Nearly half of all Americans are living with a chronic condition, and one in four have Multiple Chronic Conditions (MCC). Chronic Obstructive Pulmonary Disease (COPD) is one such chronic disorder. Affecting 15 million Americans, COPD is the third leading cause of death in the United States, and treatment for COPD costs the healthcare system in excess of $32 billion annually. One significant factor leading to the high cost of care is non-adherence to medication and lifestyle recommendations. In an effort to keep chronic-disease sufferers healthier longer, thereby ameliorating the issue of avoidable costs, public health policy leaders, researchers, healthcare systems, and clinicians are attempting to discover ways to help individuals maintain appropriate adherence levels to medication prescriptions and lifestyle recommendations. In addition, previous research found connections between positivity and improved health and health outcomes. This study investigated one potential method of helping chronic-disease sufferers stay adherent and maintain their overall health. This research studied a mobile and on-line affective-computing tool that utilized Ecological Momentary Assessment (EMA) in an effort to raise the cognitive awareness of users’ subjective well-being and positivity. The study’s objective was to determine if use of this tool led to improvement in adherence, Subjective Well-Being (SWB), positivity, and overall Quality of Life (QoL). This study used an embedded mixed methods approach and involved 96 respondents diagnosed with Alpha-1 Antitrypsin Deficiency-Associated (AATD) COPD. Alpha-1 Antitrypsin Deficiency is a rare, genetic disease affecting approximately 100,000 Americans. The most significant complications for those suffering with Alpha-1 are lung or liver diseases. This study included only those diagnosed with lung disease. Participants used the affective-computing tool over a two-month period. The research measured their levels of positivity and quality of life prior to their use of the system and subsequently following it. This study also measured participants’ use of the affective-computing tool including frequency of response to push messages and response times. It then compared these variables for users who engaged with the system through email as opposed to those who participated by text messaging or Short Message Service (SMS).
Results indicated a small but insignificant increase in adherence rates, as well as improved but insignificant QoL scores between the pre and posttest periods. However, the analyses indicated a significant increase in subjective well-being scores between the two periods. They also revealed a 91.3% average compliance rate to the study push messages over the two-month period. While the research revealed faster compliance for those using text messaging, there was no significant difference in compliance rates for those answering using text messaging compared to those using email.
While the results indicated that the use of an EMA-associated system designed to raise awareness of SWB is one way of improving overall well-being and health of chronically-ill individuals, they did more significantly reveal areas of further study among other disease states, over longer study periods, and with larger sample sizes.
|Advisor:||Jabro, Ann D.|
|Commitee:||Draus, Peter, Musante, Lou, Ross, Carl A.|
|School:||Robert Morris University|
|Department:||Information Systems and Communications|
|School Location:||United States -- Pennsylvania|
|Source:||DAI-A 78/02(E), Dissertation Abstracts International|
|Subjects:||Health sciences, Bioinformatics, Information science|
|Keywords:||Adherence, Affective computing, COPD, Ecological momentary assessment, Positivity, Subjective Well-Being|
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