Study questions + answers
Persuasive Health Technology
Chapter 1
1. Explain the relationship between technology, psychology, and health, and connect
them to eHealth
Technology, psychology and health are interrelated in the development and implementation of
eHealth.
Technology: enabling tool for health interventions
Psychology: provides the theoretical foundations and approaches for understanding behaviour with
the goal of changing attitudes and behaviours
Health: is the central focus. Improve health, well-being and health-care
2. State several application areas of eHealth and provide accompanying examples
Categorization of eHealth - Based on the involvement of specific stakeholders
1. Self-care and prevention
Patients or health consumer in the lead → foster self-management
● Decision aids: information and interaction with the system
● Self-monitoring of health-related info → smartwatches
● Online (self-help) interventions
2. Supportive care
More involvement of healthcare professionals → work together with
patient
● Telemedicine → telecommunication to exchange long-distance
medical informationn
● Electronic Personal Health Records (PHRs) → sharing clinical data
between patient and healthcare professional + support self-
management
3. Societal health
→ Involvement of both patients & healthcare professionals
→ The lead is at a societal level: broad health-related issues
→ Government vital role in creating policies and regulations
● Influence the attitude and awareness of individual about societal health issues
● Support behavior that is compliant with guidelines → technology can assist in
translating policies into action
● Manage the behaviour of individuals during outbreaks of infectious disease →
mobile tracking apps during COVID
● Support communication between health professionals about societal issues
, 3. Name several benefits and barriers of eHealth related to its development,
implementation, evaluation, and use in practice
Benefits of eHealth:
★ Access to care
● Healthcare is available independent of time (24/7) and place (at home)
● Healthcare equity: improved access for more people
- Remove threshold to healthcare: stigmatization (anonymus online
consultations)
★ Empowerment
● Enable people to take more control of their own health and care process
→ Patient-centredness
● Care-professionals: technology supports decision making
★ Innovation
● Sustainable change in health care: i.e. easy communication
● Technology opens up new possibilities, way of thinking →
innovations
★ Quality of care
● Effectiveness: improve traditional treatments → better safey, less
errors
● Efficiency: optimize resource use → achieve same results with fewer
resources
Barriers of eHealth
1. Implementation barriers
A lack of:
● Incentives → resistance to use technology
○ Financial incentives
○ Perceived benefits
● Stakeholder support
● Ability or skills to use technology → low health-literacy
● Motivation to start or continue using eHealth
● Trust and confidence in technology → fear
● Standardization - using different softwares and hardares → no
interoperable
● Clear regulations and certification procedures
2. Ethical barriers
● Privacy and security:
- Ownership of data? Who has access to the system and data?
● Transparency & liability:
- Do we understand the decision rules of algorithms that are being
used?
- Technology vs clinical eye: who is liable when things go wrong?
● Reliability & accuracy: quality of information
- To what extent can we trust the information?
- Need of reliable certifications
● Autonomy & trustworthiness:
- Expertise is needed to understand and judge your own health data
, - How to ensure that the user remains in control (when alghortism are
not used?)
3. Evidence barriers
● A lack of available evidence on (cost)effectiveness and long-term effects
● Study designs used (Randomize Control Trials - RCTs) are not adequate
○ Need of other more complete evaluation methods
● Information of (non)adherence is lacking
○ Non-adherence: wheter technology is used as intended by the
developers
● Evaluation studies outcome driven: only effectiveness is considered
○ the design & quality of the evaluated technology is often not studied
○ need to ensure replicability of studies and interventions
● Combination of Fundamental and Applied research needed: insight into the
working elements of eHealth interventions
4. Explain what a holistic vision of eHealth entails and why it is required to overcome
the barriers and achieve the benefits of eHealth
Holistic vision= considering all elements of healthcare system: Users, Context, and
technology
A good fit between technology, user and context:
- Essential to overcoming barriers related to implementation
- More likely the technology will be used and effective
5. Name and explain the importance of interdisciplinary development, implementation,
and evaluation of eHealth
eHealth: Multidisciplinary approach
● Close interrelationship between creation of the content and technology, its end-users,
stakeholders, and the healthcare context in which they will be used
● Participatory design
○ To ensure that content and design fit stakeholder needs
● Use methods, frameworks and theories from different disciplines
○ to account for all perspectives throught development, implementation and
evaluation
Article van Woezik et al: Tackling wicked
problems in infection prevention and control: a guideline for co-
creation with stakeholders.
1. Explain how a mixed-methods approach can be effectively used for stakeholder
identification, analysis, and co-creation
Mixed-methods approach can be effectively used for stakeholder identification,
analysis, and co-creation
● Stakeholder identification
, ➢ Mix-methods: interview, literature scans, expert recommendations, snowball
sampling
● Stakeholder analysis
➢ Mix-methods: survey to rank stakeholders using the salience approach
● Co-creation
➢ Mix-methods: qualitative interviews, focus groups, ranking and prioritization of
values
Article Ranney et al: Interview-based Qualitative
Research in Emergency Care Part II: Data Collection, Analysis and
Results Reporting.
1. Describe the key components that contribute to the structure of a semi-structured
interview, and explain how these components enhance the interview process
1. Develop a clear collection strategy
Establish a structured approach to data collection → well-defined interview guide
to ensure:
- accurate content
- clarity
- validity
- appropriate language and length
➔ Clarity helps interviewers to stay focused on the research objectives while allowing
for flexibility in exploring new spontaneously emerging themes
2. Define and sample the population of interest
Clearly identify the target population → appropriate sample size
➔ Adequate and diverse sample is crucial for data credibility and validity of findings
3. Obtain data in a reproducible and rich manner
Collecting data through different methods that allow for detailed and comprehensive
responses
- Detailed record of data collection process
➔ ensures research is systematic, credible and insightful
2. Describe the strategies that can be used during an interview, and explain how they
work
● Allowing pauses
● Reflective statements: paraphrasing responses to clarify and deepen the
conversation
● Complement audio/visual data with written notes
➔ enhancing rapport
