A serious game for COPD patients to perform physiotherapeutic exercises

The goal of this research was 1) to investigate the usability of the Orange Submarine game, and 2) to explore the changes in saturation and pulse rate in COPD patients while playing the game. The game was positively received by the patients and could provide a new fun way for performing exercises, either at home or as part of the regular treatment

Telemedicine provides new treatment possibilities in COPD care

Chronic Obstructive Pulmonary Disease (COPD) is a chronic, progressive lung disease. COPD has a high impact on quality of life, large social consequences, a progressive course and it cannot be cured. Physiotherapy, increasing physical participation in daily activities, and early detection and treatment of exacerbations are important elements in current COPD disease management. Home-exercise programmes and self-management of exacerbations are effective new treatment methods. When these programmes are offered as a telemedicine application, they could contribute to a reduction in labour and costs. This paper describes a number of telemedicine applications designed for implementation in COPD care: 1) remote monitoring of physical activity and symptoms; 2) coaching and feedback in daily life to gain an active lifestyle; 3) a web portal for online exercising, self-management of exacerbations and communication between professionals and patient and; 4) serious gaming. For each application we share the motivation, design, and (future) evaluations with the target group: COPD patients. The designed applications are in general positively received by patients and professionals and seem to be able to improve the patient’s well-being. Further development and further scaling of these technologies in everyday care would be an important next step

A Framework for Stakeholder Involvement in eHealth Action Research

The involvement of stakeholder groups, like patients or healthcare professionals, is highly valued in eHealth Action Research (AR) projects because it ensures a match between the project outcomes and the needs of the target group. However, few best practices or advices are available and no overview exists that describes the process of active involvement of stakeholders in the context of eHealth. Therefore, this paper presents the development of a framework for active stakeholder involvement in eHealth AR. The framework was developed based on several studies on stakeholder involvement in a project, as well as existing literature. To evaluate the framework, interviews were conducted with eight participants, who were either experts from the field or researchers currently working in practice in eHealth AR projects. Based on the suggestions made during the interviews, the framework was adjusted. The final version of the framework consists of 9 sections with a total of 56 questions, as well as material for additional reading. This framework can help researchers, especially those who are relatively new to AR and stakeholder involvement, shape their research process. A next step would be to further investigate how to operationalise the framework, for example in project meetings with stakeholders, and then, evaluate the framework in practice by implementation into an AR project from start to finish.</p

AIRplay:promoting physical activity among children with asthma through gamified environments

BACKGROUND: Asthma is the most common chronic lung disease in childhood. The large majority (70-90%) of asthmatic children is affected by exercise-induced asthma which deters children from participating in regular physical activity or leads to dropping out of play and sports. Children with asthma should be encouraged to exercise, as physical activity improves asthma symptoms and lung function.OBJECTIVE: To improve self-management of asthma in children (7-9 years old) by means of smart sensing and coaching incorporated in a mobile gaming environment in daily life.METHODS: An interactive playground resembling the known Tag game is installed at school and one class of students is invited to participate. The installation combines floor-projections with tracking and real-time analysis of the movement of the players [1]. Although AIRplay is initially conceptualized targeting children with asthma, all children in the classroom are invited to participate. The game was adapted to require mandatory breaks to all children and in this way, give time to children with asthma to take their medication. Additionally, all children receive a Fitbit Zip and an Android application. A personal physical activity goal is set based on one week of baseline measurement. In the application, the children can see their progress and of their friends towards the physical activity goal, as well as interact with each other. Finally, children with asthma receive tips on how to improve the self-management of asthma.RESULTS: The interactive playground was tested with enthusiasm by children aged 6 to 12 years old. Evaluations in the school environment will take place in April and May 2017.CONCLUSION: The AIRplay system is designed to promote physical activity by engaging children in a fun and exciting game, setting personalized physical activity goals based on the individual physical condition, and promoting a fair competition among children with and without asthma.<br/

Relating physical activity, pleasure, and daily satisfaction of older adults: a pilot study

Backround:\ud Literature has shown the potential of physical exercise in promoting well-being in the older population. However, the relation between everyday physical activity (PA) and positive emotions is still unknown.\ud \ud Objective:\ud Analyze the relation between physical activity and positive emotions in the daily living of the 65+ population.\ud \ud Methods:\ud • 5 participants (67.4±2.19 yrs) monitored during 29±3 days\ud • Objective measurements: PA assessed with 3D accelerometer counting average IMA/min\ud • Subjective measurements: Positive emotional factors (pleasure and daily satisfaction) assessed on smartphone (Figure 1). Pleasure assessed by experience sampling (ES).\ud \ud Results:\ud • ES-level analysis: negative correlation between pleasure and PA (rsall_sub=-.102*). Correlation within subject ranges from rsmax=.038 to rsmin-0.235*. (Fig. 2). Significant negative correlation between PA and hour of day (rsall_sub=-.215*; rsmax=-0.135; -0.345*) (Fig. 3);\ud • Day-level analysis: average PA is not significantly related to pleasure or daily satisfaction.\ud \ud Conclusion:\ud Daily level of PA is not correlated with the two positive emotional factors chosen in our sample. We suggest analyze of other elements of daily living (e.g. location) as mediators when analyzing relation between PA and positive emotions within individuals. Interventions for promotion of physical activity based on positive emotions must be personalized

Embodied Conversational Agents in eHealth:How Facial and Textual Expressions of Positive and Neutral Emotions Influence Perceptions of Mutual Understanding

Embodied conversational agents (ECAs) could engage users in eHealth by building mutual understanding (i.e. rapport) via emotional expressions. We compared an ECA’s emotions expressed in text with an ECA’s emotions in facial expressions on users’ perceptions of rapport. We used a 2×2 design, combining a happy or neutral facial expression with a happy or neutral textual expression. Sixty-three participants (mean, 48±22 years) had a dialogue with an ECA on healthy living and rated multiple rapport items. Results show that participants’ perceived rapport for an ECA with a happy facial expression and neutral textual expression and an ECA with a neutral facial expression and happy textual expression was significantly higher than the neutral value of the rapport scale (⁠P=0.049 and P=0.008⁠, respectively). Furthermore, results show no significant difference in overall rapport between the conditions (⁠P=0.062⁠), but a happy textual expression for an ECA with a neutral facial expression shows higher ratings of the individual rapport items helpfulness (⁠P=0.019⁠) and enjoyableness (⁠P=0.028⁠). Future research should investigate users’ rapport towards an ECA with different emotions in long-term interaction and how a user’s age and personality and an ECA’s animations affect rapport building. Optimizing rapport building between a user and an ECA could contribute to achieving long-term interaction with eHealth

Shifting Responsibilities:Developing a Pan-European Service Model for an eHealth Technology Supporting Self-Management of People with Chronic Obstructive Pulmonary Disease and Comorbidities

Introduction: Active participation of patients in their care via self-management is an important pillar to manage chronic conditions. Self-management education and continuous support are needed to improve patients’ confidence to take such active role. One way to do this is through eHealth technologies. However, those technologies can only be successful when actively used in daily practice and when integrated in overall care. Therefore, this study investigated how a self-management eHealth technology could be implemented that emphasises the active role of patients in their care. Methods: The service modelling method was utilized as implementation strategy. The design process consisted of five phases with salient stakeholders and consortium members of a European project to develop the service model. Studies with salient stakeholders were carried out in three different countries (Italy, Estonia, the Netherlands). A combination between face-to-face and online methods facilitated the participatory design process. Results: Due to the pan-European context, different stakeholders in the three countries were identified. Research nurses and case managers were not yet established in practice but once implemented, expected to contribute to optimal implementation. During service modelling, a crucial step was revealed: providing self-management training before technology use to let patient familiarise with the concept of taking an active role. As HCPs felt that they were not necessarily equipped to guide patients in terms of self-management, they also should have access to such self-management training. Conclusion: By demonstrating a way for implementation while emphasising patients’ active role, we also showed the complexity of the method in two ways. First, by demonstrating the fine line between the descriptive and prescriptive model. Thus, showcasing the need to recognize that prescriptive models may be hampered by the delay in changing work practices. Second, by highlighting the importance of identifying country-specific differences in the pan-European context, revealing that service modelling is not a one-size-fits-all approach.</p

Increasing motivation in eHealth through gamification

ICT solutions can help to alleviate the increasing demand for elderly care by e.g. enabling medical professionals to remotely provide care, and activating a healthier lifestyle which extends autonomy and independence of elderly [1].\ud We present an overview providing insights in current motivational approaches, addressing underlying theory from psychology, behavioural science and game design. In order to create sustained engagement, we should aim to address the intrinsic motivation of users and satisfy their psychological needs [6]. However, psychological and motivational aspects cannot be generically applied to individuals, and classifications of the user and its preferences are needed. Preliminary results indicate a link between personality and the preference for certain game elements

Quick, but Not Dirty:The Usefulness of Flash Mob Studies as a Method for Action Research in eHealth

Action research (AR) is a participatory research approach that works in iterative cycles that are conducted in practice. However, some cycles of AR can take a long time, slowing down the speed of iterations. Therefore, in this study we investigate the use of a relatively new method for AR: the flash mob. Flash mob studies lend themselves to spontaneous, unplanned participation, by collecting large amounts of data in a short time, while also analyzing and reporting quickly on findings. To investigate the applicability of the flash mob as a method for AR in eHealth projects, we conducted three flash mob studies in two research projects and drew recommendations based on observations, reflections and short pre- and post-surveys. Outcomes show that the flash mob is a potential method for AR, as it is situated in a practical setting where stakeholders can easily be involved, and its pace could speed up the AR cycles. To further improve the applicability for AR, our main recommendations include: promoting the flash mob adequately to increase participation and improve the involvement of ‘champions’; tracking interactions outside the flash mob (e.g., comments and questions from bystanders); and choosing an accessible and visible location, taking into account the activities associated with the location