A Digital Lifestyle Coach (E-Supporter 1.0) to Support People With Type 2 Diabetes: Participatory Development Study

Hietbrink, Eclaire A G; Middelweerd, Anouk; Empelen, Pepijn van; Preuhs, Katharina; Konijnendijk, Annemieke Ariënne Johanneke; Nijeweme-d’Hollosy, Wendy Oude; Schrijver, Laura K; Laverman, Gozewijn D.; Vollenbroek-Hutten, Miriam Marie Rosé

doi:10.2196/40017

Cited by 3 publications

(5 citation statements)

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“…E-Supporter is developed iteratively on a scientific basis, together with end users [ 53 ]. A strength is that we evaluated E-Supporter between development iterations to identify key areas for improvement that will direct the further development of E-Supporter.…”

Section: Discussionmentioning

confidence: 99%

“…E-Supporter 1.0 consisted of coaching content that can be integrated into various app-based eHealth interventions. More detailed information about the design of E-Supporter 1.0 can be found elsewhere [ 53 ].…”

Section: Methodsmentioning

confidence: 99%

“…On the basis of if-then rules, E-Supporter 1.0 offers three types of intervention options: (1) motivational messages, (2) behavioral feedback, and (3) tailor-made supportive exercises to overcome barriers to achieving goals. E-Supporter 1.0 is described in detail elsewhere [ 53 ].…”

Section: Introductionmentioning

confidence: 99%

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A Digital Coach (E-Supporter 1.0) to Support Physical Activity and a Healthy Diet in People With Type 2 Diabetes: Acceptability and Limited Efficacy Testing

Hietbrink,

Oude Nijeweme-d’Hollosy,

Middelweerd

et al. 2023

JMIR Form Res

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Background A healthy lifestyle, including regular physical activity and a healthy diet, is increasingly part of type 2 diabetes (T2D) management. As many people with T2D have difficulty living and maintaining a healthy lifestyle, there is a need for effective interventions. eHealth interventions that incorporate behavior change theories and tailoring are considered effective tools for supporting a healthy lifestyle. The E-Supporter 1.0 digital coach contains eHealth content for app-based eHealth interventions and offers tailored coaching regarding physical activity and a healthy diet for people with T2D. Objective This study aimed to assess the acceptability of E-Supporter 1.0 and explore its limited efficacy on physical activity, dietary behavior, the phase of behavior change, and self-efficacy levels. Methods Over a span of 9 weeks, 20 individuals with T2D received daily motivational messages and weekly feedback derived from behavioral change theories and determinants through E-Supporter 1.0. The acceptability of the intervention was assessed using telephone-conducted, semistructured interviews. The interview transcripts were coded using inductive thematic analysis. The limited efficacy of E-Supporter 1.0 was explored using the Fitbit Charge 2 to monitor step count to assess physical activity and questionnaires to assess dietary behavior (using the Dutch Healthy Diet index), phase of behavior change (using the single-question Self-Assessment Scale Stages of Change), and self-efficacy levels (using the Exercise Self-Efficacy Scale). Results In total, 5 main themes emerged from the interviews: perceptions regarding remote coaching, perceptions regarding the content, intervention intensity and duration, perceived effectiveness, and overall appreciation. The participants were predominantly positive about E-Supporter 1.0. Overall, they experienced E-Supporter 1.0 as a useful and easy-to-use intervention to support a better lifestyle. Participants expressed a preference for combining E-Supporter with face-to-face guidance from a health care professional. Many participants found the intensity and duration of the intervention to be acceptable, despite the coaching period appearing relatively short to facilitate long-term behavior maintenance. As expected, the degree of tailoring concerning the individual and external factors that influence a healthy lifestyle was perceived as limited. The limited efficacy testing showed a significant improvement in the daily step count (z=−2.040; P=.04) and self-efficacy levels (z=−1.997; P=.046) between baseline and postintervention. Diet was improved through better adherence to Dutch dietary guidelines. No significant improvement was found in the phase of behavior change (P=.17), as most participants were already in the maintenance phase at baseline. Conclusions On the basis of this explorative feasibility study, we expect E-Supporter 1.0 to be an acceptable and potentially useful intervention to promote physical activity and a healthy diet in people with T2D. Additional work needs to be done to further tailor the E-Supporter content and evaluate its effects more extensively on lifestyle behaviors.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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A Digital Coach (E-Supporter 1.0) to Support Physical Activity and a Healthy Diet in People With Type 2 Diabetes: Acceptability and Limited Efficacy Testing

Hietbrink,

Oude Nijeweme-d’Hollosy,

Middelweerd

et al. 2023

JMIR Form Res

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“…B. [20]). Darüber hinaus ist auch plausibel, dass sie geeignet sind, Risikofaktoren zu tracken und zu analysieren, wie dies z.…”

Section: In Diesem Beitragunclassified

Mobile, alltagsnahe digitale Technologien für die Prävention der Alzheimer-Demenz: kognitive Gesundheit und kognitive Sicherheit

Düzel¹,

Thyrian

2023

Nervenarzt

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ZusammenfassungEs ist allgemein akzeptiert, dass die Versorgung der Alzheimer-Erkrankung durch präventive Maßnahmen zur Risikoreduktion flankiert werden sollte, um kognitive Funktionen möglichst lange aufrecht zu erhalten. Aber sowohl die Forschung als auch die Entwicklung von Versorgungskonzepten stehen hier vor Herausforderungen. Zum einen erfordert die präventive Risikoreduktion ein hohes Maß an medizinischer Interdisziplinarität der Neurologie und Psychiatrie mit anderen Disziplinen, zum anderen müssen Patienten ein hohes Maß an Gesundheitskompetenz entwickeln sowie Eigenmotivation und Adhärenz aufbringen. In diesem Konzeptpapier geht es um die Frage, wie mobile, alltagsnahe digitale Technologien helfen können, diese Herausforderungen zu adressieren. Die zentrale Prämisse ist die über Disziplinen hinweg koordinierte Strukturierung der Prävention mit den Schwerpunkten kognitive Gesundheit und kognitive Sicherheit. Kognitive Gesundheit fokussiert auf eine Reduktion lebensstilassoziierter Risikofaktoren. Kognitive Sicherheit betrifft die Minimierung iatrogen verursachter Nebenwirkungen auf kognitive Funktionen. Bei den digitalen Technologien, die in diesem Zusammenhang relevant werden, handelt es sich um mobile Smartphone- oder Tablet-basierte Apps zur alltagsnahen und hochfrequenten Erfassung kognitiver Funktionen, Apps, die als Companion-Technologien die Implementierung von Lifestyleänderungen coachen können, Apps, die bei der Reduktion iatrogener Risiken assistieren können und solche, die Gesundheitskompetenz von Patienten und Angehörigen verbessern können. Entsprechende Medizinprodukte sind in ihrem Entwicklungsstand unterschiedlich weit fortgeschritten. Daher geht es in diesem Konzeptpapier nicht um eine Produktübersicht, sondern um das prinzipielle Zusammenspiel potenzieller Lösungen in der Prävention der Alzheimer-Demenz in den Bereichen kognitive Gesundheit und kognitive Sicherheit.

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“…This approach aligns with contemporary best practices in intervention design [ 35 ], which advocate for the active involvement of potential users to ensure interventions are not only effective in theory, but also embraced and utilised in practice [ 36 ]. By involving patients with prediabetes and type 2 diabetes in the development process, we aimed to ensure that the intervention was grounded in the real-world experiences and needs of those it seeks to support [ 37 ], thereby enhancing its potential for a significant and lasting impact and scalability to a broad population of (pre)diabetes patients within primary care.…”

Section: Introductionmentioning

confidence: 99%

Participatory development of an mHealth intervention delivered in general practice to increase physical activity and reduce sedentary behaviour of patients with prediabetes and type 2 diabetes (ENERGISED)

Novak,

Jurkova,

Lojkaskova

et al. 2024

BMC Public Health

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Background The escalating global prevalence of type 2 diabetes and prediabetes presents a major public health challenge. Physical activity plays a critical role in managing (pre)diabetes; however, adherence to physical activity recommendations remains low. The ENERGISED trial was designed to address these challenges by integrating mHealth tools into the routine practice of general practitioners, aiming for a significant, scalable impact in (pre)diabetes patient care through increased physical activity and reduced sedentary behaviour. Methods The mHealth intervention for the ENERGISED trial was developed according to the mHealth development and evaluation framework, which includes the active participation of (pre)diabetes patients. This iterative process encompasses four sequential phases: (a) conceptualisation to identify key aspects of the intervention; (b) formative research including two focus groups with (pre)diabetes patients (n = 14) to tailor the intervention to the needs and preferences of the target population; (c) pre-testing using think-aloud patient interviews (n = 7) to optimise the intervention components; and (d) piloting (n = 10) to refine the intervention to its final form. Results The final intervention comprises six types of text messages, each embodying different behaviour change techniques. Some of the messages, such as those providing interim reviews of the patients’ weekly step goal or feedback on their weekly performance, are delivered at fixed times of the week. Others are triggered just in time by specific physical behaviour events as detected by the Fitbit activity tracker: for example, prompts to increase walking pace are triggered after 5 min of continuous walking; and prompts to interrupt sitting following 30 min of uninterrupted sitting. For patients without a smartphone or reliable internet connection, the intervention is adapted to ensure inclusivity. Patients receive on average three to six messages per week for 12 months. During the first six months, the text messaging is supplemented with monthly phone counselling to enable personalisation of the intervention, assistance with technical issues, and enhancement of adherence. Conclusions The participatory development of the ENERGISED mHealth intervention, incorporating just-in-time prompts, has the potential to significantly enhance the capacity of general practitioners for personalised behavioural counselling on physical activity in (pre)diabetes patients, with implications for broader applications in primary care.

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A Digital Lifestyle Coach (E-Supporter 1.0) to Support People With Type 2 Diabetes: Participatory Development Study

Cited by 3 publications

References 140 publications

A Digital Coach (E-Supporter 1.0) to Support Physical Activity and a Healthy Diet in People With Type 2 Diabetes: Acceptability and Limited Efficacy Testing

A Digital Coach (E-Supporter 1.0) to Support Physical Activity and a Healthy Diet in People With Type 2 Diabetes: Acceptability and Limited Efficacy Testing

Mobile, alltagsnahe digitale Technologien für die Prävention der Alzheimer-Demenz: kognitive Gesundheit und kognitive Sicherheit

Participatory development of an mHealth intervention delivered in general practice to increase physical activity and reduce sedentary behaviour of patients with prediabetes and type 2 diabetes (ENERGISED)

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