This first chapter introduces the domain of eHealth and describes the relationship between technology, psychology and healthcare. It provides an overview of current visions of eHealth. A brief description of the changes in healthcare, society, technology and psychology that are related to eHealth is provided. After this fundamental discussion, we continue with how eHealth can be applied in healthcare by explaining three types of eHealth: self-care and prevention, supportive care and societal health. Also, the benefits and barriers of the use of eHealth are demonstrated. Then, the holistic approach towards eHealth is introduced, in which technology, people and their context are intertwined. Finally, principles that are pivotal in good eHealth development are provided.

Abstract Background Although depression is a common comorbidity of rheumatoid arthritis (RA), little is known about a potential treatment strategy. Current studies of dietary improvement for depression have recently emerged in the general population, but have hardly any coverage in RA. Also, less exercise increases the number of people experiencing depression, and current studies showed that most RA patients are physically inactive. Thus, our study aimed to identify the potential factors associated with depression in RA patients. Methods We included 157 RA patients (84.7% female; mean age 56.43±13.9 years; mean disease duration 19.53±9.54 years). All participants completed the General Health Questionnaire - 28, the Visual Analogue Scale Pain, the 36-item Short Form Health Survey, the Physical Activity Scale, and the Food Frequency Questionnaire. Correlations and multiple linear regressions were used to analyse the data. Results Bivariate analyses showed a significant association between disease activity (.25; p ≤ 0.01), functional disability (.22; p ≤ 0.01), pain (.35; p ≤ 0.001), fatigue (-.45; p ≤ 0.001), physical inactivity (-.19; p ≤ 0.05), frequent consumption of fried foods (-.22; p ≤ 0.01) and depression. No other foods were associated with depression in RA. The multiple regression analyses showed that disease activity, fatigue, and fried foods consumption were significantly associated with depression in the final model. However, the association between physical activity and depression was no longer significant using multivariate models. Explained variance in the final regression model was 27.6%. Conclusions It appears that frequent consumption of fried foods is associated with depression in RA when controlled for sociodemographic and clinical variables. Further research on specific dietary habits and underlying mechanisms in the gut-brain axis may help to develop treatment options for the prevention of psychological distress in RA. (Grant: VEGA: 1/0748/22; APVV-15-0719) Key messages • Non-pharmacological intervention for reducing depression should target the patient's diet. • Frequent consumption of fried food may influence depression more significantly than physical inactivity.

BACKGROUND The worldwide increase in community-dwelling people with dementia underscores the need for innovative eHealth technologies that aim to provide support to both patients and their informal caregivers in the home setting. However, sustainable implementation of eHealth technologies within this target group can be difficult. OBJECTIVE The goal of this study was to gain a thorough understanding of why it is often difficult to implement eHealth technologies in practice, even though numerous technologies are designed to support people with dementia and their informal caregivers at home. In particular, our study aimed to (1) provide an overview of technologies that have been used and studied in the context of informal dementia care and (2) explore factors influencing the implementation of these technologies. METHODS Following an umbrella review design, five different databases were searched (PubMed, PsycINFO, Medline, Scopus, and Cochrane) for (systematic) reviews. Among 2205 reviews retrieved, 21 were included in our analysis based on our screening and selection procedure. A combination of deductive and inductive thematic analyses was performed, using the Nonadoption, Abandonment, Scale-Up, Spread, and Sustainability (NASSS) framework for organizing the findings. RESULTS We identified technologies designed to be used “by informal caregivers,” “by people with dementia,” and “with people with dementia.” Within those groups, most of the represented technologies included, respectively: (i) devices for in-home monitoring of lifestyle, health, and safety; (ii) technologies for supporting memory, orientation, and day structure; and (iii) technologies to facilitate communication between the informal caregiver and person with dementia. Most of the identified factors influencing implementation related to the condition of dementia, characteristics of the technology, expected/perceived value of users, and characteristics of the informal caregiver. Considerably less information has been reported on factors related to the implementing organization and technology supplier, wider institutional and sociocultural context of policy and regulations, and continued adaptation of technology over time. CONCLUSIONS Our study offers a comprehensive overview of eHealth technologies in the context of informal dementia care and contributes to gaining a better understanding of a broad range of factors influencing their implementation. Our results uncovered a knowledge gap regarding success factors for implementation related to the organizational and broader context and continuous adaptation over the long term. Although future research is needed, the current findings can help researchers and stakeholders in improving the development and implementation of eHealth technologies to support informal dementia care.

Abstract The increase of People with Dementia (PwD) living at home underscores the need for innovative eHealth technologies that support both patients and informal caregivers (IC). Sustainable implementation of eHealth technologies within this target group can, however, be difficult. Our study aims at providing an overview of (1) technologies employed in the context of informal dementia care (IDC) and (2) factors influencing the implementation of these technologies. Five databases were searched for (systematic) reviews. 21 reviews were included. A combination of deductive and inductive thematic analysis was performed, using the NASSS Framework to organize the findings. We identified technologies used “by IC”, “by PwD” and “with PwD”. Most represented technologies included: (i) devices for in-home monitoring (ii) technologies for supporting memory, orientation, and day structure, and (iii) communication technologies. Most factors influencing implementation related to the condition of dementia, characteristics of the technology, the expected/perceived value by users, and the characteristics of the IC. Considerably less has been reported on factors related to the implementing organization, the technology supplier, the wider institutional and sociocultural context of policy and regulations, and the adaptation of technology over time. Our study 1) created a comprehensive overview of eHealth technologies employed in the context of IDC and contributes to a better understanding of factors influencing their implementation, and 2) uncovered a knowledge gap regarding success factors for implementation related to the wider context. Although future research is needed, these findings can help researchers improving the development and implementation of eHealth technologies to support IDC.

With specially commissioned introductions from international experts, the Psychological Insights for Understanding COVID-19 series draws together previously published chapters on key themes in psychological science that engage with people's unprecedented experience of the pandemic. In this volume on health, Dominika Kwasnicka and Robbert Sanderman introduce chapters that explore the crucial topics of health behaviour change, wellbeing, stress, and coping. They highlight the key role digital health technologies can play in how we manage health conditions, and how we facilitate change to help individuals manage stressful situations such as physical isolation, job loss, and financial strain during the COVID-19 pandemic. The volume also offers an important overview of environmental and policy-based approaches to health behaviour change and addresses the highly relevant issues of identity and trust and how they shape the health of individuals, communities, and society. Highlighting theory and research on these key topics germane to the global pandemic, the Psychological Insights for Understanding COVID-19 series offers thought-provoking reading for professionals, students, academics, and policymakers concerned with psychological consequences of COVID-19 for individuals, families, and society. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Background: Blended face-to-face and web-based treatment is a promising mode to deliver smoking cessation treatment. In an outpatient clinic in a Dutch Hospital effectiveness of a blended treatment (BSCT) was compared to usual face-to-face treatment (F2F). The results from 6 months post-treatment follow-up are presented here. Methods: In this open-label two-arm non-inferiority RCT patients (N=344) of a Dutch outpatient smoking cessation clinic were assigned either to the blended smoking cessation treatment (BSCT, N=167) or a face-to-face treatment with identical ingredients and duration (F2F, N=177). CO-validated point prevalence abstinence at 6 months follow-up, taken shortly after end of treatment was analyzed. Intention-to-treat analyses were performed, retaining missing participants as continuing smokers. Non-inferiority was assessed based on a one-sided margin of five percentage points difference between arms. Additionally, a Bayes Factor was estimated (with a BF>3 supporting non-inferiority, and a <.3 rejecting non-inferiority). Method: At 6 months follow up, 23 BSCT participants (13.8%) and 31 F2F participants (17.5%) were abstinent, with a difference of 3.7% (95%CI: 11.4;-4.0) in favor of F2F. Furthermore, a BF=1.28 was found. Discussion: Based on observed biochemically validated abstinence rates, this RCT suggests that delivering outpatient smoking cessation treatment in a blended mode yields comparable quit rates as full face-to-face treatment mode. However, non-inferiority could not be supported conclusively. Ignoring patient preferences for either of the delivery modes may explain these inconclusive findings.

Aims The objective of this study is to investigate whether type of depressive symptoms (i.e. cognitive-affective or somatic) is related to a patient-perceived need for professional psychological care in individuals with diabetes. Methods In total 2266 participants were recruited as part of the screening procedure for a multi-center randomized controlled trial on the treatment of depressive symptoms among individuals with diabetes. Individuals were invited to complete Beck Depression Inventory-II (BDI-II). Patients with elevated depressive symptoms (BDI-II ≥14) were interviewed about their psychological care need. Based on their care needs patients were categorized into: unmet need, no need, met need and unclear need. These groups were compared on type of depressive symptoms, as categorized into cognitive-affective symptoms and somatic symptoms. Results 568 eligible individuals had elevated depressive symptoms, of whom 519 were reached. Among these depressed individuals, 19.7% (102 of 519) had an unmet need for psychological care. Participants with an unmet need were younger (p<0.001) and had higher total depression scores compared to the group with no need (p<0.001). They also scored higher on cognitive-affective symptoms (p<0.001), whereas somatic symptoms did not significantly differ (p = 0.232). Logistic regression revealed that cognitive-affective symptoms predicted an unmet need (p = 0.001). However, overall predictive capacity of type of depressive symptoms on care needs was weak. Conclusions Cognitive-affective symptoms of depression—but not somatic symptoms—were associated with an unmet need for psychological care among depressed individuals with diabetes. Future research is needed to reveal better predictors explaining the discrepancy between distress and low care needs in order to optimize screening procedures.

AIMS:To investigate the acceptability of two questionnaires, the five item WHO Well-being Index (WHO-5) and the Beck Depression Inventory II (BDI-II), which differ in length and focus, by comparing three screening groups: (1) WHO-5, (2) BDI-II and (3) WHO-5 and BDI-II. METHODS:A total of 699 individuals with diabetes were approached to participate in the study, of whom 95 completed the WHO-5, 254 completed the BDI-II and 350 completed both the WHO-5 and the BDI-II questionnaires. Five facets of acceptability were compared, including objective aspects (response rate and completion level) and subjective aspects (appreciation, agreeableness and accuracy of the screening questionnaire). Data were analysed using logistic regression analysis and (multivariate) analysis of covariance. RESULTS:The overall response rate was 65% (453 out of 699). No differences between the three groups were found with respect to the response rate (WHO-5: 66%; BDI-II: 63%; WHO-5 and BDI-II: 66%; P ≥ 0.19) and completion level (WHO-5: 99.5%; BDI-II: 97.8%; WHO-5 and BDI-II: 98.7%; P=0.45). The three groups did differ significantly in their scores on two of the three subjective indicators (P<0.03), i.e. appreciation (P=0.002) and agreeableness (P=0.035), with those completing only the WHO-5 reporting greater appreciation and agreeableness. CONCLUSIONS:A brief well-being questionnaire, such as the WHO-5, results in greater appreciation of mood screening and appreciation of completing the questionnaire, but this does not result in a better response rate and higher questionnaire completion. Given these results, either or both questionnaires can be used to screen for depressive symptoms in people with diabetes in clinical practice.

This study aimed to (1) identify benefit finding trajectories in cancer patients receiving psychological care; (2) examine associations of benefit finding trajectories with levels of and changes in psychological symptoms; and (3) examine whether socio-demographic and medical characteristics distinguished trajectories. Naturalistic longitudinal study design. Participants were 241 cancer patients receiving psychological care at specialized psycho-oncological institutions in the Netherlands. Data were collected before starting psychological care, and three and 9 months thereafter. Latent class growth analysis was performed to identify benefit finding trajectories. Five benefit finding trajectories were identified: ‘high level-stable’ (8%), ‘very low level-small increase’ (16%), ‘low level-small increase’ (39%), ‘low level-large increase’ (9%), and ‘moderate level-stable’ (28%). People in distinct benefit finding trajectories reported significant differential courses of depression but not of anxiety symptoms. Compared with the other four trajectories, people in the ‘low level-large increase’ trajectory reported the largest decreases in depression over time. Perceptions of cancer prognosis distinguished these trajectories, such that people with a favourable prognosis were more likely to belong to the ‘high level-stable’ trajectory, while people perceiving an uncertain prognosis were more likely to belong to the ‘low level-large increase’ trajectory of benefit finding. Cancer patients showed distinct benefit finding trajectories during psychological care. A small proportion reporting a large increase in benefit finding were also most likely to show decreases in depressive symptoms over time. These findings suggest a relation between perceiving benefits from cancer experience and improved psychological functioning in cancer patients receiving psychological care. What is already known on this subject? What does this study add?

The Minimal Clinically Important Difference (MCID) assesses what change on a measurement tool can be considered minimal clinically relevant. Although the recall period can influence questionnaire scores, it is unclear if it influences the MCID. This study is the first to examine longitudinally the impact of the recall period of an anchor question and its design on the MCID of COPD health status tools using the COPD Assessment Test (CAT), Clinical COPD Questionnaire (CCQ) and the St. George’s Respiratory Questionnaire (SGRQ).

-Social support is supposed to have a beneficial effect on the health and wellbeing of people. It is a central concept in the 'EUropean Research on Incapacitating Dlseaes and Social Support' (EURIDISS). In general, two main distinctions concerning social support are made in the literature, providing four basic dimensions or types of social support: a social-emotional vs an instrumental type of social support, and a "crisis" or "problem-oriented' vs "everyday' or "daily" type of social support. Based on these types of social support, a series of items were formulated to measure actual supportive interactions or exchanges of resources. The items were spread over five scales. The social-emotional type of social support comprised three scales: daily emotional support; problem-oriented emotional support; and social companionship, while the instrumental type of social support consisted of two scales: the daily instrumental support and the problem-oriented instrumental support. Together, these items and scales constitute the so-called 'Social Support Questionnaire for Transactions' (SSQT).The main objective of this paper is to investigate whether one and the same instrument, i.e. the SSQT, allows for meaningful comparisons between patients with rheumatoid arthritis from different countries. More specifically, the dimensionality and invariance of the dimensions across countries of the SSQT are explored. To this end, patients from four different European countries (France, Norway, The Netherlands and Sweden) were asked to fill in the SSQT.The analysis of the data using principal component analysis (PCA) and simultaneous component analysis (SCA), did yield the intended scales, although the internal consistency of one of them, the daily instrumental support scale, is questionable. It is concluded that, particularly in the area of social-emotional support, the SSQT is a useful instrument for international comparative research. Key words--rheumatoid arthritis, social support, SSQT

The instrument of scientific publishing, originally a necessary tool to enable development of a global science, has evolved relatively little in response to technological advances. Current scientific publishing practices incentivize a number of harmful approaches to research. Health Psychology Bulletin was founded to address these issues. Health Psychology Bulletin (HPB) is a new open access journal that actively promotes full disclosure through publication of replication and analysis packages and that explicitly welcomes null findings, reports of failed manipulation, replications, as well as regular contributions. HPB strives to publish all conducted studies in a manner that maximizes the potential lessons that can be learned, fostering a shift from a competitive to a collaborative model of science. HPB also implements a double blind peer reviewing procedure that is unblinded and citable once an article is accepted, and HPB will strive to enable post-publication peer reviews. Finally, HPB offers authors the possibility to submit (and publish) their introductions, methods, study protocols and replication packages before data collection, thereby benefiting from the peer review process in optimization of their methodologies. By implementing these innovations, HPB aims to contribute to remedying a number of problems that have recently been identified in the way health psychology science is conducted. In addition, the European Health Psychology Society aims to offer a new accessible, affordable, and flexible outlet to her members (and non-member health psychology researchers).

Smoking cessation can significantly reduce the risk of developing smoking-related diseases. Several face-to-face and web-based treatments have shown to be effective. Blending of web-based and face-to-face treatment is expected to improve smoking cessation treatment. The primary objective of this study is to compare the prolonged abstinence rate of the blended smoking cessation treatment with the face-to-face treatment. Secondary objectives are to assess the benefits of blended treatment in terms of cost effectiveness and patient satisfaction, and to identify mechanisms underlying successful smoking cessation.

Objectives To assess employment status, difficulties at work and sick leave in inflammatory bowel disease (IBD) patients and their relation with sociodemographic and clinical factors, quality of life (QoL), and anxiety and depression. Materials and methods IBD patients attending an IBD outpatients’ clinic received self-report questionnaires on employment status, IBD-related difficulties at work and sick leave (Trimbos/iMTA questionnaire for Costs associated with Psychiatric Illness), sociodemographic factors, QoL (Inflammatory Bowel Disease Questionnaire and 12-item Short-form Health Survey) and anxiety and depression (Hospital Anxiety and Depression Scale). Disease activity was assessed by their gastroenterologist. Associations between paid employment and sick leave with sociodemographic and clinical factors, QoL and anxiety and depression were assessed by regression analyses. Results In total, 202 IBD patients of working age, with a mean age of 41 years, participated; 63% had Crohn’s disease and 37% had ulcerative colitis, and 57% were women and 19% had active disease. In all, 123 (61%) patients were in paid employment, of whom 31 (25%) were on sick leave, whereas 46 (23%) received a disability pension. Concentration problems (72%), low working pace (78%) and delayed work production (50%) were the most prevalent IBD-related work difficulties. IBD patients without paid employment were older and more often women, with active disease, lower QoL and higher anxiety and depression rates. Sick leave was associated with lower QoL and higher anxiety and depression rates. Conclusion More than half of IBD patients were in paid employment, whereas almost a quarter was receiving a disability pension. A large majority experienced work difficulties. Having no paid employment was associated with poorer QoL and more anxiety and depression symptomatology.