X Close

CBC Digi-Hub Blog



Archive for the 'Difficult and priority issues in digital health' Category

Is “brain hacking” right for behavioral medicine?

By ucjubil, on 9 May 2017

By Jason Fanning a health psychologist and programmer

It’s an attractive possibility: A health app so engaging the user does not want to put it down. All the better if they feel compelled to move a bit more or eat a bit less to get that next reward! This is certainly the model for many of the most popular social media applications, and the term “brain hacking” – or the attempt to purposefully trigger the brain’s reward circuit to prompt the user to come back time and time again – has recently entered the popular lexicon and received coverage from several major news outlets. (more…)

Getting help from Doctor Google

By ucjubil, on 2 May 2017

By: Julia Mueller, PhD candidate at the University of Manchester
Supervisors: Professor Chris Todd, Dr Caroline Jay, Dr Simon Harper


George has been coughing for months. When people point it out, he dismisses their concerns. “It’s just me getting older. And all those years I smoked!” But over time, he becomes more concerned. Finally, he turns to the Internet. Online, he finds a confusing, overwhelming mass of information. He can’t figure out which information is relevant. “If I go to the doctor with a tickly cough, he’ll think I’m trying to waste his time,” he reasons. So he leaves it at that. (more…)

In search of ‘well being and behaviour change’ in the workplace

By ucjubil, on 28 March 2017

By: Dr Mark Cobain, co-founder and director, Younger Lives Group


“I get asked to deliver wellbeing all the time. I still don’t know what the hell it means!” Occupational Health Professional, March 2017

Last week we exhibited our new ‘Younger Lives’ products at the Health and Wellbeing at Work event at the National Exhibition Centre in Birmingham. It’s the first time we attended. Most of those attending were largely from occupational health and human resource communities from small and large organisations in the public and private sector looking for ways to “engage” their staff with health and wellbeing. Many were just starting their foray into the space, trying to get inspiration for new ways to introduce the concept to their people.


Should a health intervention fit routines or disrupt them?

By Carmen E Lefevre, on 24 November 2016

By: Andrea Maltman, Virgin Pulse


At last count, Gallup reported that unhealthy and absent workers cost the UK economy £2.1billion in lost productivity.

Employers have proof that the health of their employees cannot be separated from the health of their organisations.

But as the modern workplace becomes the logical place to improve health and behaviours, important questions loom. Questions like: should a health intervention fit existing routines, or disrupt them?

There is a temptation to opt for the latter; to shower employees with gym memberships, boot camps and high-tech fitness devices.

These may be beneficial additions to any health strategy. But in reality, they rarely become true habits because they are too ambitious and removed from an employee’s routine to be sustainable.

What employees actually need is something small and in-sync with their current lifestyle, according to Dr BJ Fogg. He is a member of the Virgin Pulse Science Advisory Board and a leading expert on behavioural change.

In his Ted Talk, he says that for a behaviour to occur, three elements must be present: motivationability, and a trigger.

However he warns that, in order to do something difficult – like improve health and lifestyle habits – high levels of motivation are needed. And often, these alone aren’t enough.
“Relying primarily on motivation to change behaviour in the long-term is a losing strategy,” Dr Fogg says.

“But you can take motivation off the table if you make the behaviour change small enough. Then, it’s very easy to repeat, and it can become a habit.
“As we create these habits, little by little, we approach desired outcomes in a very reliable way; one that doesn’t regress, make us give up, or go back to the way things were.”

Examples illustrate the point: if a sedentary employee – dealing with stress, career pressure, deadlines and family demands – gets out of bed faced with a gruelling workout or boot camp session, then there’s little motivation and the odds are stacked against them.

But if that same employee wakes up and decides their new behaviour will be getting off the train one stop early, or listening to a meditation podcast during the commute instead of music, it’s not that huge or different.

Soon, they’ve managed to create a new behaviour, maintain it, and establish the foundations of a long-term habit – probably without even noticing.

The Virgin Pulse Global Challenge is designed to work this way. It’s based on the behavioral science outlined above, yet it also provides members with a simple and engaging journey that improves their physical and psychological health in the long term.

Statistics from the 2016 Global Challenge prove that small changes can get big results[1]:

70% of members now meet the recommendation of 10,000 steps per day

68% who tracked their weight have lost weight

69% now meet the recommended amount of sleep

69% report a decrease in their stress levels at home or at work

58% report an increase in either productivity or concentration


The results are clear: positive changes don’t need to disrupt an employee’s life. But what they do need to be is small, rewarding and introduced slowly until the desired outcome is achieved.

[1] Global Challenge. Final Global Report. 2016. Pre-event (257,984 respondents); post-event (120,402 respondents).


BIO: Over the past 13 years, the Virgin Pulse Global Challenge has helped transform the cultures of the world’s leading organisations and improve the health and performance of over two million employees. In 2016, Global Corporate Challenge (GCC) proudly joined Virgin Pulse to become the leading provider of technology solutions that promote employee engagement and wellbeing. The GCC program is now known as Virgin Pulse Global Challenge. Part of Sir Richard Branson’s Virgin Group, Virgin Pulse offers a breadth of best-in-class solutions to maximize employee engagement and performance initiatives and drive measurable and positive outcomes for your employees and business.

Prioritising future areas of digital health research into the promotion of physical activity

By Carmen E Lefevre, on 17 November 2016

By: Elpiniki Laiou, Postgraduate Researcher at the Department of Hygiene and Epidemiology of the University of Ioannina Medical School, Greece

Strong evidence shows that physical inactivity is related to many adverse health conditions, leading to shortened life expectancy.1 The widespread diffusion of mobile and Internet technologies make them potentially useful tools for promoting health and tackling physical inactivity, however, further research is needed to understand which technological components and features are likely to result in effective behaviour change interventions.2

The EC DG Research and Innovation invited five FP7 and Horizon 2020 research projects on health enhancing physical activity (PA) to share their experience with other stakeholders, to discuss how to enhance PA, to share best practices and to draw recommendations for policy makers. A workshop was organised by the research project teams themselves (CREDITS4HEALTH, EuroFIT, PASTA, REPOPA, SiTLESS), in collaboration with EC services.  The project teams worked together organizing sessions to explore common themes and to learn from one another, enhancing their own knowledge with insights from their peers.

The CREDITS4HEALTH session aimed to engage the participating PA researchers in identifying and prioritising future areas of research into the promotion of PA.  A five-minute pictorial presentation of current behavioural science knowledge stemming from systematic reviews and meta-analyses of PA behavioural interventions was given to participants as a starting point for discussion.  The presentation was followed by a brainstorming exercise, generating proposed research ideas that were grouped into research themes.  Each participant was then asked to prioritise the proposed research themes they would most like to invest in by allocating a finite budget of points.  Research investment points could be assigned all in one research theme or broken down to multiple themes.

The opening presentation identified a need for further research in the areas of social and psychological mechanisms of motivation and the contexts that are most responsible for changing sedentary behaviours (SB).  For example, there have been calls for further attention to interventions targeting SB and identifying the most effective corresponding behaviour change techniques (BCTs)3.  Furthermore, the ability of online applications such as social media to produce meaningful change in physical activity appears to remain unclear.

The CREDITS4HEALTH session was attended by 11 workshop participants.  The subsequent brainstorming exercise resulted in 41 research ideas that were grouped into 8 research themes and prioritized as follows:

  1. Inequality: Interventions for the most disadvantaged
  2. Cross-Discipline Working: Using mixed methods and multi-disciplinary work
  3. Multiple Level Interventions: Acting on across environment, cognitive behaviour change, and incentives
  4. Understanding (In)activity: Understanding the psychological components of inactivity
  5. Learning from Others: Informing PA interventions from other disciplines and contexts
  6. Personalised Interventions: Tailoring the use of BCTs to individual psychological profiles
  7. Integrating Technical Knowledge: What can technology help us to achieve?
  8. Capturing Research Data: Designing more visual interfaces for research and interventions

Based on the proposed research themes, there appears to be a need for creating more diverse research consortia, seeking to develop a deeper understanding of physical inactivity and multi-disciplinary approaches and to tackle inequality through multi-level interventions. Digital Health approaches to PA promotion might benefit from similar stakeholder engagement exercises and from the formation of multi-discipline consortia, seeking to address inequality and physical inactivity as part of multi-level interventions.


BIO: Elpiniki Laiou is a Postgraduate Researcher at the Department of Hygiene and Epidemiology of the University of Ioannina Medical School, Greece.  She holds a PhD in Public Health and an MSc in Occupational Health from the University of Birmingham, UK.  Her current work involves providing methodological support and conducting research synthesis for the EC funded project CREDITS4HEALTH. The main goal of the project has been to develop an evidence-based, person-centric approach based on finding the optimal incentive scheme to support people living in Euro-Mediterranean Countries in reducing sedentary behavior and enhance their level of physical activity and healthy dietary styles through an ICT platform.  CREDITS4HEALTH has received funding from the European Union’s Seventh Framework Programme (FP7/2007-2013) under grant agreement n° 602386.   



  1. de Rezende LF, Rodrigues Lopes M, Rey-López JP, et al. Sedentary behavior and health outcomes: an overview of systematic reviews. PLoS One. 2014 Aug 21;9(8):e105620
  2. Bardus M, Smith JR, Samaha L, et al. Mobile Phone and Web 2.0 Technologies for weight management: A systematic scoping review.  J Med Internet Res 2015; 17 (11): e259
  3. Martin A, Fitzsimons C, Jepson R, et al.  Interventions with potential to reduce sedentary time in adults: systematic review and meta-analysis.  Br J Sports Med 2015; 49 (16): 1056-63
  4. Williams G, Hamm MP, Shulhan J, et al. Social media interventions for diet and exercise behaviours: a systematic review and meta-analysis of RCTs. BMJ Open. 2014;4(2):e003926
  5. Laiou E, Ntzani E, Holmes C, Schwarzer R, Ngo J, Román-Viñas B,  Kritikou M, Tricholopoulou A, Chitano G, Vigilanza A, Cianferotti L, Brandi ML; on behalf of the Credits4Health Consortium.  Prioritising future areas of research into the promotion of physical activity. Poster presentation. 7th HEPA Europe Conference,   28-30 September 2016, Belfast, Northern Ireland