Drivers for successful long-term lifestyle change, the role of e-health: a qualitative interview study

Abstract

ObjectivesAssisting patients in lifestyle change using collaborative e-health tools can be an efficient treatment for non-communicable diseases like diabetes, cardiovascular disease and chronic obstructive lung disease that are caused or aggravated by unhealthy living in the form of unhealthy diet, physical inactivity or tobacco smoking. In a prospective pilot study, we tested an online collaborative e-health tool in general practice. The aim of this study was to identify drivers of importance for long-term personal lifestyle changes from a patient perspective when using a collaborative e-health tool, including the support of peers and healthcare professionals.SettingGeneral practice clinics in the Region of Southern Denmark.Participants10 overweight patients who had previously successfully used a hybrid online collaborative e-health tool with both face-to-face and online consultations to lose weight.ResultsThe main themes identified were facilitators, barriers and support from family and peers. Establishment of a trustworthy relationship with the healthcare professionals was of paramount importance. It was important for the patients to monitor the measurable outcomes with realistic goals and feedback from a trusted person. Often, significant life events were identified as catalysts for successful long-term lifestyle changes. Dominant barriers to change were perception of insurmountable obstacles, experience of lack of self-efficacy and excess eating of high-calorie food. Finally, experiencing of trustworthy person-to-person forums, need for acknowledgement from referent others and support from family and peers were important drivers for long-term lifestyle change.ConclusionThe most important driver in long-term weight loss was a strong relationship with a healthcare professional. Collaborative e-health tools can support the relationship and behavioural changes through monitoring and providing relevant feedback. The support from family and peers also matters, and long-term success depends on the ability to establish strong, positive support on a day-to-day basis.

The influence of an eHealth intervention for adults with type 2 diabetes on the patient–nurse relationship: a qualitative study

“…The importance of meeting face‐to‐face is underlined. This builds on findings from an earlier study suggesting ‘hybrid’ versions of eHealth is necessary to strengthen the patient–nurse relationship . Particularly the RNs were concerned about the risk of misunderstandings when communicating asynchronously in writing.…”

General Practitioners’ Perspective on eHealth and Lifestyle Change: Qualitative Interview Study

“…GPs experienced that being supported both from family and peers mattered. Maybe GPs when discussing lifestyle with patients should take a new role and discuss GPs as human beings also have to make lifestyle choices on a daily basis to stay healthy, mainly because it opens for a respectful empathic dialogue, which is important for patients’ long-term successful lifestyle improvement [ 8 ].…”

“…The semistructured interviews followed an interview guide, which allowed an iterative approach, where emerging themes and perspectives could be explored in the interviews with subsequent participants [ 10 ]; see Table 1 for an overview of the themes and probing questions in the interview guide. The interview guide was made with inspiration from a study on GPs attitude toward the treatment of cardiovascular disease [ 11 ] and a previous study exploring the patients’ perspective of using eHealth in changing lifestyle [ 8 ].…”

“…These findings were replicated in a later version of the solution in a municipality setting in the region of North East England in Durham and Darlington County for men with type 2 diabetes in a pilot randomized controlled trial where patients lost an average of 5.4 kg compared with a control group that received usual care and lost 2.8 kg. In that same study, in-depth interviews with participating patients revealed that meeting face to face was important for the patients [ 7 ], and a recent qualitative study has shown that building a relationship to a health care professional using collaborative eHealth for lifestyle change is probably the most important driver for successful long-term outcome [ 8 ].…”

Effectiveness of Combined Smartwatch and Social Media Intervention on Breast Cancer Survivor Health Outcomes: A 10-Week Pilot Randomized Trial

“…While medicinal treatments (e.g., Tamoxifen use) may be prescribed following breast cancer treatment and the beginning of remission, health behavior changes are now more commonly being recommended to breast cancer survivors—the most frequent being increased physical activity participation [ 3 , 5 , 6 , 7 , 8 , 9 , 10 ]. Given the ubiquitous nature of modern-day technology, researchers are seeking to leverage several technologies (e.g., smartphone applications, wearable technology, social media) to improve health among various populations through increased physical activity and reduced sedentary behavior [ 11 , 12 ]. Currently, smartwatches are among the most popular technologies being used to assist individuals in living more active and healthier lifestyles.…”