Exploring and Characterizing Patient Multi-Behavior Engagement Trails and Patient Behavior Preference Patterns in the Pathway-Based mHealth Hypertension Self-Management: Analysis of Usage Data (Preprint)

BACKGROUND Hypertension is a long-term medical condition. Mobile health services can help out-of-hospital patients to self-manage. However, not all management is effective, which may be because the behavior mechanism and behavior preferences of patients with various characteristics in hypertension management were unclear. OBJECTIVE The purpose of this study was to (1) explore patient multi-behavior engagement trails in the pathway-based hypertension self-management; (2) discover patient behavior preference patterns; (3) identify the characteristics of patients with different behavior preferences. METHODS This study included 863 hypertensive patients who generated 295,855 usage records in the mHealth app from December 28, 2016 to July 2, 2020. Markov Chain was used to infer the patient multi-behavior engagement trails, which contained the type, quantity, time spent, sequence, and transition probability of patient behavior. K-means algorithm was used to group patients by the normalized behavior preference features: the number of behavioral states that a patient performed in each trail. The pages in the app represented the behavior states. Chi-square tests, Z-test, analysis of variances, and Bonferroni multiple comparisons were conducted to characterize the patient behavior preference patterns. RESULTS Markov Chain analysis revealed 3 types of behavior transition (one-way transition, cycle-transition, and self-transition) and 4 trails of patient multi-behavior engagement. In perform task trail (PT-T), Patients preferred to start self-management from the states of Task BP (0.29), Task Drug (0.18), and Task Weight (0.20), and spent more time on the Task Food state (35.87s). Some patients entered the states of Task BP (0.20) and Task Drug (0.25) from the Reminder Item state. In result-oriented trail (RO-T), patients spent more energy on the Ranking state (19.66s) compared the Health Report state (13.52s). In knowledge learning trail (KL-T), there was a high probability of cycle-transition (0.47, 0.31) between the states of Knowledge List and Knowledge Content. In support acquisition trail (SA-T), there was a high probability of self-transition in the Questionnaire (0.29) state. K-means analysis discovered 3 patient behavior preference patterns: only PT-T, PT-T and KL-T, and PT-T and SA-T. There were statistically significant associations between the behavior preference pattern and gender, education level, and blood pressure (BP). CONCLUSIONS This study identified the dynamic, longitudinal, and multi-dimension characteristics of patient behavior. Patients preferred to focus on BP, medications, and weight conditions, and pay attention to BP and medications using reminders. The diet management and questionnaires were complicated and difficult to implement and record. Competitive methods such as ranking were more likely to attract patients to pay attention to their own self-management states. Female patients with lower education level and poor-controlled BP were more likely to be highly involved in hypertension health education.

A Comparative Study on Biomass Fuel Consumption, Collection and Preference Patterns by Rural Households of Forest and Non-Forest Areas in Northern Bangladesh

Biomass fuel is the most important form of renewable energy in many parts of the world including Bangladesh. Its extraction is considered as a leading cause of forest degradation of developing countries like Bangladesh. Its consumption, collection and preference patterns are thus very important indicators of overexploitation of forest. On the other hand, forests are meager in mainly northern region of Bangladesh. Reliable data and information are scanty on biomass fuel in Bangladesh, particularly in formulating its proper management plan. The aim of this study was to conduct a comparative study on the aforesaid patterns in forest and non-forest areas of northern region of Bangladesh. The study was carried out by adaptive multistage random sampling technique. A total of 90 households (45 from forest area, 45 from non-forest area) were selected randomly and based on the monthly income the households were categorized into rich, medium, poor groups. The consumption of biomass fuel was found to be differed significantly between forest (2.10 kg/capita/day) and non-forest (1.71 kg/capita/day) area. Forest, market, agriculture, homestead and roadside plantation were identified as sources of biomass fuel, and the contribution of each sources varied significantly between the areas except market. In forest area, maximum amount of biomass fuel was collected from nearby forests (44%) and poor households collected 78% of biomass fuels from the same sources. In non-forest area, roadside plantation (31%) and homesteads (24%) were the major sources of biomass fuel, and poor households collected biomass fuel mainly from roadside plantations (75%). Stems, branches, leaves, agricultural residues and cow dung were used as biomass fuel in both areas but the consumption of each biomass fuel types varied significantly except leaves. Women were identified as major biomass fuel collector and most of the biomass fuel was found to be collected during morning to noon in both areas. Most commonly used fuelwood species was Shorea robusta in forest area and Eucalyptus camaldulensis in non-forest area. The findings of this study will help policymakers to take steps in halting deforestation as well as meeting the villager’s needs for biomass fuel. Keywords: Bangladesh, biomass fuel, forest degradation, fuelwood, homesteads, natural forests

Consumer Description by Check-All-That-Apply Questions (CATA) of the Sensory Profiles of Commercial and New Mandarins. Identification of Preference Patterns and Drivers of Liking

In the last few years, the interest in developing new mandarin cultivars of superior quality has grown as a response to the increasing consumer demand of this appreciated fruit. This study evaluated the sensory profiles of five new late-season mandarin cultivars (‘Alborea‘, ’Coral‘, ’Omet‘, ’Matiz‘ and ’Tri-703‘) and six commercial cultivars found contemporarily in stores (‘Clemenules‘, ’Nova‘, ’Tango‘, ’Nadorcott‘, ‘Orri’ and ‘Ortanique’). The sensory profiles of the cultivars were described by consumers through CATA questions. Consumers’ acceptability and the main physico-chemical properties were also evaluated. Twenty-two out of 23 CATA terms differed significantly for the sensory profiles of the studied cultivars. The new cultivars shared a similar profile, described mainly as “very intense taste”, “refreshing taste”, “very aromatic” and “juicy”, and these characteristics were quite different from those of the commercial cultivars. By combining acceptability and CATA questions, drivers of liking for segments of consumers with different preference patterns were identified. This is the first time that the sensory profiles of mandarin cultivars have been described by consumers. A significant number of consumers preferred the new mandarin cultivars to the commercial ones, which allows them a promising introduction on the market.

Pairwise Voting to Rank Touristic Destinations Based on Preference Valuation

This paper presents a novel approach for ranking tourist destinations based on the eigenvector method for pairwise voting (EMPV). The proposed approach relies solely on pairwise comparisons instead of direct-vote polling. The EMPV method was tested over a real-world case application to rank various tourist destinations in the Costa del Sol region, Spain, and its outcome was compared against a polling approach using a Likert-type scale. Results show that the EMPV and the Likert-based approach provided different rankings of preferred tourist destinations. Furthermore, both the EMPV and the Likert-based approaches shared the same preference patterns per ranking position, thus confirming that the reported predilection of the tourist is independent of the measurement approach. Finally, results show that the ranking produced by the EMPV methodology was highly related to the real number of visitors of the Costa del Sol tourist destinations, surpassing the Likert-based approach in both ordering and value similarities.

Caste feel and Personal preference

<p></p><p>Caste is a known reality in rural subcontinent. In a randomized group design 265 college students belonging to 13 caste groups selected with a questionnaire for high ’caste feel’,and were given a few other structured questionnaires comprising of the questions about day to day matters for personal preference. It was assumed that caste feel because of integrated heredity transmission, group belongingness, identity, familial or other social or personal reasons may predict some personal preference patterns? Findings reflected visible similarity in participants’ response patterns due to may be a mix of nature and nature and its role in social groups, the information could be useful for varied applications, more studies would clarify further.<br></p><p></p>

Caste feel and Personal preference

<p></p><p>Caste is a known reality in rural subcontinent. In a randomized group design 265 college students belonging to 13 caste groups selected with a questionnaire for high ’caste feel’,and were given a few other structured questionnaires comprising of the questions about day to day matters for personal preference. It was assumed that caste feel because of integrated heredity transmission, group belongingness, identity, familial or other social or personal reasons may predict some personal preference patterns? Findings reflected visible similarity in participants’ response patterns due to may be a mix of nature and nature and its role in social groups, the information could be useful for varied applications, more studies would clarify further.<br></p><p></p>