University of Twente Student Theses


Preferences of people with a chronic disease towards physical activity e-coaching : a discrete choice experiment

Leusink, A. (2022) Preferences of people with a chronic disease towards physical activity e-coaching : a discrete choice experiment.

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Abstract:Background: More than 30% of the Dutch adults suffered from one or more chronic disease(s) in 2020 (Volksgezondheid en Zorg, 2021). In recent years, there has been increasing evidence of the positive effect that a healthy lifestyle can have in treating people with lifestyle-related chronic diseases. Mainly physical activity is an important lifestyle behavior in the management of several chronic diseases. Any additional amount of physical activity is advantageous and can help reduce pain and stress, as well as depressive symptoms and the risk of secondary health conditions, such as reduced fitness (Krops, 2017; WHO, 2018; NNGB, n.d.). Despite the benefits of physical activity on chronic disease prevention and management, people find it difficult to commit to it (Klein et al., 2013). The E-Manager program aims to promote healthy lifestyles while improving patient-centered health care. The E-Manager project is concerned with developing a coaching platform (the E-supporter) to help people with chronic disease improve their lifestyle by providing personalized coaching. Through motivational messages and exercises, the E-supporter provides personalized coaching aimed at maintaining a healthy lifestyle and helping people learn to cope with barriers (Hietbrink, 2020). This study aims to identify preferences for physical activity coaching through the E-supporter app. Furthermore, this study identifies whether clusters can be sorted based on people with the same levels of health and whether they share the same person characteristics and preferences for an exercise program. Aim: To investigate individual preferences towards physical activity coaching in adults with one or more chronic condition(s), to identify clusters of individuals with the same levels of health, and to identify whether individuals in these clusters differ by their demographics, health characteristics and preferences for an exercise program (Pinto et al., 2019). Methods: By means of multinomial logit analysis a Discrete Choice Experiment was performed, to determine the preference weights for the attribute levels and to identify the relative importance of the 6 attributes. In addition, two cluster were designed to identify groups with similarities based on their level of health. To determine whether there is a significant relationship between the individuals in these clusters and their demographic and health characteristics, a chi-square test was conducted. Lastly, a multinomial logit analysis was conducted to determine the similarity and differences between the clusters regarding their exercise program preferences. Results: The attribute with the highest importance, compared to the other attributes, was health improvement. Intensity was seen as the second most important attribute, with the respondents having a higher preference for exercising 3 times a week for 30-45 minutes at a time instead of exercising 5 times a week for 20-30 minutes. Furthermore, the respondents indicated that they preferred to receive guidance both face-to-face with a supervisor and guidance through the app. In addition, respondents preferred to receive weekly messages, rather than daily. The attribute with the lowest relative importance compared to the other attributes was type of guidance. Respondents attached the least importance to an app that was fully customized to their personal situation. Moreover, respondents indicated that they prefer light-intensity training rather than vigorous-intensity training. The results of the cluster analysis showed that a significant effect existed only between gender and the clusters. No significant relationship could be shown between the clusters and age, chronic disease or IPAQ category. The clusters differ from each other in terms of the attributes activity type and intensity. In contrast, the clusters correspond in their preferences for moderate health improvement, a coaching app that is not fully customized, an app that sends weekly messages and provides coaching both through the app and in a coaching practice. Conclusion: The E-supporter app can increase the willingness to exercise for people with chronic diseases by showing them the improvements that exercising can have on a person's health. Furthermore, it is recommended to offer exercise programs that are lightly or moderately intensive, given the potential limitation a person with a chronic disease may experience. Moreover, the app does not motivate if it sends multiple messages throughout the day, requires many health measurements and when individuals are only guided in a coaching practice.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:44 medicine
Programme:Health Sciences MSc (66851)
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