Journal Mobile Options
Table of Contents
Vol. 58, No. 3, 2012
Issue release date: April 2012
Section title: Regenerative and Technological Section / Original Paper
Editor's Choice -- Free Access
Gerontology 2012;58:269–281
(DOI:10.1159/000329892)

Participatory and Persuasive Telehealth

Lee D.a · Helal S.a · Anton S.b · De Deugd S.c · Smith A.c
aMobile and Pervasive Computing Laboratory, Computer and Information Science and Engineering Department (CISE), and bDepartment of Aging and Geriatric Research, University of Florida, Gainesville, Fla., and cEmerging Standards Division, IBM, Research Triangle Park, N.C., USA
email Corresponding Author

Abstract

Technological advances in telehealth systems are primarily focused on sensing and monitoring. However, these systems are limited in that they only rely on sensors and medical devices to obtain vital signs. New research and development are urgently needed to offer more effective and meaningful interactions between patients, medical professionals and other individuals around the patients. Social networking with Web 2.0 technologies and methods can meet these demands, and help to develop a more complete view of the patient. Also many people, including the elderly, may be resistant to change, which can reduce the efficacy of telehealth systems. Persuasive technology and mechanisms are urgently needed to counter this resistance and promote healthy lifestyles. In this paper, we propose the participatory and persuasive telehealth system as a solution for these two limitations. By integrating connected health solutions with social networking and adding persuasive influence, we increase the chances for effective interventions and behavior alterations.

© 2011 S. Karger AG, Basel


  

Key Words

  • Connected health
  • Remote monitoring and intervention
  • Service-oriented device architectures
  • Social network applications in healthcare
  • Behavior alteration
  • Persuasive computing
  • Persuasive technology
  • Behavior change theory
  • Behavior change model

References

  1. Healthy Aging: Improving and Extending Quality of Life Among Older Americans: At a Glance 2009. http://www.cdc.gov/chronicdisease/resources/publications/AAG/aging.htm.
  2. Weitzel M, Smith A, Lee D, Deugd S, Helal S: Participatory medicine: leveraging social networks in telehealth solutions; in Mokhtari M, Khalil I, Bauchet J, Zhang D, Nugent C (eds): Ambient Assistive Health and Wellness Management in the Heart of the City. Heidelberg, Springer, 2009, vol 5597, pp 40–47.
  3. Lee D, Helal S, Johnson BD: An action-based behavior model for persuasive telehealth. Proceedings of the 8th International Conference on Smart Homes and Health Telematics (ICOST), Seoul, June 2010.
  4. Helal A, Bose R, Chen C, Smith A, de Deugd S, Cook D: STEPSTONE: a SODA case study in personal tele-health management. J Ambient Intell Smart Environ, submitted.
  5. The Continua Health Alliance. http://www.continuaalliance.org.
  6. The Center for Connected Health. http://www.connected-health.org.
  7. Microsoft Health Vault. http://www.healthvault.com.
  8. Google Health. https://health.google.com/health.
  9. Ambient Assisted Living Joint Programme. http://www.aal-europe.edu/.
  10. Patientslikeme. http://www.patientslikeme.com/.
  11. Rahman A, El Saddik A, Gueaieb W: SenseFace: a sensor network overlay for social networks. IEEE International Instrumentation and Measurement Technology Conference, Singapore, 2009.
  12. de Deugd S, Carroll R, Kelly KE, Millett B, Ricker J: SODA: service-oriented device Architecture. IEEE Pervasive Comput 2006;5:94–97.

    External Resources

  13. Fox S: Participatory Medicine: Text of My Speech at the Connected Health Symposium. http://e-patients.net/archives/2008/11/participatory-medicine-text-of-my-speech-at-the-connected-health-symposium.html.
  14. A Smarter World for Charley. http://www.youtube.com/watch?v=QUEXdDxO37c1.
  15. The Centers for Disease Control (CDC). http://www.cdc.gov/widgets.
  16. Glanz K, Rimer BK, Lewis FM: Health Behavior and Health Education. Theory, Research and Practice. San Fransisco, Wiley & Sons, 2002.
  17. Becker MH: The health belief model and personal health behavior. Health Educ Monogr 1974;2:324–508.
  18. Rosenstock I: Historical origins of the health belief model. Health Educ Monogr 1974;2:328–335.
  19. Prochaska JO, Velicer WF, Rossi JS, et al: Stages of change and decisional balance for 12 problem behaviors. Health Psychol 1994;13:39–46.
  20. Prochaska JO, DiClemente CC, Norcross JC: In search of how people change – applications to addictive behaviors. Am Psychol 1992;47:1102–1114.
  21. Sheppard BH, Hartwick J, Warshaw PR: The theory of reasoned action: a meta-analysis of past research with recommendations for modifications and future research. J Consumer Res 1988;15:325–343.
  22. Fishbein M: A theory of reasoned action: some applications and implications; in Howe H, Page M, Lincoln NB (eds): Nebraska Symposium on Motivation. Lincoln, University of Nebraska Press, 1980, pp 65–116.
  23. Ajzen I: The Theory of Planned Behavior. Organ Behav Hum Decis Process 1991;50:179–211.

    External Resources

  24. Mearns J: Social learning theory; in Reis H, Sprecher S (eds): Encyclopedia of Human Relationships. Thousand Oaks, Sage, 2009, vol 3, pp 1537–1540.
  25. Bandura A: Social cognitive theory: an agentive perspective. Annu Rev Psychol 2001;52:1–26.
  26. Rotter JB: The Development and Applications of Social Learning Theory. Selected Papers. Englewood Cliffs, Prentice Hall, 1982.
  27. Fogg BJ: A behavior model for persuasive design. Proceedings of the 4th International Conference on Persuasive Technology (PERSUASIVE), Claremont, 2009.
  28. Fogg BJ: Persuasive Technology: Using Computers to Change What We Think and Do. San Francisco, Morgan Kaufmann Publishers, 2003.
  29. Lee D, Yamazaki T, Helal S: Robotic companions for smart space interactions. IEEE Pervasive Comput 2009;8:78–84.

    External Resources

  30. Kidd C, Breazeal C: Designing a sociable robot system for weight maintenance. IEEE Consumer Communications and Networking Conference, Las Vegas, 2006.
  31. Sung J, Guo L, Grinter R, Christensen H: ‘My Roomba Is Rambo’: Intimate Home Appliances. Proc of Ubicomp. Springer, 2007, pp 145–162.
  32. ATLAS Website. http://www.pervasa.com/.
  33. King J, Bose R, Yang H, Pickles S, Helal A: Atlas – a service-oriented sensor platform. Proceedings of the First IEEE International Workshop on Practical Issues in Building Sensor Network Applications, Tampa, 2006.
  34. DDL Webiste. http://www.icta.ufl.edu/atlas/ddl/.
  35. Chen C, Helal A: Device Integration in SODA Using the Device Description Language. Ninth Annual International Symposium on Applications and the Internet, Seattle, 2009, pp 100–106.
  36. Locke EA, Latham GP: Building a practically useful theory of goal setting and task motivation: a 35-year odyssey. Am Psychol 2002;57:705–717.
  37. Shilts MK, Horowitz M, Townsend MS: Goal setting as a strategy for dietary and physical activity behavior change: a review of the literature. Am J Health Promot 2004;19:81–93.

    External Resources

  38. King P, Tester J: The landscape of persuasive technologies. Commun ACM 1999;42:51–58.

    External Resources

  39. Berdichevsky D, Neunschwander E: Towards an ethics of persuasive technology. Commun ACM 1999;42:51–58.

    External Resources

  40. Weitzel M, Smith A, de Deugd S, Yates R: A Web 2.0 model for patient-centered health informatics applications. Computer 2010;43:43–50.

    External Resources

  41. Open Health Tools Project. https://stepstone.projects.openhealthtools.org/.
  42. The Apache Shindig Project. http://incubator.apache.org/shindig.
  43. The Open Social Foundation. http://www.opensocial.org.
  44. Helal S, Mann W, Zabadani H, King J, Kaddoura Y, Jensen E: The Gator Tech Smart House: a programmable pervasive space. IEEE Computer 2005;38:50–60.

    External Resources

  

Author Contacts

Sumi Helal, PhD, Mobile and Pervasive Computing Laboratory
Computer and Information Science and Engineering Department (CISE)
University of Florida, Room 448, CSE Building
PO Box 116125, Gainesville, FL 32611 (USA)
Tel. +1 352 392 6845, E-Mail helal@cise.ufl.edu

  

Article Information

Received: September 3, 2010
Accepted: June 8, 2011
Published online: August 31, 2011
Number of Print Pages : 13
Number of Figures : 7, Number of Tables : 0, Number of References : 44

  

Publication Details

Gerontology (International Journal of Experimental, Clinical, Behavioural and Technological Gerontology)

Vol. 58, No. 3, Year 2012 (Cover Date: April 2012)

Journal Editor: Wick G. (Innsbruck)
ISSN: 0304-324X (Print), eISSN: 1423-0003 (Online)

For additional information: http://www.karger.com/GER


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Abstract

Technological advances in telehealth systems are primarily focused on sensing and monitoring. However, these systems are limited in that they only rely on sensors and medical devices to obtain vital signs. New research and development are urgently needed to offer more effective and meaningful interactions between patients, medical professionals and other individuals around the patients. Social networking with Web 2.0 technologies and methods can meet these demands, and help to develop a more complete view of the patient. Also many people, including the elderly, may be resistant to change, which can reduce the efficacy of telehealth systems. Persuasive technology and mechanisms are urgently needed to counter this resistance and promote healthy lifestyles. In this paper, we propose the participatory and persuasive telehealth system as a solution for these two limitations. By integrating connected health solutions with social networking and adding persuasive influence, we increase the chances for effective interventions and behavior alterations.

© 2011 S. Karger AG, Basel


  

Author Contacts

Sumi Helal, PhD, Mobile and Pervasive Computing Laboratory
Computer and Information Science and Engineering Department (CISE)
University of Florida, Room 448, CSE Building
PO Box 116125, Gainesville, FL 32611 (USA)
Tel. +1 352 392 6845, E-Mail helal@cise.ufl.edu

  

Article Information

Received: September 3, 2010
Accepted: June 8, 2011
Published online: August 31, 2011
Number of Print Pages : 13
Number of Figures : 7, Number of Tables : 0, Number of References : 44

  

Publication Details

Gerontology (International Journal of Experimental, Clinical, Behavioural and Technological Gerontology)

Vol. 58, No. 3, Year 2012 (Cover Date: April 2012)

Journal Editor: Wick G. (Innsbruck)
ISSN: 0304-324X (Print), eISSN: 1423-0003 (Online)

For additional information: http://www.karger.com/GER


Article / Publication Details

First-Page Preview
Abstract of Regenerative and Technological Section / Original Paper

Received: 9/3/2010 12:33:31 PM
Accepted: 6/8/2011
Published online: 8/31/2011
Issue release date: April 2012

Number of Print Pages: 13
Number of Figures: 7
Number of Tables: 0

ISSN: 0304-324X (Print)
eISSN: 1423-0003 (Online)

For additional information: http://www.karger.com/GER


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Healthy Aging: Improving and Extending Quality of Life Among Older Americans: At a Glance 2009. http://www.cdc.gov/chronicdisease/resources/publications/AAG/aging.htm.
  2. Weitzel M, Smith A, Lee D, Deugd S, Helal S: Participatory medicine: leveraging social networks in telehealth solutions; in Mokhtari M, Khalil I, Bauchet J, Zhang D, Nugent C (eds): Ambient Assistive Health and Wellness Management in the Heart of the City. Heidelberg, Springer, 2009, vol 5597, pp 40–47.
  3. Lee D, Helal S, Johnson BD: An action-based behavior model for persuasive telehealth. Proceedings of the 8th International Conference on Smart Homes and Health Telematics (ICOST), Seoul, June 2010.
  4. Helal A, Bose R, Chen C, Smith A, de Deugd S, Cook D: STEPSTONE: a SODA case study in personal tele-health management. J Ambient Intell Smart Environ, submitted.
  5. The Continua Health Alliance. http://www.continuaalliance.org.
  6. The Center for Connected Health. http://www.connected-health.org.
  7. Microsoft Health Vault. http://www.healthvault.com.
  8. Google Health. https://health.google.com/health.
  9. Ambient Assisted Living Joint Programme. http://www.aal-europe.edu/.
  10. Patientslikeme. http://www.patientslikeme.com/.
  11. Rahman A, El Saddik A, Gueaieb W: SenseFace: a sensor network overlay for social networks. IEEE International Instrumentation and Measurement Technology Conference, Singapore, 2009.
  12. de Deugd S, Carroll R, Kelly KE, Millett B, Ricker J: SODA: service-oriented device Architecture. IEEE Pervasive Comput 2006;5:94–97.

    External Resources

  13. Fox S: Participatory Medicine: Text of My Speech at the Connected Health Symposium. http://e-patients.net/archives/2008/11/participatory-medicine-text-of-my-speech-at-the-connected-health-symposium.html.
  14. A Smarter World for Charley. http://www.youtube.com/watch?v=QUEXdDxO37c1.
  15. The Centers for Disease Control (CDC). http://www.cdc.gov/widgets.
  16. Glanz K, Rimer BK, Lewis FM: Health Behavior and Health Education. Theory, Research and Practice. San Fransisco, Wiley & Sons, 2002.
  17. Becker MH: The health belief model and personal health behavior. Health Educ Monogr 1974;2:324–508.
  18. Rosenstock I: Historical origins of the health belief model. Health Educ Monogr 1974;2:328–335.
  19. Prochaska JO, Velicer WF, Rossi JS, et al: Stages of change and decisional balance for 12 problem behaviors. Health Psychol 1994;13:39–46.
  20. Prochaska JO, DiClemente CC, Norcross JC: In search of how people change – applications to addictive behaviors. Am Psychol 1992;47:1102–1114.
  21. Sheppard BH, Hartwick J, Warshaw PR: The theory of reasoned action: a meta-analysis of past research with recommendations for modifications and future research. J Consumer Res 1988;15:325–343.
  22. Fishbein M: A theory of reasoned action: some applications and implications; in Howe H, Page M, Lincoln NB (eds): Nebraska Symposium on Motivation. Lincoln, University of Nebraska Press, 1980, pp 65–116.
  23. Ajzen I: The Theory of Planned Behavior. Organ Behav Hum Decis Process 1991;50:179–211.

    External Resources

  24. Mearns J: Social learning theory; in Reis H, Sprecher S (eds): Encyclopedia of Human Relationships. Thousand Oaks, Sage, 2009, vol 3, pp 1537–1540.
  25. Bandura A: Social cognitive theory: an agentive perspective. Annu Rev Psychol 2001;52:1–26.
  26. Rotter JB: The Development and Applications of Social Learning Theory. Selected Papers. Englewood Cliffs, Prentice Hall, 1982.
  27. Fogg BJ: A behavior model for persuasive design. Proceedings of the 4th International Conference on Persuasive Technology (PERSUASIVE), Claremont, 2009.
  28. Fogg BJ: Persuasive Technology: Using Computers to Change What We Think and Do. San Francisco, Morgan Kaufmann Publishers, 2003.
  29. Lee D, Yamazaki T, Helal S: Robotic companions for smart space interactions. IEEE Pervasive Comput 2009;8:78–84.

    External Resources

  30. Kidd C, Breazeal C: Designing a sociable robot system for weight maintenance. IEEE Consumer Communications and Networking Conference, Las Vegas, 2006.
  31. Sung J, Guo L, Grinter R, Christensen H: ‘My Roomba Is Rambo’: Intimate Home Appliances. Proc of Ubicomp. Springer, 2007, pp 145–162.
  32. ATLAS Website. http://www.pervasa.com/.
  33. King J, Bose R, Yang H, Pickles S, Helal A: Atlas – a service-oriented sensor platform. Proceedings of the First IEEE International Workshop on Practical Issues in Building Sensor Network Applications, Tampa, 2006.
  34. DDL Webiste. http://www.icta.ufl.edu/atlas/ddl/.
  35. Chen C, Helal A: Device Integration in SODA Using the Device Description Language. Ninth Annual International Symposium on Applications and the Internet, Seattle, 2009, pp 100–106.
  36. Locke EA, Latham GP: Building a practically useful theory of goal setting and task motivation: a 35-year odyssey. Am Psychol 2002;57:705–717.
  37. Shilts MK, Horowitz M, Townsend MS: Goal setting as a strategy for dietary and physical activity behavior change: a review of the literature. Am J Health Promot 2004;19:81–93.

    External Resources

  38. King P, Tester J: The landscape of persuasive technologies. Commun ACM 1999;42:51–58.

    External Resources

  39. Berdichevsky D, Neunschwander E: Towards an ethics of persuasive technology. Commun ACM 1999;42:51–58.

    External Resources

  40. Weitzel M, Smith A, de Deugd S, Yates R: A Web 2.0 model for patient-centered health informatics applications. Computer 2010;43:43–50.

    External Resources

  41. Open Health Tools Project. https://stepstone.projects.openhealthtools.org/.
  42. The Apache Shindig Project. http://incubator.apache.org/shindig.
  43. The Open Social Foundation. http://www.opensocial.org.
  44. Helal S, Mann W, Zabadani H, King J, Kaddoura Y, Jensen E: The Gator Tech Smart House: a programmable pervasive space. IEEE Computer 2005;38:50–60.

    External Resources