Cardiovascular diseases (CVDs) are a leading cause of premature death worldwide. International guidelines recommend routine delivery of all phases of cardiac rehabilitation (CR). Uptake of traditional CR remains suboptimal, as attendance at formal hospital-based CR programs is low, with community-based CR rates and individual long-term exercise maintenance even lower. Home-based CR programs have been shown to be equally effective in clinical and health-related quality of life outcomes and yet are not readily available. The aim of the current study was to develop the PATHway intervention (physical activity toward health) for the self-management of CVD. Increasing physical activity in individuals with CVD was the primary behavior. The PATHway intervention was theoretically informed by the behavior change wheel and social cognitive theory. All relevant intervention functions, behavior change techniques, and policy categories were identified and translated into intervention content. Furthermore, a person-centered approach was adopted involving an iterative codesign process and extensive user testing. Education, enablement, modeling, persuasion, training, and social restructuring were selected as appropriate intervention functions. Twenty-two behavior change techniques, linked to the six intervention functions and three policy categories, were identified for inclusion and translated into PATHway intervention content. This paper details the use of the behavior change wheel and social cognitive theory to develop an eHealth intervention for the self-management of CVD. The systematic and transparent development of the PATHway intervention will facilitate the evaluation of intervention effectiveness and future replication.
Abstract-Over the last years, due to the emergency of new challenges in the area of the health care domain, particular emphasis was dedicated to the application of ICT in this sector. This, in turn, stimulated the analysis over the software requirements engineering techniques and their applicability in this context. The
Internet of Things (IoT) technologies have become a milestone advancement in the digital healthcare domain, since the number of IoT medical devices is grown exponentially, and it is now anticipated that by 2020, there will be over 161 million of them connected worldwide. Therefore, in an era of continuous growth, IoT healthcare faces various challenges, such as the collection over multiple protocols (e.g. Bluetooth, MQTT, CoAP, ZigBEE, etc.) the interpretation, as well as the harmonization of the data format that derive from the existing huge amounts of heterogeneous IoT medical devices. In this respect, this study aims at proposing an advanced Home Gateway architecture that offers a unique data collection module, supporting direct data acquisition over multiple protocols (i.e.BLE, MQTT) and indirect data retrieval from cloud health services (i.e. GoogleFit). Moreover, the solution propose a mechanism to automatically convert the original data format, carried over BLE, in HL7 FHIR by exploiting device capabilities semantic annotation implemented by means of FHIR resource as well. The adoption of such annotation enables the dynamic plug of new sensors within the instrumented environment without the need to stop and adapt the gateway. This simplifies the dynamic devices landscape customization requested by the several telemedicine applications contexts (e.g. CVD, Diabetes) and demonstrate, for the first time, a concrete example of using the FHIR standard not only (as usual) for health resources representation and storage but also as instrument to enable seamless integration of IoT devices. The proposed solution also relies on mobile phone technology which is widely adopted aiming at reducing any obstacle for a larger adoption.
The GATEKEEPER (GK) Project was financed by the European Commission to develop a platform and marketplace to share and match ideas, technologies, user needs and processes to ensure a healthier independent life for the aging population connecting all the actors involved in the care circle. In this paper, the GK platform architecture is presented focusing on the role of HL7 FHIR to provide a shared logical data model to be explored in heterogeneous daily living environments. GK pilots are used to illustrate the impact of the approach, benefit value, and scalability, suggesting ways to further accelerate progress.
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