Cruz-Martinez, Roberto Rafael

Gemert-Pijnen, Julia Van

Sanderman, Robbert

Wentzel, Jobke

English

Cardiovascular diseases constitute an alarming crisis for health care worldwide [1, 2]. Technology-based self-management support is proposed as a potential solution [3]. However, little research has been done to understand how these technologies should be designed so that they can effectively support specific self-management goals of patients [4, 5]. This poster presents the preliminary results of a study that aims to explore expert preferences and insights when matching persuasive design strategies with self-management goals and tasks of patients with cardiovascular diseases.</p

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Persuasive 2020, Adjunct proceedings of the 15th International conference on Persuasive  Technology. Copyright © 2020 for this paper by its authors. Use permitted under Creative Commons License Attribution 4.0 International (CC BY 4.0)  Work In Progress: Matching Persuasive Design with Self-Management Needs of Patients with Cardiovascular Diseases – Preliminary Results of A Survey Vignette Experiment Roberto Rafael Cruz-Martínez1()[0000-0001-9308-364X], Jobke Wentzel1,2[0000-0003-3897-4436], Robbert Sanderman1,3[0000-0002-0823-1159], and Julia EWC van Gemert-Pijnen1[0000-0001-6511-7240]   1 Department of Psychology, Health and Technology, Faculty of Behavioural, Management and Social sciences, Technical Medical Centre, University of Twente, Enschede, NL 2 Department of Health and Social studies, Windesheim University of Applied Sciences, Zwolle, NL 3 GZW-Health Psychology–GZW-General, University Medical Center Groningen, University of Groningen, Groningen, NL {r.cruzmartinez, m.j.wentzel, r.sanderman, j.vangemert-pijnen}@utwente.nl 1 Background Cardiovascular diseases constitute an alarming crisis for health care worldwide [1, 2]. Technology-based self-management support is proposed as a potential solution [3]. However, little research has been done to understand how these technologies should be designed so that they can effectively support specific self-management goals of patients [4, 5]. This poster presents the preliminary results of a study that aims to explore expert preferences and insights when matching persuasive design strategies with self-manage-ment goals and tasks of patients with cardiovascular diseases. 2 Methods An online survey vignette experiment was conducted [6]. The experiment consists of a collection of vignettes, which content systematically varies according to different fac-tors and factor levels. The choices of factors and levels for this experiment were in-formed by the Persuasive Design Model from Oinas-Kukkonen et al. [7] and the Middle Range Theory of Self-Care of Chronic Illness from Riegel et al. [8]. The factorial design consisted therefore of 2 factors (persuasive design categories and self-management needs) with 3 levels each (primary task support, dialogue support, social support; self-care maintenance, self-care monitoring, self-care management). In total, 9 vignettes were created with a different combination of factors and levels. In each vignette the self-management need was represented with a video that described the behavioral needs of an individual living with a cardiovascular chronic condition (Figure 1).  2  Fig. 1. Still frames of video representing the case of a patient with self-care maintenance needs On other hand, the persuasive design was represented in each vignette through a mock-up of an interface and the key ingredients of an eHealth intervention (Figure 2). Experts with experience on the topics of self-management, cardiovascular diseases, and eHealth were recruited as participants.  Fig. 2. Example of mock-up representing the design of an eHealth intervention 3 3 Results More than 50 experts have answered the survey so far, up until February 2020. The survey collects quantitative data in the form of ratings about the potential success of persuasive designs (represented by the mock-ups) when matched to specific self-man-agement needs (represented by the case videos). Namely, after presenting each case and the proposed intervention design, participants are asked: “How likely is it that this in-tervention design will successfully support the self-management needs of the case pre-sented?”. Participants can respond via a 5-point Likert scale, ranging from “Extremely unlikely” to “Extremely likely”. The survey also collects qualitative data in the form of perceived barriers for the success of persuasive design strategies when matched with specific self-management needs. In this case, participants are asked: “Under what cir-cumstances would this intervention not work to support the self-management needs of the case presented?”. Participants are prompted to describe as many circumstances as they can think of. Preliminary analyses show that some persuasive design strategies might indeed be perceived by experts to work better than others depending on which specific self-management needs are targeted. Moreover, a wide range of potential bar-riers have also been listed by experts for each case-design match up. 4 Discussion Thoughtful intervention design informed by theoretical models is important for the suc-cess of eHealth. However, a review of eHealth interventions that support self-manage-ment in cardiovascular diseases showed that theoretical models are not always used to guide design [4]. The value of this poster is that it presents a study that directly ad-dresses the challenging topic of how to translate the persuasive design conceptual cat-egories into intervention components that can actually match the behavioral needs and goals of patients living with cardiovascular diseases. It is important to understand which design strategies are proposed to be potentially more effective than others, and why. The present study combines key factors of two models. First, the behavioral needs of patients living with cardiovascular diseases are described in accordance to the Middle Range Theory of Self-Care of Chronic Illness from Riegel et al. [8]. Second, the potential design strategies that can be implemented in eHealth interventions to support self-management are based on categories of the Per-suasive Design Model from Oinas-Kukkonen et al. [7]. There is a fair amount of research about how to tailor the design of eHealth inter-ventions, for example, in cardiovascular diseases [9-11], other chronic conditions [12], or in the field of mental health [13]. However, previous studies did not seek to match the design choices with specific, theory-based, key components of self-management. All in all, the results of this expert-based study will advance our knowledge about which potential paths should be followed when designing and tailoring eHealth interventions to support self-management in cardiovascular diseases. 4 References 1. Roth, G.A., Johnson, C., Abajobir, A., Abd-Allah, F., Abera, S.F., Abyu, G., Ahmed, M., et al.: Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015. J Am Coll Cardiol 70, 1-25 (2017) 2. World Health Organization: Global status report on noncommunicable diseases 2014: attaining the nine global noncommunicable diseases targets; a shared responsability. Global status report on noncommunicable diseases 2014: attaining the nine global noncommunicable diseases targets; a shared responsability, (2014) 3. Riegel, B., Moser, D.K., Buck, H.G., VaughanDickson, V., S, B.D., Lee, C.S., Lennie, T.A., et al.: Self-care for the prevention and management of cardiovascular disease and stroke: A scientific statement for healthcare professionals from the American heart association. J. Am. Heart Assoc. 6, (2017) 4. Cruz-Martínez, R.R., Wentzel, J., Asbjørnsen, R.A., Noort, P.D., van Niekerk, J.M., Sanderman, R., van Gemert-Pijnen, L.: Supporting Self-Management of Cardiovascular Diseases Through Remote Monitoring Technologies: Metaethnography Review of Frameworks, Models, and Theories Used in Research and Development. J. Med. Internet Res. (2019) 5. Cruz-Martínez, R.R., Noort, P.D., Asbjørnsen, R.A., van Niekerk, J.M., Wentzel, J., Sanderman, R., van Gemert-Pijnen, L.: Frameworks, Models, and Theories Used in Electronic Health Research and Development to Support Self-Management of Cardiovascular Diseases Through Remote Monitoring Technologies: Protocol for a Metaethnography Review. JMIR Res Protoc 8, e13334 (2019) 6. Steiner, P.M., Atzmüller, C., Su, D.: Designing Valid and Reliable Vignette Experiments for Survey Research: A Case Study on the Fair Gender Income Gap. 2017 7, 43 (2017) 7. Oinas-Kukkonen, H., Harjumaa, M.: Persuasive systems design: Key issues, process model, and system features. Commun. Assoc. Info. Syst. 24, 28 (2009) 8. Riegel, B., Jaarsma, T., Stromberg, A.: A middle-range theory of self-care of chronic illness. ANS Adv Nurs Sci 35, 194-204 (2012) 9. Haldane, V., Koh, J.J.K., Srivastava, A., Teo, K.W.Q., Tan, Y.G., Cheng, R.X., Yap, Y.C., et al.: User Preferences and Persona Design for an mHealth Intervention to Support Adherence to Cardiovascular Disease Medication in Singapore: A Multi-Method Study. JMIR Mhealth Uhealth 7, e10465 (2019) 10. Cruz-Martínez, R.R., Sieverink, F., Wesselink, R., van Gemert-Pijnen, L.: Towards Data-Driven Persuasive Coaching in a Heart Failure Telemonitoring Technology. In: Proceedings of the 6th International Workshop on Behavior Change Support Systems co-located with the 13th International Conference on Persuasive Technology (PERSUASIVE 2018), pp. 60-75. (Year) 11. Mawson, S., Nasr, N., Parker, J., Davies, R., Zheng, H., Mountain, G.: A Personalized Self-Management Rehabilitation System with an Intelligent Shoe for Stroke Survivors: A Realist Evaluation. JMIR rehabilitation and assistive technologies 3, e1 (2016) 12. Wais-Zechmann, B., Gattol, V., Neureiter, K., Orji, R., Tscheligi, M.: Persuasive Technology to Support Chronic Health Conditions: Investigating the Optimal Persuasive Strategies for Persons with COPD. pp. 255-266. Springer International Publishing, (Year) 13. Wildeboer, G., Kelders, S.M., van Gemert-Pijnen, J.E.W.C.: The relationship between persuasive technology principles, adherence and effect of web-Based interventions for mental health: A meta-analysis. Int. J. Med. Inform. 96, 71-85 (2016) 

Work in progress:Matching persuasive design with self management needs of patients with cardiovascular diseases-Preliminary results of a survey vignette experiment

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Work in progress:Matching persuasive design with self management needs of patients with cardiovascular diseases-Preliminary results of a survey vignette experiment

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