Get moving: the practice nurse is watching you!

Renee Verwey, Sanne van der Weegen, Huibert Tange, Marieke Spreeuwenberg, Trudy van der Weijden, Luc de Witte


Background The system informs the nurse about levels of physical activity in the daily living of patients who are using the It’s LiFe! tool. The tool consists of an accelerometer that transfers data to a smartphone, which is subsequently connected to a server. Nurses can monitor patients’ physical activity via a secured website. Physical activity levels are measured in minutes per day compared with pre-set activity goals, which are set in dialogue with the patient.

Objective To examine user requirements and to evaluate the usability of the secured website, in order to increase the probability of effective use by nurses.

Method The needs and preferences of nurses towards the system were determined through qualitative research. The usability of the system was evaluated in a laboratory situation and during a three-month pilot study.

Results A monitoring and feedback system to support patients in their intention to be more active was developed in a systematic way. Automatically generated feedback messages were defined based on the requirements of nurses. The results from the usability tests gave insights into how to improve the structure and quality of the information provided. Nurses were positive about the features and ease of use of the system, but made critical remarks about the time that its use entails.

Conclusion The system supports nurses when performing physical activity counselling in a structured and profound way. The opportunity to support self-management of patients in between regular consultations needs further investigation, and adaptation into the clinical workflow of the nurses.


physical activity; primary care nursing; remote sensing technology; self-management support; user-centred design

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Long Alliantie Nederland. Zorgstandaard COPD. Amersfoort: Long Alliantie Nederland, 2010.

Nederlandse Diabetes Federatie. NDF Care Standard: transparancy and quality of diabetic care for people with diabetes type 2 [NDF Zorgstandaard: transparantie en kwaliteit van diabeteszorg voor mensen met diabetes type 2]. Amersfoort: Nederlandse Diabetes Federatie, 2007.

Heijmans M, Spreeuwenberg P and Rijken M. Developments in the care of chronically ill. Reporting 2010 [Ontwikkelingen in de zorg voor chronisch zieken Rapportage 2010]. (accessed 30/01/13).

van Achterberg T, Huisman-de Waal GG, Ketelaar NA, Oostendorp RA, Jacobs JE and Wollersheim HC. How to promote healthy behaviours in patients? An overview of evidence for behaviour change techniques. Health Promotion International 2011;26:148–62.

PMid:20739325 PMCid:PMC3090154

Tudor-Locke C and Lutes L. Why do pedometers work?: A reflection upon the factors related to successfully increasing physical activity. Sports Medicine 2009;39:981–93.


Verwey R, van der Weegen S, Spreeuwenberg M, Tange H, van der Weijden T and de Witte L. A monitoring and feedback tool to support patients in achieving a more active lifestyle: the development of portable technology embedded in primary care. In: Van Gemert-Pijnen L, Ossebaard HC, Smedberg A, ir Wynchank S and Giacomelli P (eds) eTELEMED. Valencia: IARIA, 2012, pp. 147–50.

Shah SGS and Robinson I. Benefits of and barriers to involving users in medical device technology development and evaluation. International Journal of Technology Assessment in Health Care 2007;23:131–7.


de Lusignan S. Usability: a neglected theme in informatics. Informatics in Primary Care 2009;17:199–200.


De Rouck S, Leys M and Jacobs A. A methodology for shifting the focus of e-health support design onto user needs. A case in the homecare field. International Journal of Medical Informatics 2008;77:589–601.


Shah SGS, Robinson I and Alshawi S. Developing medical device technologies from users' perspectives: a theoretical framework for involving users in the development process. International Journal of Technology Assessment in Health Care 2009;25:514–21.


Martin JL, Norris BJ, Murphy E and Crowe JA. Medical device development: the challenge for ergonomics. Applied Ergonomics 2008;39:271–83.


Foster C, Hillsdon M and Thorogood M. Interventions for promoting physical activity. Cochrane Database of Systematic Reviews, 2009. Issue 2.

Bravata DM, Smith-Spangler C, SundaramVet al. Using pedometers to increase physical activity and improve health: a systematic review. JAMA 2007;298:2296–304.


Jacobson I. Object-Oriented Software Engineering: a use case-driven approach. New York: ACM Press, 2007.

Huis in't Veld RM, Widya IA, Bults RG, Sandsjo L, Hermens HJ and Vollenbroek-Hutten MM. A scenario guideline for designing new tele-treatments: a multidisciplinary approach. Journal of Telemedicine and Telecare 2010;16:302–7.


Polit DF and Beck CT. Nursing Research: generating and assessing evidence for nursing practice. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2008.

Hsieh HF and Shannon SE. Three approaches to qualitative content analysis. Qualitative Health Research 2005; 15:1277–88.


Nielsen J. Usability Engineering. Cambridge: Academic Press, 1993.

Lewis JR. Psychometric evaluation of the PSSUQ using data from five years of usability studies. International Journal of Human–Computer Interaction 2002;14:463–88.

Benedek J and Miner T, eds. Measuring desirability: new methods for evaluating desirability in a usability lab setting. Paper presented at Humanizing Design: the Eleventh Annual Usability Professionals Association Conference Proceedings; 2002 July 8–12; Orlando, FL.

Glasgow RE, Emont S and Miller DC. Assessing delivery of the five 'As' for patient-centered counseling. Health Promotion International 2006;21:245–55.


Meriwether RA, Lee JA, Lafleur AS and Wiseman P. Physical activity counseling. American Family Physician 2008;77:1129–36.


Peterson JA. Get moving! Physical activity counseling in primary care. Journal of the American Academy of Nurse Practitioners 2007;19:349–57.


Calfas KJ, Sallis JF, Oldenburg B and Ffrench M. Mediators of change in physical activity following an intervention in primary care: PACE. Preventive Medicine 1997;26:297–304.


Cockburn A. Agile Software Development. Boston: Addison-Wesley; 2002.


Farmer A, Gibson O, Hayton P et al. A real-time, mobile phone-based telemedicine system to support young adults with type 1 diabetes. Informatics in Primary Care 2005;13:171–7. PMid:16259856

Bodenheimer T, Lorig K, Holman H and Grumbach K. Patient self-management of chronic disease in primary care. JAMA 2002;288:2469–75.


Bodenheimer T, Wagner EH and Grumbach K. Improving primary care for patients with chronic illness. JAMA 2002;288:1775–9.



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