Technology and adherence in eHealth: a Systematic review as presented at Medicine 2.0'10

1. Technology and adherence in eHealth:
a Systematic review
Saskia Kelders, MSc
Robin Kok, MSc
Lisette van Gemert-Pijnen, PhD
06/12/2010 Title: to modify choose 'View' then 1
1
'Heater and footer'

2. Motivation through
technology?
Christensen et al, 2009 (JMIR 11(2):13)
2

3. Systematic review
§ Health promotion § Main exclusion criteria:
§ Intervention § no objective usage
§ Web-based § no repeated usage
§ Attrition § no effects measured
N
Included: Lifestyle 46 (22)
109 papers on Mental health 37 (15)
53 interventions Chronic disease 17 (12)
Other 9 (4)
3

4. Statement 2: Dialogue support
§ Review: Compare interventions without live/personal support
§ Can automated dialogue support take over?
Social role Similarity
Liking
Praise
Suggestion
Reminders Rewards
4

5. Statement 2: Dialogue support
§ Test the effects of personal vs automated dialogue support on adherence
5

6. 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%)
6

7. § RealU (An 2008) § Quit Smoking Network (McKay 2008)
§ Usage 18,9 / 30 weeks § Usage 2,1 / 26 weeks
§ Intended: 20 weekly visits § Intended: ??
7

8. § Fun, Food and Fitness Club § Get Up & Go (Ferney 2009)
(Thompson 2008) § Usage 8.2 / 26 weeks
§ Mean adherence 74,5% § Intended: Once a week?
§ 1 session each week
8

9. Statement 4: Methods
§ How to measure and report usage?
§ Standardized breadth and depth (Couper 2010, JMIR 12(4))
§ Relation to intended usage?
9

10. Statement 4: Methods
§ How to describe interventions?
§ Content
§ Behavior change techniques
§ Technology
§ Persuasive features
§ Communication
§ Person system
§ Person system person
§ Community
10

11. 11

12. 12

13. § PAM COACH (Slootmaker 2005)
13

14. Dieetinzicht with icat (Blanson Henkemans 2009)
14

15. Statement 4: Methods
§ How to describe interventions?
§ Content
§ Behavior change techniques
§ Technology
§ Persuasive features
§ Communication
§ Person system
§ Person system person
§ Community
15

16. Discussion
§ “Unmotivated”/”unhealthy” care consumers should be persuaded
§ Dialogue support will increase adherence
§ Fixed use will increase adherence
§ Standardization of usage measures is needed
16

17. Thank you
Questions?
s.m.kelders@utwente.nl
ww.ehealthresearchcenter.org/wiki
17