Skip to main content
SpringerLink
Log in

Designing healthy living support: mobile applications added to hybrid (e)Coach solution

  • Original Paper
  • Published:
Health and Technology Aims and scope Submit manuscript

Abstract

Healthy living is an increasingly important topic on the agenda of policy makers. Containment of health care cost through public health and specific prevention programs is seen as a key element of the current social-economic policies in the western world. Mobile health technology holds the promise to make healthy living support more effective than traditional prevention programs. We extended hybrid lifestyle support (web-based and face to face) with smart phone applications. This paper follows a design research cycle. We start from a user needs analysis, proceed to solution analysis, service development and user testing. Interestingly, despite explicit ex ante user needs for mobile App support and despite their appreciation for the apps, the users in our field test discontinued using the apps relatively fast. The eHealth law of attrition appeared to apply here too. Inspired by the user feedback, we propose several design guideline lessons. For the future, we anticipate more personal and intelligent mobile applications for health behavior tracking and feedback, plus an increasing role in health provider processes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Notes

  1. These practical user questions are also the reason why the healthy consumption guidelines should preferably aim at foods, and less at chemical compounds [27]

References

  1. Akter SJ, D’Ambra J, Ray P. Service quality of mHealth platforms: development and validation of a hierarchical model using PLS. Electron Mark. 2010;20(3):209–27.

    Article  Google Scholar 

  2. Akter S, D’Ambra J, Ray P. Continuance of mHealth Services at the bottom of the pyramid: the roles of service quality and trust. Electronic Markets. 2012;22(3):online.

  3. Anderson JW, Baird P, Davis Jr RH, Ferreri S, Knudtson M, Koraym A, et al. Health benefits of dietary fiber. Nutr Rev. 2009;67:188–205.

    Article  Google Scholar 

  4. Bandura A. Self-efficacy: the exercise of control. New York: Freeman; 1997.

    Google Scholar 

  5. Brouwer IA, Wanders AJ, Katan MB. Effect of animal and industrial trans fatty acids on HDL and LDL cholesterol levels in humans-A quantitative review. PLoS One. 2010;5:e9434.

    Article  Google Scholar 

  6. Bruck PA, Motiwalla L, Foerster F. Mobile learning with micro-content: a framework and evaluation. Paper presented at the 25th Bled eConference. from www.bledconference.org. 2012.

  7. Buijs JA, Valkenburg R. Integrale productontwikkeling. 3rd ed. Utrecht: Lemma; 2005.

    Google Scholar 

  8. Cialdini RB. Influence. The psychology of persuasion. 2nd ed. New York: William Morrow; 1993.

    Google Scholar 

  9. Cocosila M, Archer N. Adoption of mobile ICT for health promotion: an empirical investigation. Electron Mark. 2010;20(3–4):241–50.

    Article  Google Scholar 

  10. De Vries H, Mudde A. Predicting stage transitions for smoking cessation applying the Attitude–Social influence–Efficacy Model. Psychol Heal. 1998;13:369–85.

    Article  Google Scholar 

  11. De Vries H et al. The effectiveness of tailored feedback and action plans in an intervention addressing multiple health behaviors. Am J Health Promot. 2008;22(6):417–25.

    Article  Google Scholar 

  12. Deci EL, Ryan RM. Intrinsic motivation and self-determination in human behavior. New York: Plenum; 1985.

    Google Scholar 

  13. Ebeling M. Mobile Update May. http://www.emerce.nl/achtergrond/mobile-update-mei-2012. 2012.

  14. Eysenbach G. The law of attrition. J Med Internet Res. 2005;7(1):e11.

    Article  Google Scholar 

  15. Ezzati M et al. Comparative quantification of mortality and burden of disease attributable to selected risk factors. 2006.

  16. Giovannucci E, Rimm EB, Wolk A, et al. Calcium and fructose intake in relation to risk of prostate cancer. Cancer Res. 1998;58:442–7.

    Google Scholar 

  17. Gollwitzer PM, Sheeran P. Implementation intentions and goal achievement: a meta-analysis of effects and processes. Adv Exp Soc Psychol. 2006;38:69–119.

    Article  Google Scholar 

  18. Haskell WL, Alderman EL, Fair JM, Maron DJ, Mackey SF, Superko HR, et al. Effects of intensive multiple risk factor reduction on coronary atherosclerosis and clinical cardiac events in men and women with coronary artery disease the Stanford Coronary Risk Intervention Project (SCRIP). Circulation. 1994;89:975–90.

    Article  Google Scholar 

  19. Hu FB, Manson JE, Stampfer MJ, Colditz G, Liu S, Solomon CG, et al. Diet, lifestyle, and the risk of Type 2 diabetes mellitus in women. N Engl J Med. 2001;345:790–7.

    Article  Google Scholar 

  20. Jimison H, Gorman P, Woods S, Nygren P, Walker M, et al. Barriers and drivers of health information technology use for the elderly, chronically ill, and underserved. Evid Rep Technol Assess (Full Rep) 2008;(175):1–1422.

  21. Kushi LH, Doyle C, McCullough M, Rock CL, Demark-Wahnefried, et al. American Cancer Society Guidelines on Nutrition and Physical Activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin. 2012;62:30–67.

    Article  Google Scholar 

  22. Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, et al. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA. 2002;288:2709–16.

    Article  Google Scholar 

  23. Lippke S, Wiedemann AU, Ziegelmann JP, Reuter T, Schwarzer R. Self-efficacy moderates the mediation of intentions into behavior via plans. Am J Heal Behav. 2009;33(5):521–9.

    Google Scholar 

  24. Liu S, Willett WC, Stampfer MJ, et al. A prospective study of dietary glycemic load, carbohydrate intake, and risk of coronary heart disease in US women. Am J Clin Nutr. 2000;71:1455–61.

    Google Scholar 

  25. Lopez AD, et al. Measuring the global burden of disease and risk factors, 1990–2001. 2006.

  26. McCullough ML, Patel AV, Kushi LH, et al. Following cancer prevention guidelines reduces risk of cancer, cardiovascular disease, and all-cause mortality. Cancer Epidemiol Biomarkers Prev. 2011;20:1089–97.

    Article  Google Scholar 

  27. Mozaffarian D, Ludwig DS. Dietary guidelines in the 21st century — a time for food. JAMA. 2010;304:681–2.

    Article  Google Scholar 

  28. NHLBI. National Heart, Lung, and Blood Institute. We Can! Ways to Enhance Children’s Activity and Nutrition. http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/downloads/go-slow-whoa.pdf. (2012). Accessed Feb 28, 2012.

  29. Nielsen J. Why You Only Need to Test With 5 Users. Alertbox March 19, 2000, at http://www.useit.com/alertbox/20000319.html. (2000), accessed on 30/4/01.

  30. Ornish D. The spectrum: a scientifically proven program to feel better, live longer, lose weight, gain health. New York: Ballantine; 2008.

    Google Scholar 

  31. Pedersen JI, James PT, Brouwer IA, et al. The importance of reducing SFA to limit CHD. Br J Nutr. 2011;106:961–3.

    Article  Google Scholar 

  32. Pollak M. Insulin and insulin-like growth factor signalling in neoplasia. Nat Rev Cancer. 2008;8:915–28.

    Article  Google Scholar 

  33. Reiss S. Multifaceted nature of intrinsic motivation: the theory of 16 basic desires. Rev Gen Psychol. 2004;8(3):179–93.

    Article  Google Scholar 

  34. Roberts CK, Barnard RJ. Effects of exercise and diet on chronic disease. J Appl Physiol. 2005;98:3–30.

    Article  Google Scholar 

  35. Sattar N, Gaw A, Scherbakova O, Ford I, O’Reilly DSJ, Haffner SM, et al. Metabolic syndrome with and without C-reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study. Circulation. 2003;108:414–9.

    Article  Google Scholar 

  36. Schwarzer R. Modeling health behavior change: how to predict and modify the adoption and maintenance of health behaviors. Appl Psychol: Int Rev. 2008;57(1):1–29.

    Article  Google Scholar 

  37. Schwarzer R et al. Translating intentions into nutrition behaviors via planning requires self-efficacy: evidence from Thailand and Germany. Int J Psychol. 2010;45(4):260–8.

    Article  Google Scholar 

  38. Simons LPA. Multi-channel services for click and mortars: development of a design method. PhD Thesis, Delft University of Technology. 2006.

  39. Simons LPA, Hampe JF. Service Experience Design for Healthy Living Support; Comparing an In-House with an eHealth Solution. Paper presented at the 23rd Bled eConference. from www.bledconference.org. 2010.

  40. Simons LPA, Hampe JF. Exploring e/mHealth potential for health improvement; a design analysis for future e/mHealth Impact. Paper presented at the 23rd Bled eConference. from www.bledconference.org. 2010-2

  41. Simons LPA, Hampe JF, Guldemond NA. Designing ICT-support for healthy lifestyle interventions. submitted for Electronic Markets 2013.

  42. Simons LPA, Bouwman H. Designing a click and mortar channel mix. Int J Int Mark Advert. 2004;1(3):229–50.

    Google Scholar 

  43. Simons LPA, Verhagen WP. Applying value-sensitive design and quality function deployment to healthcare ICT: the case of Dutch primary care unit dossiers. J Design Res. 2008;7(2):155–76.

    Article  Google Scholar 

  44. Sperling R, Simons LPA, Bouwman H. Multi-channel service concept definition and prototyping. Int J Electron Bus. 2009;7(3):237–55.

    Article  Google Scholar 

  45. Steenbeek R, Hooftman W, Geuskens G, Wevers C. Objectiveren van gezondheidsgerelateerde nonparticipatie en de vermijdbare bijdrage van de gezondheidszorg hieraan. Hoofddorp: TNO; 2010.

    Google Scholar 

  46. Sultan S, Mohan P. Transforming usage data into a sustainable mobile health solution. Electron Mark 2012;22(3) online. doi:10.1007/s12525-012-0090-6.

  47. Vaishnavi V, Kuechler W. Design research in information systems. Last updated August 16, 2009. http://desrist.org/design-research-in-information-systems. 2004.

  48. WCRF/AICR. Second expert report: food, nutrition, physical activity, and the prevention of cancer: a global perspective. London: World Cancer Research Fund; 2007.

    Google Scholar 

  49. WHO. World Health Organization; Food and Agricultural Organization. Diet, Nutrition and the Prevention of Chronic Diseases: Report of a Joint WHO/FAO Expert Consultation (Report 916). Geneva: World Health Organization; 2003.

    Google Scholar 

  50. Wiedemann AU, Lippke S, Reuter T, Ziegelmann JP, Schwarzer R. How planning facilitates behaviour change: additive and interactive effects of a randomized controlled trial. Eur J Soc Psychol. 2011;41:42–51.

    Article  Google Scholar 

  51. Willett WC, Ludwig DS. The 2010 dietary guidelines — the best recipe for health? N Engl J Med. 2011;365:1563–5.

    Article  Google Scholar 

  52. Willett WC. Eat, drink and be healthy. New York: Simon & Schuster; 2001. p. 299p.

    Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Delft University of Technology, Delft, Netherlands

    Luuk P. A. Simons & Nick A. Guldemond

  2. University of Koblenz, Koblenz, Germany

    J. Felix Hampe

Authors
  1. Luuk P. A. Simons
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Felix Hampe
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nick A. Guldemond
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Luuk P. A. Simons.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Simons, L.P.A., Hampe, J.F. & Guldemond, N.A. Designing healthy living support: mobile applications added to hybrid (e)Coach solution. Health Technol. 3, 85–95 (2013). https://doi.org/10.1007/s12553-013-0052-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12553-013-0052-9

Keywords

Search

Navigation