Julia E W C van Gemert-Pijnen

University of Twente | UT · Department of Psychology, Health and Technology (PHT)

Obesity is a chronic disease, and while weight loss is achievable, long-term weight loss maintenance is difficult and relapse common for people living with obesity. Aiming to meet the need for innovative approaches, digital behavior change interventions show promise in supporting health behavior change to maintain weight after initial weight loss....

Background Unobtrusive sensing technologies developed for monitoring deviant behaviors in older adult care require integration with an interaction platform to facilitate the flow of information between older adults and their caregivers. However, the continuous monitoring capabilities generate a considerable amount of data that must be interpreted,...

Background: The evolution of eHealth development has shifted from standalone tools to comprehensive digital health environments, fostering data exchange among diverse stakeholders and systems. Nevertheless, existing research and implementation frameworks have primarily emphasized technological and organizational aspects of eHealth implementation, o...

Technology has a major impact on the way nurses work. Data-driven technologies, such as artificial intelligence (AI), have particularly strong potential to support nurses in their work. However, their use also introduces ambiguities. An example of such a technology is AI-driven lifestyle monitoring in long-term care for older adults, based on data...

UNSTRUCTURED Technology has a major impact on the way nurses work. Data-driven technologies, such as artificial intelligence (AI), have particularly strong potential to support nurses in their work. However, their use also introduces ambiguities. An example of such a technology is AI-driven lifestyle monitoring in long-term care for older adults, b...

BACKGROUND Unobtrusive sensing technologies developed for monitoring deviant behaviors in older adult care requires its integration with an interaction platform to facilitate the flow of information between them and concerned caregivers. However, the continuous monitoring capabilities generate a considerable amount of data that must be interpreted,...

Background: Orthopaedic footwear can only be effective in preventing diabetic foot ulcers if worn by the patient. Robust data on long-term wearing time of orthopaedic footwear are not available, and needed to gain more insights into wearing patterns and associated factors (i.e. participants' demographic, disease-related characteristics, and footwe...

Background With the increase in the older adult population, sensor-based care solutions that can monitor the deviations in physical, emotional, and physiological activities in real-time from a distance are demanded for prolonging the stay of community-dwelling older adults with cognitive impairment. To effectively develop and implement these care s...

Objective:: To explore the views and preferences of care providers on app use for the treatment of UI and to identify the anticipated barriers to, and facilitators of, implementation. Patients and Methods:: We performed an exploratory, two-phase, sequential mixed-methods study. In phase 1, the views of care providers were explored through five focu...

Supporting patients with cardiovascular disease (CVD) to adopt and maintain a healthy lifestyle is a challenging and ongoing process. eHealth technology can help patients with CVD in this challenge, by supporting self-management, offering guidance, coaching and tailored information. However, achieving long-lasting effects of eHealth is only possibl...

Background Podiatrists are key professionals in promoting adequate foot self-care for people with diabetes at high-risk of developing foot ulcers. However, merely informing patients about the advantages of foot self-care is insufficient to realise behavioural change. Motivational interviewing (MI) is a promising person-centred communication style t...

Background: Long-term weight maintenance after weight loss is challenging, and innovative solutions are required. Digital technologies can support behavior change and, therefore, have the potential to be an effective tool for weight loss maintenance. However, to create meaningful and effective digital behavior change interventions that support end...

Background: For eHealth technologies in general and audit and feedback (AF) systems specifically, integrating interdisciplinary theoretical underpinnings is essential, as it increases the likelihood of achieving desired outcomes by ensuring a fit among eHealth technology, stakeholders, and their context. In addition, reporting on the development an...

BACKGROUND Long-term weight maintenance after weight loss is challenging, and innovative solutions are called for. Digital technologies can support behavior change and therefore have the potential to be an effective tool for weight loss maintenance. To create meaningful and effective digital behavior change interventions that support end user value...

Background Vancomycin-resistant enterococci (VRE) is the cause of severe patient health and monetary burdens. Antibiotic use is a confounding effect to predict VRE in patients, but the antibiotic use of patients who may have frequented the same ward as the patient in question is often neglected. This study investigates how patient movements between...

Objective Antimicrobial resistance (AMR) is a global threat to health and healthcare. In response to the growing AMR burden, research funding also increased. However, a comprehensive overview of the research output, including conceptual, temporal, and geographical trends, is missing. Therefore, this study uses topic modelling, a machine learning ap...

Background Diabetic foot ulcers have a high impact on mobility and daily functioning and lead to high treatment costs, for example, by hospitalization and amputation. To prevent (re)ulcerations, custom-made orthopedic shoes are considered essential. However, adherence to wearing the orthopedic shoes is low, and improving adherence was not successfu...

BACKGROUND Emotional eating is a complex problem fostering obesity and resulting from maladaptive emotion regulation. Until now, attempts to decrease emotional eating with traditional behavioral weight loss interventions have shown little effect. It seems that they can be improved regarding targeting the specific needs of emotional eaters. OBJECTI...

Self-care support is a key cornerstone of treatment for patients with a cardiovascular disease. The success of any supportive intervention requires adaptation to the distinct needs of individuals. This requirement also applies to eHealth interventions. This study investigates how experts from multiple fields of science assess the potential success...

Background: Vancomycin-resistant enterococci (VRE) is the cause of severe patient health and monetary burdens. Antibiotic use is a confounding effect to predict VRE in patients, but the antibiotic use of patients who may have frequented the same ward as the patient in question is often neglected. This study investigated how the occurrence and sprea...

Background eHealth can revolutionize the way self-management support is offered to chronically ill individuals such as those with a cardiovascular disease (CVD). However, patients’ fluctuating motivation to actually perform self-management is an important factor for which to account. Tailoring and personalizing eHealth to fit with the values of ind...

Background Hand transmission of harmful microorganisms may lead to infections and poses a major threat to patients and healthcare workers in healthcare settings. The most effective countermeasure against these transmissions is the adherence to spatiotemporal hand hygiene policies, but adherence rates are relatively low and vary over space and time....

Stress is a prevalent issue amongst patients with chronic conditions. As eHealth interventions are gaining importance, it becomes more relevant to invoke the possibilities from the eHealth technology itself to provide motivational acts during experiences of stress as to enhance adherence to the intervention. Embodied Conversational Agents (ECA's) a...

Background Around 13% of the world’s population suffers from obesity. More than 40% of people with obesity display emotional eating behaviour (eating in response to negative emotions or distress). It is an alternate to more effective coping strategies for negative emotions. Our study explored the opportunities for helping adults with emotional over...

Symptoms of psychological distress and disorder have been widely reported in people under quarantine during the COVID-19 pandemic; in addition to severe disruption of peoples' daily activity and sleep patterns. This study investigates the association between physical-activity levels and sleep patterns in quarantined individuals. An international Go...

Background An increasing number of eHealth interventions aim to support healthy behaviors that facilitate weight loss. However, there is limited evidence of the effectiveness of the interventions and little focus on weight loss maintenance. Knowledge about end user values and needs is essential to create meaningful and effective eHealth interventio...

Background Public health recommendations and government measures during the COVID-19 pandemic have enforced restrictions on daily-living. While these measures are imperative to abate the spreading of COVID-19, the impact of these restrictions on mental health and emotional wellbeing is undefined. Therefore, an international online survey (ECLB-COVI...

Objective The objective of this study was to identify risk factors for surgical site infection from digestive, thoracic and orthopaedic system surgeries using clinical and data-driven cut-off values. A second objective was to compare the identified risk factors in this study to risk factors identified in literature. Summary background data Retrosp...

Persuasive technology can support users of self-paced eLearning courses during critical moments of low motivation. Agent-based models (ABMs) - a relatively unfamiliar phenomenon within the persuasive technology and eLearning domains- offers a potentially relevant methodology to understand when the support should be delivered. Using ABMs, the dynami...

Public health recommendations and governmental measures during the new coronavirus disease (COVID-19) pandemic have enforced numerous restrictions on daily living including social distancing, isolation, and home confinement. While these measures are imperative to mitigate spreading of COVID-19, the impact of these restrictions on psychosocial healt...

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Background: Despite the increase in use and high expectations of digital health solutions, scientific evidence about the effectiveness of electronic health (eHealth) and other aspects such as usability and accuracy is lagging behind. eHealth solutions are complex interventions, which require a wide array of evaluation approaches that are capable of...

Background: The potentials of audit and feedback (AF) to improve healthcare are currently not exploited. To unlock the potentials of AF, this study focused on the process of making sense of audit data and translating data into actionable feedback by studying a specific AF-case: limiting antimicrobial resistance (AMR). This was done via audit and f...

BACKGROUND An increasing amount of electronic health (eHealth) interventions aim to support healthy behaviors that facilitate weight loss. However, there is limited evidence of effects and little focus on maintenance of weight after weight loss. To create meaningful and effective eHealth interventions, knowledge about end-user values and needs is e...

COVID-19 pandemic have resulted in numerous restrictions on daily living including social distancing, isolation and home confinement. While these measures are imperative to abate the spreading of COVID-19, the impact of these restrictions on health behaviours and lifestyles at home is undefined. Therefore, an international online survey was launche...

Background: Public health recommendations and governmental measures during the COVID-19 pandemic have resulted in numerous restrictions on daily living including social distancing, isolation and home confinement. While these measures are imperative to abate the spreading of COVID-19, the impact of these restrictions on health behaviours and lifest...

Background: Electronic health (eHealth) is a rapidly evolving field informed by multiple scientific disciplines. Because of this, the use of different terms and concepts to explain the same phenomena and lack of standardization in reporting interventions often leaves a gap that hinders knowledge accumulation. Interventions focused on self-manageme...

Background Public health recommendations and governmental measures during the COVID-19 pandemic have enforced numerous restrictions on daily living including social distancing, isolation and home confinement. While these measures are imperative to mitigate spreading of COVID-19, the impact of these restrictions on psychosocial health is undefined....

Background: Although recognised as effective measures to curb the spread of the COVID-19 outbreak, social distancing and self-isolation, have been suggested to generate burden throughout the population. To provide scientific data to help identify risk-factors for the psychosocial strain during the COVID-19 outbreak, an international cross-discipli...

Background Public health recommendations and governmental measures during the COVID-19 pandemic have enforced numerous restrictions on daily living including social distancing, isolation and home confinement. While these measures are imperative to abate the spreading of COVID-19, the impact of these restrictions on health behaviours and lifestyle a...

Background: For a stress-management app to be persuasive and impactful, designers and developers should obtain a clear perspective of the value proposition according to key stakeholders before development. However, this is often not the case. In order to increase the chance of creating an impact by means of the Resilience Navigator app, this study...

Data-driven technologies can persuade humans to optimize their behavior and context based on objective data. However, current data-driven technologies have limited persuasive powers, because of a misfit between technology, end-users and context. Neglecting end-users in the development process contributes to this misfit and to limited engagement wit...

Background Advance care planning (ACP) is a process with the overall aim to enhance care in concordance with patients’ preferences. Key elements of ACP are to enable persons to define goals and preferences for future medical treatment and care, to discuss these with family and health care professionals, and to document and review these if appropria...

Background: While eMental health interventions can have many potential benefits for mental health care, implementation outcomes are often disappointing. In order to improve these outcomes, there is a need for a better understanding of complex, dynamic interactions between a broad range of implementation-related factors. These interactions and proc...

Background: Personal health records (PHRs) provide the opportunity for self-management support, enhancing communication between patients and caregivers, and maintaining and/or improving the quality of chronic disease management. Their implementation is a multi-level and complex process, requiring a holistic approach that takes into account the tec...

BACKGROUND Electronic health (eHealth) is a rapidly evolving field informed by multiple scientific disciplines. Because of this, the usage of different terms and concepts to explain the same phenomena and the lack of standardization in reporting interventions often leaves a gap that hinders knowledge accumulation. Interventions focused on self-mana...

The original article [1] contained a minor editorial typo in the following sentence which has now been corrected:

Background: Cross-border healthcare may promote the spread of multidrug-resistant microorganisms (MDRO) and is challenging due to heterogeneous antimicrobial resistance (AMR) prevention measures (APM). The aim of this article is to compare healthcare workers (HCW) from Germany (DE) and The Netherlands (NL) on how they perceive and experience AMR a...

Background: Electronic health (eHealth) is a multidisciplinary and rapidly evolving field, and thus requires research focused on knowledge accumulation, curation, and translation. Cardiovascular diseases constitute a global health care crisis in which eHealth can provide novel solutions to improve the efficiency and reach of self-management support...

Background: Maintaining weight after weight loss is a major health challenge, and eHealth (electronic health) solutions may be a way to meet this challenge. Application of behavior change techniques (BCTs) and persuasive system design (PSD) principles in eHealth development may contribute to the design of technologies that positively influence beh...

Prior research has shown that the more patients know about their disease, health, and lifestyle the better the health outcomes are. Patients who are suffering from either a physical disease with mental consequences or from mental illnesses can contribute to their own feeling of mental well-being by following evidence-based online, self-guided thera...

BACKGROUND eHealth is a multidisciplinary and rapidly evolving field, thus is in need for research focused on knowledge accumulation, curation, and translation. Cardiovascular diseases represent a global healthcare crisis where eHealth can provide novel solutions to improve the efficiency and reach of self-management support for patients where they...

In dit hoofdstuk bespreken we hoe e-health-technologieën zinvol kunnen worden ingezet in de behandeling van patiënten met psychiatrische stoornissen. We laten zien dat e-health meer is dan alleen het aanbieden van een app of website. Toch zien we al te vaak dat e-health-technologie willekeurig of zonder visie wordt ingezet, meer hype-gedreven dan g...

This chapter aims to describe persuasive health technology to help you understand the strategies that can improve the adherence to eHealth technologies and increase their effectiveness. As we have seen in Chapter 2 , behaviour change is important to improve health and well-being. Behaviour change techniques can be implemented in eHealth technology...

The CeHRes Roadmap, which was introduced in Chapter 1, is a framework that provides guidelines for a holistic development approach of eHealth technology. This chapter starts with an explanation of what a holistic approach towards eHealth development entails. After this introduction, the phases of the CeHRes Roadmap are separately described, their m...

This is the first book to provide a comprehensive overview of the social and technological context from which eHealth applications have arisen, the psychological principles on which they are based, and the key development and evaluation issues relevant to their successful intervention. Integrating how eHealth applications can be used for both ment...

Heart failure is a common disorder associated with high morbidity and mortality. Early diagnosis and treatment of exacerbations can lower the amount of (re-)hospitalizations. Patients can be supported to self-manage their disease by integrating persuasive coaching in a telemonitoring technology. The Twente TEACH Consortium is a multidisciplinary pa...

Self-tracking and automated persuasive eCoaching combined in a smartphone application may enhance stress management among employees at an early stage. For the application to be persuasive and create impact, we need to achieve a fit between the design and end-users’ and important stakeholders’ values. Semi-structured interviews were conducted among...

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Background: In electronic health (eHealth) evaluations, there is increasing attention for studying the actual usage of a technology in relation to the outcomes found, often by studying the adherence to the technology. On the basis of the definition of adherence, we suggest that the following three elements are necessary to determine adherence to eH...

Background Web-based mental health interventions have evolved from innovative prototypes to evidence-based and clinically applied solutions for mental diseases such as depression and anxiety. Open-access, self-guided types of these solutions hold the promise of reaching and treating a large population at a reasonable cost. However, a considerable f...

In electronic health (eHealth) research, limited insight has been obtained on process outcomes or how the use of technology has contributed to the users' ability to have a healthier life, improved well-being, or activate new attitudes in their daily tasks. As a result, eHealth is often perceived as a black box. To open this black box of eHealth, me...

Dementia and technology, how do they go together? Technology might be a solution to support health and well-being for patients. Although promising, a lot of technologies are not used due to higher cost than expected, ineffective implementation, and technologies that do not work or help people in a positive way. To improve the adoption and use of te...

In order to provide adequate care and housing to the growing number of people with dementia, new technologies are necessary to provide good care and reduce the costs for these care services. Numerous technologies are available, which decrease the need for care and increase the self-reliance of clients and support relatives or professional carers. T...