Preparation and lectures - Digital Health Communication
Tilburg University 2020-2021
Lecture 1 – 01-02-2021
Digital health communication
● Digital applications that support communication in a health-care setting
Websites and animation can be used to inform people about health.
- Information provision 🡪 Thuisarts.nl als voorbeeld
- Doctor and patient communication/ shared decision making
- Self-management
● Persuasive health technology
- Goes beyond information provision
- Change attitudes towards health behaviours
- Support initiation and maintain health behaviours that require self-control
Activities, eating healthy, physical activity, self-control
You have to maintain your behaviour for a longer time to get your goals
Fitbit, virtual reality
Terms:
- eHealth: refers to the use of information communication technologies (ICTs) to
deliver, or support the delivery of, health services
- mHealth: zie pp
taking health communication to the digital sphere:
● health communication theory
everything, always, everywhere
we take our digital devices everywhere
● social technology
more connected then ever. Social media is a new dimension of application
import peers, social support, new kinds of opportunities
● novel media, modes for communication
digital communication goes beyond only reading and text. Power of images, also can
use animation, audio, interaction, all kind of possibilities that can facilitates
communication transfer
● immersion, experiental effects
actually people experience e.g. virtual reality. Consequences of actions.
● The user and personalization
● Design theory: how to design digital health applications with high impact?
Which steps to take with a high impact?
Preparation T1
Article
A theory-based online health behavior intervention for new university students: study
protocol
,The transition from high-school to university is accompanied with new behaviour because
students are out of parental guidance for the first time. But students do not behave healthily
from that moment. Therefore, there are three main reasons why this transition provides a
unique opportunity to intervene in order to promote healthy lifestyle habits:
1. First, it affords the opportunity to target a large proportion of young people in the
UK. More than 350,000 students aged 20 or under start university each year,
representing around 40% of school leavers
2. Second, major life transitions, such as the move to university, represent critical or
“teachable” moments [11] to intervene in order to promote healthy lifestyle habits.
The inherent change in the environmental context, including the disruption of
established peer networks, means that peoples’ health beliefs and behaviors are
likely to be in a state of flux and therefore more amenable to change.
3. Third, unlike many major life events (e.g., bereavement, loss of employment, divorce)
the transition from school to university is a predictable event and one that is
experienced by a large proportion of young people in the UK at the same time every
year; therefore, interventions can be easily implemented to target a large number of
people on an annual basis
Digital technologies
● holds the potential to deliver interventions designed to promote healthy lifestyle
habits to large sections of the population, especially young people, who are prime
users of Internet and digital technologies
● Such interventions are convenient for providers as they are easy to disseminate and
low in cost compared to traditional modes of delivery
● digital interventions can incorporate interactive materials, such as video streaming
and chat rooms, in order to maximize engagement
● Digital interventions are also available 24-hours a day and so can be accessed at
critical moments
More advantages
● interventions designed to promote health behavior change that are based on theory
are more efficacious
,Three theory-based behaviour techniques:
1. A self-affirmation task designed to reduce defensive processing of health messages
The process of reflecting upon one’s cherished values, actions or attributes –
provides a simple and effective technique for reducing defensive resistance to health-
risk messages. Self-affirmation theory hypothesizes that messages about future
health risks not only threaten peoples’ physical integrity (e.g., by outlining the future
morbidities and heightened risk of premature mortality from continuing risky
behavior) but also their sense of being sensible, rational, “adaptively and morally
adequate” people (i.e., their “self-integrity”)
Encouraging people to self-affirm enables them to feel sufficiently secure about their
self-integrity and removes the need to maintain self-integrity by rejecting relevant
but unwelcome health-risk information. (inspelen op de eigen integriteit van mensen,
alsof het lijkt dat het hun eigen keuze is om hun gedrag te veranderen?) The
proposed intervention will, therefore, encourage participants to self-affirm before
being exposed to theory-based messages about the health risks of the target
behaviors.
2. theory-based messages designed to increase people’s motivation to adopt healthy
lifestyle habits
In order to change health behavior, it is necessary for health messages to target the
key motivational factors that underlie such behavior. According to the Theory of
Planned Behavior (TPB), the most proximal determinant of behavior is intention
which, in turn, is determined by three constructs:
o attitude (i.e., positive or negative evaluations of performing the behavior)
🡪
the likely consequences of performing the behavior
o subjective norm (i.e., perceived social pressure to perform or not perform
the behavior) 🡪 the views of specific others
o perceived behavioral control (i.e., perceived difficulty of performing the
behavior 🡪 the power of factors to facilitate or inhibit performance of the
behavior, respectively.
3. implementation intention formation designed to increase the likelihood that good
intentions are translated into behavior
Many people fail to adopt healthy lifestyle habits despite having positive intentions
(i.e., strong motivation) to do so. This “intention-behavior gap” is a major obstacle to
interventions that seek to promote healthy lifestyle habits, since interventions may
increase people’s intentions to change but fail to secure the corresponding change in
behavior.
The Model of Action Phases distinguishes between motivational processes (those
concerned with intention formation) and volitional processes (those concerned with
intention realization).
An implementation intention takes the form of an if-then plan that links a suitable
opportunity to act with a behavioural response that will help people achieve their
, goal. Forming implementation intentions ensures that the opportunity (specified in
the “if” part of the plan) is highly accessible (and so likely to be swiftly and accurately
identified) and that the behavioral response (the “then” part of the plan) is
performed relatively automatically (i.e., immediately and efficiently) once the critical
situation is encountered
The present research
It is likely that the combination of the three behavior change techniques in the online
intervention will have a synergistic effect as, together, they address three key factors that
may hinder attempts to change health behavior.
1. the self-affirmation task will reduce defensive processing and thereby increase
engagement with the health messages.
2. the theory-based messages will ensure that the key beliefs underlying each health
behavior are targeted.
3. asking participants to form implementation intentions will assist the translation of
good intentions into behavior
Potential limitations in the article
- the time before starting university and the first few months at university are likely
to be hectic and stressful for many students which may serve to reduce
engagement with the intervention
Questions to keep in mind:
● What added value is expected from the use of digital technologies, according to the
authors?
● Which theories are used in the development of the intervention?
● What argumentation do the authors use for selecting these specific theories?
● How are these theories translated into intervention components?
● Do you think the findings of this planned study potentially contribute to identifying
effective components of the intervention?
Article
A theory-based online health behaviour intervention for new university students: results
from a repeat randomized controlled trial
Reasons in the introduction why the scholars decided to repeat the research above. Mainly
because of the low engagement of participants with the research (the limitation of the first
research). The new research wanted to provide a more accurate estimate of the efficacy of
the intervention.
- The baseline questionnaire was shortened
- Key content delivered in a more structured format and make plans for all four
health behaviors.
This paper reports the results of the repeat randomized controlled trial of a theory-based
online health behaviour intervention delivered during the transition from school to
university. Additional research questions focused on whether the intervention: