The effect of robot speed on comfortable passing distances.

Robots navigate ever more often in close proximity to people. In the current work, we focused on two distinctive navigational scenarios: passing and overtaking a person who is walking. In the first experiment, we compared nine different passing distances for a humanoid robot and found that human comfort increased with passing distance and that their relationship could be described by an inverted Gaussian. In the second experiment, we validated this relationship for an industrial autonomous robot and extended the study to also include overtaking distances and different robot moving speeds. The results showed that overtaking was considered to be less comfortable than passing but that the overtaking distance had a similar relationship with human comfort. Human comfort decreases with a higher robot movement speed. Results obtained through location trackers furthermore showed that people actively take a larger distance from the robot when it starts its trajectory closer to them. The current results can be used to quantify human comfort in environments where humans and robots co-exist and they can be used as input for human-aware navigational models for autonomous robots.

The Influence of Personal Health Data on the Health Coaching Process.

Tracking health data, for example, through wearable devices or health apps, is increasingly commonplace. Consequently, health coaches (e.g., personal trainers, dieticians) are facing growing numbers of clients who bring their data to the clinic. These data potentially add value to the coaching process, for example, by showing more objective and specific information on clients' behaviors. However, in practice, it turns out to be hard to effectively utilize health data in a coaching setting, and it is not yet fully understood how data affect the coaching process and the coach-client communication. We organized a workshop (12 coaches, 3 clients) and a field study (5 coaches, 6 clients), where we observed coach-client interactions enriched with data. By including both familiar and unfamiliar coach-client pairs, as well as alternating the timing of the data presented (i.e., at the beginning, or halfway through the session), we acquired a variety of data-driven coaching interactions and analyzed this using a mixture of qualitative and quantitative methods. Our results show that data are not "plug-and-play." There is an extensive process of interpreting and contextualizing data, in which the client has a key role, which is essential to gain relevant and actionable insights from the data useful to the coaching process. We also observed that data affect the coach-client communication on both content and relationship levels. We will reflect on these insights in terms of design recommendations for wearable tracking devices and e-health technology to effectively support health coaches and their interactions with their clients.

Design of a Game-Based Training Environment to Enhance Mental Health Care Professionals' Skills in Using e-Mental Health: Multiple Methods User Requirements Analysis.

BACKGROUND: A major factor hampering the adoption of technology in mental health care is a lack of knowledge and skills. Serious gaming offers a potentially effective strategy to enhance the skills needed through experiencing and learning-by-doing in a playful way. However, serious gaming solutions are not widely available for mental health care. Therefore, the development of a game-based training environment in mental health care was pursued in a design project. The first step in such a design project is to identify user requirements that should be met. OBJECTIVE: This study aims to deliver user requirements that inform the design of a game-based training environment for mental health care professionals. This environment aims to support mental health care professionals' knowledge and skill enhancement regarding the use of e-mental health (eMH); for example, video calling, mobile apps, web-based treatment modules, and techniques such as virtual or augmented reality. METHODS: We used an exploratory multiple methods design consisting of a web-based questionnaire, co-design sessions, and interviews. To ensure a good representation of the target user group, professionals from various disciplines within mental health care were included in the research. The multiple methods design facilitates a broad view of user needs and in-depth knowledge of specific design requirements. We describe the protocol for this research project in a protocol paper published in the JMIR Research Protocols in February 2021. RESULTS: The user requirements analysis revealed three types of users for the envisioned game-based training environment: mental health care professionals who want to learn about the basic possibilities of eMH, mental health care professionals who want to develop their eMH skills to the next level, and mental health care professionals who want to experiment with new technologies. This reflects the diversity of needs that were identified, as well as the need to develop a diversity of suitable scenarios in the environment. User requirements analysis shows that the focus of a training environment should be on increasing knowledge about the possibilities of eMH, focusing on experiencing the benefits in particular situations, and building confidence in using eMH in a therapeutic setting. This requires careful consideration of the suitable game characteristics. CONCLUSIONS: Improvement of mental health care professionals' skills in eMH requires an environment that is user driven and flexible, and simultaneously incorporates contextual factors that are relevant for its implementation in practice. This user requirements analysis contributes to the understanding of the issues that should be considered in the development of a game-based training environment. This shows that there are multiple and diverse learning needs among mental health care professionals. Various client populations, services, and situations demand various options for training. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/18815.

Theory-based habit modeling for enhancing behavior prediction in behavior change support systems.

Psychological theories of habit posit that when a strong habit is formed through behavioral repetition, it can trigger behavior automatically in the same environment. Given the reciprocal relationship between habit and behavior, changing lifestyle behaviors is largely a task of breaking old habits and creating new and healthy ones. Thus, representing users' habit strengths can be very useful for behavior change support systems, for example, to predict behavior or to decide when an intervention reaches its intended effect. However, habit strength is not directly observable and existing self-report measures are taxing for users. In this paper, building on recent computational models of habit formation, we propose a method to enable intelligent systems to compute habit strength based on observable behavior. The hypothesized advantage of using computed habit strength for behavior prediction was tested using data from two intervention studies on dental behavior change ( N = 36 and N = 75 ), where we instructed participants to brush their teeth twice a day for three weeks and monitored their behaviors using accelerometers. The results showed that for the task of predicting future brushing behavior, the theory-based model that computed habit strength achieved an accuracy of 68.6% (Study 1) and 76.1% (Study 2), which outperformed the model that relied on self-reported behavioral determinants but showed no advantage over models that relied on past behavior. We discuss the implications of our results for research on behavior change support systems and habit formation.

Habit and goal-related constructs in determining toothbrushing behavior: Two sensor-based longitudinal studies.

OBJECTIVES: Two longitudinal studies were conducted to examine how habits and goal-related constructs determine toothbrushing behavior from a dual-process perspective. We aimed to describe the variations of habit strength, intention, and attitude and to test their associations with actual behavior at both inter- and intraindividual levels. In addition, toothbrushing behavior was measured both by self-report and sensors with the goal to compare these measures. METHOD: In Study 1, 40 young adults were instructed to brush their teeth twice a day, and their behaviors were measured by accelerometers for 3 weeks. Participants also self-reported their instrumental and affective attitude, habit strength, and behavior frequency weekly. Effects of interest were estimated using structural equation modeling. Study 2 replicated Study 1 with a larger and more diverse sample (N = 79), adding a measure of behavioral intention. RESULTS: Supporting the dual-process account, habit strength predicted future behavior in addition to goal-related constructs. Habit strength also attenuated the influences of goal-related constructs on behavior, but this pattern only emerged interindividually and for self-reported behavior. In addition, toothbrushing behavior was more strongly driven by affective rather than instrumental attitude. In both studies, associations among variables were weaker within-person and when sensor-measured behavior was modeled. CONCLUSIONS: The partial support for the dual-process account suggests the need of using habit-based interventions to complement intention-based interventions when attempting to change oral health routines. Our findings also highlight the importance of affective aspects of toothbrushing behavior and the potential to incorporate sensor-based objective measures in research and interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Exploring physiologic reactions to persuasive information.

Persuasion aims at changing peoples' motivations and/or behaviors. This study explores how and when physiology reflects persuasion processes and specifically whether individual differences in motivations and behaviors affect psychophysiologic reactions to persuasive information. Participants (N = 70) with medium or high meat consumption patterns watched a persuasive video advocating limited meat consumption, while their electrodermal and cardiovascular physiology was measured. Results indicated that the video increased participants' moral beliefs, perceived behavioral control, and reduction intentions. This study also found an increase in physiologic arousal during the persuasive video and that people with motivations less aligned to the persuasion objective had more physiologic arousal. The findings encourage further psychophysiologic persuasion research, especially as these insights can potentially be used to personalize persuasive messages of behavior change applications.

The Impact of Mindset on Self-Tracking Experience.

Self-tracking technologies aim to offer a better understanding of ourselves through data, create self-awareness, and facilitate healthy behavior change. Despite such promising objectives, very little is known about whether the implicit beliefs users may have about the changeability of their own behavior influence the way they experience self-tracking. These implicit beliefs about the permanence of the abilities are called mindsets; someone with a fixed mindset typically perceives human qualities (e.g., intelligence) as fixed, while someone with a growth mindset perceives them as amenable to change and improvement through learning. This paper investigates the concept of mindset in the context of self-tracking and uses online survey data from individuals wearing a self-tracking device (n = 290) to explore the ways in which users with different mindsets experience self-tracking. A combination of qualitative and quantitative approaches indicates that implicit beliefs about the changeability of behavior influence the extent to which users are self-determined toward self-tracking use. Moreover, differences were found in how users perceive and respond to failure, and how self-judgmental vs. self-compassionate they are toward their own mistakes. Overall, considering that how users respond to the self-tracking data is one of the core dimensions of self-tracking, our results suggest that mindset is one of the important determinants in shaping the self-tracking experience. This paper concludes by presenting design considerations and directions for future research.

Assessing Professionals' Adoption Readiness for eMental Health: Development and Validation of the eMental Health Adoption Readiness Scale.

BACKGROUND: The last few decades have witnessed significant advances in the development of digital tools and applications for mental health care. Despite growing evidence for their effectiveness, acceptance and use of these tools in clinical practice remain low. Hence, a validated and easy-to-use instrument for assessing professionals' readiness to adopt eMental health (EMH) is necessary to gain further insights into the process of EMH adoption and facilitate future research on this topic. OBJECTIVE: The aim of this study is to develop and validate an instrument for assessing mental health care professionals' readiness to adopt EMH. METHODS: Item generation was guided by literature and inputs from mental health care professionals and experts in survey development. Exploratory factor analyses were conducted on an initial set of 29 items completed by a sample of mental health care professionals (N=432); thereafter, the scale was reduced to 15 items in an iterative process. The factor structure thus obtained was subsequently tested using a confirmatory factor analysis with a second sample of mental health care professionals (N=363). The internal consistency, convergent validity, and predictive validity of the eMental Health Adoption Readiness (eMHAR) Scale were assessed. RESULTS: Exploratory factor analysis resulted in a 3-factor solution with 15 items. The factors were analyzed and labeled as perceived benefits and applicability of EMH, EMH proactive innovation, and EMH self-efficacy. These factors were confirmed through a confirmatory factor analysis. The total scale and subscales showed a good internal consistency (Cronbach α=.73-.88) along with acceptable convergent and predictive relationships with related constructs. CONCLUSIONS: The constructed eMHAR Scale showed a conceptually interpretable 3-factor structure having satisfactory characteristics and relationships with relevant concepts. Its ease of use allows for quick acquisition of data that can contribute to understanding and facilitating the process of adoption of EMH by clinical professionals.

Correction: Theory Integration for Lifestyle Behavior Change in the Digital Age: An Adaptive Decision-Making Framework.

[This corrects the article DOI: 10.2196/17127.].

Promoting Occupational Health through Gamification and E-Coaching: A 5-Month User Engagement Study.

Social gamification systems have shown potential for promoting healthy lifestyles, but applying them to occupational settings faces unique design challenges. While occupational settings offer natural communities for social interaction, fairness issues due to heterogeneous personal goals and privacy concerns increase the difficulty of designing engaging games. We explored a two-level game-design, where the first level related to achieving personal goals and the second level was a privacy-protected social competition to maximize goal compliance among colleagues. The solution was strengthened by employing occupational physicians who personalized users' goals and coached them remotely. The design was evaluated in a 5-month study with 53 employees from a Dutch university. Results suggested that the application helped half of the participants to improve their lifestyles, and most appreciated the role of the physician in goal-setting. However, long-term user engagement was undermined by the scalability-motivated design choice of one-way communication between employees and their physician. Implications for social gamification design in occupational health are discussed.

Theory Integration for Lifestyle Behavior Change in the Digital Age: An Adaptive Decision-Making Framework.

Despite the growing popularity of digital health interventions, limitations of traditional behavior change theories and a lack of theory integration hinder theory-driven behavior change applications. In this paper, we aim to review theories relevant to lifestyle behavior change from the broader psychology literature and then integrate these theories into a new theoretical framework called adaptive decision-making to address two specific problems. First, our framework represents lifestyle behaviors at two levels-one of individual daily decisions (action level) and one of larger behavioral episodes (reflection level)-to more closely match the temporal characteristics of lifestyle behaviors and their associated digital data. Second, the framework connects decision-making theories and learning theories to explain how behaviors and cognitive constructs dynamically influence each other, making it a suitable scaffold for building computational models. We map common digital intervention techniques onto the behavioral and cognitive processes in the framework and discuss possible contributions of the framework to both theory development and digital intervention design.

Design of a Game-Based Training Environment to Enhance Health Care Professionals' E-Mental Health Skills: Protocol for a User Requirements Analysis.

BACKGROUND: E-mental health (EMH) offers various possibilities for mental health care delivery, with many studies demonstrating its clinical efficacy. However, the uptake of EMH technologies by mental health care professionals remains to be low. One of the reasons for this is the lack of knowledge and skills in using these technologies. Skill enhancement by means of serious gaming has been shown to be effective in other areas but has not yet been applied to the development of EMH skills of mental health care professionals. OBJECTIVE: The aim of this paper is to describe a study protocol for the user requirements analysis for the design of a game-based training environment for mental health care professionals to enhance their skills in EMH. METHODS: The user requirements are formulated using three complementary outputs: personas (lively descriptions of potential users), scenarios (situations that require EMH skills), and prerequisites (required technical and organizational conditions). We collected the data using a questionnaire, co-design sessions, and interviews. The questionnaire was used to determine mental health care professionals' characteristics, attitudes, and skill levels regarding EMH and was distributed among mental health care professionals in the Netherlands. This led to a number of recognizable subuser groups as the basis for personas. Co-design sessions with mental health care professionals resulted in further specification of the personas and an identification of different user scenarios for the game-based training environment. Interviews with mental health care professionals helped to determine the preferences of mental health care professionals regarding training in EMH and the technical and organizational conditions required for the prospective game-based training environment to be used in practice. This combination of requirement elicitation methods allows for a good representation of the target population in terms of both a broad view of user needs (through the large N questionnaire) and an in-depth understanding of specific design requirements (through interviews and co-design). RESULTS: The questionnaire was filled by 432 respondents; three co-design sessions with mental health care professionals and 17 interviews were conducted. The data have been analyzed, and a full paper on the results is expected to be submitted in the first half of 2021. CONCLUSIONS: To develop an environment that can effectively support professionals' EMH skill development, it is important to offer training possibilities that address the specific needs of mental health care professionals. The approach described in this protocol incorporates elements that enable the design of a playful training environment that is user driven and flexible and considers the technical and organizational prerequisites that influence its implementation in practice. It describes a protocol that is replicable and provides a methodology for user requirements analyses in other projects and health care areas. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/18815.

Integration of Online Treatment Into the "New Normal" in Mental Health Care in Post-COVID-19 Times: Exploratory Qualitative Study.

BACKGROUND: The COVID-19 pandemic has necessitated an immediate and large-scale uptake of online treatment for mental health care. However, there is uncertainty about what the "new normal" in mental health care will be like in post-COVID-19 times. To what extent will the experiences gained during the pandemic influence a sustainable adoption and implementation of online mental health care treatment in the future? OBJECTIVE: In this paper, we aim to formulate expectations with regard to the sustainability of online mental health care after COVID-19. METHODS: In an interview study, 11 mental health care professionals were asked about their experiences and expectations for the future. Participants were recruited from a mental health care organization in the Netherlands. The interviews took place between April 7-30, 2020, at the peak of the COVID-19 crisis in the Netherlands. The data were analyzed using a thematic coding method. RESULTS: From the interviews, we learn that the new normal in mental health care will most likely consist of more blended treatments. Due to skill enhancement and (unexpected) positive experiences with online treatment, an increase in adoption is likely to take place. However, not all experiences promise a successful and sustainable upscaling of online treatment in the future. Mental health care professionals are learning that not all clients are able to benefit from this type of treatment. CONCLUSIONS: Sustainable upscaling of online mental health care requires customized solutions, investments in technology, and flexibility of mental health care providers. Online treatment could work for those who are open to it, but many factors influence whether it will work in specific situations. There is work to be done before online treatment is inherently part of mental health care.

Promoting Physical Activity With Self-Tracking and Mobile-Based Coaching for Cardiac Surgery Patients During the Discharge-Rehabilitation Gap: Protocol for a Randomized Controlled Trial.

BACKGROUND: Home-based cardiac rehabilitations (CRs) with digital technologies have been researched and implemented to replace, augment, and complement traditional center-based CR in recent years with considerable success. One problem that technology-enhanced home-based CR can potentially address is the gap between cardiac interventions and formal CR programs. In the Netherlands and some other countries (eg, Australia), patients after cardiac interventions stay at home for 3-4 weeks without much support from their physicians, and often engage in very little physical activity (PA). A home-based exercise program enabled by digital technologies may help patients to better prepare for the later center-based CR programs, potentially increasing the uptake rate of those programs. OBJECTIVE: In a randomized controlled trial (RCT), we will evaluate the effectiveness of a home-based walking exercise program enhanced by self-tracking and mobile-based coaching (treatment condition), comparing it with a version of the same program without these technologies (control condition). The added value of the digital technologies is justified if patients in the treatment group walk more steps on average (primary outcome) and show better physical fitness in a bicycle ergometer test and higher self-efficacy toward PA (secondary outcomes). METHODS: Based on a power analysis, we will recruit 100 cardiac patients and assign them evenly to the 2 parallel groups. Eligible patients are those who are scheduled in the postanesthesia care unit, know the Dutch language, have basic literacy of using smartphones, and are without medical conditions that may increase risks associated with PA. In a face-to-face meeting with a nurse practitioner, all patients are prescribed a 3-week exercise program at home (2 walking exercises per day with increasing duration), based on national and international guidelines and tailored to their physical conditions after cardiac intervention. Their physical activities (daily steps) will be measured by the Axivity AX3 accelerometer worn at hip position. Patients in the treatment group will also be supported by a Neo Health One self-tracking device and a mobile platform called Heart Angel, through which they are monitored and coached by their nurses. After the study, all patients will perform a bicycle ergometer test and return the devices within 1 week. In addition, 5 questionnaires will be sent to the patients by emails to assess their self-efficacy toward PA and other psychological states for exploratory analyses (at discharge, at the end of each monitoring week, and 1 week after the study). To minimize bias, the randomization procedure will be performed after introducing the exercise program, so the nurse practitioners are blind to the experimental conditions until that point. RESULTS: The study protocol has been approved by the Medical Research Ethics Committees United on February 26, 2018 (NL 62142.100.17/R17.51). By the end of 2018, we completed a small pilot study with 8 patients and the results based on interviews and app usage data suggest that a larger clinical trial with the targeted population is feasible. We expect to complete the RCT by the end of 2021, and statistical analyses will follow. CONCLUSIONS: Results of the RCT will help us to test the hypothesized benefits of self-tracking and mobile-based coaching for cardiac patients in home-based exercise programs during the discharge-rehabilitation gap. If the results are positive, cost-effectiveness analysis will be performed based on the insights of the study to inform the translation of the technology-enhanced program to clinical practice. We also note limitations of the trial in the discussion. TRIAL REGISTRATION: Registered at Netherlands Trial Register NL8040; https://www.trialregister.nl/trial/8040. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/16737.

Assisting Home-Based Resistance Training for Normotensive and Prehypertensive Individuals Using Ambient Lighting and Sonification Feedback: Sensor-Based System Evaluation.

BACKGROUND: Physical exercise is an effective lifestyle intervention to improve blood pressure. Although aerobic sports can be performed anywhere, resistance exercises are traditionally performed at the gym; extending the latter to the home setting may promote an increase in the number of practitioners. OBJECTIVE: This study aims to evaluate a sensor-based system that guides resistance exercises through ambient lighting and sonification (A/S) feedback in a home setting in 34 study participants who were normotensive and prehypertensive. METHODS: Participants took part in a 1.5-hour exercise session in which they experienced the A/S feedback (ie, experimental condition) as well as a control condition (ie, no feedback) and a reference condition (ie, verbal feedback through a human remote coach). The system was evaluated for improving exercise form (range of motion, timing, and breathing patterns) as well as psychophysiological experience (perceived exertion, attentional focus, competence, and motivation). RESULTS: A/S feedback was significantly better than the control for concentric (mean 2.48, SD 0.75 seconds; P<.001) and eccentric (mean 2.92, SD 1.05 seconds; P<.001) contraction times, concentric range of motion consistency (mean 15.64, SD 8.31 cm vs mean 17.94, SD 9.75 cm; P<.001), and perceived exertion (mean 3.37, SD 0.78 vs mean 3.64, SD 0.76; P<.001). However, A/S feedback did not outperform verbal feedback on any of these measures. The breathing technique was best in the control condition (ie, without any feedback). Participants did not show more positive changes in perceived competence with A/S feedback or verbal feedback. CONCLUSIONS: The system seemed to improve resistance exercise execution and perception in comparison with the control, but did not outperform a human tele-coach. Further research is warranted to improve the breathing technique.

Active Involvement of People with Dementia: A Systematic Review of Studies Developing Supportive Technologies.

Although there are promising benefits of supportive technology in dementia care, use of these technologies is still limited. It is challenging for researchers and developers in this field to actively involve people with dementia in development. This review updates and builds on existing knowledge by including a contemporary and relevant perspective. This perspective was gained by including search words and search databases from the field of Human Computer Interaction (HCI) and Design, as these fields were expected to supply novel insights in the complex task of actively involving people with dementia in developing supportive technologies. A total of 49 out of 3456 studies were included which describe the development of a great variety of technologies. Often people with dementia were involved in the generative or evaluative phase of the development. Interviews and observations were most commonly used methods. In seven articles the people with dementia were co-designers. This literature review reflects that people with dementia can influence the development of technology in regards to content, design, and even the initial idea, although the impact on how they experience their own involvement remains largely unknown. There is a lack of specific knowledge on appropriate methods and materials for active involvement of people with dementia in supportive technology development, even when including articles from the field of HCI and Design. Future research is needed to further appreciate and improve the desired role of people with dementia in meaningful technology development.

Breast Cancer Survivors' Experiences With an Activity Tracker Integrated Into a Supervised Exercise Program: Qualitative Study.

BACKGROUND: There is growing evidence that physical activity is related to a better prognosis after a breast cancer diagnosis, whereas sedentary behavior is associated with worse outcomes. It is therefore important to stimulate physical activity and reduce sedentary time among patients with breast cancer. Activity trackers offer a new opportunity for interventions directed at stimulating physical activity behavior change. OBJECTIVE: This study aimed to explore the experience of patients with breast cancer who used an activity tracker in addition to a supervised exercise intervention in the randomized UMBRELLA Fit trial. METHODS: A total of 10 patients with breast cancer who completed cancer treatment participated in semistructured in-depth interviews about their experience with and suggestions for improvements for the Jawbone UP2 activity tracker. RESULTS: The activity tracker motivated women to be physically active and created more awareness of their (sedentary) lifestyles. The women indicated that the automatically generated advice (received via the Jawbone UP app) lacked individualization and was not applicable to their personal situations (ie, having been treated for cancer). Furthermore, women felt that the daily step goal was one-dimensional, and they preferred to incorporate other physical activity goals. The activity tracker's inability to measure strength exercises was a noted shortcoming. Finally, women valued personal feedback about the activity tracker from the physiotherapist. CONCLUSIONS: Wearing an activity tracker raised lifestyle awareness in patients with breast cancer. The women also reported additional needs not addressed by the system. Potential improvements include a more realistic total daily physical activity representation, personalized advice, and personalized goals.

Perceived Drivers and Barriers to the Adoption of eMental Health by Psychologists: The Construction of the Levels of Adoption of eMental Health Model.

BACKGROUND: The internet offers major opportunities in supporting mental health care, and a variety of technology-mediated mental and behavioral health services have been developed. Yet, despite growing evidence for the effectiveness of these services, their acceptance and use in clinical practice remains low. So far, the current literature still lacks a structured insight into the experienced drivers and barriers to the adoption of electronic mental health (eMental health) from the perspective of clinical psychologists. OBJECTIVE: The aim of this study was to gain an in-depth and comprehensive understanding of the drivers and barriers for psychologists in adopting eMental health tools, adding to previous work by also assessing drivers and analyzing relationships among these factors, and subsequently by developing a structured representation of the obtained findings. METHODS: The study adopted a qualitative descriptive approach consisting of in-depth semistructured interviews with clinical psychologists working in the Netherlands (N=12). On the basis of the findings, a model was constructed that was then examined through a communicative validation. RESULTS: In general, a key driver for psychologists to adopt eMental health is the belief and experience that it can be beneficial to them or their clients. Perceived advantages that are novel to literature include the acceleration of the treatment process, increased intimacy of the therapeutic relationship, and new treatment possibilities due to eMental health. More importantly, a relation was found between the extent to which psychologists have adopted eMental health and the particular drivers and barriers they experience. This differentiation is incorporated in the Levels of Adoption of eMental Health (LAMH) model that was developed during this study to provide a structured representation of the factors that influence the adoption of eMental health. CONCLUSIONS: The study identified both barriers and drivers, several of which are new to the literature and found a relationship between the nature and importance of the various drivers and barriers perceived by psychologists and the extent to which they have adopted eMental health. These findings were structured in a conceptual model to further enhance the current understanding. The LAMH model facilitates further research on the process of adopting eMental health, which will subsequently enable targeted recommendations with respect to technology, training, and clinical practice to ensure that mental health care professionals as well as their clients will benefit optimally from the current (and future) range of available eMental health options.

Atmosphere in an urban nightlife setting: A case study of the relationship between the socio-physical context and aggressive behavior.

Aggression is strongly influenced by the surrounding socio-physical context, and the development of aggressive behavior is best understood through a continuous cycle of ongoing person-environment interactions. Empirical studies, nevertheless, have been predominantly conducted in the laboratory, studying aggression as a short-lived phenomenon, emerging from and within an individual, and - with situational factors studied in isolation - devoid of its context. The present field study, conducted in an urban nightlife area, complements this research. A qualitative, multi-method approach was followed by thematic analysis to investigate ongoing behavioral patterns of the crowd vis-à-vis the changes in the context that co-occurred with the development of unwanted behaviors, including aggression. In our study, we identified atmosphere as a dynamic and mood-like, but extra-individual state of the socio-physical setting related to the development of aggression. Our results suggest that atmosphere affects the behavior of groups and individuals by emerging from and feeding into ongoing interactions between people and the environment. At the individual level, it appears to play its part as proximate determinant of behavior; at the crowd level it reflects the synergetic product of all those persons' states, behaviors and interactions. Implications for aggression theory and for applications aimed at curbing aggression are discussed.

In Sync: The Effect of Physiology Feedback on the Match between Heart Rate and Self-Reported Stress.

Over the past years self-tracking of physiological parameters has become increasingly common: more and more people are keeping track of aspects of their physiological state (e.g., heart rate, blood sugar, and blood pressure). To shed light on the possible effects of self-tracking of physiology, a study was conducted to test whether physiology feedback has acute effects on self-reported stress and the extent to which self-reported stress corresponds to physiological stress. In this study, participants executed several short tasks, while they were either shown visual feedback about their heart rate or not. Results show that self-reported stress is more in sync with heart rate for participants who received physiology feedback. Interactions between two personality factors (neuroticism and anxiety sensitivity) and feedback on the level of self-reported stress were found, indicating that while physiology feedback may be beneficial for individuals high in neuroticism, it may be detrimental for those high in anxiety sensitivity. Additional work is needed to establish how the results of this study may extend beyond immediate effects in a controlled lab setting, but our results do provide a first indication of how self-tracking of physiology may lead to better body awareness and how personality characteristics can help us predict which individuals are most likely to benefit from self-tracking of physiology.