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Supportive accountability: a model for providing human support to enhance to eHealth interventions

14 important questions on Supportive accountability: a model for providing human support to enhance to eHealth interventions

What are the factors that are associated with adherence?

1. Accountability
2. Bond

What factors build up to accountability? (4)

1. Social presence
2. Expectations
3. Performance monitoring
4. Legitimacy

How do expectations relate to accountability/adherence? (4)

1. Understanding and agreement with the underlying rationale for the expected behavior brings across a better compliance
2. It is better to focus on process accountability than outcome accountability (desire to perform better without respect to the tools and control)
3. Rigid adherence goals may reduce helpful behavior change outside of rigid adherence goals
4. Defensive bolstering can be induced by expectations of having to justify

What are the forms of social presence and how does this influence outcomes?

It can take place in-person/online and (a)synchronous. It enhances adherence to a greater degree than automated systems.

Why is it better to focus on process accountability than on outcome accountability?

Attributed to the effect it has on increasing a desire among people to perform better without respect to the control and tools that could be used to accomplish the goals

What is the effect of rigid adherence goals and how can this be tackled?

They may reduce helpful behavior change outside of the narrowly focussed goals. Goals attached to the patient's larger goals and values may avoid these iatrogenic effects

How can defensive bolstering induced by a fear of having to justify be avoided? (2)

1. It is important to be clear about the accountability process
2. When expectations of an individual's roles have been clearly articulated and agreed upon in advance, people are more likely to engage in pre-emptive self-examination.

Where does legitimacy seem to stem from?

Patients' perceptions about the coach, dictate that the patient will voluntarily accept the influence of the coach even in the absence of other extrinsic inducements. This is influenced by both instrumental and relational factors.

What instrumental factors influence legitimacy? (2)

1. Expertise (demonstration of knowledge or degrees/certifications)
2. Reciprocity (defined patient & coach role)

What relational factors influence legitimacy? (3)

1. Trustworthiness
2. Benevolence
3. Not undermining autonomy

How can legitimacy be created and sustained? (2)

1. Created through a website: source, design, and names of associated people.
2. Sustained through meeting agreed-upon expectations or by interacting in ways that consistently convey caring and expertise.

What are the differences between alliance (bond) and legitimacy? (2)

1. They do not rely on the same relational/instrumental factors
2. Legitimacy does not necessarily include liking or bond (but: an important predictor in outcomes and emotional attachment captured by alliances likely moderates effects of legitimacy)

What is a surprising finding about lean media and what are explanations for this? (1 + 3)

With time, people are able to develop communications that are effective and emotionally/relationally rich.

1. Early in interactions people usually make more positive, idealized attributions of their communication partners. This effect is heightened when there is an expectation of future contact.
2. In general, people tend to be more willing to engage in socioemotional communication in text-based media (more self-disclosure, less superficial, higher communicational effectiveness)
3. People make more use of remaining cues/strategies: they are quite adaptive in creating new strategies.

What is the difference in how messages during night and day come across?

Task-oriented mails sent at night tend to be perceived as expressing dominancy, while personal messages sent during the day tend to be perceives as expressing affections (but: longer delays express a lack of affection)

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Compassionate Technology

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Supportive accountability: a model for providing human support to enhance to eHealth interventions

14 important questions on Supportive accountability: a model for providing human support to enhance to eHealth interventions

What are the factors that are associated with adherence?

What factors build up to accountability? (4)

How do expectations relate to accountability/adherence? (4)

What are the forms of social presence and how does this influence outcomes?

Why is it better to focus on process accountability than on outcome accountability?

What is the effect of rigid adherence goals and how can this be tackled?

How can defensive bolstering induced by a fear of having to justify be avoided? (2)

Where does legitimacy seem to stem from?

What instrumental factors influence legitimacy? (2)

What relational factors influence legitimacy? (3)

How can legitimacy be created and sustained? (2)

What are the differences between alliance (bond) and legitimacy? (2)

What is a surprising finding about lean media and what are explanations for this? (1 + 3)

What is the difference in how messages during night and day come across?

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