[Show abstract][Hide abstract] ABSTRACT: Obesity and stress are among the most common lifestyle-related health problems. Most of the current disease prevention and management models are not satisfactorily cost-effective and hardly reach those who need them the most. Therefore, novel evidence-based controlled interventions are necessary to evaluate models for prevention and treatment based on self-management. This randomized controlled trial examines the effectiveness, applicability, and acceptability of different lifestyle interventions with individuals having symptoms of metabolic syndrome and psychological distress. The offered interventions are based on cognitive behavioral approaches, and are designed for enhancing general well-being and supporting personalized lifestyle changes.
339 obese individuals reporting stress symptoms were recruited and randomized to either (1) a minimal contact web-guided Cognitive Behavioral Therapy-based (CBT) intervention including an approach of health assessment and coaching methods, (2) a mobile-guided intervention comprising of mindfulness, acceptance and value-based exercises, (3) a face-to-face group intervention using mindfulness, acceptance and value-based approach, or (4) a control group. The participants were measured three times during the study (pre = week 0, post = week 10, and follow-up = week 36). Psychological well-being, lifestyles and habits, eating behaviors, and user experiences were measured using online surveys. Laboratory measurements for physical well-being and general health were performed including e.g. liver function, thyroid glands, kidney function, blood lipids and glucose levels and body composition analysis. In addition, a 3-day ambulatory heart rate and 7-day movement data were collected for analyzing stress, recovery, physical activity, and sleep patterns. Food intake data were collected with a 48 -hour diet recall interview via telephone. Differences in the effects of the interventions would be examined using multiple-group modeling techniques, and effect-size calculations.
This study will provide additional knowledge about the effects of three low intensity interventions for improving general well-being among individuals with obesity and stress symptoms. The study will show effects of two technology guided self-help interventions as well as effect of an acceptance and value-based brief group intervention. Those who might benefit from the aforesaid interventions will increase knowledge base to better understand what mechanisms facilitate effects of the interventions.Trial registration: Current Clinical Trials NCT01738256, Registered 17 August, 2012.
BMC Public Health 04/2014; 14(1):310. · 2.08 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This paper reports the findings of a constructive design research study exploring mobile wellness applications in two different contexts: Finland and India. The study arrived at four design principles for motivating users to engage in physical exercise: 1 Be my advisor, 2 Acknowledge my efforts, 3 Grow with me and 4 Keep me engaged. These design principles were built upon the results of exploratory and participatory field studies. The validation of the design principles was done by adopting them in the design process of a mobile application concept called the "Living Application", which was evaluated in focus groups. The research process involved the total of 47 participants and 10 design professionals. The results indicate that the four design principles are relevant in the design of wellness applications, but need to be adapted to the local context and individual needs.
International Journal of Mobile Human Computer Interaction. 10/2013; 5(4):20-55.
[Show abstract][Hide abstract] ABSTRACT: Background: Prevention and management of work-related stress and related mental problems is a great challenge. Mobile applications are a promising way to integrate prevention strategies into the everyday lives of citizens.
Objective: The objectives of this study was to study the usage, acceptance, and usefulness of a mobile mental wellness training application among working-age individuals, and to derive preliminary design implications for mobile apps for stress management.
Methods: Oiva, a mobile app based on acceptance and commitment therapy (ACT), was designed to support active learning of skills related to mental wellness through brief ACT-based exercises in the daily life. A one-month field study with 15 working-age participants was organized to study the usage, acceptance, and usefulness of Oiva. The usage of Oiva was studied based on the usage log files of the application. Changes in wellness were measured by three validated questionnaires on stress, satisfaction with life (SWLS), and psychological flexibility (AAQ-II) at the beginning and at end of the study and by user experience questionnaires after one week’s and one month’s use. In-depth user experience interviews were conducted after one month’s use to study the acceptance and user experiences of Oiva.
Results: Oiva was used actively throughout the study. The average number of usage sessions was 16.8 (SD 2.4) and the total usage time per participant was 3 hours 12 minutes (SD 99 minutes). Significant pre-post improvements were obtained in stress ratings (mean 3.1 SD 0.2 vs mean 2.5 SD 0.1, P=.003) and satisfaction with life scores (mean 23.1 SD 1.3 vs mean 25.9 SD 0.8, P=.02), but not in psychological flexibility. Oiva was perceived easy to use, acceptable, and useful by the participants. A randomized controlled trial is ongoing to evaluate the effectiveness of Oiva on working-age individuals with stress problems.
Conclusions: A feasibility study of Oiva mobile mental wellness training app showed good acceptability, usefulness, and engagement among the working-age participants, and provided increased understanding on the essential features of mobile apps for stress management. Five design implications were derived based on the qualitative findings: (1) provide exercises for everyday life, (2) find proper place and time for challenging content, (3) focus on self-improvement and learning instead of external rewards, (4) guide gently but do not restrict choice, and (5) provide an easy and flexible tool for self-reflection.
[Show abstract][Hide abstract] ABSTRACT: Common risk factors such as obesity, poor nutrition, physical inactivity, stress, and sleep deprivation threaten the wellness and work ability of employees. Personal health technologies may help improve engagement in health promotion programs and maintenance of their effect.
[Show abstract][Hide abstract] ABSTRACT: Mobile wellness applications can motivate people to exercise more because of their ubiquitous presence and suitable technological possibilities. Wellness applications utilize several factors that can increase physical activity levels of users, e.g., data tracking, social sharing and playfulness. We describe the design and evaluation of a mobile-phone based wellness application addressing social sharing and playfulness. In our user study with 37 participants we focus on presentation of physical activity data as a virtual trip on a map-based game world. The findings reveal design implications that support users to be motivated in doing the physical exercise, including setting departure and destination places and viewing up-to-date progress between them. The virtual trip was considered an understandable, concrete and interesting analogy. The familiarity of the map of the home country as the game world was liked because it added concreteness and understandability to the achievements.
Proceedings of the 6th Nordic Conference on Human-Computer Interaction 2010, Reykjavik, Iceland, October 16-20, 2010; 01/2010
[Show abstract][Hide abstract] ABSTRACT: Chronic conditions closely related to lifestyles are the major cause of disability and death in the developed world. Behavior change is the key to managing well-being and preventing and managing chronic diseases. Wellness diary (WD) is a mobile application designed to support citizens in learning about their behavior, and both making and maintaining behavior changes. WD has been found acceptable, useful, and suitable for long-term use as a part of an intervention. When used independently, however, it does not seem to have enough engaging and motivating features to support adoption and long-term commitment. The main improvement needs identified based on a review of WD-related studies were: personalization of the application to individual needs, increasing motivation during early use, maintaining motivation, and aiding in relapse recovery in long-term use. We present concepts to improve the personalization of WD as well as improvements to the feedback and interpretation of the self-observation data. We also present usage models on how this type of mobile application could be utilized.
IEEE transactions on information technology in biomedicine: a publication of the IEEE Engineering in Medicine and Biology Society 12/2009; 14(2):456-63. · 1.69 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Lecture Notes in Computer Science. Volume 5726/2009. Proceedings of the International Conference on Human-Computer Interaction. INTERACT 2009., 772 - 781 This paper explores how the user interface of a mobile device could support human perception and conception of changes in its environment. Animated transition effects may hold potential for visualizing changes in the resources available for the user through the context-aware user interface. Four different transition types are investigated. Each transition represents a different approach for visualizing changes in UI. The transitions are evaluated with 40 test subjects, half in India and half in Europe. Statistical analysis of the results indicates that animated transition effects have a clear positive effect on perception and conception of change.
[Show abstract][Hide abstract] ABSTRACT: The PhD research explores the design space of mobil e wellness applications by utilizing design research methods. Several case studies are included in the research, e.g. (1),(2), (3),(4). The main focus of the research is on the aspects, considerat ions and solutions related to motivational and persuasive mo bile wellness applications. The research draws from the multiface ted combination of theories of human behavior, motivati on and knowledge of technological possibilities, especiall y from the user experience perspective. Introduction The global concern of an increasing number of healt h problems due to the modern lifestyle is well-known - people around the world increasingly suffer from obesity etc. These c ause a variety of problems at both personal and societal levels. M obile technologies have been harnessed to support and motivate people in their wellness processes, and there is already p lenty of research conducted in the domain. Most of the research and d esign on the domain has been conducted in the western, developed areas. One of our focuses is cross-cultural, combining researc h findings from two extremely different areas. The purpose is to st udy the similarities and differences as regards to wellness applications in these cultural contexts, and how should these affec t to the design of them. Another theme of the research, which the d omain is also lacking, is the long-term usage of wellness applica tions, i.e. what aspects characterize the use of different wellness technologies in a long time period? This paper describes the motivati on, methodology and outcomes of these research cases. Cross-Cultural Factors on Wellness The design research process consists of several pha ses: explorative field studies, concept design iteration s and concept evaluation. All phases were conducted in Finland an d India. As data collection methods we used in-depth interviews , technology probe and participatory design tasks. Based on the findings from the field studies we built a concept model of a mot ivating mobile wellness application meant for the long-term use. T he analysis of the results is still under progress. So far, one ar ticle concerning the design principles has been published (4). Diffe rences between the cultural contexts were found in the wellness de finitions of the participants, their wellness activities and spaces, and the attitudes towards goal setting. Similarities were the wish fo r an interactive wellness application to keep up the curiosity towar ds the wellness activity, the application to provide interpretation instead of raw facts only, and the perceived high effort of manual input required by the used technology probe. The field study findi ngs, as well as the concept model and its evaluation results in bot h contexts, are described in detail in the recently submitted journ al article. Long-Term Use of Wellness Applications Nuadu is a one-year health promotion trial with 120 participants using a set of available wellness technologies. In the trial we had a unique opportunity to study and compare the user ex periences and motivational aspects of wellness technologies durin g a long time period with real consumers, who all are potential u sers of the wellness technologies. The technology toolkit consi sted of seven wellness technologies, including wearable, mobile a nd Web-based solutions. The user experience data was collected w ith application logs, online questionnaires and telephone interview s in several phases of the trial. The findings of the use of mob ile applications in the first phase of the trial have already been p ublished (2). In general, the applications got a positive response a mong the participants. In the beginning, many participants s eemed to try out different functionalities due to curiosity and beca use they were looking for the most suitable solutions for themsel ves. In the end of the period, the usage habits and personal goals had shaped towards more practical and needs related usage, and active user groups had sprang up for each application. The anal ysis of the data during the whole trial is under progress, and will probably focus on how users with different profiles took the applications in to use, how their usage during a long time period c hanged, and what does the findings mean for the design of motiv ating wellness applications.
Proceedings of the 11th Conference on Human-Computer Interaction with Mobile Devices and Services, Mobile HCI 2009, Bonn, Germany, September 15-18, 2009; 01/2009
[Show abstract][Hide abstract] ABSTRACT: An ever-increasing number of people are affected by lifestyle-related health risks, such as overweight, physical inactivity and stress. An ongoing Nuadu trial studies the user acceptance and effectiveness of technologies in supporting the wellness management of working-age citizens. The technologies consist of different Web, mobile and wearable solutions. In this paper, we present the user experience results of three mobile wellness applications: the Wellness Diary, Mobile Coach and SelfRelax. We studied their usefulness, perceived usability, usage habits and motivational factors gathered during the first phase of the trial. The data were collected with user experience questionnaires and interviews, as well as actual usage logs from mobile applications. The findings indicate that the usage habits change during the usage period of more than two months towards more practical ways of use. The results also point out several aspects to be considered when developing future wellness applications for long-term use. These are, e.g. adaptability, versatility, guidance and usability.
3rd International Conference on Pervasive Computing Technologies for Healthcare, PervasiveHealth 2009, London, UK, April 1-3, 2009; 01/2009
[Show abstract][Hide abstract] ABSTRACT: This paper presents research findings on designing social features for mobile wellness applications. The focus is on opportunities to support and motivate wellness by utilizing and enhancing social interaction between users. New knowledge is created using a 'Research through Design' process. The process combines findings of the user studies performed in India during the year 2008, existing research knowledge on mobile communication technology that provides social features to support wellness activities, and technological possibilities provided by the mobile devices available in the market at the time of the research. New design knowledge is presented in the format of design findings and concept descriptions, as well as concept evaluations. These can then be used by practitioners as inspirational material for product design, and by researchers for exploring the domain of wellness applications.
Proceedings of the 8th International Conference on Mobile and Ubiquitous Multimedia, MUM 2009, Cambridge, United Kingdom, November 22-25, 2009; 01/2009
[Show abstract][Hide abstract] ABSTRACT: Poor lifestyles - overweight, unhealthy diet, physical inactivity, sleep deprivation, and stress - are significant risk factors to chronic illnesses, which cause majority of the health care costs. Hence, behavioral change towards healthy lifestyles is one of the keys to health care cost containment. Personal health systems (PHS) offer tools to support behavioral change. As health risks, personal needs and preferences vary from an individual to another, personalization of the PHS is needed. In Nuadu project we have developed a PHS integrating several different personal health technologies. This system was studied in a large (N=354) randomized controlled trial where employees with several health risks participated in a health promotion program. The study will finish in June 2009. User feedback and technology usage logs reveal that especially simple mobile technologies were actively used during the program. However, usage models varied between individuals and time, and there was a significant number of both active users and non-users. The results emphasize that "one size" does not fit all, and instead of individual "killer applications", PHS with different personalizable and interoperable options should be developed. In addition, screening and profiling methods should be developed to identify those users who would best accept and benefit from technology-supported health promotion. Successful technologies combine high usability and conceptual simplicity to clear and perceivable added value for the end users.
Conference proceedings: ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference 01/2009; 2009:316-9.
[Show abstract][Hide abstract] ABSTRACT: In this paper, we present the results of research that examined how young and active mobile phone users describe their relationship and attachment with their phone, and what features and processes have played an active role in building the attachment. The results are based on street interviews of 40 mobile phone users that were conducted in India and Europe. Our analysis revealed that the following factors contribute towards building the relationship between the mobile phone and its user: 1) habit, 2) memories, 3) personalization, 4) adaptation, 5) process from use to presence, 6) buying the phone, and 7) phone content.
Mobile Ubiquitous Computing, Systems, Services and Technologies, 2008. UBICOMM '08. The Second International Conference on; 11/2008
[Show abstract][Hide abstract] ABSTRACT: In this paper, we present a user study of the heart rate monitors (HRM), which is a commonly used personal wellness technology. HRMs have been used over several years for adjusting the exercise level and in the advanced form, also for measuring the users' fitness level and its progress. The user study included interviews with the HRM users and a survey with over 860 active or former users. We identified four different types of HRM users based on the current usage activity and their perceived progress of usage motivation within time, and compared their perceptions of the strengths and weaknesses related to HRMs. The findings provide valuable information for understanding the end-user needs and background knowledge for developing personal wellness technologies and applications further.
Conference proceedings: ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference 02/2008; 2008:1591-7.
[Show abstract][Hide abstract] ABSTRACT: Majority of the health risks and diseases in the modern world are related to lifestyles, e.g., overweight, unhealthy diet, physical inactivity, sleep deprivation, and stress. Behavioral change towards healthy lifestyles is the key to the prevention and management of these risks, but early and efficient interventions are scarcely available. We present the Nuadu Concept, an ICT (Information and Communication Technologies) assisted wellness toolbox for the management of multiple, behavior-originated health risks. The concept is based on psychological models, which provide methods and motivation for behavior change. The individual is considered as the best expert of his/her own wellness. Thus, the Nuadu Concept provides a variety of personal wellness technologies and services, among which the user may freely choose the best tools for him/herself. We believe this approach has the potential to provide efficient, acceptable, available, and affordable wellness management support for a significant number of people.
Conference proceedings: ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference 02/2008; 2008:5846-50.
[Show abstract][Hide abstract] ABSTRACT: Due to the high penetration rate of mobile phones today, they have the potential to provide accessible and easy-to-use applications that help people manage their health and be physically more active. This paper describes the aim and progress of the author's PhD studies on the user interaction, usability and motivational issues related to mobile wellness applications.
Extended Abstracts Proceedings of the 2008 Conference on Human Factors in Computing Systems, CHI 2008, Florence, Italy, April 5-10, 2008; 01/2008
[Show abstract][Hide abstract] ABSTRACT: This paper explores the design of mobile applications for supporting wellness activities. A cross-cultural user study was conducted in India and Finland. 16 participants used a technology probe (a mobile application called Wellness Diary) for the duration of two weeks. The focus of the study was to identify design factors that need to be considered when designing culturally sensitive mobile wellness applications. The findings are based on the subjective user experience reported by the participants, data collected with the technology probe, and ideas and needs of the participants that surfaced during the study. Results show that both cultural and environmental factors affect the needs towards the wellness application and usage of it. Differences were identified, for example, in how users defined wellness, what wellness concerns they had, attitudes towards setting goals, and how built and natural environments affected wellness activities.
Proceedings of the 20th Australasian Computer-Human Interaction Conference, OZCHI 2008: Designing for Habitus and Habitat, Cairns, Australia, December 8-12, 2008; 01/2008
[Show abstract][Hide abstract] ABSTRACT: In this paper, the potential role of a sport tracking application is examined in the context of supporting tracking outdoor
sporting activities. A user study with 28 participants was conducted to study the usage habits and user experiences evoked.
The application consists of a mobile tracking tool and a related web service. It collects and stores workout data such as
the route, speed and time, and compiles a training diary that can be viewed in many ways during the exercise and afterwards.
Data can be uploaded into a web service for further analysis or for sharing it with others. The results show high interest
in tracking outdoor sports with a mobile phone application – the participants used the application during almost all exercise
sessions and stated that they would continue using the application after the study. Sharing data was not perceived as valuable,
although some usage scenarios for social sharing arose.
Ambient Intelligence, European Conference, AmI 2008, Nuremberg, Germany, November 19-22, 2008. Proceedings; 01/2008
[Show abstract][Hide abstract] ABSTRACT: System integration is one of the major challenges for building wellbeing or healthcare related information systems. In this paper, we are going to share our experiences on how to design a service platform called Nuadu service platform, for providing integrated services in occupational health promotion and health risk management through two heterogeneous systems. Our design aims for a light integration covering the layers, from data through service up to presentation, while maintaining the integrity of the underlying systems.
Conference proceedings: ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference 02/2007; 2007:5865-8.
[Show abstract][Hide abstract] ABSTRACT: Mobile telecommunication technology with enhanced connectivity and multimedia features offers new possibilities to develop field tools for mobile workers. In this paper we present a study on developing a mobile tool for road maintenance workers by applying user centric design process, and discuss the challenges of the environment for both the process and the outcome
Proceedings of the 4th International Conference on Mobile Technology, Applications, and Systems and the 1st International Symposium on Computer Human Interaction in Mobile Technology, Mobility Conference 2007, Singapore, September 10-12, 2007; 01/2007