Uptake and Effects of the e-Vita Personal Health Record with Self-Management Support and Coaching, for Type 2 Diabetes Patients Treated in Primary Care

We studied the use, uptake, and effects of e-Vita, a personal health record, with self-management support and personalized asynchronized coaching, for type 2 diabetes patients treated in primary care. Patients were invited by their practice nurse to join the study aimed at testing use and effects of a personal health record. Patients were followed up for 6 months. Uptake and usage were monitored using log data. Outcomes were self-reported diabetes self-care, diabetes-related distress, and emotional wellbeing. Patients’ health status was collected from their medical chart. 132 patients agreed to participate in the study of which less than half (46.1%) did not return to the personal health record after 1st login. Only 5 patients used the self-management support program within the personal health record, 3 of whom asked a coach for feedback. Low use of the personal health record was registered. No statistical significant differences on any of the outcome measures were found between baseline and 6 month follow-up. This study showed minimal impact of implementing a personal health record including self-management support in primary diabetes care. Successful adoption of web-based platforms, as ongoing patient centered care, is hard to achieve without additional strategies aimed at enhancing patient motivation and engaging professionals

How to improve eHealth interventions in Health Psychology and Behavioral Medicine

Introduction: eHealth is gaining more and more ground in health psychology and behavioural medicine to support wellbeing, a healthier lifestyle or adherence to medications. Despite the large number of eHealth projects to date, the actual use of eHealth interventions is lower than expected. Many projects in Health fail to survive beyond the pilot phase and studies that investigate the effectiveness of eHealth applications most often do not show long-term effects. The ongoing concern in academic literature about these shortcomings situates eHealth as an immature research domain not capable to follow the golden standards of high quality research in health psychology and behavioral medicine. On the other side, in lifestyle or mental health interventions positive results with internet-based interventions can be observed and patients favor internet interventions. Therefore, we will discuss how to make eHealth interventions more enjoyable, feasible, and cost-effective. Objectives: In this workshop we demonstrate how eHealth interventions can be improved, using technology as a driver for adherence and behavior change. In our workshop we introduce a new approach to guide the development of eHealth interventions. The approach is based on an integration of theories form behavioural sciences and persuasive technology. The purpose of the workshop is first, to provide new opportunities to develop eHealth interventions that are user centred and that are implementable in practice, second to discuss an agenda for future research in eHealth for health psychology and behavioral medicine-interventions. Learning outcomes are insight in how to use technology to develop eHealth interventions that work, help and are cost effective, and knowledge about how to evaluate the effects of eHealth interventions on adherence and outcomes. Workshop activities: The workshop starts with a demonstration of examples of eHealth interventions to support self-care and safe-care. Interventions we focus on are blended therapy for depression, selfmanagement applications to support patients with chronic diseases, and applications to support medical professionals to increase safety at work. The examples will be discussed alongside the new approach for development and implementation to improve eHealth interventions. Persuasive Technology will be highlighted as a strategy to increase the adherence to eHealth interventions. The effects of persuasive technology on adherence and its’ consequences for design will be discussed with participants. Participants will evaluate the persuasiveness and user friendliness of eHealth interventions using the eHealthwiki.org (toolkit) and a persuasive model for system and content design. Finally, the workshop synthesizes views on innovative research methods to improve the uptake and impact of eHealth interventions. For the workshop we use our book, Improving eHealth(www.elevenpub.com