Medicine2.0'10: Technology and adherence in eHealth: a Systematic review

106/12/2010 Title: to modify choose 'View' then

'Heater and footer'1

Technology and adherence in eHealth:a Systematic review

Saskia Kelders, MSc

Robin Kok, MSc

Lisette van Gemert-Pijnen, PhD

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Motivation throughtechnology?

Christensen et al, 2009 (JMIR 11(2):13)

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Systematic review

§ Health promotion

§ Intervention

§ Web-based

§ Attrition

9 (4)Other

17 (12)Chronic disease

37 (15)Mental health

46 (22)Lifestyle

N

§ Main exclusion criteria:

§ no objective usage

§ no repeated usage

§ no effects measured

Included:

109 papers on

53 interventions

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Statement 2: Dialogue support

§ Review: Compare interventions without live/personal support§ Can automated dialogue support take over?

Social role

Liking

Similarity

Suggestion

Reminders Rewards

Praise

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Statement 2: Dialogue support

§ Test the effects of personal vs automated dialogue support on adherence

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Statement 3: Free vs. fixed use

§ Compare fixed and free use

§ Preliminary results review:§ 16 fixed use interventions; mean adherence 61% (range 1% - 100%)§ 5 free use interventions; mean adherence 43% (range 31% - 61%)

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§ RealU (An 2008)§ Usage 18,9 / 30 weeks§ Intended: 20 weekly visits

§ Quit Smoking Network (McKay 2008)§ Usage 2,1 / 26 weeks§ Intended: ??

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§ Fun, Food and Fitness Club (Thompson 2008)§ Mean adherence 74,5%§ 1 session each week

§ Get Up & Go (Ferney 2009)§ Usage 8.2 / 26 weeks§ Intended: Once a week?

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Statement 4: Methods

§ How to measure and report usage?§ Standardized breadth and depth (Couper 2010, JMIR 12(4))§ Relation to intended usage?

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Statement 4: Methods

§ How to describe interventions?§ Content§ Behavior change techniques

§ Technology§ Persuasive features

§ Communication§ Person system§ Person system person§ Community

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12

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§ PAM COACH (Slootmaker 2005)

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Dieetinzicht with icat (Blanson Henkemans 2009)

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Statement 4: Methods

§ How to describe interventions?§ Content§ Behavior change techniques

§ Technology§ Persuasive features

§ Communication§ Person system§ Person system person§ Community

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Discussion

§ “Unmotivated”/”unhealthy” care consumers should be persuaded

§ Dialogue support will increase adherence

§ Fixed use will increase adherence

§ Standardization of usage measures is needed

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Thank you Questions?

[email protected]

ww.ehealthresearchcenter.org/wiki