E-health nazorg counseling voor een fysiek actievere levensstijl: Kan een op maat gemaakte e-health interventie een fysiek actievere levensstijl bevorderen?

T. Mullens, A.J.A. Köke

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Abstract

Introduction: Research shows that rehabilitants encounter difficulties to participate in a healthy and active lifestyle
in their home situation after their rehabilitation period.2 Effective prevention of secondary health problems, as a
result of an inactive lifestyle, should start at the end of the rehabilitation period.3 The question is whether a customized
e-health intervention is effective starting after outpatient rehabilitation treatment?
Methods: In a randomised longitudinal experiment the effects of a custom-made e-health aftercare intervention
on ‘physical active behaviour’, ‘exercise self-efficacy’ and ‘behavioural intention’ was determined. Adult patients
were included 1-12 months after their rehabilitation treatment. These ex-rehabilitants (n = 16) diagnosed with spinal
core injury (n = 8), CVA (n = 5) or acquired brain injury (n = 3) from rehabilitation centre Adelante Hoensbroek were
randomly divided into two groups. Group 1 received three counselling sessions based on motivational interviewing
using a webcam in a time period of 3 months. They further received a schematic reflection report (prompt) one week
after each counselling session. Group 2 (control group) received no intervention the first three months. The second
period of 3 months, group 2 received the same intervention as group 1, while group 1 received no intervention.
In all three variables, the effect of the intervention was measured by comparing the difference score between T0 -
T1 for group 1 with the difference score between T0 - T1 of group 2. In addition, the difference score within group 2
between T1 - T2 and T0 - T1 were also compared on all 3 variables. In order to see if the possible effects of the intervention
after T1 remained stable, T1 was compared to T2 in group 1.
At the end of the study, participants were contacted by mail for written feedback regarding the intervention.
Results: Statistically significant difference was found for ‘physically active behaviour’ in favour of group 1 as compared
to group 2 between T0 and T1. Within group 2, there was no significant difference between T1 and T2. ‘Exercise selfefficacy’
and ‘behavioral intent’ did not significantly improve, both in comparison between both groups and over time
within the groups. One exception was the ‘exercise self-efficacy’ within group 2 between T1 and T2. Here a significant
difference was found. Over time the intervention had no significant effect on outcome when groups were pooled.
Conclusions: The tailor-made e-health intervention applied in this study seems to have effect on the ‘physically active
behavior’ of the participants. However, the effect doesn’t remain over time (three months). Continued research is
desirable to determine how the effect of intervention can be increased and results can be maintained over time.
Original languageDutch
Pages (from-to)205-210
Number of pages6
JournalNederlands Tijdschrift voor Revalidatiegeneeskunde
Volume39
Issue number5
Publication statusPublished - Dec 2017

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