Patient s Empowerment and Behaviour Change: PEGASO experience and approach Renata Guarneri, Fondazione Politecnico di Milano Marco Decandia, Lombardia Informatica S.p.A. Luca Piras, Lombardia Informatica S.p.A.
Outline Empowerment: Definition and Approaches Empowerment and Behaviour Tools for Empowerment and Behaviour Change Platforms PEGASO The project Behaviour Change Approach System characteristics Preliminary results
Patient empowerment: what is it? A concept dating back to the 50s Transforming relationship between healthcare providers and patient Similar concepts: engagement, involvement A mean to improve health care effectiveness Needed for improving chronic conditions treatment
Approaches to empowerment Several ways to put the patient at the heart of the process: making the patient an active subject: Training Information Motivation (e.g. Motivational Interviews) Improved communication The right mix produces benefits
Benefits of patient s empowerment Empowerment may achieve a lot: Healthier Behaviors Greater Satisfaction Better Decisions Hence: Sustainable Services Reduced costs Empowerment is effective when it actually changes the way patients behave
Effects on the patient Empowered patients should be more: Engaged Knowledgeable Collaborative Committed Tolerant of uncertainty Because empowerment should have changed their attitude
Properly Empowered patient s attitude Empowered patient desired attitude Better understanding his condition Participating in making decisions about his care Being supported to better self manage his health and treatment Expressing his views and preferences in a way that makes a meaningful difference Feeling confident to ask questions and challenge professionals and organizations Having the chance to join network or groups of other patients in similar circumstances Unfortunately is not always the case
Empowerment and attitude for maximum benefits Empowerment without the right attitude may be uneffective Empowerment is a good way to foster behaviour change, but alone, it may not be enough Empowerment and Behaviour Change should work together Behavior change is not always the consequence of patient empowerment and here Behavior Change Platforms come into play where
PEGASO: The project PEGASO Fit 4 Future promotion of sustainable behavior change towards healthy lifestyles in teen-agers Three levels of intervention enabling teen-agers to become co-producers of their wellbeing: Generating self-awareness Enhancing and sustaining motivation Changing behavior towards a healthy lifestyle. Validation of approach with three pilots: Italy, UK and Spain
Target Users and Stakeholders 14-16 year old boys and girls with experience and interest in using technological devices. Families and schools as key players in increasing understanding of and promoting a balance and healthy lifestyle amongst their children and students. Other actors: Food Industry, Public and Private Health Policy actors, Fitness industries, Media, Insurance companies etc.
The PEGASO Approach Challenging teen-agers in their own fields and areas of interest, with a holistic and multidisciplinary approach Application of behaviour change techniques to prevention Development of a mobile-based Behaviour Change Platform that can effectively address teen-agers.
Elements of Behavior Change PEGASO works along four levels of engagement towards persuasion for user (the teen-agers) empowerment in healthcare: Develop Awareness Affective learning Create Motivation Enable Behavior Change
Behaviour Change Timeline
The proposed solution mobile, social and networked gaming platform
Main characteristics Smartphone as central element and agent for behaviour change Europe s smartphone penetration is amongst the highest in the world, The smartphone offers unique characteristics for a cost-effective and scalable solution; Wearable sensors added with a modular approach; Cloud based service offering based on a behaviour and situation recognition system; Possibility to share info with health-care service providers.
PEGASO Services and Functions Goal of PEGASO BCP: Support and facilitate the adoption of healthy behaviour Tools/functionalities include: Self monitoring (collecting and managing info) Dashboards Social Networking Gamification and games Motivational and inspirational messages Behaviour monitoring Journals and reminders Feedback
PEGASO Results Running for about one and a half year Comprehensive Virtual Individual Model Focus Groups with students in the three target countries Overall architecture Definition of initial set of services / applications
Initial feedback from Focus Groups Gaming and technology should promote real sport and activity; not just a virtual experience Relevance of visual language in the communication codes (Videos, images) New gaming experiences. When it s nothing like what teenagers have tried before, it drums up enthusiasm Linking real world activity with online & gaming applications Relating top experts through forums or specific platform where teenagers can have access, and decide whether or not make their identity public.
Next Steps Pre-pilots activities: testing first implementations with small number of selected users Boost dissemination activities to engage potential users and attract stakeholders Develop, develop, develop Smart Companion, PEGASO Apps, PEGASO Game, PEGASO learning platform and modules and integration with sensor system Integration in single PEGASO system including behaviour detection algorithms and other back-end services - and creation of API for third party providers Development o business model and localisation of services through engagement of local partners Running of PEGASO pilots
Expected Impacts Enhancing self-awareness of younger people for health issues, by means of inclusive approach integrating individuals into a community context, and promoting behavioral changes in favour of physical activity and healthy diets. Preventing juvenile overweight/obesity and reducing morbidities associated to juvenile overweight/obesity in the short time, and long term health consequences, including adult obesity, and associated medical, social and personal costs. Reducing medical, social and personal costs associated to juvenile and adult overweight/obesity.