title: Motivational cues as real-time feedback for changing daily activity behavior of patients with COPD.
abstract: OBJECTIVE
  To investigate how COPD patients respond to motivational cues that aim to improve activity behavior and how these responses are related to cue- and context characteristics. In addition, to explore whether activity can be increased and better distributed over the day by providing such cues.
  
  
  METHODS
  Fifteen COPD patients participated. Patients used an activity sensor with a smartphone for four weeks, at least four days/week. Patients received motivational cues every 2h with advice on how to improve their activity, on top of real-time visual feedback. The response was calculated by the amount of activity 30 min before and after a cue.
  
  
  RESULTS
  In total, 1488 cues were generated. The amount of activity significantly decreased in the 30 min after a discouraging cue (p<0.001) and significantly increased (p<0.05) in the 10 min after an encouraging cue. The activity level increased with 13% in the intervention period compared to corrected baseline (p=0.008). The activity was not more balanced over the day.
  
  
  CONCLUSIONS
  COPD patients significantly change their activity level in response to motivational cues, based on continuous ambulatory assessment of activity levels.
  
  
  CONCLUSIONS
  Motivational cues could be a valuable component of telemedicine interventions that aim to improve activity behavior.
authors: Telemedicine Group, Roessingh Research and Development, Enschede, The Netherlands; Telemedicine Group, University of Twente, Enschede, The Netherlands. Electronic address: m.tabak@rrd.nl.
authors: Monique
authors: M
authors: Tabak
authors: Telemedicine Group, Roessingh Research and Development, Enschede, The Netherlands; Telemedicine Group, University of Twente, Enschede, The Netherlands.
authors: Harm
authors: H
authors: op den Akker
authors: Telemedicine Group, Roessingh Research and Development, Enschede, The Netherlands; Telemedicine Group, University of Twente, Enschede, The Netherlands.
authors: Hermie
authors: H
authors: Hermens
mesh_terms: D061725:Accelerometry; D000203:Activities of Daily Living; D000368:Aged; D003463:Cues; D030141:Feedback, Psychological / Q000502:physiology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009043:Motor Activity / Q000502:physiology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology* / Q000534:rehabilitation; D017010:Reminder Systems; D013689:Telephone; D016896:Treatment Outcome
keywords: Activity behavior; COPD; Feedback; Motivational cues; Telemedicine