scholarly journals Tailoring Persuasive Electronic Health Strategies for Older Adults on the Basis of Personal Motivation: Web-Based Survey Study

10.2196/11759 ◽  
2019 ◽  
Vol 21 (9) ◽  
pp. e11759 ◽  
Author(s):  
Lex van Velsen ◽  
Marijke Broekhuis ◽  
Stephanie Jansen-Kosterink ◽  
Harm op den Akker
Keyword(s):  
Older Adults ◽  
Factor Structure ◽  
Individual Characteristics ◽  
Survey Study ◽  
Living Situation ◽  
Web Based ◽  
Cronbach Alpha ◽  
Personal Motivation ◽  
Electronic Health ◽  
Ehealth Intervention

Background Persuasive design, in which the aim is to change attitudes and behaviors by means of technology, is an important aspect of electronic health (eHealth) design. However, selecting the right persuasive feature for an individual is a delicate task and is likely to depend on individual characteristics. Personalization of the persuasive strategy in an eHealth intervention therefore seems to be a promising approach. Objective This study aimed to develop a method that allows us to model motivation in older adults with respect to leading a healthy life and a strategy for personalizing the persuasive strategy of an eHealth intervention, based on this user model. Methods We deployed a Web-based survey among older adults (aged >60 years) in the Netherlands. In the first part, we administered an adapted version of the revised Sports Motivation Scale (SMS-II) as input for the user models. Then, we provided each participant with a selection of 5 randomly chosen mock-ups (out of a total of 11), each depicting a different persuasive strategy. After showing each strategy, we asked participants how much they appreciated it. The survey was concluded by addressing demographics. Results A total of 212 older adults completed the Web-based survey, with a mean age of 68.35 years (SD 5.27 years). Of 212 adults, 45.3% were males (96/212) and 54.7% were female (116/212). Factor analysis did not allow us to replicate the 5-factor structure for motivation, as targeted by the SMS-II. Instead, a 3-factor structure emerged with a total explained variance of 62.79%. These 3 factors are intrinsic motivation, acting to derive satisfaction from the behavior itself (5 items; Cronbach alpha=.90); external regulation, acting because of externally controlled rewards or punishments (4 items; Cronbach alpha=.83); and a-motivation, a situation where there is a lack of intention to act (2 items; r=0.50; P<.001). Persuasive strategies were appreciated differently, depending on the type of personal motivation. In some cases, demographics played a role. Conclusions The personal type of motivation of older adults (intrinsic, externally regulated, and/or a-motivation), combined with their educational level or living situation, affects an individual’s like or dislike for a persuasive eHealth feature. We provide a practical approach for profiling older adults as well as an overview of which persuasive features should or should not be provided to each profile. Future research should take into account the coexistence of multiple types of motivation within an individual and the presence of a-motivation.

scholarly journals Tailoring Persuasive Electronic Health Strategies for Older Adults on the Basis of Personal Motivation: Web-Based Survey Study (Preprint)

2018 ◽  
Author(s):  
Lex van Velsen ◽  
Marijke Broekhuis ◽  
Stephanie Jansen-Kosterink ◽  
Harm op den Akker
Keyword(s):  
Older Adults ◽  
Factor Structure ◽  
Individual Characteristics ◽  
Survey Study ◽  
Living Situation ◽  
Web Based ◽  
Cronbach Alpha ◽  
Personal Motivation ◽  
Electronic Health ◽  
Ehealth Intervention

BACKGROUND Persuasive design, in which the aim is to change attitudes and behaviors by means of technology, is an important aspect of electronic health (eHealth) design. However, selecting the right persuasive feature for an individual is a delicate task and is likely to depend on individual characteristics. Personalization of the persuasive strategy in an eHealth intervention therefore seems to be a promising approach. OBJECTIVE This study aimed to develop a method that allows us to model motivation in older adults with respect to leading a healthy life and a strategy for personalizing the persuasive strategy of an eHealth intervention, based on this user model. METHODS We deployed a Web-based survey among older adults (aged >60 years) in the Netherlands. In the first part, we administered an adapted version of the revised Sports Motivation Scale (SMS-II) as input for the user models. Then, we provided each participant with a selection of 5 randomly chosen mock-ups (out of a total of 11), each depicting a different persuasive strategy. After showing each strategy, we asked participants how much they appreciated it. The survey was concluded by addressing demographics. RESULTS A total of 212 older adults completed the Web-based survey, with a mean age of 68.35 years (SD 5.27 years). Of 212 adults, 45.3% were males (96/212) and 54.7% were female (116/212). Factor analysis did not allow us to replicate the 5-factor structure for motivation, as targeted by the SMS-II. Instead, a 3-factor structure emerged with a total explained variance of 62.79%. These 3 factors are intrinsic motivation, acting because of deriving satisfaction from the behavior itself (5 items; Cronbach alpha=.90); external regulation, acting because of externally controlled rewards or punishments (4 items; Cronbach alpha=.83); and a-motivation, a situation where there is a lack of intention to act (2 items; r=0.50; P<.001). Persuasive strategies were appreciated differently, depending on the type of personal motivation. In some cases, demographics played a role. CONCLUSIONS The personal type of motivation of older adults (intrinsic, externally regulated, and/or a-motivation), combined with their educational level or living situation, affects an individual’s like or dislike for a persuasive eHealth feature. We provide a practical approach for profiling older adults as well as an overview of which persuasive features should or should not be provided to each profile. Future research should take into account the coexistence of multiple types of motivation within 1 individual and the presence of a-motivation.

scholarly journals Electronic Health Program to Empower Patients in Returning to Normal Activities After General Surgical and Gynecological Procedures: Intervention Mapping as a Useful Method for Further Development (Preprint)

2018 ◽  
Author(s):  
Chantal M den Bakker ◽  
Frederieke G Schaafsma ◽  
Eva van der Meij ◽  
Wilhelmus JHJ Meijerink ◽  
Baukje van den Heuvel ◽  
...  
Keyword(s):  
Intervention Program ◽  
Intervention Mapping ◽  
Theoretical Framework ◽  
Mobile App ◽  
Survey Study ◽  
Program Outcomes ◽  
Activity Tracker ◽  
Electronic Health ◽  
Ehealth Intervention ◽  
Further Development

BACKGROUND Support for guiding and monitoring postoperative recovery and resumption of activities is usually not provided to patients after discharge from the hospital. Therefore, a perioperative electronic health (eHealth) intervention (“ikherstel” intervention or “I recover” intervention) was developed to empower gynecological patients during the perioperative period. This eHealth intervention requires a need for further development for patients who will undergo various types of general surgical and gynecological procedures. OBJECTIVE This study aimed to further develop the “ikherstel” eHealth intervention using Intervention Mapping (IM) to fit a broader patient population. METHODS The IM protocol was used to guide further development of the “ikherstel” intervention. First, patients’ needs were identified using (1) the information of a process evaluation of the earlier performed “ikherstel” study, (2) a review of the literature, (3) a survey study, and (4) focus group discussions (FGDs) among stakeholders. Next, program outcomes and change objectives were defined. Third, behavior change theories and practical tools were selected for the intervention program. Finally, an implementation and evaluation plan was developed. RESULTS The outcome for an eHealth intervention tool for patients recovering from abdominal general surgical and gynecological procedures was redefined as “achieving earlier recovery including return to normal activities and work.” The Attitude-Social Influence-Self-Efficacy model was used as a theoretical framework to transform personal and external determinants into change objectives of personal behavior. The knowledge gathered by needs assessment and using the theoretical framework in the preparatory steps of the IM protocol resulted in additional tools. A mobile app, an activity tracker, and an electronic consultation (eConsult) will be incorporated in the further developed eHealth intervention. This intervention will be evaluated in a multicenter, single-blinded randomized controlled trial with 18 departments in 11 participating hospitals in the Netherlands. CONCLUSIONS The intervention is extended to patients undergoing general surgical procedures and for malignant indications. New intervention tools such as a mobile app, an activity tracker, and an eConsult were developed. CLINICALTRIAL Netherlands Trial Registry NTR5686; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5686 

Regulation of Experienced and Anticipated Regret for Daily Decisions in Younger and Older Adults in a Swedish One-Week Diary Study

GeroPsych ◽  
2013 ◽  
Vol 26 (4) ◽  
pp. 233-241 ◽  
Author(s):  
Pär Bjälkebring ◽  
Daniel Västfjäll ◽  
Boo Johansson
Keyword(s):  
Older Adults ◽  
Diary Study ◽  
Anticipated Regret ◽  
Younger Adults ◽  
Web Based ◽  
Decision Regret ◽  
Diary Method ◽  
Regulation Strategies

Regret and regret regulation were studied using a weeklong web-based diary method. 108 participants aged 19 to 89 years reported regret for a decision made and a decision to be made. They also reported the extent to which they used strategies to prevent or regulate decision regret. Older adults reported both less experienced and anticipated regret compared to younger adults. The lower level of experienced regret in older adults was mediated by reappraisal of the decision. The lower level of anticipated regret was mediated by delaying the decision, and expecting regret in older adults. It is suggested that the lower level of regret observed in older adults is partly explained by regret prevention and regulation strategies.

scholarly journals Patients’ moral attitudes toward electronic health records: Survey study with vignettes and statements

2021 ◽  
Vol 27 (1) ◽  
pp. 146045822098003
Author(s):  
Tania Moerenhout ◽  
Ignaas Devisch ◽  
Laetitia Cooreman ◽  
Jodie Bernaerdt ◽  
An De Sutter ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
De Novo ◽  
Information Access ◽  
Survey Study ◽  
Sensitive Information ◽  
Patient Portal ◽  
Care Providers ◽  
Health Records ◽  
Electronic Health ◽  
Moral Attitudes

Patient access to electronic health records gives rise to ethical questions related to the patient-doctor-computer relationship. Our study aims to examine patients’ moral attitudes toward a shared EHR, with a focus on autonomy, information access, and responsibility. A de novo self-administered questionnaire containing three vignettes and 15 statements was distributed among patients in four different settings. A total of 1688 valid questionnaires were collected. Patients’ mean age was 51 years, 61% was female, 50% had a higher degree (college or university), and almost 50% suffered from a chronic illness. Respondents were hesitant to hide sensitive information electronically from their care providers. They also strongly believed hiding information could negatively affect the quality of care provided. Participants preferred to be informed about negative test results in a face-to-face conversation, or would have every patient decide individually how they want to receive results. Patients generally had little experience using patient portal systems and expressed a need for more information on EHRs in this survey. They tended to be hesitant to take up control over their medical data in the EHR and deemed patients share a responsibility for the accuracy of information in their record.

scholarly journals Using Everyday Technology Independently When Living with Forgetfulness: Experiences of Older Adults in Barcelona

2021 ◽  
Vol 7 ◽  
pp. 233372142199375
Author(s):  
Samuel Briones ◽  
Louise Meijering
Keyword(s):  
Older Adults ◽  
Qualitative Methodology ◽  
Local Community ◽  
Phenomenological Study ◽  
Later Life ◽  
Learning Opportunities ◽  
Individual Characteristics ◽  
Community Dwelling ◽  
Community Dwelling Older Adults ◽  
The Capability Approach

Older adults living with forgetfulness encounter difficulties when engaging with changing and dynamic everyday technology (ET). The capability to use ET is important for independence in later life and is affected by the contextual and individual characteristics of older adults. Using the capability approach as a theoretical lens, this phenomenological study aims to explore the experiences of older adults living with forgetfulness, in order to identify contextual and individual factors that facilitate the use of ET in everyday life. A qualitative methodology was used to interview 16 community-dwelling older adults participating in memory and technology workshops at local community centres in Barcelona. Findings show that motivation and openness to learning played a facilitating role in our participants’ use of ET. The presence of social support in the form of “technology experts” and community centres offering learning opportunities were also enhancing factors that encourage independence when engaging with ET. In conclusion, our study demonstrates the importance of expanding intergenerational ET learning opportunities, through the creation of age-friendly spaces.

scholarly journals Depression and loneliness of older adults in Europe and Israel after the first wave of covid-19

2021 ◽  
Author(s):  
Josefine Atzendorf ◽  
Stefan Gruber
Keyword(s):  
Older Adults ◽  
Well Being ◽  
Individual Characteristics ◽  
Control Measures ◽  
Epidemic Control ◽  
Government Response ◽  
Country Level ◽  
Interaction Terms ◽  
Share Data ◽  
Using Data

AbstractEpidemic control measures that aim to introduce social distancing help to decelerate the spread of the COVID-19 pandemic. However, their consequences in terms of mental well-being might be negative, especially for older adults. While existing studies mainly focus on the time during the first lockdown, we look at the weeks afterward in order to measure the medium-term consequences of the first wave of the pandemic. Using data from the SHARE Corona Survey, we include retired respondents aged 60 and above from 25 European countries plus Israel. Combining SHARE data with macro-data from the Oxford COVID-19 Government Response Tracker allows us to include macro-indicators at the country level, namely the number of deaths per 100,000 and the number of days with stringent epidemic control measures, in addition to individual characteristics. The findings show that both macro-indicators are influential for increased feelings of sadness/depression, but that individual factors are crucial for explaining increased feelings of loneliness in the time after the first lockdown. Models with interaction terms reveal that the included macro-indicators have negative well-being consequences, particularly for the oldest survey participants. Additionally, the results reveal that especially those living alone had a higher risk for increased loneliness in the time after the first COVID-19 wave.

scholarly journals Rationale and design of the Novel Uses of adaptive Designs to Guide provider Engagement in Electronic Health Records (NUDGE-EHR) pragmatic adaptive randomized trial: a trial protocol

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Julie C. Lauffenburger ◽  
Thomas Isaac ◽  
Lorenzo Trippa ◽  
Punam Keller ◽  
Ted Robertson ◽  
...  
Keyword(s):  
Older Adults ◽  
Usual Care ◽  
Behavioral Science ◽  
Inappropriate Prescribing ◽  
The Novel ◽  
Care Providers ◽  
Health Records ◽  
Electronic Health ◽  
Stage 1

Abstract Background The prescribing of high-risk medications to older adults remains extremely common and results in potentially avoidable health consequences. Efforts to reduce prescribing have had limited success, in part because they have been sub-optimally timed, poorly designed, or not provided actionable information. Electronic health record (EHR)-based tools are commonly used but have had limited application in facilitating deprescribing in older adults. The objective is to determine whether designing EHR tools using behavioral science principles reduces inappropriate prescribing and clinical outcomes in older adults. Methods The Novel Uses of Designs to Guide provider Engagement in Electronic Health Records (NUDGE-EHR) project uses a two-stage, 16-arm adaptive randomized pragmatic trial with a “pick-the-winner” design to identify the most effective of many potential EHR tools among primary care providers and their patients ≥ 65 years chronically using benzodiazepines, sedative hypnotic (“Z-drugs”), or anticholinergics in a large integrated delivery system. In stage 1, we randomized providers and their patients to usual care (n = 81 providers) or one of 15 EHR tools (n = 8 providers per arm) designed using behavioral principles including salience, choice architecture, or defaulting. After 6 months of follow-up, we will rank order the arms based upon their impact on the trial’s primary outcome (for both stages): reduction in inappropriate prescribing (via discontinuation or tapering). In stage 2, we will randomize (a) stage 1 usual care providers in a 1:1 ratio to one of the up to 5 most promising stage 1 interventions or continue usual care and (b) stage 1 providers in the unselected arms in a 1:1 ratio to one of the 5 most promising interventions or usual care. Secondary and tertiary outcomes include quantities of medication prescribed and utilized and clinically significant adverse outcomes. Discussion Stage 1 launched in October 2020. We plan to complete stage 2 follow-up in December 2021. These results will advance understanding about how behavioral science can optimize EHR decision support to improve prescribing and health outcomes. Adaptive trials have rarely been used in implementation science, so these findings also provide insight into how trials in this field could be more efficiently conducted. Trial registration Clinicaltrials.gov (NCT04284553, registered: February 26, 2020)

Psychometric properties and factor structure of the Medical Outcomes Study Social Support Survey Instrument in a sample of Spanish older adults

2021 ◽  
Author(s):  
Cristina G. Dumitrache ◽  
Laura Rubio ◽  
José Luis Cabezas Casado ◽  
Eulogio Cordón-Pozo
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Psychometric Properties ◽  
Factor Structure ◽  
Survey Instrument ◽  
Medical Outcomes ◽  
Outcomes Study
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