Improving Fluid Intake Behavior Among Patients With Kidney Stones: Understanding Patients' Experiences and Acceptability of Digital Health Technology.

OBJECTIVE: To understand kidney stone patients' experiences with increasing fluid intake, common barriers to adherence, and technology-mediated intervention techniques that may improve adherence in this population. Increasing fluid intake to produce at least 2.5 L of urine daily is a well-established preventive strategy to reduce the risk of kidney stones. Unfortunately, adherence with this well-known and inexpensive recommendation is commonly below 50%. MATERIALS AND METHODS: Patients with a history of kidney stones were recruited to participate in semistructured focus groups about their experiences with increasing fluid intake. Inductive content analysis was used to extract themes from focus group transcripts. RESULTS: Themes from discussions with 19 patients described current fluid intake strategies, barriers to increasing fluid intake, and desirable features in a digital tool for promoting fluid intake. Common barriers to increasing fluid intake included work habits, travel, leisure activities, forgetting to drink, limited access to water, and not feeling thirsty. Patients had tried to increase fluid intake using strategies such as carrying a water bottle, identifying contextual cues for drinking, self-monitoring fluid intake, and seeking social support. Patients expressed interest in wearing sensors to improve fluid intake if the sensor was aesthetically pleasing, had guaranteed benefit and was able to connect to existing devices. The most acceptable location to wear a sensor was as a wristband or bracelet. CONCLUSION: The use of automated and semiautomated tracking technology in combination with evidence-based behavior change techniques should be explored in efforts to improve adherence to fluid intake recommendations.

Towards a Generalizable Method for Detecting Fluid Intake with Wrist-Mounted Sensors and Adaptive Segmentation.

Over the last decade, advances in mobile technologies have enabled the development of intelligent systems that attempt to recognize and model a variety of health-related human behaviors. While automated dietary monitoring based on passive sensors has been an area of increasing research activity for many years, much less attention has been given to tracking fluid intake. In this work, we apply an adaptive segmentation technique on a continuous stream of inertial data captured with a practical, off-the-shelf wrist-mounted device to detect fluid intake gestures passively. We evaluated our approach in a study with 30 participants where 561 drinking instances were recorded. Using a leave-one-participant-out (LOPO), we were able to detect drinking episodes with 90.3% precision and 91.0% recall, demonstrating the generalizability of our approach. In addition to our proposed method, we also contribute an anonymized and labeled dataset of drinking and non-drinking gestures to encourage further work in the field.

Physical Activity and Sedentary Behavior in Older Gastrointestinal Cancer Survivors: Need and Acceptability of Digital Health Interventions.

PURPOSE: This study aimed to characterize physical activity (PA) and sedentary behavior (SB) profiles in older gastrointestinal (GI) cancer survivors, assess their interest in interventions to modify these behaviors, and evaluate the acceptability of digital tools for delivering interventions to modify these behaviors. METHODS: Survivors (M = 65 years) from an outpatient survivorship clinic at the Penn State Cancer Institute completed a questionnaire during a clinic appointment. RESULTS: Most survivors failed to attain the recommended level of PA (79%) or exceeded an average of 8 h of daily SB (42%). Access to internet and text messaging capabilities were high (70%), yet few survivors had access to smartphones or tablets (< 40%) or reported interest in using digital tools to improve PA or reduce SB (< 30%). Digital PA and SB interventions were more acceptable to younger survivors, survivors reporting more SB, and survivors engaging in more PA. The monetary value ascribed to digital health interventions did not differ as a function of mode of delivery (i.e., text messages, web, e-mail, tablet computer apps, or smartphone apps). CONCLUSIONS: Older GI cancer survivors can benefit from interventions to increase PA and decrease SB. Interest in such interventions was moderate and the acceptability of digital health tools for these interventions was limited. At the present time, behavioral interventions for older GI cancer survivors should not be delivered exclusively through digital tools and strategies to improve adoption of various technologies should be implemented when using these tools to modify PA and SB.