Motivational cues as real-time feedback for changing daily activity behavior of patients with COPD

Objective: To investigate how COPD patients respond to motivational cues that aim to improve activity behavior and how these responses are related to cue- and context characteristics. In addition, to explore whether activity can be increased and better distributed over the day by providing such cues. Methods: Fifteen COPD patients participated. Patients used an activity sensor with a smartphone for four weeks, at least four days/week. Patients received motivational cues every two hours with advice on how to improve their activity, on top of real-time visual feedback. The response was calculated by the amount of activity 30 minutes before and after a cue. Results: In total, 1488 cues were generated. The amount of activity significantly decreased in the 30 min after a discouraging cue (p<0.001) and significantly increased (p<0.05) in the 10 min after an encouraging cue. The activity level increased with 13% in the intervention period compared to corrected baseline (p=0.008). The activity was not more balanced over the day. Conclusions: COPD patients significantly change their activity level in response to motivational cues, based on continuous ambulatory assessment of activity levels. Practice implications: Motivational cues could be a valuable component of telemedicine interventions that aim to improve activity behavior.