Directions for ICT Research in Disease Prevention




 FP7-ICT-2009.5.1 – Support Action




                     User pro...
Health behavior matters

• Poor lifestyle choices
  increasingly are the largest
  contributors to common
  adverse health...
Lifestyle change - a challenge

• Education and knowledge are required
   – not everyone is aware of their health risks an...
Need for assistance and support

In order to empower the citizen to adopt a healthy lifestyle

1. Profile the person and h...
PROFILING THE PERSON – FACTORS THAT
INFLUENCE BEHAVIOR



                www.preve-eu.org
Determinants of health behavior

  Values, personality
                  Social                          Ability
         ...
Motivators / Incentives

• emerge from personal
  values which are
  relatively stable

• guide intentions by
  defining t...
Environmental context

• influences our choices                      Public policy
  through
   – the availability of prod...
Life stages and trigger events


Motivators




Resources



Trigger
events

             Childhood   Adolescence    Adult...
Example Persona, diet & exercise
                       1. Basic information                     10. Outcome expectations ...
Interventions for Oscar 1/2
    Aim: strengthen the weak intention / motivation for healthy diet &
    regular exercise
Pr...
Interventions for Oscar 2/2
Problem to target Methods to use
Outcome                  Arguments for positive images that m...
Personal profile
                                                                      Ability
                           ...
IMPLICATIONS FOR INTERVENTIONS



              www.preve-eu.org
Main principles

• Primary aims:
   – Create or strengthen intention
   – Increase abilities and remove barriers

• Consid...
High-level intervention logic




     www.preve-eu.org
Targeting vs. tailoring

• Targeting: designing interventions for subgroups with
  common characteristics
   – Segmentatio...
Concluding Vision:
       ICT enabled personalized interventions
• A Do-It-Yourself platform for profiling yourself and to...
PREVE partners

Valtion teknillinen tutkimuskeskus, VTT

Aarhus University

Fondazione Centro San Raffaele del
  Monte Tab...
Appendix: Investigated theories by their
                  focus areas
Individual behavior and behavior change   Specific ...
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pHealth - User profiling and segmentation

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pHealth - User profiling and segmentation

  1. 1. Directions for ICT Research in Disease Prevention FP7-ICT-2009.5.1 – Support Action User profiling and segmentation: Personalizing interventions for healthy behavior Anita Honka, Kirsikka Kaipainen VTT Technical Research Center of Finland pHealth 2010, Berlin Session 11: ICT research directions for disease prevention This project is partially funded under the 7th Framework Programme by the European Commission
  2. 2. Health behavior matters • Poor lifestyle choices increasingly are the largest contributors to common adverse health outcomes • WHO: 77% of the disease Non-Modifiable Contributors to Disease Lifestyle Contributors to Disease burden in Europe is accounted for by disorders Hu et al. Diet, lifestyle and the risk of type 2 Diabetes in women. NEJM 2001 Sep 13;345(11):790-7. Stampfer MJ, Hu FB, Manson JE, Rimm EB, Willett WC. Primary related to lifestyles prevention of coronary heart disease in women through diet and lifestyle. N Engl J Med. 2000; 343: 16–22 Life style risk factors Diet Alcohol consumption Sleep Physical activity Smoking Stress www.preve-eu.org
  3. 3. Lifestyle change - a challenge • Education and knowledge are required – not everyone is aware of their health risks and how to live healthily • Lifestyle change is difficult – often requires people to change their familiar habits and give up their preferred ways of living • Motivation is the main challenge – how to motivate people to take preventive actions against diseases that might occur in the distant future www.preve-eu.org
  4. 4. Need for assistance and support In order to empower the citizen to adopt a healthy lifestyle 1. Profile the person and his environment  personal profile – Identify health risk factors, – sources of motivation and – difficulties and barriers that discourage / prevent behavior change 2. Provide personalized guidance for behavioral change www.preve-eu.org
  5. 5. PROFILING THE PERSON – FACTORS THAT INFLUENCE BEHAVIOR www.preve-eu.org
  6. 6. Determinants of health behavior Values, personality Social Ability influences Reasoned Awareness Self-efficacy Intention behavior Outcome expectations Barriers Automatic behaviors Environmental contexts www.preve-eu.org
  7. 7. Motivators / Incentives • emerge from personal values which are relatively stable • guide intentions by defining the perceived value for expected outcomes • fulfill our needs and are considered as benefits Motivational value types by Schwarz www.preve-eu.org
  8. 8. Environmental context • influences our choices Public policy through – the availability of products, Community services and facilities that support / discourage healthy behaviors – ways choices are presented Organizational i.e. the choice architecture – social norms and public Interpersonal regulations • is built by actors from Individual multiple levels Influences on different levels www.preve-eu.org
  9. 9. Life stages and trigger events Motivators Resources Trigger events Childhood Adolescence Adulthood Old age www.preve-eu.org
  10. 10. Example Persona, diet & exercise 1. Basic information 10. Outcome expectations 2. Values, personality Oscar, 28 years, Finnish. I could get into shape, make my wife Hedonism: seeks for pleasure and enjoyment, lives Lives with her wife, no happy and possibly live longer, in the moment, hates planning, somewhat worried children. BUT it’s not worth the effort: of his looks. Education: vocational. Too complicated to plan and cook food Benevolence: helpful and generous, pleased to Occupation: carpenter. everyday, exercising is hard and makes make people happy. me feel nauseous. Watching TV is much Self-direction: practical type, wants to create with 8. Social influences more fun. his hands. Discouraging. Friends have bad Attitude: Better to live a short life of Interests: hunting and motor vehicles habits, too. Eat out together and enjoyment than a long life with Motivators: enjoyment, appreciation, practicality, watch sports from TV. Wife tries restrictions. uncomplicatedness, body shape, interests to push him to change his habits, which he considers as nagging. 4. Current health behavior 5. Risk factors Poor. Eats irregularly. Often Family history of 12. External resources enjoys sugary and fatty foods. hypertension, bad Fair. Good exercise facilities near, but Gets some physical activity at working ergonomics, variety of sports lacking. Healthy food work, but that’s about it. slight overweight varieties available, but unhealthy products even more. Sufficient time for 9. Self-efficacy 7. Awareness leisure. Money is not a problem. Strong. Is confident Fair. Is aware of his unhealthy habits, of his capability to but is not concerned of the future. 11. Abilities change behavior. Discounts the value of health. Thinks Poor. Low knowledge literacy, draws that in any case the quality of life will conclusions based on the experiences 13. Channels, services deteriorate significantly after turning 50. of few people only. Does not have Information sources he considers eligible: 6. Intention enough patience to follow very internet discussion forums, friends, parents, 3. Quality of life / Health status Weak. Has thought complex information. Suffers from a siblings and professionals. Generally good. Occasional back pain about changing his panic disorder, which is triggered by Media: TV, hunting, weapon and motorcycle due to bad working ergonomics. Poor habits, but is not hard physical effort. Low self-control: magazines. fitness: recognizes this when lifting ready to take action. hard to resist temptations. Services: restaurants, movie rentals, hunting heavy things at work, gets rather easily club. exhausted during hunting trips. www.preve-eu.org
  11. 11. Interventions for Oscar 1/2 Aim: strengthen the weak intention / motivation for healthy diet & regular exercise Problem to target Methods to use Awareness: Education on the long-term health benefits of healthy lifestyle. Pointing out lack of knowledge, poor reliable health information sources. knowledge literacy Methods: Images as analogies, Tailoring information Co-creator: health care Awareness: Information about personal risk: musculoskeletal problems in the near future, biased risk assessment, cardiovascular disease, diabetes. discounting the value of Imaginary time-shifting with loss-frame: plausible future scenarios of his body health shape and quality of life. Contacts with older people who had similar thoughts and habits when younger and their experiences on aging. Co-creators: health care, Facebook Social influences: Health education targeted to friends, parents and siblings. habit for unhealthy Making friends’ health expectations and attitudes visible. social activities Mobilizing social support: engaging everyone in a common health promotion plan. Wife to have an encouraging attitude instead of complaining, show special appreciation when her husband cooks. Co-creators: health care, psychologists, exercise facility providers, community www.preve-eu.org
  12. 12. Interventions for Oscar 2/2 Problem to target Methods to use Outcome Arguments for positive images that motivate e.g. good-looking and fit expectations: motorcyclist, hunting without getting exhausted, energy to apply at work. disadvantages exceed Providing short-term benefits for healthy behavior e.g. seasonal hunting limit advantages health behavior dependent, encouragement to use creativity in cooking. Co-creators: psychologists, hunting club, restaurants, grocery shops, work place Abilities: Guided practise: training for preparing healthy, but easy meals. complicated to plan Practical tips to help planning, pre-planned cooking and eating schedule. and prepare meals Co-creators: nutritionists, restaurants, grocery shops Abilities: Learning coping strategies. Treatment for the disorder. Support in finding panic disorder appropriate exercise options that do not trigger the condition. Co-creators: health care, psychologies Abilities: Practical tips: e.g. do not storage sugary and fatty foods at home, go shopping weak self-control to when hungry, or keep TV open in the background. Make a shopping list before resist temptations entering the shop. Co-creators: health care, psychologists External resources: Modifying availability and choice architecture: Unhealthy foods out of direct unhealthy food readily sight in shops, less in variety. Less fast food places. Increased availability of available healthy products. Co-creators: grocery shops, community, government, restaurants www.preve-eu.org
  13. 13. Personal profile Ability Profiling variables Reasoned Intention - Current health behaviors and risk factors behavior - Degree of intention towards healthy behaviors - Motivators derived from values and interests Barriers - Resources Resources (barriers & abilities) External resources Internal resources Social environment Psychological abilities Service environment Physical abilities Physical environment Determinants of intention Channels and services used Habits and routines Time & Monetary resources Dynamicity www.preve-eu.org
  14. 14. IMPLICATIONS FOR INTERVENTIONS www.preve-eu.org
  15. 15. Main principles • Primary aims: – Create or strengthen intention – Increase abilities and remove barriers • Consider the environmental contexts of the person – Remove barriers and create facilitators – Guide people with appropriate choice architectures – Offer immediate, tangible benefits for healthy behaviors Make changes on multiple levels through involving different actors  Identify co-creators of health and involve them in delivering interventions (business models) • Take advantage of trigger events in people’s lives www.preve-eu.org
  16. 16. High-level intervention logic www.preve-eu.org
  17. 17. Targeting vs. tailoring • Targeting: designing interventions for subgroups with common characteristics – Segmentation dimensions: health behavior, motivators and resources – Benefits: reach many individuals, fairly affordable – Challenge: to provide interventions personalized enough • Tailoring: fitting an intervention to meet the personal needs and characteristics of a person rather than a group – The most effective approach, but traditionally costly • Persuasive technologies as a way of delivering guidance for individuals – affordable, accessible, personalized www.preve-eu.org
  18. 18. Concluding Vision: ICT enabled personalized interventions • A Do-It-Yourself platform for profiling yourself and to select interventions that match your profile – Enables tailored interventions • ICT could faciliate the execution of interventions – Bring the co-creators, meaningful interpersonal relations and the citizen together – Provide personal guidance e.g. suggestions for healthy options, reminders, practical tips, feedback – Context awareness www.preve-eu.org
  19. 19. PREVE partners Valtion teknillinen tutkimuskeskus, VTT Aarhus University Fondazione Centro San Raffaele del Monte Tabor Universidad Politécnica de Valencia www.preve-eu.org
  20. 20. Appendix: Investigated theories by their focus areas Individual behavior and behavior change Specific behavioral determinants Theories of individual behavior • Theories of social networks and social • Social Cognitive Theory (SCT) support • Health Belief Model (HBM) • Prototype Willingness Model (PWM) • Theory of Reasoned Action (TRA) • Self-determination Theory (SDT) • Theory of Planned Behavior (TPB) • Protection Motivation Theory (PMT) • Integrated Change Model (ICM) • Goal-setting theories • Attribution theory Theories of stages of behavior change • Transtheoretical Model (TTM) Communication • Precaution Adoption Process Model (PAPM) • Elaboration Likelihood Model (ELM) • Health Action Process Approach (HAPA) • Diffusion of Innovations Theory (DIT) • Persuasion-Communication Matrix (PCM) Frameworks of behavioral theories • Social marketing framework Applications of theories • Behavioral economics • Psychological therapies • Persuasive technologies Theories of automatic behavior and habits Life stages and profiling Learning theories • Developmental theories www.preve-eu.org

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