Ann DeSmet

• Professor in Health Psychology
• Professor (Assistant) at Université Libre de Bruxelles

User engagement in digital (serious) games may be important to increase their effectiveness. Insights into how to create engaging games for healthy lifestyle promotion are needed, as despite their potential, not all digital (serious) games are highly engaging. This study systematically reviewed game features that were associated with higher user en...

Background: Wearable trackers for monitoring physical activity (PA) and total sleep time (TST) are increasingly popular. These devices are not only used by consumers to monitor their behavior but also by researchers to track the behavior of large samples and by health professionals to implement interventions aimed at health promotion and to remote...

Cyberbullying victimization is associated with mental health problems and reported to occur more in nonheterosexual orientation youth (lesbian, gay, bisexual, and questioning (LGBQ)) than among heterosexual youth. Parental support may protect against mental health problems after being victimized, but nonsupportive parental influences may also exace...

Physical activity interventions for youth are direly needed given low adherence to physical activity guidelines, but many interventions suffer from low user engagement. Exergames that require bodily movement while played may provide an engaging form of physical activity intervention but are not perceived as engaging to all. This study aimed to eval...

Background: The use of chatbots may increase engagement with digital behavior change interventions in youth by providing human-like interaction. Following a Person-Based Approach (PBA), integrating user preferences in digital tool development is crucial for engagement, whereas information on youth preferences for health chatbots is currently limite...

Objective: Health behaviors often conflict with other life goals due to time constraints but can also facilitate personal values. Behaviors that fulfill personal values are more likely to be adopted, while conflict impedes adoption. This study examines the interplay between personal values and health goals, focusing on the conflicting and facilitat...

People often intend to embrace a healthy lifestyle but struggle to adopt or maintain these habits. Conflict and facilitation between health goals and other life goals (horizontal interrelations) or personal values (vertical interrelations) can impact the initiation and maintenance of health behaviors. Optimal measures of such goal interrelations ar...

Background: Mobile health interventions are promising behaviour change tools, but they might benefit deprived populations less. Evidence so far mainly stems from analyses of clinical trial data, which may suffer from selection bias. This systematic review investigated differences in uptake of, engagement with, and effectiveness of exclusively mobil...

In this scientific advisory report, which offers guidance to public health policy-makers, the Superior Health Council of Belgium provides recommendations of digital interventions and apps for mental health. Available in English, French and Dutch (https://www.health.belgium.be/en/report-9745-apps-mental-health). To be cited as SHC - Superior Health...

The development, evaluation, and implementation of digital health interventions requires contributions from scientists, healthcare professionals, and developers. Albeit exciting, interdisciplinary and cross-sectoral collaboration is challenging and so often slow and its impact limited. By outlining challenges and potential action-oriented solutions...

Background A healthy lifestyle may improve mental health. It is yet not known whether and how a mobile intervention can be of help in achieving this in adolescents. This study investigated the effectiveness and perceived underlying mechanisms of the mobile health (mHealth) intervention #LIFEGOALS to promote healthy lifestyles and mental health. #LI...

BACKGROUND Improving healthy lifestyles may promote mental health in adolescents, and mobile health (mHealth) may be a valuable way to reach that objective. So far, no mobile healthy lifestyle intervention existed for promoting mental health in the general adolescent population. The mHealth intervention #LIFEGOALS was developed using a participator...

Mobile health interventions are promising behavior change tools. However, there is a concern that they may benefit some populations less than others and thus widen inequalities in health. This systematic review investigated differences in uptake of, engagement with, and effectiveness of mobile interventions for weight-related behaviors (i.e., diet,...

Background: This paper describes the development process of the mobile health (mHealth) intervention #LIFEGOALS, using the CeHRes Roadmap (van Gemert-Pijnen et al., 2011) as framework. #LIFEGOALS is directed to the general population of young adolescents (12-15y) in Flanders, Belgium, with the aim to improve their lifestyle behaviors for promoting...

Background Over the last decades, adolescents’ sleep has deteriorated, suggesting the need for effective healthy sleep interventions. To develop such interventions, it is important to first gather insight into the possible factors related to sleep. Moreover, previous research has indicated that chances of intervention effectivity could be increased...

Serious digital games use the game's entertaining characteristics for a “serious” health learning, treatment, or behavior change purpose. Serious digital games have been used and shown to be effective in a variety of health settings (i.e., medical training, rehabilitation, mental health treatment, prevention and health promotion). Effects are, howe...

Background The promotion of multiple healthy lifestyles has been implemented as part of public health efforts to prevent and reduce the burden of non-communicable diseases. However, these interventions have shown a heterogeneity in their effectiveness. The pursuit of multiple daily goals may influence overall progress in achieving health goals. Hor...

COVID-19 has presented a substantial burden on students and healthcare staff. This mixed-method, descriptive and correlational study aimed to: 1) describe academic; and 2) professional burnout levels; 3) their associations with working in COVID-19-related care; and 4) with perceived COVID-19 impact on studies and internships among medical students...

Rationale At the start of 2021, several SARS-CoV-2 cluster outbreaks in schools threatened in-person education and created a fairly chaotic and frightening environment for school personnel. To keep the schools open while preventing COVID-19 outbreaks, intensive diagnostic testing in teachers and school personnel was strongly recommended but missing...

The prevalence of bullying worldwide is high (UNESCO, 2018). Over the past decades, many anti-bullying interventions have been developed to remediate this problem. However, we lack insight into for whom these interventions work and what individual intervention components drive the total intervention effects. We conducted a large-scale individual pa...

Mobile health interventions are promising behaviour change tools. However, there is a concern that they may widen inequalities in health. This systematic review investigated differences in uptake of, engagement with, and effectiveness of mobile interventions for diet, physical activity, and sedentary behaviour based on a range of inequality indicat...

Background: Mobile health (mHealth) interventions may help adolescents adopt healthy lifestyles. However, attrition in these interventions is high. Overall, there is a lack of research on nonusage attrition in adolescents, particularly regarding the role of socioeconomic status (SES). Objective: The aim of this study was to focus on the role of...

Background: Gamification is purported to enhance engagement with health behavior apps, ultimately improving their effectiveness. This study aimed to examine (1) whether the inclusion of gamification features in a physical activity smartphone app was associated with improved app usage and goal adherence, describe (2) use of the gamification features...

COVID-19 has presented a substantial burden on students and healthcare staff. This mixed-method, descriptive and correlational study aimed to : 1) describe academic; and 2) professional burnout levels; 3) their associations with working in COVID-19-related care; and 4) with perceived COVID-19 impact on studies and internships among medical students...

BACKGROUND Mobile health (mHealth) interventions may help adolescents in adopting a healthy lifestyle. However, attrition in these interventions is high. Overall, there is a lack of research on non-usage attrition in adolescents, in particular on the role of socioeconomic status (SES). OBJECTIVE This study focused on the role of SES in three resea...

The measurement of automatic attitudes towards sleep, in addition to reflective self‐reports, might improve our ability to predict and explain sleep‐hindering practices. Two types of implicit association tests (IATs), a sleep‐related evaluations IAT and a sleep‐related self‐identity IAT, were developed to evaluate their efficacy for assessing autom...

The aim of this systematic review and meta-analysis was to examine the effectiveness of ehealth interventions for the treatment of children and adolescents with overweight or obesity. Databases were searched up to November 2020. Studies were randomised controlled trials where interventions were delivered via e-health (e.g. computers, tablets, smart...

Childhood obesity is a public health concern. Electronic and mobile health (e-&mHealth) approaches can facilitate the delivery of interventions for obesity prevention and treatment. Synthesizing reviews of e-&mHealth interventions to improve weight and weight-related behaviors (physical activity, sedentary behavior, and diet) is useful to character...

In March 2020, the Your COVID-19 Risk tool was developed in response to the global spread of SARS-CoV-2. The tool is an online resource based on key behavioural evidence-based risk factors related to contracting and spreading SARS-CoV-2. This article describes the development of the tool, the produced resources, the associated open repository, and...

A vast body of evidence regarding eHealth interventions for nutrition, physical activity, sedentary behavior, and obesity exists. This scoping review of systematic reviews aimed to evaluate the current level of evidence in this growing field. Seven electronic databases were searched for systematic reviews published until October 27, 2019. The syste...

Achtergrond. Omdat het slaapgedrag van adolescenten in de afgelopen decennia verslechterd is en dit samenhangt met negatieve gezondheidsgevolgen, zijn interventies nodig. Voor de ontwikkeling daarvan is kennis nodig over de belangrijkste factoren die het slaapgedrag beïnvloeden. Het doel van dit kwalitatieve onderzoek was de determinanten van slaap...

Background: Healthy lifestyles may contribute to better mental health, which is particularly important in adolescence, an age at which half of all mental health problems first occur. This association may be even more relevant in adolescents of low family affluence, who show more mental health problems, as well as more unhealthy lifestyles. This st...

Background: Ecological momentary assessment (EMA) is a method of collecting real-time data based on repeated measures and observations that take place in participant's daily environment. EMA has many advantages over more traditional, retrospective questionnaires. However, EMA faces some challenges to reach its full potential. The aims of this syst...

Background Healthy lifestyles may contribute to better mental health, which is particularly important in adolescence, an age at which half of all mental health problems first occur. This association may be even more relevant in adolescents of low family affluence, who show more mental health problems, as well as more unhealthy lifestyles. This stud...

Handling Bullying Questionnaire (HBQ), adjusted for cyberbullying: this questionnaire is designed to assess how teachers and educators handle cyberbullying.

BACKGROUND Wearable trackers for monitoring physical activity (PA) and total sleep time (TST) are increasingly popular. These devices are not only used by consumers to monitor their behavior, but also by researchers to track the behavior of large samples and health professionals to implement interventions aimed at health promotion and to remotely m...

Introduction. Bystanders in cyberbullying may play a crucial role in reducing cyberbullying’s harm for victims. This study assessed bystander responses, and the associations with adolescent victims’ emotional reactions to cyberbullying and victims’ mental health outcomes (symptoms of depression, anxiety and stress; suicidal ideation). Methods. A to...

Background: Sedentary behavior occurs largely subconsciously, and thus specific behavior change techniques are needed to increase conscious awareness of sedentary behavior. Chief amongst these behavior change techniques is self-monitoring of sedentary behavior. The aim of this systematic review and meta-analysis was to evaluate the short-term effe...

This study examines the mediating role of sleep duration and sleep onset difficulties in the association of school pressure, physical activity, and screen time with psychological symptoms in early adolescents. Data were retrieved from 49,403 children (13.7 ± 1.6 years old, 48.1% boys) from 12 countries participating in the World Health Organization...

Adolescents often seek and provide peer support as an effective strategy for countering cyberbullying victimization. Little is known about the actual content of such peer support, however, partly due to limitations inherent to survey, interview or focus group research. The current study examined online peer support that had been sought and provided...

Objective: The aim of this study was to investigate which narrative elements of digital game narratives are preferred by the general adolescent population, and to examine associations with gender, socioeconomic status (SES), and gameplay frequency. Further, the study aims to discuss how results can be translated to serious digital games. Materials...

The report consists of a systematic review of systematic reviews of modifiable determinants of physical activity and sedentary behaviour among adolescents. It focuses on the strength of the evidence for certain determinants, but also assesses which determinants have been succesfully changed in health promotion interventions, to provide insights in...

Abstract Background Aging-related cognitive decline and cognitive impairment greatly impacts older adults’ daily life. The worldwide ageing of the population and associated wave of dementia urgently calls for prevention strategies to reduce the risk of cognitive decline. Physical activity (PA) is known to improve cognitive function at older age thr...

Purpose The purpose of this study was to assess how a mobile location-based exergame to increase physical activity in adolescents, can be optimally integrated in adolescents' daily life. The game receives its input from a smart shirt and the game design not solely departs from the content of the game, but strongly considers the most suitable contex...

This paper describes the items, scale validity and scale reliability of a self-report questionnaire that measures bystander behavior in cyberbullying incidents among adolescents, and its behavioral determinants. Determinants included behavioral intention, behavioral attitudes, moral disengagement attitudes, outcome expectations, self-efficacy, subj...

Cyberbullying is associated with negative mental health outcomes including adolescent suicidal ideation. This requires effective and accessible preventive efforts. Healthy lifestyles are factors adolescents themselves can modify that may lower their risk of suicidal ideation. The aim of this study was to examine associations between physical activi...

Exergames, more specifically console-based exergames, are generally enjoyed by adolescents and known to increase physical activity. Nevertheless, they have a reduced usage over time and demonstrate little effectiveness over the long term. In order to increase playing time, mobile exergames may increase potential playing time, but need to be engagin...

Background: Electronic health (eHealth) and mobile health (mHealth) approaches to address low physical activity levels, sedentary behavior, and unhealthy diets have received significant research attention. However, attempts to systematically map the entirety of the research field are lacking. This gap can be filled with a bibliometric study, where...

Introduction Traditional (offline) bullying and cyberbullying involvement are associated with severe psychosocial problems. Non-heterosexual (LGBQ) youth are more often victimized by traditional bullying than heterosexual (non-LGBQ) youth, but little research is available on LGBQ youth's cyberbullying victimization and perpetration rates. Moreover,...

UNSTRUCTURED Engagement in electronic health (eHealth) and mobile health (mHealth) behavior change interventions is thought to be important for intervention effectiveness, though what constitutes engagement and how it enhances efficacy has been somewhat unclear in the literature. Recently published detailed definitions and conceptual models of enga...

Engagement in electronic health (eHealth) and mobile health (mHealth) behavior change interventions is thought to be important for intervention effectiveness, though what constitutes engagement and how it enhances efficacy has been somewhat unclear in the literature. Recently published detailed definitions and conceptual models of engagement have h...

Using Smart Textil with exer-games to promote energy related behaviours in adolescents.

Cyberbullying is a social phenomenon which can bring severe harm to victims. Bystanders can show positive bystander behavior (e.g. defending) and decrease cyberbullying and its harm, or negative behavior (e.g. passive bystanding, joining) and sustain cyberbullying and its negative effects. Few interventions have currently targeted bystanders and ev...

Abstract: Inactivity and high sedentary behavior among adolescents are main societal problems. Unhealthy lifestyles place a large burden on society and promoting healthy lifestyles is thus key for health, wellness and economic prosperity. These non-communicable diseases and unhealthy lifestyles furthermore occur more often among lower socio-econom...

Background Home environment has an important influence on children’s fruit and vegetable (FV) consumption, but children may in turn also impact their home FV environment, e.g. by asking for FV. The Squire’s Quest II serious game intervention aimed to increase asking behaviors to improve home FV availability and children’s FV intake. This study’s ai...

Introduction. Cyberbullying is a social phenomenon which can bring severe harm to victims. Bystanders can show positive bystander behavior (e.g. defending) and decrease cyberbullying and its harm, or negative behavior (e.g. passive bystanding, joining) and sustain cyberbullying and its negative effects. Few interventions have currently targeted bys...

Background: Serious digital games can be effective at changing healthy lifestyles, but large differences in their effectiveness exist. The extent of user involvement in game design may contribute to game effectiveness by creating a better fit with user preferences. Participatory design (PD), which represents active user involvement as informant (i...

Background Positive bystander behavior in cyberbullying among adolescents may effectively mitigate cyberbullying and its harm for the victim. Limited, scattered, and sometimes only qualitative research is available on predictors of positive (e.g. defending, comforting or reporting) and negative (e.g. passive bystanding, joining, reinforcing) bystan...

This chapter describes the current research on the negative outcomes of traditional and cyberbullying concerning psychological health, physical health, social functioning, and behaviour problems. They explore these problems from the perspective of bullies, victims, bully/victims, and bystanders, and discuss whether the impact of cyberbullying compa...

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Videogames for health (G4H) offer exciting, innovative, potentially highly effective methods for increasing knowledge, delivering persuasive messages, changing behaviors, and influencing health outcomes. Although early outcome results are promising, additional research is needed to determine the game design and behavior change procedures that best...

Poster presentation at a scientific conference on a review of UX measurements in serious games promoting a healthy lifestyle.

School educators play an important role in cyberbullying management. Since scarce earlier research indicated low perceived competence of school educators in handling cyberbullying, more insight is needed in what determines their actions and how to improve these practices. This study assessed school educator practices, their perceptions and context...

Cyberbullying entails bullying, an intentional act to cause repeated harm or distress to the victim, using electronic or digital media. Cyberbullying among adolescents can be considered a public health problem that warrants specific research attention and interventions. The quality-of-life and health problems that youngsters who are involved in cyb...

Videogames for health (G4H) offer exciting, innovative, potentially highly effective methods for increasing knowledge, delivering persuasive messages, changing behaviors, and influencing health outcomes. Although early outcome results are promising, additional research is needed to determine the game design and behavior change procedures that best...

• Klinische vraag Hoe sterk is bij volwassenen de relatie tussen sedentaire tijd en de kans op hospitalisatie, mortaliteit, cardiovasculaire ziekte, diabetes mellitus en kanker, en is die relatie afhankelijk van de fysieke activiteitsgraad? • Besluit van Minerva Uit deze systematische review met meta-analyses kunnen we besluiten dat er bij volwas...

As cyberbullying is a phenomenon that is inherently social, the normative social influence of significant others can play an important role in the behaviour of adolescents involved in cyberbullying incidents. Using data from 525 adolescent bystanders of cyberbullying, we created a path model in order to investigate whether injunctive and descriptiv...

Serious games may be effective in promoting sexual health behavior. Their confidential nature may encourage users to discuss sensitive sexuality topics. Furthermore, they can tailor messages to the individual's needs and may be intrinsically motivating. This meta-analysis investigates the effectiveness of interventions for sexual health promotion t...

As cyberbullying is a phenomenon that is inherently social, the normative social influence of significant others can play an important role in the behaviour of adolescents involved in cyberbullying incidents. Using data from 525 Flemish adolescent bystanders of cyberbullying we created a path model in order to investigate whether injunctive and des...

Despite its relevance, formative research on games may be an undervalued part of the game development process. At the 2014 International Society of Behavioral Nutrition and Physical Activity exergaming preconference satellite meeting, a roundtable discussion was held to assemble experiences and suggestions on enhancing the use of formative research...

Background Chronic diseases may be prevented through programmes that promote physical activity and healthy nutrition. Computer-tailoring programmes are effective in changing behaviour in the short- and long-term. An important issue is the implementation of these programmes in general practice. However, there are several barriers that hinder the ado...

Introduction The Intervention Mapping Protocol (IMP) was applied to the design of a serious game against cyberbullying among adolescents (12-14y). Method The IMP comprises 6 predefined steps. A systematic review assessed the cyberbullying problem and associated health risks (Step 1). Surveys and focus groups collected information on behavior and it...

When bystanders want to help victims of harassment on social network sites, they can be guided by the affordances of different communication modalities in order to make a communicative choice. Elaborating on the data of a previous experimental study with 453 adolescents, we compared bystanders’ behavioural intentions to help the victim according to...

Several systematic reviews have described health-promoting effects of serious games but so far no meta-analysis has been reported. This paper presents a meta-analysis of 54 serious digital game studies for healthy lifestyle promotion, in which we investigated the overall effectiveness of serious digital games on healthy lifestyle promotion outcomes...

When bystanders want to help victims of harassment on social network sites, they can be guided by the affordances of different communication modalities in order to make a communicative choice. Elaborating on the data of a previous experimental study with 453 adolescents, we compared bystanders’ behavioural intentions to help the victim via ICT or f...

Abstract This study explores behavioral determinants of self-reported cyberbullying bystander behavior from a behavioral change theoretical perspective, to provide levers for interventions. Nine focus groups were conducted with 61 young adolescents (aged 12-16 years, 52% girls). Assertive defending, reporting to others, providing advice, and seekin...

Obese youth are at increased risk for peer victimization, which may heighten their risk of psychosocial problems and physical activity avoidance, and lower the effectiveness of professional and lifestyle weight-loss initiatives. Little is known about obese adolescents' risk for victimization from cyber-bullying and how this relates to psychosocial...

In this study, a systematic review and meta-analyses of cyberbullying prevention programs was conducted. The systematic review focused on the target group, program aims and program elements of the prevention programs. Meta-analytic procedures were used to assess the efficacy of cyberbullying prevention programs on cyber victimization and cyber perp...

Cyberbullying on social network sites poses a significant threat to the mental and physical health of victimized adolescents. Although the role of bystanders in solving bullying instances has been demonstrated repeatedly in research on traditional bullying, their role in cyberbullying remains relatively understudied. Therefore, we set up an experim...

To support parents in improving the health of their young children, examples of effective parenting practices for a healthy diet, physical activity (PA) and sedentary behavior (SB) are needed. This study explores perceived effective and ineffective parenting practices in difficult situations concerning raising healthy children and investigates thei...

One of the main goals of primary care is providing equitable health-care, meaning equal access, equal treatment and equal outcomes of healthcare for all in equal need. Some studies show that patients from lower socioeconomic groups visit a GP more often, while other studies show that they are more likely to postpone a visit to a GP. In this study,...