolnici), pozitivna tehnologija je kao i pozitivna psihologija, usmjerena na poticanje, razvijanje i rast određenih aspekata ljudskog djelovanja, ali uz pomoć tehnologije. Postoje tri područja unutar pozitivne tehnologije koja se razlikuju s obzirom na različite interese ljudskog djelovanja i doživljavanja koja proučavaju, a to su: hedonističko, eudemonistično, te društveno i interpersonalno područje

Mental health clinicians��� motivation and awareness of key considerations as predictors of online therapy uses and applications

A thesis submitted in partial fulfilment of the requirements of the University of Wolverhampton, for the award of Professional Doctorate Counselling Psychology (PsychD).Despite their well-documented effectiveness, online psychological interventions seem to be underperforming with the latest evidence revealing high client dropout rates. The literature indicates that online client engagement tends to improve through a sound online therapeutic alliance and interventions that are credible, reliable and of high-quality. There is little research, however, as to the specific clinician-related factors that might predict the adoption of online therapy practices and interventions that map onto the above online therapy qualities. To address this gap in the literature, the current thesis assesses statistically, whether online practicing clinicians��� awareness of key considerations in online therapy (AKCOT) and motivations are linked to the adoption of associated (outcome) online therapy uses and applications (OOTUA). It was hypothesised that clinicians��� AKCOT and motivations would predict OOTUA. Two studies were employed to this effect. Study one (n= 19, UK-based participants) developed a series of purpose-built scales measuring AKCOT and OOTUA. It also evaluated pre-existing motivational scales such as intrinsic, extrinsic motivation, perceived competence (in forming an online therapeutic alliance) and attributional style towards mental health stigma, ascertaining their usefulness in the context of the current project. Study two adopted a multiple regression analysis design where a total of 174 (138 UK-based and 36 America-based) online practicing clinicians completed an online survey. The factors of AKCOT were measured by the purpose-built scales developed in study one, assessing awareness of key consideration in online disinhibition theory, online therapy ethical considerations and training requirements. The corresponding OOTUA factors were measured on self-report scales capturing associated (to the AKCOT) online therapy applications. The motivational constructs were measured using an intrinsic motivation inventory, general causality-controlled orientation and perceived competence scales. The main findings showed that the AKCOT predictors consistently accounted for approximately 30% and the motivation predictors for approximately 10-20% of the variance in OOTUA. Discussion of the findings considers theoretical and practical implications at the professional regulatory and training level. It is proposed that professional psychological bodies update their regulations around online therapy, and counselling and psychotherapy training courses ensure that trainees are familiarised with online therapy theoretical and practical key considerations as part of their core qualifying training