Self-monitoring Program Research Articles

자기점검 인지기능 훈련 프로그램이 ADHD성향 아동의 주의집중능력 및 과잉행동에 미치는 영향

자기점검 인지기능 훈련 프로그램이 ADHD성향 아동의 주의집중능력 및 과잉행동에 미치는 영향

Eficacia de un programa de autocontrol en el tratamiento con anticoagulantes orales antivitamina K. Estudio de factibilidad

Background and objectivesTo compare the efficacy of a self-monitoring programme vs. the conventional method used before the intervention in maintaining the international normalised ratio (INR) in the therapeutic range in patients receiving oral anticoagulants, as well as complications, quality of life and the time invested in the tests. Patients and methodsPre-pospilot and feasibility study. The study included 15 patients over the age of 18 years who had been attending the monitoring programme for more than 6months. In the pre phase, patients performed the tests and follow-up in the outpatient clinic. After conducting an individual training session with each patient to teach them how to perform venipuncture, use the coagulometer, manage dosing tables and subsequent follow-up from the virtual clinic, we compared the percentage of in-range INR tests, complications, quality of life, and the time invested in performing the tests pre- (conventional) and post-intervention (intervention for self-monitoring). ResultsThe percentage of INR tests in the therapeutic range was significantly higher in the post-phase than in the pre-phase (65.6% vs. 37.8%, p<.001). Likewise, the incidence of both minor and serious complications decreased in the post-phase (20% vs. 0%, and 6.7% vs. 0%, respectively). Finally, all 5dimensions of the quality of life questionnaire improved significantly, while the time invested decreased. ConclusionsIn our experience, OAT self-monitoring is associated with a significant improvement in patient management, a reduction in the rate of complications, improved quality of life and timesaving.

Is home monitoring of inflammatory bowel disease feasible? A randomized controlled study

Objectives: The aim of this prospective study was to evaluate the home monitoring with a rapid fecal calprotectin test combined with a symptom questionnaire in patients with colonic IBD in real-life setting.Methods: We randomized 180 patients with colonic IBD in a study or a control group. The home monitoring patients performed the fecal calprotectin test and filled in a symptom questionnaire every second month and in cases with increasing symptoms. The control patients filled in the symptom questionnaire at baseline and at 6 and 12 months as well as for the appointment at the outpatient clinic. The study duration was 12 months.Results: The patient adherence to the self-monitoring program was low. Patients with a higher disease burden were more adherent than patients with better health-related quality of life, but otherwise, there were no significant factors predicting the adherence. The home monitoring patients had fewer contacts with the outpatient clinic, but otherwise, the disease course between the home monitoring and the control group were similar.Conclusions: The self-monitoring of IBD activity with a combination of a rapid fecal calprotectin home test and a symptom questionnaire provides an option for individualized care for IBD patients. However, adherence to the self-monitoring program remains a challenge.

SKIP (Supporting Kids with diabetes In Physical activity): Feasibility of a randomised controlled trial of a digital intervention for 9-12 year olds with type 1 diabetes mellitus

BackgroundPhysical activity and self-monitoring are important for children with type 1 diabetes mellitus (T1DM) but it is unclear whether interventions delivered online are feasible, acceptable to patients and efficacious. The aim was to assess the feasibility and acceptability of an internet-based physical activity and self-monitoring programme for children with T1DM, and of a randomised controlled trial (RCT) to evaluate efficacy.MethodsA total of 49 children aged 9-12 with T1DM were randomly assigned to usual care only or to an interactive intervention group combining a website (STAK-D) and a PolarActive activity watch (PAW; Polar Electro (UK) Ltd.), alongside usual care. Participants completed self-report measures on their health, self-efficacy and physical activity at baseline (T0), eight weeks (T1) and six months (T2). They also wore a PAW to measure physical activity for one week at the end of T0, T1 and T2. Intervention participants were interviewed about their experiences at T2. Explanatory variables were examined using multi-level modelling and examination of change scores, 95% confidence intervals and p-values with alpha set at 0.95. Descriptive analysis was undertaken of the ‘end-of-study questionnaire’. Qualitative analysis followed a framework approach.ResultsCompletion rates for all self-report items and objective physical activity data were above 85% for the majority of measures. HbA1c data was obtained for 100% of participants, although complete clinical data was available for 63.3% to 63.5% of participants at each data collection time-point. Recruitment and data collection processes were reported to be acceptable to participants and healthcare professionals. Self-reported sedentary behaviour (-2.28, p=0.04, 95% CI=-4.40, -0.16; p = 0.04; dppc2 = 0.72) and parent-reported physical health of the child (6.15, p=0.01, 95%CI=1.75, 10.55; p = 0.01; dppc2 = 0.75) improved at eight weeks in the intervention group.ConclusionsThe trial design was feasible and acceptable to participants and healthcare providers. Intervention engagement was low and technical challenges were evident in both online and activity watch elements, although enjoyment was high among users. Reported outcome improvements were observed at 8 weeks but were not sustained.Trial registrationISRCTN 48994721 (prospectively registered). Date of registration: 28.09.2016.

Experimental Evaluation of Surface Water Sampling Variability for Environmental Monitoring in Iron Ore Operations

Environmental self-monitoring is a government requirement for Swedish process industries. This includes sampling and analysis of recipient water that might be adversely affected by emissions. The requirements for accredited analytical methods are strict, with well-defined measurement uncertainties, but estimations of the attendant sampling variability are seldom required, presented, or evaluated in environmental surface water sampling. The goal of this study was to perform an initial evaluation of the measurement variability for surface water sampling within the self-monitoring program for a large mining company in northern Sweden. The results indicate that the method for evaluation of sampling and measurement variability itself affects the results obtained. Therefore, the evaluation scope must be clearly defined in advance, so that the most appropriate approach, resulting in a realistic quantification of total variability, can be selected. This study shows that duplicate sampling experiments result in significantly larger sampling variability estimates when accounting for ambiguities in the sampling protocol than similar experiments under repeatability conditions. This is due to large temporal variations in stream flux and analyte concentrations in the evaluated sampling targets. The ambiguities in different sampling protocols must be fully described and considered when designing empirical evaluation experiments to allow valid evaluation of the total sampling and measurement system variability. An automated sampler using volume-proportional sampling to collect increments for composite samples is recommended to reduce unnecessary sampling variability and address significant temporal changes in stream flux and analyte concentrations appropriately.

The use of conversation maps in the metabolic control of diabetes in Brazilians: a randomized clinical trial.

To evaluate effects of an educative intervention over the self-monitoring of blood glucose (SMBG) at home for metabolic control. A total of 91 people with diabetes participated, recruited from the home capillary blood glycemia self-monitoring program. Two groups of participants were formed: one group participated in the SMBG program at home and with usual care (control group), while the other group participated in the SMBG at home and with educative intervention (intervention group). In total there were 12 meetings, three for each conversation map in the control of diabetes, during four months in 2011 and 2012. For all the analysis, a significance statistical level of 5% (p ≤ 0.05) was adopted. Most part of participants were females, married, with an average age of 62.1years old and schooling from four to seven years of study. In the intervention group, an improvement was observed in the following measures: body mass index, abdominal circumference, diastolic blood pressure, fasting plasma glucose, HDL cholesterol, LDL cholesterol and triglycerides. The control group showed improvement in measures of systolic and diastolic blood pressure, fasting plasma glucose, HDL cholesterol and LDL cholesterol. Moreover, an increase on the values of glycated hemoglobin was observed in both groups. It was observed that there was not statistical significant improvement of the metabolic control. However, it was possible to confirm that an educative intervention for SMBG at home presented a clinical significance, which in turn, resonates in a special way on the health of participants.

Abstract P348: Evaluation of Check. Change. Control. in the Asian American &amp; Pacific Islander Community

Background: Heart Disease is the #1 cause of death and stroke is #3 for Asian Americans and Pacific Islanders (AAPI) 65 years and older. Approx. 21% of deaths among certain AAPIs are due to high blood pressure (HBP). In response, the Western States Affiliate (WSA)-American Heart Association (AHA) adapted our evidence-based self-monitoring community program to reduce and control HBP with AAPI senior citizens. Blood pressure (BP) awareness, treatment and control remains suboptimal among US adults with hypertension. Objectives: We evaluated the efficacy, acceptability, and cultural relevancy among Chinese, Korean, Vietnamese, Pacific Islander older adults in California and Washington. Methods: We collaborated with 4 community-based AAPI organizations and recruited 800+ AAPI senior citizens. We used a multi-pronged evaluation approach including pre and post surveys to determine existing lifestyle partners and readiness to change, health assessments to identify risk factors, monthly self-monitoring blood readings, and aggregated biometric data to demonstrate progress towards control and HBP reduction. Results: At baseline, more than 30% of participants experienced high blood pressure. There were significant reductions in both SBP and DBP overall and especially among those with elevated BP at baseline. SBP drop changes varied by site and by ethnic group from baseline to final visit. Each site implemented adapted self- monitoring program for cultural relevancy and readiness level. Conclusion: Adapting our self-monitoring program had a significant impact in reducing BP for AAPI participants, especially among those with elevated BP at baseline. Further study is needed across multiple sites and AAPI ethnicities.

STUDY OF THE STRATIFICATION PROCESS AT THE RESERVOIR OF THE HYDROELECTRIC POWER PLANT GOV. PEDRO VIRIATO PARIGOT DE SOUZA (CAPIVARI-CACHOEIRA), PARANÁ, BRAZIL.

The study of the stratification processes in reservoirs is important because they happen along with several physical and chemical changes in the water, as in the distribution of dissolved gases and nutrients. The aim of this work was to study the stratification process of the Capivari-Waterfall Hydroelectric Power Plant, based on the data of the vertical profiles of dissolved oxygen and temperature, as well as the comparison of them with the calculation of Froude's Densimetric Number, and reservoir residence time. The data used are part of the self-monitoring program carried out by COPEL. These data were collected quarterly between 2005 and 2016. The hydraulic and operational data from the reservoir were used to calculations. According to the measurements of dissolved oxygen and temperature, it was considered to be stratified during almost all the year, with a trend of circulation in the colder months, this behavior characterizes lakes with warm monomictic circulation pattern. Therefore, the result of Froude's Densimetric Number, corresponded correctly with the observed. Regarding the residence time, this was not consistent with the results obtained, from the models. The use of different methodologies in evaluating circulation in reservoirs should be used in order to make the best management decision.

Weekly self-measurement of FEV1 and PEF and its impact on ACQ (asthma control questionnaire)-scores: 12-week observational study with 76 patients

The “Asthma Control Questionnaire” (ACQ) is a very common questionnaire for assessing asthma control. This study compares different ACQ versions in a self-monitoring program over a 12-week period combining them with patients' self-measurements of peak expiratory flow (PEF) and forced expiratory volume in one second (FEV1). The objective was to test the feasibility of FEV1-self-measurements and to compare ACQ versions regarding possible additional information given by lung function. In this prospective multicenter observational study 100 adult asthma patients, recruited at six family practices and two pulmologists' private practices in Germany, completed the ACQ weekly, performing self-measurements of PEF and FEV1. Seventy-six patients were included into final analysis with only 3% missing values. Scores for all ACQ versions improved significantly (all P-values < 0.05) with reductions of 32% for ACQ5, 31% for ACQ6, 22% for ACQ7-FEV1, and 21% for ACQ7-PEF with high Pearson’s correlation coefficients of all scores (r between 0.96 and 0.99). ACQ7-FEV1 scores were significantly higher than others. Separated courses of lung function parameters showed nearly no change, but ACQ5 and ACQ6 as scores for symptoms and reliever medication improved constantly. ACQ5 and ACQ6 revealed higher percentages of patients classified as “controlled” than ACQ7-scores. In conclusion, with only a few missing data points, our results suggest feasibility of FEV1-self-measurements. Courses of symptom-related and lung function-related ACQ items differ clearly. Our results support the GINA recommendations to consider symptoms and lung function separately. FEV1-self-measurements for research purposes may be included with the ACQ, but in clinical practice seem to measure a different domain to symptomatic asthma control.

Abstract P105: A Pharmacist Guided Patient Driven Interdisciplinary Program to Improve Blood Pressure Control in Patients with Hypertension

Introduction: Approximately 65% of patients treated for hypertension do not meet blood pressure goals. New strategies are needed to improve this number given the high impact of hypertension on CV disease. Dietary approaches and patient-driven self-titration of BP medications have been shown to be effective and safe in clinical studies but are under utilized in clinical practice. We present our experience with this ongoing project. Aims: Implement a pharmacist-guided, patient-driven self-monitoring and medication titration program. Implement standardized evidence-based dietary counseling to hypertensive patients. Intervention: Patients with uncontrolled hypertension on 3 or fewer anti-hypertensive agents were contacted to participate. BP goals were established based on individual risk factors. Patients were referred to the clinical pharmacist who devised a personalized plan for BP medication titration. Provide Education on dietary modification was provided to patients. The project was first introduced at the University of Colorado Hospital CKD clinic and then transitioned to the primary care setting at A.F. Williams Family Medicine Center. Outcomes: Appeal--both to providers and patients via pre/post survey Adherence/effectiveness--tracked via patient EMR blood pressure entries Adverse Events (via survey) experienced by patients will be analyzed. Results: At time of submission 19 patients have been enrolled and 3 patients have completed 6 month follow-up visits Of all ongoing and completed patients adherence to protocol is 72.2% 2 of the 3 patients completing 6 month follow-up had significant improvement in blood pressure (avg 16.26 mmHG) Comparison of descriptive statistics gathered from pre and 6 mo program provider surveys suggest favorable acceptance of program from renal providers All patients enrolled received dietary counseling with 3 patients receiving formal dietary consults. Conclusion: Our model for self-titration and dietary counseling appears to be feasible, safe and well received from providers. At the time of submission this project is ongoing, however early results from patients completing the protocol appear to be promising.

Sustainability and comanagement of subsistence hunting in an indigenous reserve in Guyana.

Although hunting is a key component of subsistence strategies of many Amazonians, it is also one of the greatest threats to wildlife. Because indigenous reserves comprise over 20% of Amazonia, effective conservation often requires that conservation professionals work closely with indigenous groups to manage resource use. We used hunter-generated harvesting data in spatially explicit biodemographic models to assess the sustainability of subsistence hunting of indigenous Waiwai in Guyana. We collected data through a hunter self-monitoring program, systematic follows of hunters, and semistructured interviews. We used these data to predict future densities of 2 indicator species, spider monkeys (Ateles paniscus) and bearded sakis (Chiropotes sagulatus), under different scenarios of human population expansion and changing hunting technology. We used encounter rates from transect surveys and hunter catch-per-unit effort (CPUE) to validate model predictions. Paca (Cuniculus paca) (198 /year), Currosaw (Crax alector) (168), and spider monkey (117) were the most frequently harvested species. Predicted densities of spider monkeys were statistically indistinguishable from empirically derived transect data (Kolmogorov-Smirnov D = 0.67, p = 0.759) and CPUE (D = 0.32, p = 1.000), demonstrating the robustness of model predictions. Ateles paniscus and C. sagulatus were predicted to be extirpated from <13% of the Waiwai reserve in 20 years, even under the most intensive hunting scenarios. Our results suggest Waiwai hunting is currently sustainable, primarily due to their low population density and use of bow and arrow. Continual monitoring is necessary, however, particularly if human population increases are accompanied by a switch to shotgun-only hunting. We suggest that hunter self-monitoring and biodemographic modeling can be used effectively in a comanagement approach in which indigenous parabiologists continuously provide hunting data that is then used to update model parameters and validate model predictions.

Effects of Education about Action Plans according to Self-Monitoring on Self-Management Adherence, Knowledge, Symptom Control, and Quality of Life among Adult Asthma Patients: A Randomized Controlled Trial

This study was conducted to identify the effects of education regarding action plans according to a self-monitoring program on self-management adherence, knowledge, symptom control, and health-related quality of life (HRQoL) among adults with asthma. Thirty-four patients were randomly assigned to the intervention group and thirty-two to the control group in this study. A tailored 50-minute intervention based on the contents of self-monitoring and action plans developed by the National Heart Lung and Blood Institute was provided to the intervention group. Structured and well developed questionnaires were used to measure the dependent variables. There were no differences in all general and clinical characteristics, and the dependent variables between two groups in the pre-test. In the post-test, there were differences in the level of self-management adherence (t=4.41, p<.001), knowledge (t=2.26, p=.027), symptom control (t=-2.56, p=.013), and total HRQoL (t=2.14, p=.036) between the two groups, although there was a difference only in the sub-domain of emotion (t=2.03, p=.047) in HRQoL. This study found that action plans according to self-monitoring that enhance a participatory interaction in the treatment and care could help patients with moderate to severe asthma to engagead equately in self-care, to control their symptoms, and to improve their HRQoL. Further studies are still needed to identify longitudinal effects of this program.

Self-Monitoring Utilization Patterns Among Individuals in an Incentivized Program for Healthy Behaviors.

BackgroundThe advent of digital technology has enabled individuals to track meaningful biometric data about themselves. This novel capability has spurred nontraditional health care organizations to develop systems that aid users in managing their health. One of the most prolific systems is Walgreens Balance Rewards for healthy choices (BRhc) program, an incentivized, Web-based self-monitoring program.ObjectiveThis study was performed to evaluate health data self-tracking characteristics of individuals enrolled in the Walgreens’ BRhc program, including the impact of manual versus automatic data entries through a supported device or apps.MethodsWe obtained activity tracking data from a total of 455,341 BRhc users during 2014. Upon identifying users with sufficient follow-up data, we explored temporal trends in user participation.ResultsThirty-four percent of users quit participating after a single entry of an activity. Among users who tracked at least two activities on different dates, the median length of participating was 8 weeks, with an average of 5.8 activities entered per week. Furthermore, users who participated for at least twenty weeks (28.3% of users; 33,078/116,621) consistently entered 8 to 9 activities per week. The majority of users (77%; 243,774/315,744) recorded activities through manual data entry alone. However, individuals who entered activities automatically through supported devices or apps participated roughly four times longer than their manual activity-entering counterparts (average 20 and 5 weeks, respectively; P<.001).ConclusionsThis study provides insights into the utilization patterns of individuals participating in an incentivized, Web-based self-monitoring program. Our results suggest automated health tracking could significantly improve long-term health engagement.

MPS 08-08 The influence of Wireless Self-Monitoring Program on the Relationship between Patient Activation and Health Behaviors, Medication Adherence, and Blood Pressure levels in Hypertensive patients

MPS 08-08 The influence of Wireless Self-Monitoring Program on the Relationship between Patient Activation and Health Behaviors, Medication Adherence, and Blood Pressure levels in Hypertensive patients

The Effectiveness of Terri Hiltel’s Self-Monitoring Program on Improving the Attention of the Students with Attention Deficit/Hyperactivity Disorder (ADHD)

&lt;p&gt;&lt;strong&gt;Introduction:&lt;/strong&gt; This study aimed to examine Terri Hiltel’s Self-monitoring Program on improving the attention of four primary school students with Attention Deficit/Hyperactivity Disorder (ADHD).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and Methods:&lt;/strong&gt; Single subject multiple-baseline design (ABA) across participants was utilized. The participants were observed along the baseline phase and the percentage of their target behaviors was accurately recorded. After the baseline, the students were trained by Terri Hiltel’s Self-monitoring program (called &lt;em&gt;shiny light bulb method&lt;/em&gt;) for 12 sessions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Level and trend analysis showed that the data points were placed at a level lower than the baseline for all the participants at intervention phase. That is, manifestation of off-task behaviors of the students in this phase decreased compared to the non-intervention phase (baseline); However, therapeutic effects discontinued and reduced at follow-up phase.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt; Findings supported the effectiveness of self-monitoring program as a therapeutic cognitive-behavioral technique. The Study implications are discussed for applying this technique in schools and using it along with other treatments.&lt;/p&gt;

Dietary knowledge Among Female Diabetic Patients in Amman, Jordan

The aim of this study was to assess dietary knowledge among females with diabetes in Amman, Jordan. We performed a cross-sectional study of diabetic patients attending outpatient diabetes clinics, at several hospitals in Amman . A questionnaires and 24-hour dietary recall were completed by the participants. The study used a face to face interview during which a questionnaire was filled by the investigator about knowledge and attitudes of diabetic patients. The study sample was composed of 180 females. Most of the patients have diabetes for more than two years (78.3%) and had a positive family history of diabetes as a first degree relative. About 50% suffered from diabetes related health disease and about half of the patients were overweight and 32.2% were obese. More than half of patients (56.1%) gave wrong answers for meals recommended for diabetes/day and that should be used with hypoglycemia (44.5%), food rich in protein (47.6%), number of snacks (50.6%) and their role (43.1%), drinks permitted with unlimited amounts (61.4%) and suitable time to drink juice (78.1%). Most of the patients gave correct answers for food rich in fats (48.4%), cholesterol (47.8%), and controlling blood sugar (51.7%), right and number of snacks recommended (68.7%) and food which raises blood sugar (49.1%). According to the results, the dietary knowledge of diabetic patients is inadequate and need improvement. The study recommends that there is a need to set up a health education programme on diabetes mellitus which would also include a self-monitoring programme.

The Influence of Wireless Self-Monitoring Program on the Relationship Between Patient Activation and Health Behaviors, Medication Adherence, and Blood Pressure Levels in Hypertensive Patients: A Substudy of a Randomized Controlled Trial.

BackgroundActive engagement in the management of hypertension is important in improving self-management behaviors and clinical outcomes. Mobile phone technology using wireless monitoring tools are now widely available to help individuals monitor their blood pressure, but little is known about the conditions under which such technology can effect positive behavior changes or clinical outcomes.ObjectiveTo study the influence of wireless self-monitoring program and patient activation measures on health behaviors, medication adherence, and blood pressure levels as well as control of blood pressure in hypertensive patients.MethodsWe examined a subset of 95 hypertensive participants from a 6-month randomized controlled trial designed to determine the utility of a wireless self-monitoring program (n=52 monitoring program, n=43 control), which consisted of a blood pressure monitoring device connected with a mobile phone, reminders for self-monitoring, a Web-based disease management program, and a mobile app for monitoring and education, compared with the control group receiving a standard disease management program. Study participants provided measures of patient activation, health behaviors including smoking, drinking, and exercise, medication adherence, and blood pressure levels. We assessed the influence of wireless self-monitoring as a moderator of the relationship between patient activation and health behaviors, medication adherence, and control of blood pressure.ResultsImprovements in patient activation were associated with improvements in cigarette smoking (beta=−0.46, P<.001) and blood pressure control (beta=0.04, P=.02). This relationship was further strengthened in reducing cigarettes (beta=−0.60, P<.001), alcohol drinking (beta=−0.26, P=.01), and systolic (beta=−0.27, P=.02) and diastolic blood pressure (beta=−0.34, P=.007) at 6 months among individuals participating in the wireless self-monitoring program. No differences were observed with respect to medication adherence.ConclusionsParticipation in a wireless self-monitoring program provides individuals motivated to improve their health management with an added benefit above and beyond that of motivation alone. Hypertensive individuals eager to change health behaviors are excellent candidates for mobile health self-monitoring..Trial RegistrationClinicalTrials.gov NCT01975428, https://clinicaltrials.gov/ct2/show/NCT01975428 (Archived by WebCite at http://www.webcitation.org/6iSO5OgOG)

DEVELOPMENT AND IMPLEMENTATION OF TOOLS FOR SELF-MONITORING OF STAFF EXPOSED TO 131I IN NUCLEAR MEDICINE CENTRES OF CHILE.

Currently in Chile, there are about 42 nuclear medicine centres that mainly use 99mTc and 131I in diagnostic and therapeutic procedures. Therefore, staff performs various tasks that increase the risk of internal incorporation and the need to implement routine monitoring programmes. This article shows tools for self-monitoring of staff who exposed to 131I from measurements in thyroid and urine samples, using the gamma cameras of Nuclear Medicine Units. Then, the calibration factors of gamma cameras of participating units were determined, and a one-worker dose was calculated due to internal incorporation, using an Excel spreadsheet for self-monitoring. The worker who handles 131I in one of the studied units was monitored for 6 months. The goal of this study is to implement a routine self-monitoring programme for the estimation of committed effective dose of staff exposed to 131I using gamma cameras in Nuclear Medicine Units of clinical centres in Chile.

The Feasibility of Financial Incentives to Increase Exercise Among Canadian Cardiac Rehabilitation Patients.

To examine the feasibility of conducting a randomized controlled trial investigating the effectiveness of financial incentives for exercise self-monitoring in cardiac rehabilitation (CR). A 12-week, 2 parallel-arm, single-blind feasibility study design was employed. A volunteer sample of CR program graduates was randomly assigned to an exercise self-monitoring intervention only (control; n = 14; mean age ± SD, 62.7 ± 14.6 years), or an exercise self-monitoring plus incentives approach (incentive; n = 13; mean age ± SD, 63.6 ± 11.8 years). Control group participants received a "home-based" exercise self-monitoring program following CR program completion (exercise diaries could be submitted online or by mail). Incentive group participants received the "home-based" program, plus voucher-based incentives for exercise diary submissions ($2 per day). A range of feasibility outcomes is presented, including recruitment and retention rates, and intervention acceptability. Data for the proposed primary outcome of a definitive trial, aerobic fitness, are also reported. Seventy-four CR graduates were potentially eligible to participate, 27 were enrolled (36.5% recruitment rate; twice the expected rate), and 5 were lost to followup (80% retention). Intervention acceptability was high with three-quarters of participants indicating that they would likely sign up for an incentive program at baseline. While group differences in exercise self-monitoring (the incentive "target") were not observed, modest but nonsignificant changes in aerobic fitness were noted with fitness increasing by 0.23 mL·kg-·min- among incentive participants and decreasing by 0.68 mL·kg-·min- among controls. This preliminary study demonstrates the feasibility of studying incentives in a CR context, and the potential for incentives to be readily accepted in the broader context of the Canadian health care system.

뇌졸중 환자의 자가감시 재활 프로그램이 신체적 기능, 자기효능감 및 삶의 질에 미치는 효과

Purpose: This study was conducted to identify the effects of a self-monitoring rehabilitation program based on the Bandura's self-efficacy theory on the activities of daily living (ADL), 6-minute walking distances, self-efficacy and quality of life (QoL) among stroke patients after three to six months.Methods: The participants consisted of 29 patients in the experiment group and 28 patients in the control group who admitted at rehabilitation specific hospital. Self-monitoring program developed by the researcher lasted twice a week for 8 weeks from August to September, 2013.Results:ANCOVA showed that all of dependent variables of this study, ADL and 6-minutewalking distances as a physical function, self-efficacy andQoL for intervention group were higher than those for control group(p<.001). Conclusion: The self-monitoring rehabilitation program based on the self-efficacy theory was found to be effective in improving physical function, self-efficacy and QoL for early post-stroke patients. Early rehabilitation program for stroke patients was recommended to consider the self-monitoring of current physical and psychosocial status as a strategy of self-management.