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Bucharest, 17 June 2016dr. Tom Van Daele
WEARABLES FOR THE WORKFORCEHYPE OR HELP?
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GREETINGS FROM ANTWERP
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• www.menti.com
GETTING TO KNOW YOU
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• code 78 88 44
WHAT TO EXPECT THIS AFTERNOON?
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• challenges for EAPs
• stress
• mHealth & wearables− research
− limitations
− conclusion
• carewear - the near future
• discussion
CHALLENGES FOR EAPS
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• break through stigma associated with making use of EAPs
• increase usage of EAPs within organizations
• optimizing available data and provide meaningful analytics on organisations to relevant stakeholders (e.g. CEOs)
• tailor programs to the needs of individual employees
Harlow (1998), Yu et al. (2009)
theoretical background based on Van den Bergh (2016)
STRESS – CONCEPT
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stress
• homegenous?
− integration of different proceses
− clear and stable cohesion
− similar for everyone
− different measurement reflect being ‘under strain’
− and are concordant: all measurment tell you exactly thesame
STRESS – CONCEPT
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STRESS – CONCEPT
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stress
• heterogeneous!
− orchestrested action tendency
− chosen action tendency determines cohesion
− depends both on both individual and situation
− different measurements = different strategies & tactics
− discordance: measurements each tell a different story
STRESS – CONCEPT
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stressphysiology
‘motor preparation’
verbal
affective / feeling
behaviour
attention, impact on
working memory
STRESS – CONCEPT
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• physiology− does not necessarily represent emotions
− aims to support action & behaviour
• it reflects− strategies & tactics
− that are context dependent
→ only to some extent useful for deriving ‘stress’
STRESS – CONCEPT
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• need for multisystem measurements to get the full picture− psychophysiology faces many confounding factors
− self-report not always useful to determine stress-relevance
• “decoupling of subsystems in stress/emotion”− “feeling changes without concomitant autonomic changes”
− “autonomic changes without concomitant feeling changes”
Kreibig (2010)
STRESS – CHALLENGE 1
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• activation ≠ stress
• emotionally− challenge ↔ threat
• energy− OK during task ↔ OK during task
− stops after task ↔ prior and afterwords
• end result− satisfaction ↔ frustration, depression, anxiety
STRESS – CHALLENGE 2
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STRESS – CHALLENGE 2
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Wilhelm et al. (2010)
STRESS – CHALLENGE 2
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McEwen (2007)
STRESS – CHALLENGE 3
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McEwen, 2007
McEwen (2007)
STRESS – CHALLENGE 3
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McEwen, 2007
MHEALTH – WEARABLES
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“mobile computing, medical sensor, and communications technologies”
Istepanian, Jovanov, & Ehang (2004)
MHEALTH – WEARABLES
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MHEALTH – WEARABLES
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• wearables
− the whole range of sensors, and devices that can be wornby a user
− with the aim to collect physiological data in a manner thatis reliable but also as non-invasive as possible
MHEALTH – WEARABLES
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MHEALTH – WEARABLES
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physiological …
• electrocardiogram
• electro-encephalogram
• heart rythm variability
• breathing frequency
• skin conductance
but also
• movement
• temperature
• images
MHEALTH – WEARABLES
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• quantified self – movement
• “using data to monitor andimprove everyday life”
• narrative clip as an exampleof a non-physiologicalwearable
Swan (2013)
WEARABLES – RESEARCH
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WEARABLES – RESEARCH
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• wearables already have been playing a role in scientific psychological research for over a decade.
• examples of a number of studies can provide anindication of what might be possible for practice.
WEARABLES – RESEARCH
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• accelerometer
− National Health & Nutrition Examination Study
− physical activity of 4000 adults
− effect on symptoms of depression
− at least 3 days a week moderately intense physical activitywas related to a 28 percent chance of reduction in thedevelopment of depressive symptoms
Song, Lee, Baek, & Miller (2012)
WEARABLES – RESEARCH
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• heart rythm variability
− stress reduction using a smartphone
− for students of higher education
− who received CBT-techniques in stressful situations
− combined with breathing visualisation
− actual effect however insufficiently evaluated
Morris & Guilak (2009)
• skin conductance
− non-interventional approach
− making a distinction between relaxed & stressful situations& tasks
− staying relaxed vs. mathematical operations vs. breathingdeeply vs. reading as fast as possible
Villarejo, Zapirain, & Zorrilla (2012)
WEARABLES – RESEARCH
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WEARABLES – RESEARCH
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• activity detection
− several mental health problems involve physical activity or physical behaviour
− ADHD, schizophrenia, major depression, bipolar disorder
Van Laerhoven (2015)
WEARABLES – RESEARCH
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• long term monitoring far better than 1 shot
− white coat hypertension: 10% of patients have high blood pressure when visiting their GP, but not in everyday life and receiving unnecessary medication
− when observed in lab settings, people brush their teeth on average for 2 minutes. At home only half that time.
WEARABLES – RESEARCH
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WEARABLES – RESEARCH
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• state-of-the art
− capacity available for reliable and valid measurement
− limited for intervention
− mainly academic or not validated for practice
WEARABLES – LIMITATIONS
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WEARABLES – LIMITATIONS
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• technology
1. quality of data highly different dependent on wearables used
• vast progress in recent yearse.g. energy expenditure
WEARABLES – LIMITATIONS
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WEARABLES – LIMITATIONS
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• technology
2. big data
• eye on the bigger picture
• intra- en interindividual differences
WEARABLES – LIMITATIONS
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• technology
3. need for software development
• both for data visualization & analysis
• and for end-user feedback
4. ‘translating’ to create added value for clinical practice
• practiceprofessionals not yet sufficiently familiar
1. technique
• how to use wearable valid & reliably
• being flexible with both hardware & software
2. content
• knowledge of neuropsychology & physiology
• practical use and interpretation of data
WEARABLES – LIMITATIONS
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WEARABLES - CONCLUSION
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• simplification, but still, good prospects ahead
• evolution towards less invasive & multimodaldevices
• can be a part of a better, more effective service
• may help to tackle major workplace and MHC challenges
CAREWEAR
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CAREWEAR – GOAL
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wearables as usefultools for practice
as a part of EAPs in clinical contexts
CAREWEAR – TEAM
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CAREWEAR – PARTNERS
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CAREWEAR – BURN-OUT
45Carewear
CAREWEAR – BURN-OUT
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• preventive screening and ongoing support
− aimed at employees looking to gain insights in their stress-related complaints
− moving beyond self-report → wearable
CAREWEAR – BURN-OUT
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• preventive screening and ongoing support
− following initial screening , counselor makes an assessment
1. continued support in group sessions or individually
2. personalised exercices
− wearable optionally in follow-up for
1. monitoring
2. tailored feedback
CAREWEAR – FIRST WIREFRAMES
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• www.menti.com
THE VERDICT
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• code 78 88 44
ONE MORE THING - EDX.ORG
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• Trends in e-Psychology MOOC
REFERENCES
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• Freeman, L. M. Y., & Gil, K. M. (2004). Daily stress, coping, and dietary restraint in binge eating. International Journal of Eating Disorders, 36, 204-212.
• Harlow, K. C. (1998). Employee attitudes toward an internal employee assistance program. Journal of Employment Counseling, 35(3), 141.
• Istepanian, R. S., Jovanov, E., & Zhang, Y. T. (2004). Guest editorial introduction to the special section on m-health: Beyond seamless mobility and global wireless health-care connectivity. IEEE Transactions on Information Technology in Biomedicine, 8, 405-414.
• Kreibig, S. D. (2010). Autonomic nervous system activity in emotion: A review.Biological psychology, 84(3), 394-421.
• McEwen, B. S. (2007). Physiology and neurobiology of stress and adaptation: central role of the brain. Physiological reviews, 87(3), 873-904.
• Meuret, A. E., Rosenfield, D., Wilhelm, F. H., Zhou, E., Conrad, A., Ritz, T., & Roth, W. T. (2011). Do unexpected panic attacks occur spontaneously? Biological psychiatry, 70, 985-991.
• Morris, M., & Guilak, F. (2009). Mobile Heart Health: Project Highlight. IEEE Pervasive Computing, 8(2), 57-61. doi:10.1109/MPRV.2009.31
• Song, M. R., Lee, Y.-S., Baek, J.-D., & Miller, M. (2012). Physical Activity Status in Adults with Depression in the National Health and Nutrition Examination Survey, 2005–2006. Public Health Nursing, 29, 208–217. doi: 10.1111/j.1525-1446.2011.00986.x
• Swan, M. (2013). The quantified self: Fundamental disruption in big data science and biological discovery. Big Data, 1(2), 85-99.
• Van den Bergh, O. (2016). Stress. Is meten weten? [PowerPoint slides]. Retrieved from http://carewear.be/wp-content/uploads/2016/02/1-Keynote-1-Stress-Is-meten-weten.pdf
• Van Laerhoven, K. (2016). Towards detecting activity in long-term wearable deployments [PowerPoint slides]. http://carewear.be/wp-content/uploads/2016/02/3-Keynote-2bis-Towards-detecting-activity-in-long-term-wearable-deployments.pdf
• Villarejo, M. V., Zapirain, B. G., & Zorrilla, A. M. (2012). A stress sensor based on Galvanic Skin Response (GSR) controlled by ZigBee. Sensors, 12, 6075-6101.
• Wilhelm, F. H., & Grossman, P. (2010). Emotions beyond the laboratory: Theoretical fundaments, study design, and analytic strategies for advanced ambulatory assessment. Biological psychology, 84(3), 552-569.
• Yu, M. C., Lin, C. C., & Hsu, S. Y. (2009). Stressors and burnout: The role of employee assistance programs and self-efficacy. Social Behavior and Personality: an international journal, 37(3), 365-377.
