Persuasive system design does matter: a systematic review of adherence to web-based interventions

Background: Although web-based interventions for promoting health and health-related behavior can be effective, poor adherence is a common issue that needs to be addressed. Technology as a means to communicate the content in web-based interventions has been neglected in research. Indeed, technology is often seen as a black-box, a mere tool that has no effect or value and serves only as a vehicle to deliver intervention content. In this paper we examine technology from a holistic perspective. We see it as a vital and inseparable aspect of web-based interventions to help explain and understand adherence. Objective: This study aims to review the literature on web-based health interventions to investigate whether intervention characteristics and persuasive design affect adherence to a web-based intervention. Methods: We conducted a systematic review of studies into web-based health interventions. Per intervention, intervention characteristics, persuasive technology elements and adherence were coded. We performed a multiple regression analysis to investigate whether these variables could predict adherence. Results: We included 101 articles on 83 interventions. The typical web-based intervention is meant to be used once a week, is modular in set-up, is updated once a week, lasts for 10 weeks, includes interaction with the system and a counselor and peers on the web, includes some persuasive technology elements, and about 50% of the participants adhere to the intervention. Regarding persuasive technology, we see that primary task support elements are most commonly employed (mean 2.9 out of a possible 7.0). Dialogue support and social support are less commonly employed (mean 1.5 and 1.2 out of a possible 7.0, respectively). When comparing the interventions of the different health care areas, we find significant differences in intended usage (p = .004), setup (p < .001), updates (p < .001), frequency of interaction with a counselor (p < .001), the system (p = .003) and peers (p = .017), duration (F = 6.068, p = .004), adherence (F = 4.833, p = .010) and the number of primary task support elements (F = 5.631, p = .005). Our final regression model explained 55% of the variance in adherence. In this model, a RCT study as opposed to an observational study, increased interaction with a counselor, more frequent intended usage, more frequent updates and more extensive employment of dialogue support significantly predicted better adherence. Conclusions: Using intervention characteristics and persuasive technology elements, a substantial amount of variance in adherence can be explained. Although there are differences between health care areas on intervention characteristics, health care area per se does not predict adherence. Rather, the differences in technology and interaction predict adherence. The results of this study can be used to make an informed decision about how to design a web-based intervention to which patients are more likely to adher

Advances in Teaching & Learning Day Abstracts 2005

Proceedings of the Advances in Teaching & Learning Day Regional Conference held at The University of Texas Health Science Center at Houston in 2005

Game Changer: Investing in Digital Play to Advance Children's Learning and Health

Based on a literature review and interviews with digital learning experts, explores how digital games can foster skills and knowledge for better academic performance and health. Makes recommendations for government research, partnerships, and media

Alcuni abstract di articoli che trattano argomenti relativi all'eHealth

Non utile per esam

The technological growth in eHealth services

The infusion of information communication technology (ICT) into health services is emerging as an active area of research. It has several advantages but perhaps the most important one is providing medical benefits to one and all irrespective of geographic boundaries in a cost effective manner, providing global expertise and holistic services, in a time bound manner. This paper provides a systematic review of technological growth in eHealth services. The present study reviews and analyzes the role of four important technologies, namely, satellite, internet, mobile, and cloud for providing health services.Web of Scienceart. no. 89417

Introduction of a Medical Patient Portal to the Uninsured Patient

abstract: Purpose: The purpose of this evidence-based practice project was to improve participation by increasing registration on to a medical patient portal to an uninsured population. Medical patient portals have the potential to provide patients with timely, transparent access to health care information and engage them in their health care process and management. This may result in improved disease management outcomes. Methods: This project was guided by a The Rosswurm and Larrabee Model for Change to Evidence- Based Practice and Pender’s health promotion framework. IRB Approved by ASU. The instruction was implemented at an urban clinic in downtown phoenix that serves uninsured and underserved individuals. Uninsured participants were recruited (n=50). A survey pre and post registration was conducted to assess knowledge and medical portal participation in addition a random pre and post chart review was performed. Results: Descriptive statistics was used to describe sample and outcome variables. A chi-square test of independence was calculated comparing pre and post intervention significant change was found (χ2 (1) = .002, P<0.05.), a paired sample t test was calculated to compare knowledge pre and post registration instruction the mean pre-10.187(SD = 4.422), post mean was 16.958(SD=.856). A significant increase of knowledge was found (t (47) =-9.573, p (<.001). Outcomes: In this population both patients and providers have seen significant benefits such as increased communication and patient participation, from the implementation of evidence based educational tools such as instruction with teach back, and the usage of brochures. Potential Implication for sustainability includes the lack of a designated individual that is bilingual to register patients, making patients aware of the existence of a medical patient portal, patient’s fear of sharing immigration status

Doctor of Philosophy

dissertationThis dissertation describes a line of research that addresses translational research questions related to the use of computerized simulation to affect the knowledge, beliefs, motivation and self-management behaviors of individuals with chronic disease. The specific research projects focus on type 2 diabetes (T2DM) and physical activity as exemplars of a prevalent chronic disease and an underutilized selfmanagement behavior, respectively. We first describe a conceptual framework for the design of Consumer Health Informatics (CHI) applications. The design of an envisioned diabetes self-management application is described as an example of the application of design principles derived from this framework. Subsequent chapters describe tests of research questions related to this envisioned intervention. The second chapter describes the development and preliminary evaluation of the interface for the intervention described above. The estimation of simulated glucose curves for individuals with T2DM is described. Next, the formative evaluation of a paperbased prototype based on those curves and a novel method to measure individuals' outcome expectations are described. The third chapter describes a randomized experiment of a narrated simulation based on simulated glucose curves. This trial tested the question: can computerized simulations affect the beliefs and behaviors of individuals with T2DM? In this experiment participants' beliefs changed in accordance with the discrepancy between the presented evidence, and their prior beliefs, and in combination with the completion of a planning intervention, which resulted in significantly greater increase in physical activity The fourth chapter describes a test of the question: can predictive models of the acute physiologic effects of behavior be individualized? In this study we compared different predictive modeling techniques and found that a mixed effects modeling approach improves in accuracy as the individual contributes more data. This result is foundational to the development of the next generation of our simulation-based intervention, and has implications for CHI as a field; these are discussed. The dissertation concludes with a review of the strengths and limitations of the work described, a discussion of the implications of this work for consumer health informatics and a brief discussion of the next steps in this line of research

Aging and Technology Perspectives of Web-Based Chronic Disease Self-Management

Many people suffer from chronic disease; however, older adults are at greatest risk of chronic conditions. Although social workers regularly engage with chronically ill older adults, they are not noticeably involved with the research and development of chronic disease management. As such, with recent movements toward health information technology, the efficacy of technology-based chronic disease management is not well established for older adults. Informed by theories of self-management, human development, and technology design, this research investigated lifespan differences of web-based chronic disease self-management. Using a sequential mixed methods design, a secondary data analysis of a diabetes specific web-based self-management intervention (n=462) was performed, followed by qualitative focus groups with 40 older intervention participants, and then mixed for overall interpretation. Results indicated that social workers must take a leadership role in the evaluation and implementation of web-based self-management for older adults to address identified lifespan differences

Speaking Their Language: Integrating Social Media into Childbirth Education Practice

With the advancement of modern technology, the internet has become a standard platform for many forms of communication and education. The majority of pregnant females fall into the cohort known as Millenials and have experienced technology since early in life. Millenials consider technology as part of their everyday life and use it for personal interaction or a source of information. The established comfort with the use of technology combined with busy lifestyles, multiple commitments, transportation costs or logistics, childcare, or a desire for privacy, support the use of perinatal online learning. This article examines options that childbirth educators may consider for integrating social media or other forms of technology into their repertoire