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To examine the feasibility and potential effectiveness of a behavioural intervention to increase physical activity in patients admitted to the cardiology ward.In this proof-of concept study, we dev...

Background Smoking is more prevalent and persistent among lower socio-economic status (SES) compared with higher-SES groups, and contributes greatly to SES-based health inequities. Few interventions exist that effectively help lower-SES smokers quit. This study evaluated “De StopCoach”, a mobile phone delivered eHealth intervention targeted at lower-SES smokers based on the evidence-based StopAdvisor, in a real-world setting (five municipalities) in The Netherlands in 2019–2020. Method We conducted individual semi-structured interviews with project leaders, healthcare professionals, and participating smokers (N = 22), and examined log data from the app (N = 235). For practical reasons, SES of app users was not measured. Qualitative data were analysed using the Framework Approach, with the Consolidated Framework for Implementation Research (CFIR) and Unified Theory of Acceptance and Use of Technology (UTAUT) as theoretical models. Results Qualitative data showed that factors from the Intervention and Setting domains were most important for the implementation. StopCoach seemed suitable for lower-SES smokers in terms of performance and effort expectancy, especially when integrated with regular smoking cessation counseling (SCC). Key barriers to implementation of the app were limited integration of the app in SCC programs in practice, difficulty experienced by project leaders and healthcare professionals to engage the local community, and barriers to SCC more generally (e.g., perceived resistance to quitting in patients) that prevented healthcare professionals from offering the app to smokers. Quantitative data showed that 48% of app users continued using the app after the preparation phase and pre-quit day, and that 33% of app users had attempted to quit. Both app adherence and quit attempts were more likely if smokers also received SCC from a professional coach. Posthoc analyses suggest that adherence is related to higher likelihood of a quit attempt among participants with and without a professional coach. Conclusions Smokers, healthcare professionals and project leaders indicated in the interviews that the StopCoach app would work best when combined with SCC. It also appears from app log that app adherence and quit attempts by app users can be facilitated by combining the app with face-to-face SCC. As such, blended care appears promising for helping individual smokers quit, as it combines the best of regular SCC and eHealth. Further research on blended care for lower-SES smokers is needed.

Background Eating rate is a basic determinant of appetite regulation: people who eat more slowly feel sated earlier and eat less. A high eating rate contributes to overeating and potentially to weight gain. Previous studies showed that an augmented fork that delivers real-time feedback on eating rate is a potentially effective intervention to decrease eating rate in naturalistic settings. This study assessed the impact of using the augmented fork during a 15-week period on eating rate and body weight. Methods In a parallel randomized controlled trial, 141 participants with overweight (age: 49.2 ± 12.3 y; BMI: 31.5 ± 4.48 kg/m2) were randomized to intervention groups (VFC, n = 51 or VFC+, n = 44) or control group (NFC, n = 46). First, we measured bite rate and success ratio on five consecutive days with the augmented fork without feedback (T1). The intervention groups (VFC, VFC+) then used the same fork, but now received vibrotactile feedback when they ate more than one bite per 10 s. Participants in VFC+ had additional access to a web portal with visual feedback. In the control group (NFC), participants ate with the fork without either feedback. The intervention period lasted four weeks, followed by a week of measurements only (T2) and another measurement week after eight weeks (T3). Body weight was assessed at T1, T2, and T3. Results Participants in VFC and VFC+ had a lower bite rate (p p p Conclusions The findings of this study indicate that an augmented fork with vibrotactile feedback is a viable tool to reduce eating rate in naturalistic settings. Further investigation may confirm that the augmented fork could support long-term weight loss strategies. Trial registration The research reported in this manuscript was registered on 4 November 2015 in the Netherlands Trial Register with number NL5432 (https://www.trialregister.nl/trial/5432).

Overweight is associated with a range of negative health consequences, such as type 2 diabetes, cardiovascular disease, gastrointestinal disorders, and premature mortality.1 One means to combat overweight is through encouraging people to eat more slowly.2 People who eat quickly tend to consume more3, 4 and 5 and have a higher body mass index,6, 7, 8 and 9 whereas people who eat more slowly feel sated earlier and eat less.10, 11, 12 and 13. Unfortunately, eating rate is difficult to modify, because of its highly automatic nature.14 In clinical settings, researchers have had some success changing behavior by using devices that deliver feedback in real time.15, 16 and 17 However, existing technologies are either too cumbersome18 or not engaging enough19 for use in daily life contexts. Training people to eat more slowly in everyday eating contexts, therefore, requires creative and engaging solutions. This article presents a qualitative evaluation of the feasibility of a smart fork to decelerate eating rate in daily life contexts. Furthermore, we outline the planned research to test the efficacy of this device in both laboratory and community settings

Item does not contain fulltext Eating rate is a basic determinant of appetite regulation, as people who eat more slowly feel sated earlier and eat less. Without assistance, eating rate is difficult to modify due to its automatic nature. In the current study, participants used an augmented fork that aimed to decelerate their rate of eating. A total of 114 participants were randomly assigned to the Feedback Condition (FC), in which they received vibrotactile feedback from their fork when eating too fast (i.e., taking more than one bite per 10 s), or a Non-Feedback Condition (NFC). Participants in the FC took fewer bites per minute than did those in the NFC. Participants in the FC also had a higher success ratio, indicating that they had significantly more bites outside the designated time interval of 10 s than did participants in the NFC. A slower eating rate, however, did not lead to a significant reduction in the amount of food consumed or level of satiation. These findings indicate that real-time vibrotactile feedback delivered through an augmented fork is capable of reducing eating rate, but there is no evidence from this study that this reduction in eating rate is translated into an increase in satiation or reduction in food consumption. Overall, this study shows that real-time vibrotactile feedback may be a viable tool in interventions that aim to reduce eating rate. The long-term effectiveness of this form of feedback on satiation and food consumption, however, awaits further investigation. 7 p.