Bridging Community, History, and Culture in Personal Informatics Tools

A healthy diet and increased physical activity are essential for reducing the prevalence of cardiovascular disease and related deaths, a worldwide public health concern that disproportionately affects Black American communities. Still, Black Americans can face unique challenges meeting dietary and physical activity requirements due to inequities in access and quality of care, environmental and local factors, and difficulties in changing individual health behaviors. Personal informatics and self-tracking tools are one way of increasing awareness of health behaviors to motivate behavior change. However, there are still gaps in knowledge about what encourages different users to engage with personal informatics tools over time, particularly when used in collaborative, community-health settings. This paper contributes a nuanced understanding of fifteen participants' reasons for engaging in an existing community-based health education and behavior change program that combines collaborative self-tracking with culturally relevant content and social engagement to motivate heart-healthy behaviors. We illustrate participants' positive and negative experiences engaging in self-tracking and collaborative tasks during the program. We also discuss how participants envision that integrating technology might support or hinder participant engagement and the work of deploying community-based public health interventions. Finally, we discuss design implications for culturally informed, community-based personal informatics tools that engage Black American's in heart-healthy activities.

Temporal relationships between device-derived sedentary behavior, physical activity, and sleep in early childhood

Study Objectives Understanding the ideal composition of a child’s day requires a better understanding of the relations between wake behaviors (sedentary behavior [SB], physical activity [PA]) and sleep. Here we examine between- and within-person temporal associations between daytime wake behaviors and overnight sleep in early childhood, an important age when healthy behaviors are initiated and 24-hour behaviors are largely determined by caregivers. Methods Daily, repeated measures of wake behavior and overnight sleep were assessed via wrist-worn actigraphy (mean=9 days/nights) in 240 children (50.8±9.8 months). Multilevel models with lagged effects were used to examine the temporal associations between wake and overnight sleep measures and adjusted for daily nap duration, age, sex, and socioeconomic status. Results Between-person associations for sleep outcomes were negative between MVPA and total activity for sleep efficiency (SE). Between-person associations for wake outcomes were positive between sleep duration and light PA, and negative between SE and both MVPA and total PA. When children obtained higher SE relative to their individual average, they were more likely to engage in less SB and greater MVPA and total PA the next day. Conclusions Generally, days with greater activity or sleep were not associated with greater subsequent sleep or PA. Most subsequent behaviors were not influenced by children achieving higher activity or sleep relative to their individual average levels, although higher sleep efficiency was beneficially associated with next day wake behaviors. Future analyses with young children should consider within-person associations and could investigate lagged effects beyond one day.

It's All About the Heart

This chapter aimed to provide responses, within the issue of cardiovascular health, to the effectiveness of the relation between the message's content (“what”) and form (“how”) and the triad of (cognitive-affective-behavioral) effects. The qualitative content analysis, concretely thematic and rhetorical types, was applied to a corpus of five ads from international campaigns (2015-2019) and three static Portuguese ads (2018-2019). One online survey of Portuguese university students (N = 55) was conducted. The findings show that the ads' issues vary from irreparable losses to the encouragement of healthy behaviors. The pathos tends to elicit various reactions (e.g., alarm, call to action, empathy, fear, guilt, hurt, worry). The logos are constructed of discursive devices (e.g., construction of a narrative, use of questions, selection of colors with connotative purposes, descriptions of concepts), evidence, and stylistic devices. Most of the respondents recognize the cognitive and affective influence, but not the behavioral effects.

Children’s and Families’ Determinants of Health-Related Behaviors in an Italian Primary School Sample: The “Seven Days for My Health” Project

Childhood obesity is an established health problem, and there is a growing need for health promotion interventions focused on healthy behaviors in collaboration with parents and schools. The Mediterranean diet (MD) could help to tackle obesity, but it is essential to maintain a good level of physical activity (PA) and limit time spent in sedentary activities (ST). To explore family determinants, adherence to the MD and PA levels as potential predictors of a child’s health-related behaviors, we performed a cross-sectional analysis of 368 Italian primary school children with a mean age of 8.95 years (SD = 1.43). Data were collected from May to June 2017 using a weekly diary, an interactive tool to assess the child’s and parents’ lifestyle. The child’s degree of adherence to the MD was calculated using the KIDMED index. Adherence to the MD was high, medium and poor in 5.2%, 62.5% and 32.3% of children, respectively. Higher maternal educational level was positively associated with children’s MD and PA (p < 0.05) and negatively correlated to ST. Maternal fruit and vegetable consumption was positively related to the MD and negatively related to ST (p < 0.05). Maternal PA was positively associated with the MD (p < 0.001). Paternal PA, and fruit and vegetable consumption, were positively associated with children’s PA (p < 0.05). Our results underline the need for future studies, mainly focused on school-based and family-based interventions, to promote healthy lifestyles and nutritional habits.

The role of positive psychological constructs in diet and eating behavior among people with metabolic syndrome: A qualitative study

Positive Psychological (PP) constructs (e.g., optimism and gratitude) may impact the adherence to healthy behaviors, including diet, though prior studies have shown mixed findings. This qualitative study explored the relationships between PP constructs and dietary behaviors among 21 adults with metabolic syndrome through semi-structured interviews. Directed content analysis led to five themes: eating healthfully leads to PP constructs, PP constructs lead to eating healthfully, eating healthfully prevents negative emotions, healthy behaviors associated with diet, and an upward healthy spiral. Given the close relationship between PP constructs and diet, these may be targeted to improve diet in risk populations through interventions that promote well-being.

CONFIDENCE LEVEL OF A MOTION FEEDBACK SYSTEM FOR ANALYZING EXERCISE TRAINING EFFICACY

The increase in aged population is a global trend. Inculcating healthy behaviors such as regular exercises in the elderly has a significant impact on the financial and medical burden globally. Moreover, air pollution and the outbreak of the coronavirus disease 19 (COVID-19) pose a serious threat to public health. In order to improve the health conditions of the population, this study developed a motion feedback system named MoveV that can be used for several indoor training exercises. This system provides instant motion feedback by synchronizing exercise training videos on the website using a motion analysis algorithm that is applicable on smartphones, and a cloud database platform is used to record health behaviors. Feature extraction is performed based on force intensity, motion velocity, and exercise direction. The resultant accuracy of the motion feedback system was tested by a motion science expert and presented as the confidence level. For perfect movement, a confidence level of up to 90.5% was achieved, indicating that the MoveV system was able to record users’ exercise frequency and distinguish whether the user was performing well in the exercise movements. The proposed system is convenient and does not incur additional expenditure by purchasing any new device. Furthermore, it provides visual and voice feedback, companionship, and exercise motivation to the users, all of which are important factors when using online exercise platforms.

Prediction of Self-care Behaviors in COVID-19 Prevention Based on Persuasion Techniques

Background: Persuasion is a method used to correct and modify the attitude and behaviors of community members to protect collective benefits, especially during crises. Objectives: The present study aimed to predict COVID-19 preventive behaviors based on persuasion techniques in five countries. Methods: This descriptive, correlational study was conducted on the population aged more than 18 years in Iran, Australia, the United Kingdom, Sweden, and Canada. The sample size determined by Morgan’s table was 498 individuals who were selected via convenience sampling in the spring of 2020. Data were collected online using a Demographic Questionnaire, a Persuasion Scale (2020), and the Questionnaire of Healthy Preventive Behaviors for COVID-19 (2020). The inclusion criteria were the age of more than 18 years and basic literacy, and the exclusion criterion was incomplete questionnaires. Data analysis was performed in SPSS version 21 using Pearson’s correlation-coefficient and multiple regression analysis. Results: A positive significant correlation was observed between persuasion techniques and healthy preventive behaviors for COVID-19 (P < 0.001). Among the components of persuasion, fear, interest in the messenger, frequency of the message, and reliability of the messenger could most significantly predict healthy behaviors (P < 0.001). Conclusions: According to the results, the mass media and authorities could enhance the effectiveness of their agenda by identifying the influential factors in the success of persuasion techniques. These findings could be beneficial to social psychiatrists, authorities, and the mass media.

Improving Family Health Climate, Effect of Role Modeling and Maternal Support in Female Student

Introduction: Girls can use their mothers emotional, informational and behavioral support to perform healthy behaviors due to their constant access to their mothers. This study aimed to evaluate the effect of role modeling and maternal support in the family to improve healthy behaviors and perceived Family Health Climate (FHC) in female students.Methods: In this quasi-experimental study 261 female students (133 in intervention group and 128 in control group) and 223 mothers (109 intervention and 114 control) were selected, using cluster multi-stages sampling method and entered the study. Participants completed the FHC scale at three stages (Before intervention, immediately after the intervention and two month after intervention). A training programme which comprised 12 sessions for students and 6 sessions for their mothers using collaborative learning techniques and printed materials was conducted with the experimental group. Data were analyzed using SPSS20 via chi-square test, independent t-test, and Repeated Measures ANOVA at significance level of 0.05.Results: Before the intervention, there was no significant difference between demographic variables and the score of FHC scale in both groups (p<0.05). Immediately and two months after the intervention, the experimental group (female students and their mothers) showed a significant increase in dimensions of FHC including FHC-NU and FHC-PA (their subscales) compared to the control group (p<0.05).Conclusions: Educating and informing mothers about their role model defects for their children, especially girls, can make them more aware of health-oriented behaviors towards their children. Such findings reinforced the importance of focusing on actions to encourage a healthy lifestyle (healthy diet and physical activity) in students with a focus on role modeling and parental support, especially mothers.

“Taking Care of Your Pregnancy”: A mixed-methods study of group antenatal care in Kakamega County, Kenya

Background Traditional antenatal care (ANC) models often do not meet women’s needs for information, counseling, and support, resulting in gaps in quality and coverage. Group ANC (GANC) provides an alternative, person-centered approach where pregnant women of similar gestational age meet with the same health provider for facilitated discussion. There are few studies that show associations between GANC and various outcomes. Methods We used mixed methods to evaluate a contextualized GANC model (Lea Mimba Pregnancy Clubs) and to understand implementation experiences at six health facilities in Kakamega County, Kenya. Between April 2018 and January 2019, we tracked 1,652 women who were assigned to 162 GANC cohorts to assess ANC retention. Using an intention-to-treat approach, we conducted baseline (N = 112) and endline surveys (N = 360) with women attending immunization visits to assess outcomes and used time diaries to assess wait times. At endline, we conducted 29 in-depth interviews (IDIs) and three focus group discussions with women who were currently and previously participating in GANC, and 15 IDIs with stakeholders. Results GANC was associated with enhanced social support, with some evidence for improved knowledge, adoption of healthy behaviors, enhanced self-efficacy, and improved experience of care. Quantitatively, we found strong associations between GANC and knowledge of danger signs, women who shared their feelings with other women, knowledge and competence of health workers, respect shown by ANC providers, overall quality of care, and birth preparations; as well as an improvement in ANC retention. No changes were seen in knowledge of positive behaviors, empowerment, several aspects related to women’s experience of care, ANC retention, early initiation of ANC, and other healthy behaviors. Qualitatively, women and stakeholders noted improved interactions between health providers and women, improved counseling, increased feelings of empowerment to ask questions and speak freely, and strengthened social networks and enhanced social cohesion among women. Both wait times and counseling times increased in GANC compared to traditional ANC. Conclusions This is one of the few mixed-methods studies evaluating GANC and offers new measures for experience of care, empowerment, and adoption of healthy behaviors. While more research is required, GANC holds promise for enhancing women’s experiences during pregnancy. Modifications are needed for sustainability and scalability.