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Assessing and enhancing the travel-related physical activity of persons with coronary heart disease: synergy between transportation and health sciences
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CTASS: an intelligent framework for personalized travel behaviour advice to cardiac patients
No full textCurrent cardiac rehabilitation programs intending to increase physical activity of patients suffer from a lack of knowledge about effective patient’s activity profiles and their associated behavior. This leads to the fact that therapies are not completely tailored to the patient, causing non-adherence to the proposed treatment schedule. An important potential for increasing the physical activity level of patients is available in their daily travel behaviour that can be made more active. To validate this potential, we propose a Cardiac Travel Advice Support System (CTASS) digital framework for personalized travel behaviour advice to cardiac patients. The travel behaviour of the group of patients whose actual physical activity level is expected to be too low is monitored by a smartphone application that objectifies their daily activity schedules. The data from the schedules is analysed semi-automatically by the CTASS. Based on this analysis, the doctor can provide a treatment that is personalized to the specific contexts of the patient. In this way, we try to optimize their travel-related physical activity. Moreover, we predict the risk of non-adherence to the therapy taking into account the derived characteristics of the patient
CTASS: a framework for contextualized travel behavior advice to cardiac patients
No full textCurrent cardiac rehabilitation programs intending to increase physical activity of patients suffer from a lack of knowledge about effective patient’s activity profiles and their associated behavior. This leads to the fact that therapies are not completely tailored to the patient causing non-adherence to the proposed treatment schedule. An important potential for increasing the physical activity level of patients is available in their daily travel behavior that can be made more active. To validate this potential, we propose a Cardiac Travel Advice Support System (CTASS) digital framework for contextualized travel behavior advice to cardiac patients. The patient’s travel behaviour is monitored by a smartphone application which objectify their daily activity schedules. The data from the schedules is analysed semi-automatically by the CTASS. Based on this analysis the doctor can provide a treatment that is personalized to the specific contexts of the patient. In this way, we try to optimize their travel-related physical activity and detect non-adherence to the therapy
Design process and design evaluation of web-based visualization dashboard to monitor and support the decision-making of travel-related physical activity
No full textPatients suffering from coronary heart disease (CHD) require to attend cardiac rehabilitation to manage modifiable risk factors including physical activity (PA) to avoid the progression of the disease. However, attendance in these programs is low. Travel-related PA (TPA) monitoring via a smartphone app can provide an opportunity to assess the part of routine PA level. A digital framework consisting of a smartphone app to monitor travel behaviour and a semi-automated feedback report to show the performance of TPA was used in a pilot trial. An important component of this digital framework is a web-based visualization dashboard designed for healthcare providers to get insights into the routine TPA performance of their patients. This study aims to describe the design process and design evaluation of healthcare providers for the visualization dashboard. After designing the user interface screens of the dashboard, the prospective healthcare providers were contacted from the four hospitals in Belgium. Seven interested representative participants attended a focus group session. The session's proceedings were recorded and transcribed. A directed content analysis was used which utilizes a predetermined coding scheme. The usability of the web-based visualization dashboard's content (monitoring and enhancing TPA) was evaluated as of significant importance within and after the rehabilitation programs in the secondary prevention of CHD. TPA monitoring can be effective in motivating targeted patients who have sedentary lifestyles and do not attend rehabilitation programs. Experts particularly recommended adopting engagement strategies for the TPA monitoring and enhancing frameworks. The strategies to enhance patient engagement should be given high importance in future intervention design.The authors would like to acknowledge Dr Pieter Vandervoort and Christophe JP Smeets for facilitating this research at ZOL’s cardiology department and the rehabilitation centers. I am thankful for the cooperation of the staff of the rehabilitation centers in all four cooperating hospitals (Jessa, Hasselt; ZOL, Genk; SFZ, Heusden Zolder, AZ Delta, Roeselare) for recognizing the importance of the research topic and participation and engagement in the focus group session
Implication of travel behaviour patterns and psychological factors of cardiac patients towards increasing active trips
No full textIschemic Heart Disease (IHD) is among the leading causes of death in Europe. It is caused by plaque build-up in the blood vessels resulting in insufficient oxygen supply to the heart. Achieving a certain amount of Physical Activity (PA) reduces significantly the risk of IHD. Walking and biking are proved to be a beneficial form of PA and require no additional skills or equipment (a bike in case of biking). If walking and biking is performed for daily travel purposes it helps in achieving an increased PA level and it has environmental benefits. Considering the health benefits of active travel, a pilot study is conducted to have an overview of existing active travel behaviour patterns of IHD patients. Data from an activity-based travel behaviour diary was collected for one day from random IHD patients (550) in the Flemish region of Belgium. Among 86 responses received, 70 IHD patients made the trips on the specified day. 37% of the car trips (driver as well as passenger) were identified as shorter trips (≤5km) contributing to the potential for PA increase by replacing these trips to walking or biking. 60% of the IHD patients were identified as sedentary or did not achieve 30 minutes of walking or bike use in a day. The remaining 40% of patients achieved the recommended PA level or more (up till 5 times) in a day. Additionally, IHD patients are found to have significantly different amounts of active and car trips based on their weight status (normal and unhealthy weight). This study proposes to perform a cluster analysis considering the socio-demographic information in combination with medical risk factors and psychological factors such as past behaviour, attitude, Perceived Behavioural Control (PBC) and social norms. The patients filled a standard questionnaire for stating their attitude and behaviour towards use of active travel behaviour. Medical risk factors were gathered from the patient's medical files at their affiliated hospitals. Clustering can identify the patients who are "potential changers" or the ones "already active". Classifying the patients in such different profiles can help caretakers to develop and tailor interventions that are customized to the patient's needs. The patients will be able to improve their PA level during daily trips as a complimentary medicine in management of their disease. Exploiting the behavioural theories and combining them with an objective measure of PA will support identifying the opportunities within their daily lifestyle and increasing the number of active trips
Implication of travel behaviour patterns and psychological factors of cardiac patients towards increasing active trips
No full textIschemic Heart Disease (IHD) is among the leading causes of death in Europe. It is caused by plaque build-up in the blood vessels resulting in insufficient oxygen supply to the heart. Achieving a certain amount of Physical Activity (PA) reduces significantly the risk of IHD. Walking and biking are proved to be a beneficial form of PA and require no additional skills or equipment (a bike in case of biking). If walking and biking is performed for daily travel purposes it helps in achieving an increased PA level and it has environmental benefits. Considering the health benefits of active travel, a pilot study is conducted to have an overview of existing active travel behaviour patterns of IHD patients. Data from an activity-based travel behaviour diary was collected for one day from random IHD patients (550) in the Flemish region of Belgium. Among 86 responses received, 70 IHD patients made the trips on the specified day. 37% of the car trips (driver as well as passenger) were identified as shorter trips (≤5km) contributing to the potential for PA increase by replacing these trips to walking or biking. 60% of the IHD patients were identified as sedentary or did not achieve 30 minutes of walking or bike use in a day. The remaining 40% of patients achieved the recommended PA level or more (up till 5 times) in a day. Additionally, IHD patients are found to have significantly different amounts of active and car trips based on their weight status (normal and unhealthy weight). This study proposes to perform a cluster analysis considering the socio-demographic information in combination with medical risk factors and psychological factors such as past behaviour, attitude, Perceived Behavioural Control (PBC) and social norms. The patients filled a standard questionnaire for stating their attitude and behaviour towards use of active travel behaviour. Medical risk factors were gathered from the patient's medical files at their affiliated hospitals. Clustering can identify the patients who are "potential changers" or the ones "already active". Classifying the patients in such different profiles can help caretakers to develop and tailor interventions that are customized to the patient's needs. The patients will be able to improve their PA level during daily trips as a complimentary medicine in management of their disease. Exploiting the behavioural theories and combining them with an objective measure of PA will support identifying the opportunities within their daily lifestyle and increasing the number of active trips
Design of a feedback intervention to increase travel related physical activity of CVD patients
No full textCardiovascular disease (CVD) patients benefit from an active lifestyle with a certain level of physical activity. Assessing the physical activity level of patients in an objective manner can be problematic. Self-reporting tends to be biased and lack of therapy adherence has a negative influence on managing disease risk factors. In this paper we propose a digital framework which collects the level of physical activity of CVD patients with an app and processes this data to obtain an objective measure of physical activity, which is visualized in a dashboard available for the caretakers. By exploiting behavioural theories and combining them with this objective measure of physical activity, patients are classified according to their attitude towards active travel behaviour. Based on this knowledge, caretakers can propose a more active lifestyle to patients by identifying opportunities in making the daily trips of the patients more active. For example, short distances done by car can be suggested to be replaced by walking or biking. The behaviour theories also allow to assess the risk of not adhering to the prescribed therapy. This tool will help in providing a more tailored care and approach to persons with CVD
Promoting Sustainable Transportation: A Transtheoretical Examination of Active Transport Modes
No full textThe use and promotion of active transportation has been scientifically proven to play a fundamental role in influencing global sustainable development goals. Despite increased recognition, there is a notable gap in understanding how to effectively transition the general population from convenience-oriented transport to embracing active modes. The application of the Transtheoretical Model (TTM) in understanding the utilization of active transport modes is currently constrained. The first aim is to include measuring the readiness to change in the use of active transport modes to increase physical activity (PA) using a continuous measure (i.e., University of Rhode Island Change Assessment, URICA). A second aim is to determine whether the decisional balance (perception of pros and cons) and self-efficacy increase as respondents progress through the stages of change as well as with the increase in self-reported active transport use. In total, 260 university students and staff filled out an online survey containing self-reported use of active transport modes and TTM constructs. The results suggest that URICA successfully identifies five stages of change. The decision balance and self-efficacy of the behaviour increase as individuals progress through the stages. The
same is also true for the use of active transport modes.I would like to acknowledge Geert Wets and Paul Dendale for providing the opportunity to work on this research topic. I am thankful for the cooperation of the administration staff and especially Nadine Smeyers who has provided her assistance in the translation of the documents
It's how you say it - The extended Theory of Planned Behaviour explains active transport use in cardiac patients depending on the type of self-report in a hypothesis-generating study
No full textPhysical activity (PA) plays an essential part in the secondary prevention of persons with coronary heart disease (CHD). A substantial amount of PA can be gained through increasing the use of active transport modes (walking or cycling for at least 10 min/day) in CHD patients' daily routine, benefiting the mortality and morbidity rate as well as the environment. The current study aims to investigate the utility of the Theory of Planned Behaviour (TPB) framework extended with habit strength, in understanding the behavioural intention and the behaviour of using active transport modes during the daily travel routine of CHD patients. A cross-sectional survey was conducted from 131 CHD patients. The behaviour was measured using three self-report methods; 1) scale measure, the walking or cycling frequency, 2) direct ATS (Active Travel Score, PA calculated by the directly reported aggregated time spent per day for walking or cycling for travel purposes), and 3) indirect ATS (PA calculated by combining the duration spent on trips by walking and cycling from the self -reported one-day travel diary). Additionally, the participants completed surveys on the direct measures of TPB constructs and habit strength. The results indicated that the TPB constructs explained a 38% variance in the intention to use active transport modes of CHD patients, by which the variance increased to 59% with the addition of habit strength. On the contrary, different behavioural measures were explained differently by TPB and habit strength. The scale measure of behaviour was best predicted (up to 21%) by TPB and habit strength. However, the direct and indirect measures of behaviour were poorly explained (up to 3% and 10% only, respectively). Habit strength moderated the relationship between behaviour (scale measure) and behavioural intention. Surprisingly, higher behavioural intention resulted in a lower behavioural frequency when the habit strength to be active is low. This suggests a limited control over the behaviour thus indicating the intention-behaviour gap. The current study findings highlight the inconsistent predictive utility of TPB across different types of behavioural self-report measures, targeted at the use of active transport modes in CHD patients. However, considering this study as hypothesis-generating, further research is necessary to replicate and extend these findings.I would like to acknowledge Dr Pieter Vandervoort for facilitating this research at ZOL’s cardiology department and related rehabilitation centre. I am thankful for the cooperation of the staff of the rehabilitation centres at Jessa and ZOL hospitals, especially the paramedical department head Kim Bonne, and the physiotherapist of cardiac rehabilitation Toon Alders at Jessa hospital, for their support and facilitation during the recruitment. I would like to pay my special regards to the students who have provided their assistance in the recruitment and data collection
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