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An interactive health technology solution for encouraging physical activity: a first model based on a user perspective
Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Innovation, Design and Engineering. (IFT, ESS-H)ORCID iD: 0000-0002-7882-5438
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Globally, the level of physical inactivity is increasing. The overall aim of this thesis was to develop and test a first model of an interactive health technology solution (called App&Move) that should encourage physically inactive adults to be more physically active. App&Move was iteratively developed based on the user perspective, a so-called user-centered design. First, available technology was assessed; the validity and reliability of one smartphone pedometer application and one commonly used traditional pedometer were investigated. It was found that none of the investigated pedometers could measure correctly in all investigated situations. However, measurements by a smartphone appli-cation was identified to have high potential when aimed at monitoring physical activity in everyday situations. As the next step, a questionnaire was developed and distributed in central Sweden. The 107 respondents who answered the questionnaire were divided and analyzed in groups of users and non-users of physical activity self-monitoring technology. The results showed that users and non-users of such technology mainly had similar opinions about desirable functions of the technology. To gain further knowledge concerning how to design App&Move, the target group physically inactive non-users participated in focus group interviews. Important results were that the technology should focus on encouragement rather than measurements and that it preferably should be integrated into already existing technology, if possible already owned and worn by the person. A brainstorming workshop confirmed that the smartphone was a suitable platform, and a decision to develop a smartphone application was taken. A first draft of App&Move was developed, focusing on encouragement and measuring everyday activity and exercise in minutes per day. App&Move was based on available physical activity recommendations and strategies for successful behavior change. App&Move was positively received in a user workshop and thereafter iteratively refined and developed based on further user input. App&Move was usability tested in 23 physically inactive adults who used App&Move for four weeks and answered two questionnaires. Three usability aspects, effectiveness, efficiency and satisfaction, were assessed as follows: acceptable, high and medium, and slight increases in activity minutes were observed during the test period. To conclude, this thesis has investigated the user perspective of physical activity self-monitoring technology with a target group of physically inactive adults. Based on these findings, a behavior change application for smartphone, App&Move, was presented. The usability test indicated promising results with respect to usability and indicated an ability to encourage the users to physical activity to some extent.

Abstract [sv]

Andelen fysiskt inaktiva ökar i världen. Det övergripande syftet med denna avhandling var att utveckla och testa en första modell av en interaktiv hälsotekniklösning (benämnd App&Move), som syftar till att uppmuntra fysiskt inaktiva vuxna till ökad fysisk aktivitet. Utvecklingen av App&Move var baserad på användarperspektivet, och utvecklades i en iterativ process, så kallad användarcentrerad design. Inledningsvis gjordes en undersökning av befintlig teknik för ändamålet; validitet (giltighet) och reliabilitet (tillförlitlighet) studerades i en studie med en stegräknarapplikation för smartphone och en vanligt förekommande traditionell stegräknare. Resultatet visade att ingen av de studerade stegräknarna kunde utföra tillförlitliga mätningar i alla situationer. Dock visade det sig att mätning med stegräknarapplikation hade en lovande potential för att monitorera fysisk aktivitet i det vardagliga livet. Som ett nästa steg utvecklades och distribuerades en enkät till utvalda personer i Mellansverige. De 107 som svarade på enkäten delades in och analyserades i grupperna användare respektive icke användare av fysisk aktivitetsmonitoreringsteknik. Studien visade att båda grupperna i huvudsak hade liknande åsikter om hur denna teknik borde utformas och vilken funktionalitet den borde ha. För att inhämta vidare kunskap om utformningen av App&Move, så utfördes fo-kusgruppsintervjuer med målgruppen fysiskt inaktiva. Analysen påvisade att denna teknik i huvudsak borde fokusera på att uppmuntra till fysisk aktivitet snarare än att mäta fysisk aktivitet, och att det var önskvärt att tekniken skulle vara integrerad i befintlig teknik som användaren redan ägde och bar med sig. En workshop bekräftade att en smartphone var en lämplig plattform att använda, och beslut togs därefter att utveckla en smartphoneapplikation. Ett första förslag av App&Move utvecklades, med fokus på uppmuntran, men som även mätte vardagsaktivitet och träning i form av antal minuter per dag. App&Move baserades på tillgängliga rekommendationer gällande fysisk aktivitet samt strategier för framgångsrik beteendeförändring. Förslaget presenterades och mottogs positivt i en workshop med användare, och förslaget blev därefter förfinat och utvecklat vidare baserat på användarnas återkoppling. App&Move användbarhetstestades därefter på 23 fysiskt inaktiva vuxna, vilka använde appen under fyra veckor samt besvarade två enkäter. Tre användbarhetsaspekter användes i studien, vilka bedömdes som acceptabel, hög och medel, och en antydan till ökning av aktivitetsminuter under testperioden kunde iakttagas. Sammanfattningsvis har denna avhandling undersökt användarperspektiv hos målgruppen fysiskt inaktiva, gällande fysisk aktivitetsmonitoreringsteknik. Utifrån dessa resultat har en beteendeförändringsapplikation utvecklats och testats. Användbarhetstestet indikerade lovande potential gällande användbarheten, och tydde även på att appen till viss del kan uppmuntra användarna till ökad fysisk aktivitet.

Place, publisher, year, edition, pages
Västerås: Mälardalen University Press , 2018.
Series
Mälardalen University Press Dissertations, ISSN 1651-4238 ; 254
Keywords [en]
physical activity, user perspective, user, technology, encourage, behavior change, application, smartphone
Keywords [sv]
fysisk aktivitet, användarperspektiv, användare, teknik, uppmuntra, beteendeförändring, applikation, smartphone
National Category
Medical Engineering
Research subject
Care Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-38561ISBN: 978-91-7485-374-2 (print)OAI: oai:DiVA.org:mdh-38561DiVA, id: diva2:1180543
Public defence
2018-03-20, Sal Pi, Mälardalens Högskola, Västerås, 09:30 (English)
Opponent
Supervisors
Funder
Knowledge Foundation, 20120275Available from: 2018-02-06 Created: 2018-02-06 Last updated: 2018-02-22Bibliographically approved
List of papers
1. Investigation of the validity and reliability of a smartphone pedometer application
Open this publication in new window or tab >>Investigation of the validity and reliability of a smartphone pedometer application
2016 (English)In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 18, no 3, p. 185-193Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to investigate the validity and measurement agreement of a smartphone pedometer application and a traditional pedometer, both compared to manual step count, in six environments. The study also examined the relative reliability of two positions of the smartphone pedometer application in the six environments. Twenty participants carried two smartphones (iPhone 4S) with the same pedometer application (Pedometer FREE GPSþ) in two device positions together with a traditional pedometer (Yamax LS2000) while walking in six environments. The pedometer application in the chest position (app chest) differed significantly from the manual step count when walking uphill (p¼0.003), the application in the trouser (pants) position (app pants) differed for downhill (p¼0.001) and the traditional pedometer (trad ped) differed upstairs (p¼0.007). The measurement agreement was high for app pants uphill, app chest downhill and trad ped downstairs. The relative reliability was fair for app chest, but poor for app pants. In conclusion, the pedometer application and traditional pedometer were valid for step self-monitoring in some environments, and the measurement agreement compared to manual step count was mainly medium to high. The relative reliability for the smartphone pedometer application was partly acceptable. Smartphones could be useful in some environments for physical activity self-monitoring.

Place, publisher, year, edition, pages
Sweden: , 2016
Keywords
Device position, environment, measure, physical activity, selfmonitoring, step
National Category
Electrical Engineering, Electronic Engineering, Information Engineering
Identifiers
urn:nbn:se:mdh:diva-33820 (URN)10.3109/21679169.2016.1174297 (DOI)000390400200008 ()2-s2.0-84969776539 (Scopus ID)
Available from: 2016-11-21 Created: 2016-11-21 Last updated: 2018-02-06Bibliographically approved
2. Technologies for physical activity self-monitoring: a study of differences between users and non-users
Open this publication in new window or tab >>Technologies for physical activity self-monitoring: a study of differences between users and non-users
2017 (English)In: Open Access Journal of Sports Medicine, ISSN 1179-1543, E-ISSN 1179-1543, Vol. 8, p. 17-26Article in journal (Refereed) Published
Abstract [en]

Background: Different kinds of physical activity (PA) self-monitoring technologies are used today to monitor and motivate PA behavior change. The user focus is essential in the development process of this technology, including potential future users such as representatives from the group of non-users. There is also a need to study whether there are differences between the groups of users and non-users. The aims of this study were to investigate possible differences between users and non-users regarding their opinions about PA self-monitoring technologies and to investigate differences in demographic variables between the groups. Materials and methods: Participants were randomly selected from seven municipalities in central Sweden. In total, 107 adults responded to the Physical Activity Products Questionnaire, which consisted of 22 questions. Results: Significant differences between the users and non-users were shown for six of the 20 measurement-related items: measures accurately (p = 0.007), measures with high precision (p = 0.024), measures distance (p = 0.020), measures speed (p = 0.003), shows minutes of activity (p = 0.004), and shows geographical position (p = 0.000). Significant differences between the users and non-users were also found for two of the 29 encouragement items: measures accurately (p = 0.001) and has long-term memory (p = 0.019). Significant differences between the groups were also shown for level of education (p = 0.030) and level of physical exercise (p = 0.037). Conclusion: With a few exceptions, the users and the non-users in this study had similar opinions about PA self-monitoring technologies. Because this study showed significant differences regarding level of education and level of physical exercise, these demographic variables seemed more relevant to investigate than differences in opinions about the PA self-monitoring technologies.

Place, publisher, year, edition, pages
DOVE MEDICAL PRESS LTD, 2017
National Category
Electrical Engineering, Electronic Engineering, Information Engineering
Identifiers
urn:nbn:se:mdh:diva-35358 (URN)10.2147/OAJSM.S124542 (DOI)000399936500001 ()28280399 (PubMedID)
Available from: 2017-05-22 Created: 2017-05-22 Last updated: 2018-02-06Bibliographically approved
3. How can technology promote physical activity? Opinions from physically inactive non-users of self-monitoring technologies
Open this publication in new window or tab >>How can technology promote physical activity? Opinions from physically inactive non-users of self-monitoring technologies
(English)Manuscript (preprint) (Other academic)
Abstract [en]

BACKGROUND: To achieve a more physically active and healthier population, the opinions of potential future users of physical activity self-monitoring technologies need further investigation. Therefore, the aim of this study was to investigate the opinions of physically inactive non-users of physical activity self-monitoring technologies, regarding how and when technology possibly could measure and encourage physical activity. METHODS: Two focus group interviews were performed, consisting of 11 physically inactive persons who had no previous experience with regular use of physical activity self-monitoring technology. The focus groups were analyzed by qualitative content analysis. RESULTS: The transcripts of the two focus groups resulted in 17 subcategories and five categories, which formed two themes: measurement complexity and performance and basic qualities. CONCLUSION: This study showed that the physically inactive non-users of physical activity self-monitoring technologies had positive, innovative and mainly similar opinions about how technology could promote physical activity. Since the concept of encouragement permeates the results, it can be concluded that the physical activity technology for this particular target group should primarily be based on encouraging features and functions. Further, the study indicated that it is preferable to integrate physical activity self-monitoring technology into already existing technology that the user already owns.

Keywords
physical activity, technology, measure, enourage
National Category
Medical Engineering
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-38538 (URN)
Funder
Knowledge Foundation, 20120275
Available from: 2018-02-05 Created: 2018-02-05 Last updated: 2018-02-06Bibliographically approved
4. The development and usability evaluation of an interactive health technology solution for the encouragement of physical activity in inactive adults - based on the user perspective
Open this publication in new window or tab >>The development and usability evaluation of an interactive health technology solution for the encouragement of physical activity in inactive adults - based on the user perspective
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Physical inactivity is increasing worldwide. Technology shows good evidence forhaving a good impact on health. Successful behaviour change regarding physical activity requires user involvement and the integration of relevant behaviour change techniques into the technology. The aim of this study was, based on the user perspective, to develop and later evaluate the usability of an interactive health technology solution that can encourage physically inactive adults to physical activity. A mixed methods design with a user-centred approach was used. The data collection included a brainstorming workshop, a user workshop, technical development and a usability evaluation (effectiveness, efficiency, satisfaction) involving 35 participants. From the brainstorming workshop, four themes were identified: focus, platform, characteristics and content. A schematic model of a first prototype was presented at the user workshop, and the feedback was positive. A behaviour change application was developed (App&Move), with a focus on encouraging functions. App&Move, which measures physical activity in minutes per day, has integrated behaviour change techniques, is based on available physical activity recommendations, relies on scientific evidence and is strongly based on the user perspective. The usability evaluation of App&Move showed that effectiveness was acceptable, efficiency was (with one exception) high, and satisfaction was medium. The results from this study contributes to the development of a first model of a behaviour change application that aims to encourage physically inactive adults to physical activity. In conclusion, the usability evaluation of App&Move showed promising usability, and the application seemed to encourage physical activity to some extent.

Keywords
user, encourage, physical activity, smartphone, application, usability
National Category
Medical Engineering
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-38540 (URN)
Funder
Knowledge Foundation, 20120275
Available from: 2018-02-05 Created: 2018-02-05 Last updated: 2018-02-06Bibliographically approved

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