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      Usability Evaluation of an Online, Tailored Self-Management Intervention for Chronic Obstructive Pulmonary Disease Patients Incorporating Behavior Change Techniques

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          Abstract

          Background

          An eHealth intervention using computer tailored technology including several behavior change techniques was developed to support the self-management of chronic obstructive pulmonary disease patients.

          Objective

          The goal of this study was to evaluate and improve the usability of the eHealth intervention.

          Methods

          We conducted a usability evaluation with 8 chronic obstructive pulmonary disease patients, with a mixed methods design. We improved the usability through iterative cycles of evaluation and adaptation. Participants were asked to think aloud during the evaluation sessions. Participants then completed a semi-structured interview. The sessions were observed and recorded. Descriptive statistics and content analysis were used to uncover usability issues.

          Results

          Areas for improvement were layout, navigation, and content. Most issues could be solved within 3 iterations of improvement. Overall, participants found the program easy to use. The length of the program urged us to further analyze the appreciation of behavior change techniques. Some were perceived as helpful and easy to use, while others evoked frustration.

          Conclusions

          The usability study identified several issues for improvement, confirming the need for usability evaluation during the development of eHealth interventions. The uncovered strengths and limitations of behavior change techniques may lead to optimization of eHealth interventions, but further insight is needed.

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          Most cited references33

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            How people intentionally change addictive behaviors with and without treatment is not well understood by behavioral scientists. This article summarizes research on self-initiated and professionally facilitated change of addictive behaviors using the key trans-theoretical constructs of stages and processes of change. Modification of addictive behaviors involves progression through five stages--pre-contemplation, contemplation, preparation, action, and maintenance--and individuals typically recycle through these stages several times before termination of the addiction. Multiple studies provide strong support for these stages as well as for a finite and common set of change processes used to progress through the stages. Research to date supports a trans-theoretical model of change that systematically integrates the stages with processes of change from diverse theories of psychotherapy.
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              Understanding tailoring in communicating about health.

              'Tailoring' refers to any of a number of methods for creating communications individualized for their receivers, with the expectation that this individualization will lead to larger intended effects of these communications. Results so far have been generally positive but not consistently so, and this paper seeks to explicate tailoring to help focus future research. Tailoring involves either or both of two classes of goals (enhancing cognitive preconditions for message processing and enhancing message impact through modifying behavioral determinants of goal outcomes) and employs strategies of personalization, feedback and content matching. These goals and strategies intersect in a 2 x 3 matrix in which some strategies and their component tactics match better to some goals than to others. The paper illustrates how this framework can be systematically applied in generating research questions and identifying appropriate study designs for tailoring research.
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                Author and article information

                Contributors
                Journal
                JMIR Res Protoc
                JMIR Res Protoc
                ResProt
                JMIR Research Protocols
                JMIR Publications Inc. (Toronto, Canada )
                1929-0748
                Jan-Jun 2013
                16 January 2013
                : 2
                : 1
                : e3
                Affiliations
                [1] 1CAPHRI Department of General Practice Maastricht University Medical Center MaastrichtNetherlands
                [2] 2Centre of Research on Autonomy and Participation of Persons with a Chronic Illness Faculty of Health and Care Zuyd University of Applied Sciences HeerlenNetherlands
                [3] 3University of Oklahoma Health Sciences Center Department of Family and Preventive Medicine Oklahoma City, OKUnited States
                [4] 4CAPHRI Department of Health Promotion Maastricht University Medical Center MaastrichtNetherlands
                Author notes
                Corresponding Author: Viola Voncken-Brewster viola.voncken@ 123456maastrichtuniversity.nl
                Article
                v2i1e3
                10.2196/resprot.2246
                3628158
                23612363
                881651dd-c02f-4724-b322-1cb56ab2a016
                ©Viola Voncken-Brewster, Albine Moser, Trudy van der Weijden, Zsolt Nagykaldi, Hein de Vries, Huibert Tange. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 16.01.2013.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org, as well as this copyright and license information must be included.

                History
                : 29 June 2012
                : 04 October 2012
                : 09 December 2012
                : 23 December 2012
                Categories
                Original Paper

                usability testing,internet intervention,computer tailoring,chronic obstructive pulmonary disease,self-management

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