Smartphone-based physical activity telecoaching in chronic obstructive pulmonary disease: Mixed-methods study on patient experiences and lessons for implementation

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Title: Smartphone-based physical activity telecoaching in chronic obstructive pulmonary disease: Mixed-methods study on patient experiences and lessons for implementation
Authors: Loeckx, M
Rabinovich, RA
Demeyer, H
Louvaris, Z
Tanner, R
Rubio, N
Frei, A
De Jong, C
Gimeno-Santos, E
Rodrigues, FM
Buttery, SC
Hopkinson, NS
Busching, G
Strassmann, A
Serra, I
Vogiatzis, I
Garcia-Aymerich, J
Polkey, MI
Troosters, T
Item Type: Journal Article
Abstract: Background: Telecoaching approaches can enhance physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD). However, their effectiveness is likely to be influenced by intervention-specific characteristics. Objective: This study aimed to assess the acceptability, actual usage, and feasibility of a complex PA telecoaching intervention from both patient and coach perspectives and link these to the effectiveness of the intervention. Methods: We conducted a mixed-methods study based on the completers of the intervention group (N=159) included in an (effective) 12-week PA telecoaching intervention. This semiautomated telecoaching intervention consisted of a step counter and a smartphone app. Data from a project-tailored questionnaire (quantitative data) were combined with data from patient interviews and a coach focus group (qualitative data) to investigate patient and coach acceptability, actual usage, and feasibility of the intervention. The degree of actual usage of the smartphone and step counter was also derived from app data. Both actual usage and perception of feasibility were linked to objectively measured change in PA. Results: The intervention was well accepted and perceived as feasible by all coaches present in the focus group as well by patients, with 89.3% (142/159) of patients indicating that they enjoyed taking part. Only a minority of patients (8.2%; 13/159) reported that they found it difficult to use the smartphone. Actual usage of the step counter was excellent, with patients wearing it for a median (25th-75th percentiles) of 6.3 (5.8-6.8) days per week, which did not change over time (P=.98). The smartphone interface was used less frequently and actual usage of all daily tasks decreased significantly over time (P<.001). Patients needing more contact time had a smaller increase in PA, with mean (SD) of +193 (SD 2375) steps per day, +907 (SD 2306) steps per day, and +1489 (SD 2310) steps per day in high, medium, and low contact time groups, respectively; P for-trend=.01. The overall actual usage of the different components of the intervention was not associated with change in step count in the total group (P=.63). Conclusions: The 12-week semiautomated PA telecoaching intervention was well accepted and feasible for patients with COPD and their coaches. The actual usage of the step counter was excellent, whereas actual usage of the smartphone tasks was lower and decreased over time. Patients who required more contact experienced less PA benefits.
Issue Date: 1-Dec-2018
Date of Acceptance: 24-Sep-2018
URI: http://hdl.handle.net/10044/1/67493
DOI: https://dx.doi.org/10.2196/mhealth.9774
ISSN: 2291-5222
Publisher: JMIR Publications
Journal / Book Title: JMIR mHealth and uHealth
Volume: 6
Issue: 12
Copyright Statement: ©Matthias Loeckx, Roberto A Rabinovich, Heleen Demeyer, Zafeiris Louvaris, Rebecca Tanner, Noah Rubio, Anja Frei, CorinaDe Jong, Elena Gimeno-Santos, Fernanda M Rodrigues, Sara C Buttery, Nicholas S Hopkinson, Gilbert Büsching, AlexandraStrassmann, Ignasi Serra, Ioannis Vogiatzis, Judith Garcia-Aymerich, Michael I Polkey, Thierry Troosters. Originally publishedin JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 17.12.2018. This is an open-access article distributed under the terms ofthe Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properlycited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyrightand license information must be included.
Keywords: Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Medical Informatics
physical activity
COPD
telemedicine
smartphone
patient adherence
patient satisfaction
outcome and process assessment (health care)
INTERVENTION
TECHNOLOGY
LIFE
COPD
outcome and process assessment (health care)
patient adherence
patient satisfaction
physical activity
smartphone
telemedicine
Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Medical Informatics
physical activity
COPD
telemedicine
smartphone
patient adherence
patient satisfaction
outcome and process assessment (health care)
INTERVENTION
TECHNOLOGY
LIFE
Publication Status: Published
Article Number: e200
Online Publication Date: 2018-12-21
Appears in Collections:National Heart and Lung Institute
Airway Disease



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