Title
A Digital Lifestyle Coach (E-Supporter 1.0) to Support People With Type 2 Diabetes: Participatory Development Study
Author
Hietbrink, E.A.G.
Middelweerd, A.
van Empelen, P.
Preuhs, K.
Konijnendijk, A.A.J.
Oude Nijeweme-d'Hollosy, W.
Schrijver, L.K.
Laverman, G.D.
Vollenbroek-Hutten, M.M.R.
Publication year
2023
Abstract
Background: A healthy lifestyle, including regular physical activity and a healthy diet, is becoming increasingly important in the treatment of chronic diseases. eHealth interventions that incorporate behavior change techniques (BCTs) and dynamic tailoring strategies could effectively support a healthy lifestyle. E-Supporter 1.0 is an eCoach designed to support physical activity and a healthy diet in people with type 2 diabetes (T2D). Objective: This paper aimed to describe the systematic development of E-Supporter 1.0. Methods: Our systematic design process consisted of 3 phases. The definition phase included the selection of the target group and formulation of intervention objectives, and the identification of behavioral determinants based on which BCTs were selected to apply in the intervention. In the development phase, intervention content was developed by specifying tailoring variables, intervention options, and decision rules. In the last phase, E-Supporter 1.0 integrated in the Diameter app was evaluated using a usability test in 9 people with T2D to assess intervention usage and acceptability. Results: The main intervention objectives were to stimulate light to moderate-vigorous physical activities or adherence to the Dutch dietary guidelines in people with T2D. The selection of behavioral determinants was informed by the health action process approach and theories explaining behavior maintenance. BCTs were included to address relevant behavioral determinants (eg, action control, self-efficacy, and coping planning). Development of the intervention resulted in 3 types of intervention options, consisting of motivational messages, behavioral feedback, and tailor-made supportive exercises. On the basis of IF-THEN rules, intervention options could be tailored to, among others, type of behavioral goal and (barriers to) goal achievement. Data on these variables could be collected using app data, activity tracker data, and daily ecological momentary assessments. Usability testing revealed that user experiences were predominantly positive, despite some problems in the fixed delivery of content. Conclusions: The systematic development approach resulted in a theory-based and dynamically tailored eCoach. Future work should focus on expanding intervention content to other chronic diseases and lifestyle behaviors, enhancing the degree of tailoring and evaluating intervention effects on acceptability, use, and cost-effectiveness.
Subject
Acceptability
Behavior change
Behavioral
Blended care
Chronic disease
Coaching
Cost
Design
Diet
Dynamic tailoring
EHealth
Intervention
Lifestyle change
MHealth
Nutrition
Physical activity
Ttheory
Treatment
Type 2 diabetes
Usability
To reference this document use:
http://resolver.tudelft.nl/uuid:aeb86074-51a1-4e1f-baea-d740bbc4ffc6
DOI
https://doi.org/10.2196/40017
TNO identifier
981324
Source
JMIR Human Factors, 10 (10)
Document type
article