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Janols, Rebecka
Publications (10 of 12) Show all publications
Lundberg, V., Sandlund, M., Eriksson, C., Janols, R., Lind, T. & Fjellman-Wiklund, A. (2022). How children and adolescents with juvenile idiopathic arthritis participate in their healthcare: health professionals' views. Disability and Rehabilitation, 44(10), 1908-1915
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2022 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 44, no 10, p. 1908-1915Article in journal (Refereed) Published
Abstract [en]

Background: The study explores how healthcare professionals view participation of children and adolescents with juvenile idiopathic arthritis, in healthcare encounters.

Methods: This qualitative study includes focus groups of HCPs from different professions. The interviews were analysed with qualitative content analysis.

Results: The theme “Creating an enabling arena” illuminates how HCPs face possibilities and challenges when enabling children to communicate and participate in clinical encounters. HCPs, parents, and the healthcare system need to adjust to the child. The sub-theme “Bringing different perspectives” describes how children and their parents cooperate and complement each other during healthcare encounters. The sub-theme “Building a safe and comfortable setting” includes how HCPs address the child’s self-identified needs and make the child feel comfortable during encounters. The sub-theme “Facilitating methods in a limiting organisation” includes how HCPs’ working methods and organization may help or hinder child participation during encounters.

Conclusions: HCPs encourage children and adolescents to make their views known during healthcare encounters by creating an enabling arena. Collaboration and building good relationships between the child, the parents and the HCPs, before and during the healthcare encounters, can help the child express their wishes and experiences. Clinical examinations and use of technology, such as photos, films and web-bases questionnaires can be a good start for a better child communication in healthcare encounters.

Place, publisher, year, edition, pages
Taylor & Francis, 2022
Keywords
Adolescent, child, chronic condition, communication, healthcare professionals, participation, qualitative
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-175079 (URN)10.1080/09638288.2020.1811406 (DOI)000565631500001 ()32875956 (PubMedID)2-s2.0-85090155995 (Scopus ID)
Available from: 2020-09-30 Created: 2020-09-30 Last updated: 2022-07-12Bibliographically approved
Janols, R., Sandlund, M., Lindgren, H. & Pettersson, B. (2022). Older adults as designers of behavior change strategies to increase physical activity: report of a participatory design process. Frontiers In Public Health, 10, Article ID 988470.
Open this publication in new window or tab >>Older adults as designers of behavior change strategies to increase physical activity: report of a participatory design process
2022 (English)In: Frontiers In Public Health, ISSN 2296-2565, Vol. 10, article id 988470Article in journal (Refereed) Published
Abstract [en]

Background: Despite the significant value of physical activity for the health of older adults, this population often fails to achieve recommended activity levels. Digital interventions show promise in providing support for self-managed physical activity. However, more information is needed about older adults' preferences for digital support to change physical activity behaviors as well as the process of designing them. The aim of this paper was to describe the participatory design process in which older adults were involved in the co-creation of digitally supported behavioral change strategies to support self-managed physical activity, and how the results were integrated in a prototype.

Methods: The participatory design process involved with nine older adults and two researchers. The participants were divided in two groups, and each group participated in three workshops and completed home tasks in between workshops. Following an iterative design process influenced by theories of behavior change, the workshops and home tasks were continuously analyzed, and the content and process were developed between groups and the next set of workshops. Prototypes of a mobile health (mHealth) solution for fall preventive exercise for older adults were developed in which the conceptualized strategies were integrated. To support coherence in reporting and evaluation, the developed techniques were mapped to the Behavior Change Technique Taxonomy v1 and the basic human psychosocial needs according to the Self-determination Theory.

Results: The results highlight different preferences of older adults for feedback on physical activity performance, as well as the importance of transparency regarding the identification of the sender of feedback. Preferences for content and wording of feedback varied greatly. Subsequently, the design process resulted in a virtual health coach with three different motivational profiles and tools for goal setting and self-monitoring. These behavior change strategies were integrated in the exercise application Safe Step v1. The conformity of the design concepts with the needs of Self-determination Theory and Behavior Change Technique Taxonomy v1 are presented.

Conclusion: The participatory design process exemplifies how older adults successfully contributed to the design of theory-based digital behavior change support, from idea to finished solution. Tailoring feedback with a transparent sender is important to support and not undermine motivation.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2022
Keywords
behavior change, co-creation, digital technology, mHealth, motivation, participatory design
National Category
Human Computer Interaction
Identifiers
urn:nbn:se:umu:diva-202585 (URN)10.3389/fpubh.2022.988470 (DOI)000910855400001 ()36620266 (PubMedID)2-s2.0-85145500489 (Scopus ID)
Funder
Swedish Research Council, 521–2011-3250Swedish Research Council, 2015-03481Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2023-01-12 Created: 2023-01-12 Last updated: 2023-09-05Bibliographically approved
Pettersson, B., Janols, R., Wiklund, M., Lundin-Olsson, L. & Sandlund, M. (2021). Older adults’ experiences of behavior change support in a digital fall prevention exercise program: A qualitative study framed by the self-determination theory. Journal of Medical Internet Research, 23(7), Article ID e26235.
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2021 (English)In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 23, no 7, article id e26235Article in journal (Refereed) Published
Abstract [en]

Background: Exercise is an effective intervention to prevent falls in older adults; however, long-term adherence is often poor. To increase adherence, additional support for behavior change has been advocated. However, consistency in the reporting of interventions using behavior change techniques is lacking. Recently, a classification system has been developed to increase consistency in studies using behavior change techniques within the self-determination theory.

Objective: This study aimed to explore expressions of self-determination among community-dwelling older adults using a self-managed digital fall prevention exercise program comprising behavior change support (the Safe Step program), which was developed in co-creation with intended users.

Methods: The qualitative study design was based on open-ended responses to questionnaires, and individual and focus group interviews. A deductive qualitative content analysis was applied using the classification system of motivation and behavior change techniques as an analytical matrix, followed by an inductive analysis. Twenty-five participants took part in a feasibility study and exercised in their homes with the Safe Step program for 4 months. The exercise program was available on computers, smartphones, and tablets, and was fully self-managed.

Results: In the deductive analysis, expressions of support were demonstrated for all three basic human psychological needs, namely, autonomy, competence, and relatedness. These expressions were related to 11 of the 21 motivation and behavior change techniques in the classification system. The inductive analysis indicated that autonomy (to be in control) was valued and enabled individual adaptations according to different rationales for realizing exercise goals. However, the experience of autonomy was also two-sided and depended on the participants’ competence in exercise and the use of technology. The clarity of the program and exercise videos was seen as key for support in performance and competent choices. Although augmented techniques for social support were requested, support through relatedness was found within the program.

Conclusions: In this study, the Safe Step program supported the establishment of new exercise routines, as well as the three basic human psychological needs, with autonomy and competence being expressed as central in this context. Based on the participants’ experiences, a proposed addition to the classification system used as an analytical matrix has been presented.

Place, publisher, year, edition, pages
JMIR Publications, 2021
Keywords
Accidental falls, Aged, Behavior change, Behavior change techniques, Classification of motivation, EHealth, Exercise, Fall prevention, Qualitative research, Self-determination theory, Self-management
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-183075 (URN)10.2196/26235 (DOI)000680402200002 ()34328438 (PubMedID)2-s2.0-85111690599 (Scopus ID)
Note

Originally included in thesis in manuscript form.

Available from: 2021-05-17 Created: 2021-05-17 Last updated: 2024-01-17Bibliographically approved
Månsson, L., Lundin-Olsson, L., Skelton, D. A., Janols, R., Lindgren, H., Rosendahl, E. & Sandlund, M. (2020). Older adults' preferences for, adherence to and experiences of two self-management falls prevention home exercise programmes: a comparison between a digital programme and a paper booklet. BMC Geriatrics, 20(1), Article ID 209.
Open this publication in new window or tab >>Older adults' preferences for, adherence to and experiences of two self-management falls prevention home exercise programmes: a comparison between a digital programme and a paper booklet
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2020 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 20, no 1, article id 209Article in journal (Refereed) Published
Abstract [en]

Background: Fall prevention exercise programmes are known to be effective, but access to these programmes is not always possible. The use of eHealth solutions might be a way forward to increase access and reach a wider population. In this feasibility study the aim was to explore the choice of programme, adherence, and self-reported experiences comparing two exercise programmes – a digital programme and a paper booklet.

Methods: A participant preference trial of two self-managed fall prevention exercise interventions. Community-dwelling adults aged 70 years and older exercised independently for four months after one introduction meeting. Baseline information was collected at study start, including a short introduction of the exercise programme, a short physical assessment, and completion of questionnaires. During the four months intervention period, participants self-reported their performed exercises in an exercise diary. At a final meeting, questionnaires about their experiences, and post-assessments, were completed. For adherence analyses data from diaries were used and four subgroups for different levels of participation were compared. Exercise maintenance was followed up with a survey 12 months after study start.

Results: Sixty-seven participants, with mean age 77 ± 4 years were included, 72% were women. Forty-three percent chose the digital programme. Attrition rate was 17% in the digital programme group and 37% in the paper booklet group (p = .078). In both groups 50–59% reported exercise at least 75% of the intervention period. The only significant difference for adherence was in the subgroup that completed ≥75% of exercise duration, the digital programme users exercised more minutes per week (p = .001). Participants in both groups were content with their programme but digital programme users reported a significantly higher (p = .026) degree of being content, and feeling supported by the programme (p = .044). At 12 months follow-up 67% of participants using the digital programme continued to exercise regularly compared with 35% for the paper booklet (p = .036).

Conclusions: Exercise interventions based on either a digital programme or a paper booklet can be used as a self-managed, independent fall prevention programme. There is a similar adherence in both programmes during a 4-month intervention, but the digital programme seems to facilitate long-term maintenance in regular exercise.

Place, publisher, year, edition, pages
BioMed Central, 2020
Keywords
Accidental falls, Aged, 80 and over, Digital health, eHealth, Exercise, Falls prevention, Independent living, mHealth, Self-management
National Category
Geriatrics Physiotherapy
Identifiers
urn:nbn:se:umu:diva-173444 (URN)10.1186/s12877-020-01592-x (DOI)000542669000001 ()32539711 (PubMedID)2-s2.0-85086546237 (Scopus ID)
Funder
Swedish Research Council, 521-2011-3250Swedish Research Council, 2015-03481Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2020-07-10 Created: 2020-07-10 Last updated: 2023-03-23Bibliographically approved
Pettersson, B., Wiklund, M., Janols, R., Lindgren, H., Lundin-Olsson, L., Skelton, D. A. & Sandlund, M. (2019). "Managing pieces of a personal puzzle': Older people's experiences of self-management falls prevention exercise guided by a digital program or a booklet. BMC Geriatrics, 19, Article ID 43.
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2019 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 19, article id 43Article in journal (Refereed) Published
Abstract [en]

Background: Exercise is effective in order to prevent falls in community-dwelling older people. Self-management programs have the potential to increase access and reduce costs related to exercise-based fall prevention. However, information regarding older people's views of participating in such programs is needed to support implementation. The aim of this study was to explore older people's experiences of a self-management fall prevention exercise routine guided either by a digital program (web-based or mobile) or a paper booklet.

Methods: This qualitative study was part of a feasibility study exploring two completely self-managed exercise interventions in which the participants tailored their own program, guided either by a digital program or a paper booklet. Individual face-to-face semi-structured interviews were conducted with a purposeful sample of 28 participants (18 women), mean age 76yrs. Qualitative content analysis was used to analyse the data.

Results: Self-managing and self-tailoring these exercise programs was experienced as Managing pieces of a personal puzzle'. To independently being able to create a program and manage exercise was described in the categories Finding my own level' and Programming it into my life'. The participants experienced the flexibility and independence provided by completely self-managed exercise as positive and constructive although it required discipline. Furthermore, different needs and preferences when managing their exercise were described, as well as varying sources of motivation for doing the exercise, as highlighted in the category Defining my source of motivation'. The category Evolving my acquired knowledge' captures the participants' views of building their competence and strategies for maintenance of the exercise. It describes a combined process of learning the program and developing reflection, which was more clearly articulated by participants using the digital program.

Conclusions: This study provides new knowledge regarding experiences, preferences and motivations of older people to engage in home-based self-managed fall prevention exercise. They expressed both a capability and willingness to independently manage their exercise. A digital program seems to have strengthened the feeling of support while creating their own exercise program and tailoring it to their preferences and circumstances, which might therefore create better opportunities for adoption and adherence in the long term.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Accidental falls, Aged, Exercise, Qualitative research, eHealth, Digital health, Self-management, Falls prevention, Intervention, Behaviour change
National Category
Geriatrics Nursing
Identifiers
urn:nbn:se:umu:diva-157209 (URN)10.1186/s12877-019-1063-9 (DOI)000459122200003 ()30777026 (PubMedID)2-s2.0-85061861155 (Scopus ID)
Available from: 2019-03-26 Created: 2019-03-26 Last updated: 2023-03-24Bibliographically approved
Janols, R. & Lindgren, H. (2017). A method for co-designing theory-based behaviour change systems for health promotion. Studies in Health Technology and Informatics, 235, 368-372
Open this publication in new window or tab >>A method for co-designing theory-based behaviour change systems for health promotion
2017 (English)In: Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365, Vol. 235, p. 368-372Article in journal (Refereed) Published
Abstract [en]

A methodology was defined and developed for designing theory-based behaviour change systems for health promotion that can be tailored to the individual. Theories from two research fields were combined with a participatory action research methodology. Two case studies applying the methodology were conducted. During and between group sessions the participants created material and designs following the behaviour change strategy themes, which were discussed, analysed and transformed into a design of a behaviour change system. Theories in behavioural change and persuasive technology guided the data collection, data analyses, and the design of a behaviour change system. The methodology has strong emphasis on the target group's participation in the design process. The different aspects brought forward related to behaviour change strategies defined in literature on persuasive technology, and the dynamics of these are associated to needs and motivation defined in literature on behaviour change. It was concluded that the methodology aids the integration of theories into a participatory action research design process, and aids the analyses and motivations of design choices.

Place, publisher, year, edition, pages
Amsterdam: IOS Press, 2017
Keywords
Health promotion, Participatory action research, behavioural change systems, persuasive design
National Category
Human Computer Interaction
Research subject
medical informatics; computer and systems sciences; människa-datorinteraktion
Identifiers
urn:nbn:se:umu:diva-134631 (URN)10.3233/978-1-61499-753-5-368 (DOI)28423816 (PubMedID)2-s2.0-85018840920 (Scopus ID)
Available from: 2017-05-10 Created: 2017-05-10 Last updated: 2023-03-24Bibliographically approved
Baskar, J., Janols, R., Guerrero, E., Nieves, J. C. & Lindgren, H. (2017). A Multipurpose Goal Model for Personalised Digital Coaching. In: Agents and Multi-Agent Systems for Health Care: 10th International Workshop, A2HC 2017, São Paulo, Brazil, May 8, 2017, and International Workshop, A-HEALTH 2017, Porto, Portugal, June 21, 2017, Revised and Extended Selected Papers. Paper presented at A2HC 2017 : X Workshop on Agents Applied in Health Care, Sao Paolo, Brazil, May 8-9, 2017 (pp. 94-116). Springer, 10685
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2017 (English)In: Agents and Multi-Agent Systems for Health Care: 10th International Workshop, A2HC 2017, São Paulo, Brazil, May 8, 2017, and International Workshop, A-HEALTH 2017, Porto, Portugal, June 21, 2017, Revised and Extended Selected Papers, Springer, 2017, Vol. 10685, p. 94-116Conference paper, Published paper (Refereed)
Abstract [en]

Supporting human actors in daily living activities for improving health and wellbeing is a fundamental goal for assistive technology. The personalisation of the support provided by assistive technology in the form of digital coaching requires user models that handle potentially conflicting goals and motives. The aim of this research is to extend a motivational model implemented in an assistive technology, into a multipurpose motivational model for the human actor who is to be supported, which can be translated into a multipurpose goal model for a team of assistive agents. A team of assistive agents is outlined with supplementary goals following the human’s different properties. A method for generating multipurpose arguments relating to different motives were developed, and implemented in a human-agent dialogue system. The results are exemplified based on a use case from an earlier pilot user study of the assistive technology. Future work includes user studies to validate the model.

Place, publisher, year, edition, pages
Springer, 2017
Series
Lecture Notes in Artificial Intelligence
National Category
Computer Sciences Human Computer Interaction
Research subject
Computer Science; human-computer interaction
Identifiers
urn:nbn:se:umu:diva-141360 (URN)10.1007/978-3-319-70887-4_6 (DOI)2-s2.0-85036631742 (Scopus ID)
Conference
A2HC 2017 : X Workshop on Agents Applied in Health Care, Sao Paolo, Brazil, May 8-9, 2017
Available from: 2017-10-31 Created: 2017-10-31 Last updated: 2023-03-24Bibliographically approved
Janols, R., Guerrero, E. & Lindgren, H. (2017). A Pilot Study on Personalised Coaching to Increase Older Adults' Physical and Social Activities. In: Juan F. De Paz, Vicente Julián, Gabriel Villarrubia, Goreti Marreiros, Paulo Novais (Ed.), Ambient Intelligence - Software and Applications - 8th International Symposium on Ambient Intelligence (ISAmI 2017): . Paper presented at Ambient Intelligence - Software and Applications - 8th International Symposium on Ambient Intelligence (ISAmI 2017), Porto, Portugal, June 21-13, 2017. (pp. 140-148). Springer, 615
Open this publication in new window or tab >>A Pilot Study on Personalised Coaching to Increase Older Adults' Physical and Social Activities
2017 (English)In: Ambient Intelligence - Software and Applications - 8th International Symposium on Ambient Intelligence (ISAmI 2017) / [ed] Juan F. De Paz, Vicente Julián, Gabriel Villarrubia, Goreti Marreiros, Paulo Novais, Springer, 2017, Vol. 615, p. 140-148Conference paper, Published paper (Refereed)
Abstract [en]

The aim of this research is to conduct a pilot study of a prototype that provides feedback using theory-based motivating messages developed by older adults, in a context of every day activities that include both physical and social activities. The prototype mobile application integrated the messages, a motivational model, and a personalization module that selects motivational messages based on preferences, motivational profile and the situation. The four participating older adults used the application for planning and following up social and physical activities. They found the messages entertaining and appreciated the dialogues with the application. They used the dialogues primarily to reinforce their satisfaction regarding conducted activities and did not necessarily tell the truth about conduced activities in the interaction with the application. The results are preliminary, but give valuable implications for further development of the personalisation module towards more purposeful use of ambient information, and aspects to explore in future user studies.

Place, publisher, year, edition, pages
Springer, 2017
Series
Advances in Intelligent Systems and Computing, E-ISSN 2194-5357
Keywords
Behaviour change, Persuasive technology, Personalisation, Ambient intelligence, Physical activity, Social inclusion, Older adults
National Category
Human Computer Interaction Computer Sciences
Research subject
människa-datorinteraktion; computer and systems sciences
Identifiers
urn:nbn:se:umu:diva-141030 (URN)10.1007/978-3-319-61118-1_18 (DOI)000452846600018 ()2-s2.0-85021678496 (Scopus ID)978-3-319-61118-1 (ISBN)978-3-319-61117-4 (ISBN)
Conference
Ambient Intelligence - Software and Applications - 8th International Symposium on Ambient Intelligence (ISAmI 2017), Porto, Portugal, June 21-13, 2017.
Available from: 2017-10-22 Created: 2017-10-22 Last updated: 2019-01-22Bibliographically approved
Janols, R. & Lindgren, H. (2017). A study on motivational messages for supporting seniors to increase physical activity and social participation. In: ECCE '17: Proceedings of the European Conference on Cognitive Ergonomics. Paper presented at 35th Annual Conference of the European Association of Cognitive Ergonomics, ECCE 2017, Umeå, Sweden, September 19-22, 2017 (pp. 57-58). ACM Digital Library
Open this publication in new window or tab >>A study on motivational messages for supporting seniors to increase physical activity and social participation
2017 (English)In: ECCE '17: Proceedings of the European Conference on Cognitive Ergonomics, ACM Digital Library, 2017, p. 57-58Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

The aim is to develop an adaptive computer-based intervention that gives seniors personalized support for increasing physical and social activity. The user-centered studies have been conducted. The results indicate that the seniors need to be categorized based on their preferences regarding a sub-set of messages.

Place, publisher, year, edition, pages
ACM Digital Library, 2017
Series
ACM International Conference Proceeding Series
Keywords
Activity theory, Motivational messages, Personalization, Self-determination theory
National Category
Human Computer Interaction
Identifiers
urn:nbn:se:umu:diva-206116 (URN)10.1145/3121283.3121417 (DOI)2-s2.0-85033498040 (Scopus ID)9781450352567 (ISBN)
Conference
35th Annual Conference of the European Association of Cognitive Ergonomics, ECCE 2017, Umeå, Sweden, September 19-22, 2017
Available from: 2023-03-29 Created: 2023-03-29 Last updated: 2023-03-29Bibliographically approved
Lindgren, H., Guerrero, E. & Janols, R. (2017). Personalised Persuasive Coaching to Increase Older Adults' Physical and Social Activities: a Motivational Model. In: Advances in Practical Applications of Cyber-Physical Multi-Agent Systems: The PAAMS Collection: 15th International Conference, PAAMS 2017, Porto, Portugal, June 21-23, 2017, Proceedings. Paper presented at PAAMS 2017: 15th International Conference on Practical Applications of Agents and Multi-Agent systems, Portugal, June 21-23, 2017 (pp. 170-182). Springer
Open this publication in new window or tab >>Personalised Persuasive Coaching to Increase Older Adults' Physical and Social Activities: a Motivational Model
2017 (English)In: Advances in Practical Applications of Cyber-Physical Multi-Agent Systems: The PAAMS Collection: 15th International Conference, PAAMS 2017, Porto, Portugal, June 21-23, 2017, Proceedings, Springer, 2017, p. 170-182Conference paper, Published paper (Refereed)
Abstract [en]

The overall aim of this research is to develop an adaptive digital coaching system that gives seniors personalized support for increasing physical activity, and promoting participation in social activity and their own care. The main research question is how can different behavioral and motivational factors of an individual be formally integrated into the knowledge base of a coach agent for generating support tailored to the individual’s needs and preferences in a specific situation?

The results include a theory-based motivational model incorporating different person-centric factors, and an algorithm for generating the adaptive and persuasive behavior of the agent that aims to motivate the individual. These are integrated in a mobile coaching application together with a set of theory-based motivating messages targeting primarily physical and social activities. Future work includes the development of methods for handling conflicting motives, and user studies.

Place, publisher, year, edition, pages
Springer, 2017
Series
Lecture Notes in Computer Science ; 10349
Keywords
Agents, Behaviour change, Persuasive technology, Personalisation, Physical activity, Social inclusion, Older adults
National Category
Computer Sciences Human Computer Interaction
Research subject
computer and systems sciences; human-computer interaction
Identifiers
urn:nbn:se:umu:diva-141029 (URN)10.1007/978-3-319-59930-4_14 (DOI)2-s2.0-85021702584 (Scopus ID)978-3-319-59929-8 (ISBN)978-3-319-59930-4 (ISBN)
Conference
PAAMS 2017: 15th International Conference on Practical Applications of Agents and Multi-Agent systems, Portugal, June 21-23, 2017
Available from: 2017-10-22 Created: 2017-10-22 Last updated: 2023-03-24Bibliographically approved
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