Personal Health Technologies in Employee Health Promotion: Usage Activity, Usefulness, and Health-Related Outcomes in a 1-Year Randomized Controlled Trial

Probably not a substantial claim: may not pass S3 (load-bearing).

Interviewees noted benefits of SelfRelax, which provided relaxation programs for specific situations, such as falling asleep, relaxing after work, or unwinding after a challenging encounter.

“The interviewees also noted the benefits of SelfRelax, which provided relaxation programs for specific situations, such as falling asleep, relaxing after work, or unwinding after a challenging encounter.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The benefits of the Wellness Diary were the record it provided of personal progress and development in long-term health data through graphical feedback.

“The benefits of the Wellness Diary were the record it provided of personal progress and development in long-term health data through graphical feedback.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Among participants in the technology group, sustained users were slightly older than non-sustained users.

“The sustained users were slightly older than the non-sustained users (Table 4).”

Probably not a substantial claim: may not pass S3 (load-bearing).

There were 7 major themes identified in the interview responses: ease of use, usefulness, motivation, learning, barriers to use, role of technologies in achieving wellness benefits, and usage habits.

“There were 7 major themes (ie, ease of use, usefulness, motivation, learning, barriers to use, role of technologies in achieving wellness benefits, and usage habits) identified in the interview responses.”

May combine two claims.

The scales, pedometer, and Wellness Diary were perceived as having useful features by 79-83%, 79-88%, and 45-66% of respondents, respectively.

“The same technologies were also perceived as having useful features by most respondents: 79–83% for the scales, 79–88% for the pedometer, and 45–66% for Wellness Diary.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Response rates to the usefulness questionnaires varied between questionnaires and between questions within the questionnaires.

“Response rates to the usefulness questionnaires varied between questionnaires and also between questions within the questionnaires.”

May combine two claims.

Among sustained users, aerobic fitness and total cholesterol increased from baseline to end.

“Weight, body fat, BMI, waist circumference decreased, aerobic fitness, and total cholesterol increased among sustained users (Table 5).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The median number of usage weeks among interviewees was 16 in the first interview and 13 in the second interview.

“The median number of usage weeks among the interviewees was 16 in the first interview and 13 in the second interview.”

May combine two claims.

The key factors in usefulness were simplicity, integration into daily life, and clear feedback on progress.

“The key factors in usefulness were: simplicity, integration into daily life, and clear feedback on progress.”

May combine two claims.

The weight scales and pedometer were regarded as the best technologies for supporting wellness management in all post-intervention questionnaires, followed by Wellness Diary and heart rate belt.

“The weight scales and pedometer were regarded as the best technologies for supporting wellness management in all post-intervention questionnaires, followed by Wellness Diary and heart rate belt (Figure 4).”

Probably not a substantial claim: may not pass S3 (load-bearing).

Typical barriers to using the technologies included problems with the phone or the Portal being down.

“Typical barriers to using the technologies included problems with the phone or the Portal being down.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The interviewees represented different types of technology users, including non-users, moderately active and sustained users.

“The interviewees represented different types of technology users, including non-users, moderately active and sustained users.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The heart rate belt was borrowed at least once by 65 subjects (57.0%).

“The heart rate belt was borrowed at least once by 65 (57.0%) subjects.”

May combine two claims.

Of the 114 subjects, 64 (56.1%) responded to the 1-month questionnaire, 60 (52.6%) to the 3-month questionnaire, 85 (74.6%) to the 6-month questionnaire, and 95 (83.3%) to the 12-month questionnaire.

“Of the 114 subjects, there were 64 (56.1%) who responded to the 1-month questionnaire (range for individual questions 33–64 subjects, 28.9–56.1%), 60 subjects (52.6%) to the 3-month questionnaire (range 49–60 subjects, 43.0–52.6%), 85 subjects (74.6%) to the 6-month questionnaire (range 77–85 subjects, 67.5–74.6%), and 95 subjects (83.3%) to the 12-month questionnaire (range 90–95 subjects, 78.9–8”

Probably not a substantial claim: may not pass S3 (load-bearing).

The benefits of the Mobile Coach were seen to be its adaptive exercise programs and coaching.

“The benefits of the Mobile Coach were seen to be its adaptive exercise programs and coaching.”

May combine two claims.

67-80% of respondents would recommend the scales, 71-85% the pedometer, and 38-55% the Wellness Diary to others.

“Most of the respondents reported that they would also recommend these technologies to others: 67–80% would recommend the scales, 71–85% the pedometer, and 38–55% the Wellness Diary.”

May combine two claims.

Among sustained users, weight, body fat, BMI, and waist circumference decreased from baseline to end.

“Weight, body fat, BMI, waist circumference decreased, aerobic fitness, and total cholesterol increased among sustained users (Table 5).”

Probably not a substantial claim: may not pass S3 (load-bearing).

The main appeal of the weight scales and pedometer were their simplicity, ease of use, and concreteness.

“The main appeal of the weight scales and pedometer were their simplicity, ease of use, and concreteness.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

9 subjects (7.9%) borrowed the heart rate belt 2 times and 3 subjects (2.6%) borrowed it 3 times.

“In addition, 9 (7.9%) subjects borrowed it 2 times and 3 (2.6%) subjects 3 times.”

May combine two claims.

Sustained users lost more weight and body fat and decreased their waist circumference more than non-sustained users.

“Sustained users lost more weight and body fat and decreased their waist circumference more than non-sustained users.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Interviewees reported taking breaks, and a typical time to take a break was summer holidays.

“The interviewees also reported taking breaks, and recommended that the technologies could better support such intermittent usage. A typical time to take a break was summer holidays.”

May combine two claims.

The technologies were not well integrated; similar information had to be entered to several applications.

“In addition, the technologies were not well integrated. Similar information had to be entered to several applications, for example, whenever someone wanted to use both the Wellness Diary and Mobile Coach for tracking exercises.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Some respondents continued to use the technologies after a break but others did not.

“Some of the respondents continued to use the technologies after a break but others did not.”

May combine two claims.

Among those 23 respondents, 17 had lost at least 0.5% of baseline weight, 5 had maintained or gained weight, and 1 had no end measurement.

“There were 17 respondents who had lost at least 0.5% of their baseline weight, 5 who had maintained or gained weight, and 1 respondent who had no end measurement.”

May combine two claims.

Only about 38% of the employee population responded to the screening questionnaire and only 29% of the subjects in the technology group self-selected to use technologies over the long-term.

“Only about 38% of the employee population responded to the screening questionnaire and only 29% of the subjects in the technology group self-selected to use technologies over the long-term.”

May combine two claims.

There were few, if any, health-related benefits in any of the study arms, which may be linked to the selection of the study population.

“Secondly, there were few, if any, health-related benefits in any of the study arms [23], which may be linked to the selection of the study population.”

• cites [23] Hopsu, L, 2010, Barents Newsletter on Occupational Health and SafetyNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

Users changed technologies during the study.

“The users also changed technologies during the study.”

May combine two claims.

Among those 51 respondents, 36 had increased aerobic fitness, 13 had maintained or decreased fitness, and 2 had no end measurement.

“There were 36 respondents who had increased their aerobic fitness, 13 who had maintained or decreased their fitness, and 2 who had no end measurement.”

May combine two claims.

Half of the subjects had used mobile or Web technologies throughout the active intervention period (weeks 1-8), after which the number of users declined, leaving 33 (29%) sustained users.

“Half of them had used mobile or Web technologies throughout the active intervention period (weeks 1–8), after which the number of users declined, leaving 33 (29%) sustained users.”

May combine two claims.

Reasons for decreased usage of the Wellness Diary were a change of routines from daily entries to entering several days' data at a time or stopping usage of certain variables due to a perceived lack of need.

“The reasons for the decrease in usage of the Wellness Diary were a change of routines from daily entries to entering several days’ data at a time or stopping usage of certain variables due to a perceived lack of need.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Some subjects had difficulty adopting the study phone as their primary phone, while others considered the phone screen, font, and keypad to be too small.

“Some subjects had difficulty adopting the study phone as their primary phone, while others considered the phone screen, font, and keypad to be too small.”

May combine two claims.

The scales and pedometer were the most popular technologies; at the end of the study, 72% of questionnaire respondents reported continuing to use the scales and 39% the pedometer.

“The scales and pedometer were the most popular technologies; at the end of the study, 72% of the questionnaire respondents reported continuing to use the scales and 39% the pedometer.”

May combine two claims.

The technologies were at different stages of maturity; some were already at the commercial or pre-commercial stage whereas others were being developed specifically for the study and had undergone limited technical and user testing.

“Firstly the technologies were at different stages of maturity; some of them were already at the commercial or pre-commercial stage whereas others were being developed specifically for the study and had undergone limited technical and user testing.”

May combine two claims.

Overall, the features appreciated in any of the technologies were ease of use, simplicity, availability, and clear and informative feedback.

“Overall, the features appreciated in any of the technologies were ease of use, simplicity, availability, and clear and informative feedback.”

May combine two claims.

Although the inclusion criteria required sub-optimally healthy lifestyles, the subjects were in fact generally healthy, and thus had less room to show improvement except for overweight.

“Although the inclusion criteria required sub-optimally healthy lifestyles, the subjects were in fact generally healthy, and thus had less room to show improvement except for overweight.”

May combine two claims.

Almost all the subjects tried to make use of the Web and mobile technologies but less than 30% of them did so for the entire 1-year period of the study.

“Almost all the subjects tried to make use of the Web and mobile technologies but less than 30% of them did so for the entire 1-year period of the study.”

May combine two claims.

Sustained usage was associated with slightly older subjects and lower baseline aerobic fitness.

“Sustained usage was associated with slightly older subjects and lower baseline aerobic fitness.”

Classified as probably not a substantial claim. May combine two claims.

Single-approach interventions were used a median of 3 times, whereas multiple approach interventions had a median of 11 usage sessions.

“Portnoy et al [1] found that single-approach interventions were used a median of 3 times, whereas multiple approach interventions had a median of 11 usage sessions.”

• cites Portnoy et al [1]Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

A weight loss program delivered via a heart rate monitor was superior to standard care weight management advice.

“Byrne et al [14] found that a weight loss program delivered via a heart rate monitor was superior to standard care weight management advice.”

• cites Byrne et al [14]Not checked yet

  Not checked in the free run.

May combine two claims.

Low participation and high attrition also plague eHealth interventions.

“Low participation and high attrition also plague eHealth interventions [19].”

• cites [19] sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Using pedometers is associated with significant increases in physical activity and decreases in body mass index and blood pressure.

“A review by Bravata et al [13] found that using pedometers was associated with significant increases in physical activity and decreases in body mass index and blood pressure.”

• cites Bravata et al [13]Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

The median attrition rate in worksite health promotion programs was 28%.

“In a review by Bull et al [18], the median attrition rate in worksite health promotion programs was 28%.”

• cites Bull et al [18]Not checked yet

  Not checked in the free run.

Classified as probably not a substantial claim.

Frequent self-weighing is associated with better weight loss and weight maintenance results.

“Frequent self-weighing has been found to be associated with better weight loss and weight maintenance results [11,12].”

• cites [11] sourceNot checked yet

  Not checked in the free run.

• cites [12] sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Mobile health promotion interventions using text messaging or portable devices have produced favorable outcomes in weight loss, physical activity, smoking cessation, and anxiety.

“These interventions have produced favorable outcomes in areas such as weight loss, physical activity, smoking cessation, and anxiety [3-7].”

• cites [3] sourceNot checked yet

  Not checked in the free run.

• cites [4] sourceNot checked yet

  Not checked in the free run.

• cites [5] sourceNot checked yet

  Not checked in the free run.

• cites [6] sourceNot checked yet

  Not checked in the free run.

• cites [7] sourceNot checked yet

  Not checked in the free run.

Classified as probably not a substantial claim. May combine two claims.

Computerized interventions have been successful in changing health-related knowledge, attitudes, and intentions; nutrition and smoking, but not physical activity or weight.

“Portnoy et al [1] reviewed 75 articles on computerized interventions over 20 years and found that they were successful in changing health-related knowledge, attitudes, and intentions; nutrition and smoking, but not physical activity or weight.”

• cites Portnoy et al [1]Not checked yet

  Not checked in the free run.

Classified as probably not a substantial claim.

In the United States, the majority of adults have more than 1 out of the 4 main health risks (smoking, risky alcohol consumption, physical inactivity, and overweight).

“In the United States, the majority of adults have more than 1 out of the 4 main health risks (smoking, risky alcohol consumption, physical inactivity, and overweight ) [15]”

• cites [15] sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Combined with low usage rates, participants usually do not receive the intended dose of intervention, which detracts from effectiveness, cost-effectiveness, and generalizability.

“Combined with low usage rates, this usually means that the participants do not receive the intended dose of intervention, which detracts from the effectiveness, cost-effectiveness, and generalizability of the interventions [20].”

• cites [20] sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

Programs consisting of multiple components or targeting multiple behaviors produced higher participation rates.

“Robroek et al [17] found that programs consisting of multiple components or targeting multiple behaviors produced higher participation rates.”

• cites Robroek et al [17]Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

About half of eHealth intervention studies had favorable outcomes for eHealth interventions compared to control groups in increasing physical activity, improving diet, and facilitating weight loss.

“Norman et al [2] reviewed 47 eHealth intervention studies and found that about half of them had favorable outcomes for eHealth interventions compared to control groups in increasing physical activity, improving diet, and facilitating weight loss.”

• cites Norman et al [2]Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Thirteen subjects did not participate in laboratory measurements at the end of the study, and their data were unavailable; no imputations were made and these subjects were excluded from the analysis.

“There were 13 subjects who did not participate in laboratory measurements at the end of the study, and thus their data were unavailable. No imputations were made but the subjects were excluded from the analysis.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The trial was registered with a local ethics committee in Finland, but not in any international registry.

“The trial was registered with a local ethics committee in Finland, but not in any international registry.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The ethics committee of Helsinki and Uusimaa Hospital District approved the study and all subjects gave written informed consent.

“The ethics committee of Helsinki and Uusimaa Hospital District approved the study and all the subjects gave their written informed consent.”

Probably not a substantial claim: may not pass S3 (load-bearing).

There were 13 subjects (12 of them non-sustained users) who did not attend the laboratory measurements at the end of the study.

“There were 13 subjects (12 of them non-sustained users) who did not attend the laboratory measurements at the end of the study.”

Classified as probably not a substantial claim.

Randomization was done by drawing a random number between 0-1 from a uniform distribution for each eligible respondent, sorting the numbers ascending, and assigning the lowest 120 to the technology-supported intervention, the next 120 to the intervention without technologies, and the next 120 to control.

“The randomization was done by drawing a random number between 0-1 from a uniform distribution for each eligible respondent. The random numbers were sorted to ascending order and the subjects with the lowest 120 random numbers were assigned to the intervention supported by technologies, the next 120 to the intervention without technologies, and the next 120 to control group.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Post hoc power was calculated for all analyses where sustained and non-sustained users were compared.

“Additionally, we calculated the post hoc power for all analyses where sustained and non-sustained users were compared.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

At week 48, 95% of the subjects stayed enrolled in the study, after which they gradually finished the study.

“At week 48, 95% of the subjects stayed enrolled in the study, after which they gradually finished the study.”

May combine two claims.

The authors conducted multiple tests without correcting the alpha level, so the probability of having at least 1 significant result is greater than 0.05.

“We also note that we have conducted multiple tests without correcting the alpha level. As a consequence the probability of having at least 1 significant result is greater than 0.05.”

Probably not a substantial claim: may not pass S3 (load-bearing).

In a study of a commercial weight loss service, Neve et al found that 30% of participants could still be classified as users after 1 year.

“In a study of a commercial weight loss service, Neve et al [48] used criteria comparable to ours to define sustained usage. They found that 30% of participants could still be classified as users after 1 year.”

• cites [48] sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Self-reporting was used to assess the usage of personal monitoring devices, though this gives less accurate results and the likelihood of positive bias.

“Self-reporting was used to assess the usage of these technologies, though this gives less accurate results and the likelihood of positive bias.”

• AssumptionRests on an assumption: Self-reported usage of personal monitoring devices gives less accurate results and is likely positively biased.

Probably not a substantial claim: may not pass S3 (load-bearing).

The lower physical fitness level may be an indication of technologies being adopted by those who had a real need to improve their wellness.

“The lower physical fitness level may be an indication of technologies being adopted by those who had a real need to improve their wellness.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Potential reasons of non-usage include that the intervention is not mandatory or not critical to wellness, a lack of tangible and immediate advantages, a lack of encouragement and reminders, and distraction due to routine events.

“Potential reasons of non-usage include that the intervention is not mandatory or not critical to wellness, a lack of tangible and immediate advantages, a lack of encouragement and reminders, and distraction due to routine events [19].”

• cites [19] sourceNot checked yet

  Not checked in the free run.

May combine two claims.

In a study by Robroek et al, 64% of participants visited the intervention website 3 times or more, with a median of 3 visits (IQR 2-6) over 2 years.

“In a study by Robroek et al [20], 64% of participants visited the intervention website 3 times or more, the median number of visits being 3 (IQR 2-6) over 2 years.”

• cites [20] sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The average age difference between the groups was only 3 years, so this tendency may not have practical relevance.

“As the average age difference between the groups was only 3 years, this tendency may not have practical relevance.”

Probably not a substantial claim: may not pass S2 (checkable).

Although the results are not clinically significant, maintenance of current weight is in itself beneficial for health if the alternative is continued weight gain.

“Although the results are not clinically significant, maintenance of current weight is in itself beneficial for health if the alternative is continued weight gain.”

• AssumptionRests on an assumption: Maintenance of current weight is beneficial for health if the alternative is continued weight gain.

May combine two claims.

Usage rates of the personal monitoring devices could not be continuously logged at the time of the study and so they could not be included in the detailed analysis of sustained usage.

“Usage rates of the personal monitoring devices could not be continuously logged at the time of the study and so they could not be included in the detailed analysis of sustained usage.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The subjects may have made minor changes in several areas, which may not be considered relevant changes in any single health-related outcome measure when the changes are looked at separately.

“The subjects may also have made minor changes in several areas, which may not be considered relevant changes in any single health-related outcome measure when the changes are looked at separately.”

May combine two claims.

Since there were no differences in participation between the two intervention conditions at the group level, the result may indicate that the technologies improved engagement with the intervention and also partly explain the slightly better health-related outcomes in sustained users as compared to non-sustained users.

“Since there were no differences in participation between two intervention conditions at the group level [22], this result may indicate that the technologies improved engagement with the intervention and also partly explain the slightly better health-related outcomes in sustained users as compared to non-sustained users.”

• cites [22] Hopsu, L, 2010, Nuadu: Terveyden edistäminen terveysteknologiallaNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Low participation and high attrition rates are common drawbacks in occupational health promotion programs.

“Low participation and high attrition rates are common drawbacks in occupational health promotion programs.”

• cites [47] McCarty, CA, 2005, WMJNot checked yet

  Not checked in the free run.

May combine two claims.

The results highlight the key requirements for personal health technologies: ease of use, simplicity, integration to daily life, and clear feedback.

“The results highlight the key requirements for personal health technologies: ease of use, simplicity, integration to daily life, and clear feedback.”

May combine two claims.

Despite the high expectations placed on personal health technologies to cost-effectively support or deliver health promotion interventions to a broad range of users, high attrition rates, and modest health-related outcomes related to sustained usage may limit their potential.

“Despite the high expectations placed on personal health technologies to cost-effectively support or deliver health promotion interventions to a broad range of users, high attrition rates, and modest health-related outcomes related to sustained usage may limit their potential.”