pHealth - Lessons learned from products and project
Directions for ICT Research in Disease Prevention
FT7-ICT-2009.5.1 – Support Action
Lessons learned from products
and projects dealing with primary
prevention through ICT
Technologies for Health & Wellbeing (TSB)
Universidad Politécnica de Valencia, Spain
• The WHO Report 2002 describes in detail how a few major risk factors
account for a significant proportion of all deaths and diseases in most
• All the most important risk factors for premature death are related to lifestyle
• Six out of the seven relate to diet and physical activity
• Unhealthy diets and lack of physical activity are
therefore the leading causes of avoidable illness and
premature death in Europe.
• It has been estimated that…
– …up to 80% of coronary heart disease cases…
– …90% of type 2 diabetes cases…
– …one third of cancers …
• Population based approaches
addressing lifestyle factors have
huge potential for the prevention
of severe morbidity and mortality.
• For this purpose in the last years
numerous scientific reports have
been produced by different
International Public Health
– including guidelines and
– for the management of the diverse
clinical conditions associated to the
presence or to the development of
an elevated risk profile.
What is done?
Revision of research projects of ICT and
Revision of commercial products, websites
and online health promotion organizations
Revision of complementary domains:
secondary and tertiary prevention, marketing
• Correct risk stratification for the
• Taking into account all the risk factors,
The best • not only the physic-pathological
• Also the genetic, environmental,
choice is socio-cultural, behavioral and
guided by… • In order to personalize health-hygiene
measures on the basis of the risk
The Challenges of Primary Prevention...
Identification & Assessment
• Who is at risk?
• Which is the risk?
Definition of the adequate strategy
• Which is the correct healthy lifestyle for me?
• How can I match my preferences with my healthy lifestyle?
Psychological approach to change
• Why should I change the life I have decided to live?
• How can I match my social role and life with my healthy lifestyle?
Sustainability & Control
• How can I keep control but reduce my need to intervene?
• Why should I incorporate the change to my life?
Identification & Assessment
Identifying the people at risk and correctly assessing
which are their key risks and to what extent is very
People that are just
Risk is an indicator that is calculated based on
at risk are not
probabilities and population inferences made
identified inside the
for a specific pathology
Personalized and dynamic risk
A much bigger part of the
assessment of the individual and
population could be traced Only used for providing
its evolving lifestyle can provide
incorporating new stakeholders population based
the necessary knowledge for the
into the game: school, workplace, recommendations.
personalization of the prevention
Definition of Adequate Strategy
Definition of adequate actions that the person must do or
that have to be applied to the person to improve his risk
profile and reduce the probability of developing a disease.
As the risk model becomes more complex and the action more
personalized, the possibilities for interventions need to be
boosted with the support of a dynamic and adaptive system.
The evidence in the literature supports the
The needs of the individual and the desired
belief that a comprehensive and personalized
lifestyle trends could be better aligned
action towards the major risk factors that are
moving to a more personalized intervention
modifiable can result in a major
than the traditional public health campaigns.
improvement of the individual’s risk profile.
The individual is required to change the lifestyle he
and his circumstances have chosen to follow and this
change is normally neither easy nor wanted.
To achieve the success in moving people towards a
healthier lifestyle, thus reducing their risk profile,
there is the need for a combined action
Any intervention should incorporate a highly
Including all the possible actors and mediators psychological strategy that contributes to the
that are related, both that influence the citizen idea of convincing the person that the lifestyle
(school, workplace, community) or that depends change is required, and providing a continuous
on the citizen (family). motivation to support the permanence of those
Sustainability & intrusiveness
People at risk are in general terms healthy people that may be more or
less aware of the consequences of not preventing risk but that for sure
can’t be expected to invest a great amount of resources in solutions
with just a preventive background.
In general people wouldn’t like to be immersed in a highly intrusive
environment that in some way constrains their normal life.
New business models, enhanced motivational
strategies and innovative technological solutions In this scenario, Ambient Intelligence can lead to
are needed, involving non-traditional actors, a disruptive breakthrough in the way of
and using products and services that are more interaction.
consumer-oriented than health-oriented.