How Can Self-monitoring Best Support Behaviour Change?

3907691Some of today’s biggest public health challenges, such as obesity and  heart disease, can be linked to personal lifestyle decisions. Governments have tried tackling these issues with smoking bans and taxes on high-fat foods, with moderate success. However, personal health behaviour change is needed to make a significant, lasting impact. Can self-monitoring of health information be the answer?

Studies in diabetes, hypertension, medication compliance and weight loss have shown that patients who successfully self-monitor their activities and set personal goals enjoy improved health outcomes and better adherence to treatment 1-6. We now have an abundance of apps and wearable technology at our fingertips to comprehensively track numerous aspects of our lifestyle, analyse results and observe improvements over time. These self-monitoring tools can then be easily integrated into social health networks so that we can share experiences, track our progress against that of our peers, and give and receive advice on how to succeed.

It is estimated that there are more than 40,000 health and fitness apps available. But with this bewildering variety of choice, how can we know which ones will encourage lasting behaviour change?

Easy does it

The apps which make the process of data upload as effortless as possible for the end user are the ones most likely to catch on in the long-term. Devices that automatically record data and synchronise it with online analysis programmes in real time provide a seamless transition and are not hampered by general forgetfulness or lack of time.

Keep it simple

Health information needs to be engaging, and simple enough to be universally accessible. The average person is likely to find sorting the data that matters from what doesn’t time-consuming and intellectually daunting—in fact, many patients who have to actively monitor a condition like type II diabetes don’t always fully engage with self-monitoring for these very reasons.7

Be realistic

Establishing aspirational but realistic goals and providing reinforcing feedback can help bring self-monitoring systems to life and make them personally meaningful.  A recent study into self-monitoring to improve diabetes treatment found that the main concerns patients had with the system were disappointment with unmet expectations and difficulty fitting the programme into the demands of daily life. 1

Collaborate

Ideally, fitness or health tracking app developers should collaborate closely with specialist healthcare providers and device makers as well as social scientists who understand how to bring about behaviour change. Such cross-fertilisation could result in truly useful tools that track fitness alongside other health metrics, such as blood sugar levels or medication adherence.

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1.  Barlow J, et al. Self management approaches for people with chronic conditions: a review. Patient Education Counseling 2002;48:177–87.

2.  Benhamou PY. Improving diabetes management with electronic health records and patients’ health records. Diabetes Metab 2011;37(Suppl 4):S53–6.

3.  Dennis EA, et al. Weight gain prevention for college freshmen: comparing two social cognitive theory-based interventions with and without explicit self-regulation training. J Obes 2012;2012:803769.

4.  Parker R, et al. An electronic medication reminder, supported by a monitoring service, to improve medication compliance for elderly people living independently. J Telemed Telecare 2012;18:156–8.

5.  Ralston JD, et al. Patients’ experience with a diabetes support programme based on an interactive electronic medical record: qualitative study. BMJ 2004;328:1159.

6.  Wagner PJ, et al. Personal health records and hypertension control: a randomized trial. J Am Med Inform Assoc 2012;19:626–34.

7.  Choose Control Survey. Choosing to take control in type 2 diabetes. Available at: http://www.diabetes. org.uk/Documents/Reports/Choose_Control_report.pdf (Last accessed May 2013).

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