A new tool for the assessment of readiness for digital health interventions

Abstract

Background/Introduction: Our Western lifestyle is characterized by an irregular and poorly balanced dietary pattern and insufficient PA. Purpose: The digital health application PROTEIN, developed within the H2020-RI-project PROTEIN (https://protein-h2020.eu/), aims to engage people in a healthy, nutritionally sound and active lifestyle. To obtain information on acceptability, usability, feasibility and preliminary effectiveness, pilots are being conducted in various countries. Results: from these pilots aim to guide the development of personalized nutrition applications. Methods: In Belgium, a pilot study was implemented between May-October 2022. Participant attitudes and beliefs about their diet and PA were assessed by means of the readiness to change questionnaire. Their habits, including smoking, diet (MEDAS), alcohol consumption, (AUDIT) and PA (IPAQ) were evaluated at baseline and at 4 weeks of FU. Herein we describe attitudes and beliefs around their lifestyles. Results: Twenty-three patients with overweight/obesity (n ¼ 19$) and 17 patients with CVD (n ¼ 8$) volunteered to test PROTEIN. On average, participants were 48.5 years old (19-76), with a BMI of 29.5 (16.7-41 kg/m 2). 43% believed they were sufficiently active, 43% thought they were not. Six patients did not know how to rate their PA. The majority (77.5%) was convinced that they would be more active, while 22.5% didn't think they would change their PA behavior. 72.5% thought they could maintain an active lifestyle over a longer duration. Twenty-one participants reported not having a healthy diet compared to 45% who believed that they were eating healthy. 83% of participants were motivated to eat healthier in future. Background/Introduction: Multiple questionnaires exist to assess digital literacy. However, participation and adherence to digital health interventions is linked with other factors such as digital skills and access. Purpose: The aim of the development of the Digital Health Readiness-Q (DHR-Q) was to create a short, usable, and freely accessible questionnaire that was designed from a clinical practice perspective. Methods: This was a prospective single-centre survey study conducted in Jessa Hospital Hasselt in Belgium. All participants who were visiting the cardiology department as patients were eligible for participation. Cronbach's a and confirmatory factor analysis were performed. Results: A total number of 315 participants were included in this survey study of which 118 (37.5%) were female. The mean age of the participants was 62.6 ± 15.1. Cronbach a analysis resulted in all domains of the DHR-Q scoring higher than 0.7 which means acceptable internal consistency. The fit indices of the confirmatory factor analysis showed a reasonably good fit: SRMR ¼0.065, RMSEA ¼0.098 (CI ¼0.090-0.106), TLI ¼0.895, and CFI ¼0.912. Conclusions: The new DHR-Q questionnaire is an easy-to-use and quick assessment tool for readiness for a Digital Health intervention. It was developed from a clinical perspective. This study demonstrates that the DHR-Q is a valid tool.