A new computer-based counselling system for the promotion of physical activity in patients with chronic diseases--results from a pilot study.

OBJECTIVE: To develop a computer-based counselling system (CBCS) for the improvement of attitudes towards physical activity in chronically ill patients and to pilot its efficacy and acceptance in primary care. METHODS: The system is tailored to patients' disease and motivational stage. During a pilot study in five German general practices, patients answered questions before, directly and 6 weeks after using the CBCS. Outcome criteria were attitudes and self-efficacy. Qualitative interviews were performed to identify acceptance indicators. RESULTS: Seventy-nine patients participated (mean age: 64.5 years, 53% males; 38% without previous computer experience). Patients' affective and cognitive attitudes changed significantly, self-efficacy showed only minor changes. Patients mentioned no difficulties in interacting with the CBCS. However, perception of the system's usefulness was inconsistent. CONCLUSION: Computer-based counselling for physical activity related attitudes in patients with chronic diseases is feasible, but the circumstances of use with respect to the target group and its integration into the management process have to be clarified in future studies. PRACTICE IMPLICATION: This study adds to the understanding of computer-based counselling in primary health care. Acceptance indicators identified in this study will be validated as part of a questionnaire on technology acceptability in a subsequent study.

Specifying computer-based counseling systems in health care: a new approach to user-interface and interaction design.

Computer-based counseling systems in health care play an important role in the toolset available for medical doctors to inform, motivate and challenge their patients according to a well-defined therapeutic goal. The design, development and implementation of such systems require close collaboration between users, i.e. patients, and developers. While this is true of any software development process, it can be particularly challenging in the health counseling field, where there are multiple specialties and extremely heterogeneous user groups. In order to facilitate a structured design approach for counseling systems in health care, we developed (a) an iterative three-staged specification process, which enables early involvement of potential users in the development process, and (b) a specification language, which enables an author to consistently describe and define user interfaces and interaction designs in a stepwise manner. Due to the formal nature of our specifications, our implementation has some unique features, like early execution of prototypes, automated system generation and verification capabilities.