The Value of Tracking Data on the Behavior of Patients Who Have Undergone Bariatric Surgery:Explorative Study

Background: To maintain the benefits of a bariatric procedure, patients have to change their lifestyle permanently. This happens within a context of coresponsibilities of health care professionals and their social support system. However, most interventions are focused on the patient as an individual. In this explorative pilot study, behavioral, contextual, and experiential data were gathered to obtain insight on coresponsibility. Objective: The aim of this study is to explore the use of trackers by patients who have undergone bariatric surgery in a data-enabled design approach. Methods: Behavioral and contextual data on the households of patients who have undergone bariatric surgery were explored using a smartphone with an interactive user interface (UI), weight scale, activity bracelet, smart socket, accelerometer motion sensor, and event button to find examples of opportunities for future interventions. Results: A total of 6 households were monitored. Approximately 483,000 data points were collected, and the participants engaged in 1483 conversations with the system. Examples were found using different combinations of data types, which provided the obesity team a better understanding of patient behaviors and their support system, such as a referral to a family coach instead of a dietician. Another finding regarding the partners was, for example, that the conversational UI system facilitated discussion about the support structure by asking for awareness. Conclusions: An intelligent system using a combination of quantitative data gathered by data tracking products in the home environment and qualitative data gathered by app-enhanced short conversations, as well as face-to-face interviews, is useful for an improved understanding of coresponsibilities in the households of patients who have undergone bariatric surgery. The examples found in this explorative study so far encourage research in this field.</p

The Value of Tracking Data on the Behavior of Patients Who Have Undergone Bariatric Surgery:Explorative Study

Background: To maintain the benefits of a bariatric procedure, patients have to change their lifestyle permanently. This happens within a context of coresponsibilities of health care professionals and their social support system. However, most interventions are focused on the patient as an individual. In this explorative pilot study, behavioral, contextual, and experiential data were gathered to obtain insight on coresponsibility. Objective: The aim of this study is to explore the use of trackers by patients who have undergone bariatric surgery in a data-enabled design approach. Methods: Behavioral and contextual data on the households of patients who have undergone bariatric surgery were explored using a smartphone with an interactive user interface (UI), weight scale, activity bracelet, smart socket, accelerometer motion sensor, and event button to find examples of opportunities for future interventions. Results: A total of 6 households were monitored. Approximately 483,000 data points were collected, and the participants engaged in 1483 conversations with the system. Examples were found using different combinations of data types, which provided the obesity team a better understanding of patient behaviors and their support system, such as a referral to a family coach instead of a dietician. Another finding regarding the partners was, for example, that the conversational UI system facilitated discussion about the support structure by asking for awareness. Conclusions: An intelligent system using a combination of quantitative data gathered by data tracking products in the home environment and qualitative data gathered by app-enhanced short conversations, as well as face-to-face interviews, is useful for an improved understanding of coresponsibilities in the households of patients who have undergone bariatric surgery. The examples found in this explorative study so far encourage research in this field.</p

Careful Curation of Care Content:A Case Study of a Technology-Supported Atrial Fibrillation Outpatient Clinic

Medical care received outside the doctor’s office and the hospital is gaining traction. Lifestyle programs for transmural and remote care are increasingly facilitated by hospitals as part of rehabilitation, by general practitioners as preventative measures, and by various private (health) organizations through consumer apps. What is often overlooked is the time and energy spent on creating the content (i.e., health information and education) in these programs so that it is effective, appealing, relatable, and personalized. In this article, we discuss the elaborate content creation process of lifestyle content for an outpatient clinic for atrial fibrillation patients. We describe the close collaboration between clinicians, design researchers, data designers, and a copywriter, and reflect on how to streamline and formalize the clinical content creation process. Additionally, we highlight opportunities for further content personalization by making it dynamic, more versatile in terms of delivery and expanding the system further into the home context

Supporting bariatric surgery patients in their aftercare journey: a playful technological intervention “Truth-or-Dare?"

Background The amount of people coping with obesity keeps on increasing. While the physical comorbidities are clearly visible, mental issues such as a low self-image are just as damaging. Bariatric surgery is currently the most effective treatment with long-term results [2, 3]. Its effectiveness is however often expressed in postoperative weight loss, leaving the impact on psychological health aside [3]. Methods To support bariatric patients in the aftercare pathway, we designed Truth-or-Dare. Combining a physical artefact and a mobile app, Truth-or-Dare is a playful way to track patients' mental state, using challenges to help them to establish a better self-image and a physical exercise routine. The frame attracts attention by dropping magnetic wooden blocks, indicating it is time to play! The app displays a personalized exercise or reflection challenge. By placing the block back on one side of the frame the choice is made: truth or dare? The Truth-or-Dare frame and app have been used by a former bariatric patient for two weeks. Every 6-12 hours a block fell out of the frame. We conducted two semistructured interviews, the first focused on the experience and initial thoughts about the product, the second informed by the data gathered. During the deployment, we also implemented a feedback loop to collect participants’ experiences with the challenges, allowing to understand which strategy was the most effective for a patient and to iterate on them. Findings The challenges were positively perceived by the participant and helped her to become more aware of her behavior and mindset. While she enjoyed taking her time to perform each challenge, she felt pressed and rushed by the too short interval between challenges. She often rated the challenges as unpleasant, complicated or annoying, yet motivating. If a challenge is annoying, it does not mean it is not motivating. “If I would not want challenges like that, I would ignore my problems.” We observed a pattern of switching between truth and dare challenges, mainly triggered by the physical properties of the board. Discussion Playful Truth-or-Dare challenges implemented in a physical artefact and a related app are a new intervention approach for mental wellbeing after bariatric surgery. It shows potential in raising awareness amongst patients around their behaviors and motivating them throughout their journey. As the product is placed in a shared environment, family members are encouraged to join, which has a positive influence on both the patient and partner [1]. The design of the physical product uses friction as a motivational mechanism: (a) a block on the ground calls for action. Will the patient remove it without performing a challenge or engage with the game? (b) placing the block back, one can choose Truth or Dare. Yet, the board is designed to prevent one type of challenge to be chosen too often. These moments of friction act as triggers to step outside the comfort zone. Further research is necessary to refine the challenges, or even personalize them, and to investigate the longterm effect of Truth-or-Dare on patients’ mental wellbeing and self-image

The Value of Tracking Data on the Behavior of Patients Who Have Undergone Bariatric Surgery: Explorative Study

BackgroundTo maintain the benefits of a bariatric procedure, patients have to change their lifestyle permanently. This happens within a context of coresponsibilities of health care professionals and their social support system. However, most interventions are focused on the patient as an individual. In this explorative pilot study, behavioral, contextual, and experiential data were gathered to obtain insight on coresponsibility. ObjectiveThe aim of this study is to explore the use of trackers by patients who have undergone bariatric surgery in a data-enabled design approach. MethodsBehavioral and contextual data on the households of patients who have undergone bariatric surgery were explored using a smartphone with an interactive user interface (UI), weight scale, activity bracelet, smart socket, accelerometer motion sensor, and event button to find examples of opportunities for future interventions. ResultsA total of 6 households were monitored. Approximately 483,000 data points were collected, and the participants engaged in 1483 conversations with the system. Examples were found using different combinations of data types, which provided the obesity team a better understanding of patient behaviors and their support system, such as a referral to a family coach instead of a dietician. Another finding regarding the partners was, for example, that the conversational UI system facilitated discussion about the support structure by asking for awareness. ConclusionsAn intelligent system using a combination of quantitative data gathered by data tracking products in the home environment and qualitative data gathered by app-enhanced short conversations, as well as face-to-face interviews, is useful for an improved understanding of coresponsibilities in the households of patients who have undergone bariatric surgery. The examples found in this explorative study so far encourage research in this field

Improving outcomes of AF ablation by integrated personalized lifestyle interventions: rationale and design of the prevention to improve outcomes of PVI (POP) trial

Progression of atrial fibrillation (AF) and outcomes of ablation therapy are strongly affected by modifiable risk factors. Although previous studies show beneficial effects of modifying single risk factors, there is lack of evidence from randomized controlled trials on the effects of integrated AF lifestyle programmes. The POP trial is designed to evaluate the clinical outcomes of a dedicated nurse-led AF lifestyle outpatient clinic in patients with symptomatic AF. This study is a prospective, 1:1 randomized, single centre, investigator-initiated clinical trial in 150 patients with paroxysmal or persistent AF referred for a first pulmonary vein isolation (PVI). Prior to the ablation, patients in the intervention group receive a personalized risk factor treatment programme in a specialized, protocolized, nurse-led outpatient clinic. Patient education and durable lifestyle management is promoted with an e-health platform. Patients in the control group receive standard care by cardiologists before ablation. The primary endpoint is the number of hospitalizations for re-ablation and cardioversion, with a follow-up of 12 months after ablation. Secondary endpoints include mortality, number of acute ischemic events, stroke or hospitalizations for heart failure, quality of life, number of ablations cancelled because of symptom reduction, and ablation success rate at 12 months. Determinants of patient and staff experience are explored and a cost-effectiveness analysis is included. The POP trial will help ascertain the efficacy and cost-effectiveness of an integrated technology-supported lifestyle therapy in patients with symptomatic AF. The trial is funded by the Netherlands Organisation for Health Research and Development [10070012010001]. Home sleep apnoea testing devices were provided by Itamar Medical, Ltd. ClinicalTrials.gov Identifier NCT05148338. Graphical abstract: [Figure not available: see fulltext.] AF atrial fibrillation, OSA obstructive sleep apnoea, PFA pulsed field ablation, PVI pulmonary vein isolation