Designing pervasive technology for physical activity self-management in arthritis patients

Abstract Background Hypoglycaemia is a common and potentially avoidable adverse event in people with type 2 diabetes (T2D). It can reduce quality of life, increase healthcare costs, and reduce treatment success. We investigated self-management issues associated with hypoglycaemia and self-identified causes of hypoglycaemia in these patients. Methods In this mixed methods study qualitative semi-structured interviews were performed, which informed a subsequent quantitative survey in T2D patients. All interviews were audio recorded, transcribed verbatim and coded independently by two coders using directed content analysis, guided by the Theoretical Domains Framework. Descriptive statistics were used to quantify the self-management issues and causes of hypoglycaemia collected in the survey for the respondents that had experienced at least one hypoglycaemic event in the past. Results Sixteen participants were interviewed, aged 59–84 years. Participants perceived difficulties in managing deviations from routine, and they sometimes lacked procedural knowledge to adjust medication, nutrition or physical activity to manage their glucose levels. Grief and loss of support due to the loss of a partner interfered with self-management and lead to hypoglycaemic events. Work ethic lead some participant to overexerting themselves, which in turn lead to hypoglycaemic events. The participants had difficulties preventing hypoglycaemic events, because they did not know the cause, suffered from impaired hypoglycaemia awareness and/or did not want to regularly measure their blood glucose. When they did recognise a cause, they identified issues with nutrition, physical activity, stress or medication. In total, 40% of respondents reported regular stress as an issue, 24% reported that they regularly overestimated their physical abilities, and 22% indicated they did not always know how to adjust their medication. Around 16% of patients could not always remember whether they took their medication, and 42% always took their medication at regular times. Among the 83 respondents with at least one hypoglycaemic event, common causes for hypoglycaemia mentioned were related to physical activity (67%), low food intake (52%), deviations from routine (35%) and emotional burden (28%). Accidental overuse of medication was reported by 10%. Conclusion People with T2D experience various issues with self-managing their glucose levels. This study underlines the importance of daily routine and being able to adjust medication in relation to more physical activity or less food intake as well as the ability to reduce and manage stress to prevent hypoglycaemic events.

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The effects of social distancing and self-isolation during the COVID-19 pandemic on adults diagnosed with asthma: A qualitative study

Journal of Health Psychology ◽

10.1177/13591053211012766 ◽

2021 ◽

pp. 135910532110127

Author(s):

Leanne Tyson ◽

Wendy Hardeman ◽

Gareth Stratton ◽

Andrew M Wilson ◽

Joanna Semlyen

Keyword(s):

Physical Activity ◽

Thematic Analysis ◽

Lifestyle Changes ◽

Vulnerable Groups ◽

Self Management ◽

Activity Levels ◽

Window Of Opportunity ◽

Social Distancing ◽

Online Focus Groups ◽

Physical Activity Levels

This study aimed to explore how social distancing and self-isolation measures, aimed at protecting vulnerable groups from COVID-19, affected the wellbeing and physical activity levels among adults diagnosed with asthma. Twenty-seven participants took part across four online focus groups. Transcripts were analysed using thematic analysis. Participants reported becoming more health conscious due to being labelled as vulnerable. Their relationship with the severity of their asthma was altered and they reported making positive changes to increase their physical activity levels. Findings suggest there is a window of opportunity to engage with people diagnosed with asthma to promote beneficial lifestyle changes and self-management.

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Using Physical Activity Trackers in Arthritis Self‐Management: A Qualitative Study of Patient and Rehabilitation Professional Perspectives

Arthritis Care & Research ◽

10.1002/acr.23780 ◽

2019 ◽

Vol 71 (2) ◽

pp. 227-236 ◽

Cited By ~ 2

Author(s):

Jenny Leese ◽

Graham G. Macdonald ◽

Bao Chau Tran ◽

Rosalind Wong ◽

Catherine L. Backman ◽

...

Keyword(s):

Physical Activity ◽

Qualitative Study ◽

Self Management ◽

Activity Trackers ◽

Professional Perspectives ◽

Rehabilitation Professional

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Use of self-management strategies in a 2-year cognitive-behavioral intervention to promote physical activity

Behavior Therapy ◽

10.1016/s0005-7894(00)80020-9 ◽

2000 ◽

Vol 31 (2) ◽

pp. 365-379 ◽

Cited By ~ 86

Author(s):

Brian E. Saelens ◽

Christine A. Gehrman ◽

James F. Sallis ◽

Karen J. Calfas ◽

Julie A. Sarkin ◽

...

Keyword(s):

Physical Activity ◽

Behavioral Intervention ◽

Management Strategies ◽

Cognitive Behavioral ◽

Self Management ◽

Use Of Self ◽

Cognitive Behavioral Intervention

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Assessing the Efficacy of a Group Mediated Nutritional Knowledge Intervention for Individuals with Obesity

Canadian Journal of Dietetic Practice and Research ◽

10.3148/cjdpr-2016-022 ◽

2016 ◽

Vol 77 (4) ◽

pp. 206-209 ◽

Cited By ~ 3

Author(s):

Baukje Miedema ◽

Andrea Bowes ◽

Ryan Hamilton ◽

Stacey Reading

Keyword(s):

Physical Activity ◽

Intervention Program ◽

Eating Habits ◽

Nutrition Knowledge ◽

The Self ◽

Self Management ◽

Nutritional Knowledge ◽

Healthy Foods ◽

Registered Dietitians ◽

Active Intervention

Purpose: This study reports on the effect of a group-based nutrition and physical activity intervention program on nutrition knowledge and eating habits in a cohort of people with obesity. Methods: A quasi-experimental design with pre- and post-test measures. The intervention consisted of physical activity led by certified exercise physiologists and a nutritional education component led by registered dietitians over a 6-month period followed by 6 months of self-management. Participants’ nutrition knowledge and eating habits were assessed using the modified Nutrition Assessment, the Nutrition Knowledge Survey, and the Food Choice Questionnaires at baseline, after the 6-month intervention, and after 6 months of self-management. Results: Complete data were available for 59 (40%) of participants after 12 months because of attrition. Nutritional knowledge and behaviours improved. Participants reported increasing their consumption of healthy foods during the active intervention and maintained these changes through the self-management phase. Knowledge of healthy foods was improved and a greater likelihood of choosing food for weight control and health properties was reported. Conclusions: Knowledge and reported consumption of healthier nutrition improved during the active intervention and was maintained during the self-management period for individuals who completed the program. Registered dietitians can play an important role in managing patients with obesity in group settings.

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Impact of a Wearable Device-Based Walking Programs in Rural Older Adults on Physical Activity and Health Outcomes: Cohort Study (Preprint)

10.2196/preprints.11335 ◽

2018 ◽

Author(s):

Il-Young Jang ◽

Hae Reong Kim ◽

Eunju Lee ◽

Hee-Won Jung ◽

Hyelim Park ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Health Care ◽

Health Outcomes ◽

Rural Areas ◽

Wearable Devices ◽

Community Dwelling ◽

Wearable Device ◽

Self Management ◽

Community Dwelling Older Adults

BACKGROUND Community-dwelling older adults living in rural areas are in a less favorable environment for health care compared with urban older adults. We believe that intermittent coaching through wearable devices can help optimize health care for older adults in medically limited environments. OBJECTIVE We aimed to evaluate whether a wearable device and mobile-based intermittent coaching or self-management could increase physical activity and health outcomes of small groups of older adults in rural areas. METHODS To address the above evaluation goal, we carried out the “Smart Walk” program, a health care model wherein a wearable device is used to promote self-exercise particularly among community-dwelling older adults managed by a community health center. We randomly selected older adults who had enrolled in a population-based, prospective cohort study of aging, the Aging Study of Pyeongchang Rural Area. The “Smart Walk” program was a 13-month program conducted from March 2017 to March 2018 and included 6 months of coaching, 1 month of rest, and 6 months of self-management. We evaluated differences in physical activity and health outcomes according to frailty status and conducted pre- and postanalyses of the Smart Walk program. We also performed intergroup analysis according to adherence of wearable devices. RESULTS We recruited 22 participants (11 robust and 11 prefrail older adults). The two groups were similar in most of the variables, except for age, frailty index, and Short Physical Performance Battery score associated with frailty criteria. After a 6-month coaching program, the prefrail group showed significant improvement in usual gait speed (mean 0.73 [SD 0.11] vs mean 0.96 [SD 0.27], P=.02), International Physical Activity Questionnaire scores in kcal (mean 2790.36 [SD 2224.62] vs mean 7589.72 [SD 4452.52], P=.01), and European Quality of Life-5 Dimensions score (mean 0.84 [SD 0.07] vs mean 0.90 [SD 0.07], P=.02), although no significant improvement was found in the robust group. The average total step count was significantly different and was approximately four times higher in the coaching period than in the self-management period (5,584,295.83 vs 1,289,084.66, P<.001). We found that participants in the “long-self” group who used the wearable device for the longest time showed increased body weight and body mass index by mean 0.65 (SD 1.317) and mean 0.097 (SD 0.513), respectively, compared with the other groups. CONCLUSIONS Our “Smart Walk” program improved physical fitness, anthropometric measurements, and geriatric assessment categories in a small group of older adults in rural areas with limited resources for monitoring. Further validation through various rural public health centers and in a large number of rural older adults is required.

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The Effect of the Mobile ‘Blood Pressure Management Application’ on Hypertension Self-Management Enhancement: A Randomised Controlled Trial

10.21203/rs.2.1820/v2 ◽

2019 ◽

Author(s):

Ali Bozorgi ◽

Hamed Hosseini ◽

Hassan Eftekhar ◽

Reza Majdzadeh ◽

Ali Yoonessi ◽

...

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Clinical Trial ◽

Repeated Measures ◽

Patient Adherence ◽

Intervention Group ◽

Public Hospitals ◽

Self Management ◽

Control Group ◽

Management Application

Abstract Background : Self-management of blood pressure is of great significance given the increasing incidence of hypertension and associated disabilities. With the increased use of mobile health in medicine, the present study evaluated the effect of the self-management application on patient adherence to hypertension treatment. Methods : This clinical trial was performed on 120 hypertensive patients who were provided with a mobile intervention for 8 weeks and followed-up to 24 th weeks. Data on the primary outcome (adherence to treatment) and secondary outcomes (adherence to the DASH diet, regular monitoring of blood pressure, and physical activity) were collected using a questionnaire and a mobile application, respectively. The inter-group change difference over time was analyzed using repeated measures ANOVA (General Linear Model). Results : The treatment adherence score increased by an average of 5.9 (95%CI: 5.0-6.7) in the intervention group compared to the control group. Scores of adherence to the low-fat and low-salt diet plans were 1.7 (95%CI: 1.3-2.1) and 1.5 (95%CI: 1.2-1.9), respectively. Moreover, moderate physical activity increased to 100.0 minutes (95%CI: 61.7-138.3) per week in the intervention group. Conclusion: The treatment and control of blood pressure require a multifaceted approach given its complexity and multifactorial nature. Considering the widespread use of smartphones , mhealth interventions can be effective in self-management and better patient adherence to treatments. Our results showed that this application can be used as a successful tool for hypertension self-management in patients attending public hospitals in developing countries. Trial registration: This study was registered in the Iran Randomized Clinical Trial Center under the number IRCT2015111712211N2 on 1 January 2016.

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Effectiveness of an online self-management tool, OPERAS (an On-demand Program to EmpoweR Active Self-management), for people with rheumatoid arthritis: a research protocol

10.21203/rs.2.11788/v2 ◽

2019 ◽

Author(s):

Johnathan Tam ◽

Diane Lacaille ◽

Teresa Liu-Ambrose ◽

Chris D Shaw ◽

Hui Xie ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Physical Activity ◽

Disease Activity ◽

Disease Status ◽

Management Tool ◽

Self Management ◽

Secondary Outcome ◽

On Demand ◽

Management Ability ◽

Web App

Abstract Background. Active self-management is a process where patients are fully engaged in managing their health in daily life by having access to contextualized health data and tailored guidance to support a healthy lifestyle. The current study aims to determine whether an e-health intervention which incorporates symptom/disease activity monitoring and physical activity counselling can improve self-management ability in patients with rheumatoid arthritis (RA). Methods. The Empowering active self-management of arthritis: Raising the bar with OPERAS (an On-demand Program to EmpoweR Active Self-management) project is a randomized controlled trial which uses a delayed control design. 134 participants with RA will be randomized to either start the intervention immediately (Immediate Group) or start 6 months later (Delayed Group). The intervention involves: 1) use of a Fitbit-compatible web app to record and monitor their RA disease activity, symptoms and time spent on physical activity and a Fitbit; 2) group education and individual counselling by a physiotherapist (PT), and 3) 6 phone calls with a PT. The primary outcome measure is self-management ability measured by the Patient Activation Measure. Secondary outcome measures include disease status, fatigue, pain, depressive symptoms, and characteristics of habitual behavior. In addition, time spent in physical activity and sedentary activity with a wearable multi-sensor device (SenseWear Mini). Following the 6-month intervention, we will interview a sample of participants to examine their experiences with the intervention. Discussion. The results of this study will help to determine whether this technology-enhanced self-management intervention improves self-management ability and their health outcomes for people living with RA. A limitation of this study is that participants will need to self-report their symptoms, disease status, and treatment use through questionnaires on the OPERAS web app. The user-friendly interface, reminder emails from the research staff, and tailored guidance from PTs will encourage participants to actively engage with the app. Trial Registration. Date of last update in ClinicalTrials.gov: January 2, 2019 ClinicalTrials.gov Identifier: NCT03404245

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