Maintenance Notice

Due to necessary scheduled maintenance, the JMIR Publications website will be unavailable from Monday, March 11, 2019 at 4:00 PM to 4:30 PM EST. We apologize in advance for any inconvenience this may cause you.

Who will be affected?

Advertisement

Currently submitted to: JMIR mHealth and uHealth

Date Submitted: Sep 27, 2019
Open Peer Review Period: Sep 27, 2019 - Nov 22, 2019
(closed for review but you can still tweet)

NOTE: This is an unreviewed Preprint

Warning: This is a unreviewed preprint (What is a preprint?). Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn (a note “no longer under consideration” will appear above).

Peer-review me: Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period (in this case, a “Peer-Review Me” button to sign up as reviewer is displayed above). All preprints currently open for review are listed here. Outside of the formal open peer-review period we encourage you to tweet about the preprint.

Citation: Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author).

Final version: If our system detects a final peer-reviewed “version of record” (VoR) published in any journal, a link to that VoR will appear below. Readers are then encourage to cite the VoR instead of this preprint.

Settings: If you are the author, you can login and change the preprint display settings, but the preprint URL/DOI is supposed to be stable and citable, so it should not be removed once posted.

Submit: To post your own preprint, simply submit to any JMIR journal, and choose the appropriate settings to expose your submitted version as preprint.

A pantheoretical framework to optimize adherence to healthy lifestyle behaviors and medication adherence: The use of personalized approaches to overcome barriers and optimize facilitators to achieve adherence

  • Azizi Seixas; 
  • Colleen Conners; 
  • Alicia Chung; 
  • Tiffany Donley; 
  • Girardin Jean-Louis; 

ABSTRACT

Background:

Poor adherence to primary prevention and management of chronic health conditions (such as lifestyle health behaviors and medications) has significant economic and health consequences, resulting in greater healthcare expenditures, multiple morbidities, and deaths. The burgeoning use of mobile technology to deliver health, lifestyle and wellness interventions has shown initial signs of improving adherence to primary prevention and management of chronic health conditions. However, the full potential of achieving optimized levels of adherence are thwarted by a wide range of sociodemographic, psychosocial, behavioral, and system-level barriers and the lack of a personalized medicine and a precision population health approach—approaches that understands disease and health and provides just-in-time, adaptive, and just-enough interventions based on biological/individual (e.g. genes, biomarkers, circadian profile), lifestyle/behavioral (diet, physical activity, sleep and stress management), and environmental/contextual (household, neighborhood, and cultural) factors.

Objective:

The purpose of this paper is to explore: 1) modifiable and non-modifiable barriers and facilitators of adherence to primary prevention and management of chronic health conditions, especially in mHealth solutions; 2) a personalized medicine and precision population health framework that overcomes barriers and accentuates facilitations to adherence in primary prevention and management solutions of chronic health conditions; and 3) how to implement a personalized medicine and precision population health approach in mHealth/digital health solutions.

Methods:

Through a careful review of the literature via several public databases such as PubMed and Google Scholar (years 2017-2019), we identified and describe key barriers and facilitators to adherence to primary prevention and management strategies in chronic health conditions. To overcome these challenges, we provide a novel mHealth solution steeped in precision and personalized population health and pantheoretical approach that increase the likelihood of adherence. We describe the stages of a pantheoretical approach focuses on tailoring, clustering/profiling, personalizing and optimizing interventions/strategies to obtain adherence and highlight minimal engineering needed to build such a solution.

Results:

Addressing modifiable determinants such as social support, health literacy, user motivation, emotional status, cognition (memory and information processing), and healthcare systems may provide better opportunities to effect behavior change and long-term adherence to health behaviors. We further argue that a mobile health solution may be a viable approach to address modifiable barriers and optimize adherence, while taking into consideration non-modifiable factors, which serve to tailor, cluster/profile, personalize and optimize interventions/strategies to obtain adherence, the pantheoretical approach.

Conclusions:

Although mHealth solutions can be ideal for successful achievement and maintenance of adherence behaviors, they can also exacerbate barriers and thus compromise adherence.


 Citation

Please cite as:

Seixas A, Conners C, Chung A, Donley T, Jean-Louis G

A pantheoretical framework to optimize adherence to healthy lifestyle behaviors and medication adherence: The use of personalized approaches to overcome barriers and optimize facilitators to achieve adherence

JMIR Preprints. 27/09/2019:16429

DOI: 10.2196/preprints.16429

URL: https://preprints.jmir.org/preprint/16429


Request queued. Please wait while the file is being generated. It may take some time.

© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.