Universiteit Leiden

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Research project

We all BENEFIT: The Ecosystem for Healthy Living

The modification of risk factors and related health behaviors lies at the very core of adequate cardiovascular risk management, yet evidence shows that the majority of people with cardiovascular disease (CVD) fail to achieve a healthy lifestyle in the long term. The main objective of this project is to ensure that by 2022, the BENEFIT program forms an attractive, effective, and accessible supplement to rehabilitation that will help CVD patients to maintain a healthy lifestyle (c.f., DHF).

Andrea Evers
The Dutch Heart Foundation
ZonMw ZonMw

Cardiologists, neurologists, general practitioners, academics, entrepreneurs, and patients have joined forces. Our mission is to make healthy living fun. Rather than telling people how to behave, we make healthy lifestyle choices appealing: the carrot is mightier than the stick. We envisage a national ecosystem that combines evidence-based lifestyle interventions focused on the individual, with an innovative environmental system that incorporates rewarding everyday lifestyle and adherence behaviors. The ecosystem integrates care and non-care settings, connects public and private lifestyle partners, is financially sustainable, and is fueled by continuous scientific evaluation. We all BENEFIT!

The BENEFIT project is divided into five research projects:

1. Lifestyle change at the level of the individual
Extensive research supports the efficacy of cognitive-behavioral approaches in individual lifestyle programs for improving physical and mental outcomes across a range of emotional, psychiatric, and somatic conditions. This project focuses on the agile development, rollout, and evaluation of a digital platform which includes these evidence-based lifestyle maintenance strategies. Important tasks include evaluating the effect of different forms of automated and personal coaching on lifestyle maintenance, and tailoring the platform to preferences of different user groups.

Supervisors Leiden University: prof. dr. Andrea Evers, dr. Veronica Janssen, Mike Keesman and prof. dr. Douwe Atsma (LUMC)
PhD candidate: Talia Cohen Rodrigues

2. Lifestyle change at the environmental level
Reward-based reinforcement is a much-researched learning theory strategy to promote behavior change. Its effectiveness was originally proven in the treatment of substance abuse disorders. Since then, incentive-based interventions have been successfully applied to other areas of behavior change, ranging from smoking cessation and physical exercise to counseling attendance and medication adherence This project focuses on the agile development, rollout, and evaluation of the reward-based system of the BENEFIT program. Important tasks include determining the most efficient reward structure, conducting research on game principles, and testing the effect of the reward program on lifestyle maintenance.

Supervisors Leiden University: prof. dr. Andrea Evers, dr. Veronica Janssen, Mike Keesman and H. Kemps, MD PhD (MMC)
PhD candidate: David de Buisonjé

3. Data science
In the BENEFIT project we will receive three major streams of data that need merging (1) lifestyle and risk factor assessments collected as part of standard care, (2) lifestyle questionnaire data and digital platform log data collected for research purposes, and (3) show/no show health appointment data and wearable technology data on the basis of which BENEFIT loyalty points will be allocated. This project facilitates the other WPs and targets the definition of the (clinical) data set, and technological issues, such as data management, data storage and infrastructure. Important tasks include devising an infrastructure for data collection and storage, facilitating data sharing between systems, aggregating data, and FAIR data management.

Leiden University: prof. dr. Andrea Evers, dr. Veronica Janssen, prof. dr. Wessel Kraaij, Mike Keesman and prof. dr. Douwe Atsma (LUMC)

4. Implementation science
Combined, our implementation partners are treating hundreds of thousands of people with a (high risk of) developing cardiovascular disease. A major strength of our consortium is that both primary, secondary, and public health care partners have joined forces. This project focuses on the conditions of sustainable implementation. Important tasks include identifying determinants for dissemination and upscaling of the program, identifying conditions for continuity of secondary and primary prevention care, development of tailored implementation strategies, and process evaluation of implementation.

Supervisors Leiden University: prof. dr. Andrea Evers, dr. Veronica Janssen, Mike Keesman and prof. dr. W. Scholte op Reimer (AMC-UvA)
PhD candidate: Renée IJzerman

5. Value-based development
The CeHRes-Roadmap for user-centered and stakeholder-driven development and evaluation of e-health interventions is used as a guiding framework for the development and refinement of elements of the digital platform and the reward system. The CeHRes-Roadmap is an evidence-based method that reflects a participatory design process, in which representative stakeholders (e.g. patients, patient organizations, primary care practices, hospitals, rehabilitation centers, health insurers, business partners) participate in all stages of development and evaluation of the BENEFIT program. This project focuses on co-creation and evaluation with stakeholders and end-users, business modeling, and strategic acquisitions. Furthermore, the cost-effectiveness and the real-time use of the digital platform will be evaluated (process analysis).

Leiden University: prof. dr. Andrea Evers, dr. Veronica Janssen, Mike Keesman and 
University of Twente: prof. dr. Lisette van Gemert-Pijnen, dr. Floor Sieverink, and dr. Jobke Wentzel

This research program is part of the Research Group Psychoneurobiology of Health and Disease (www.andreaevers.nl) and is conducted in collaboration with the co-executors Vital10 and the Leiden University Medical Center. Both public and private partners contribute to the BENEFIT consortium, which includes many significant players in health care, academia and industry in the Netherlands.

Do you want to learn more about the BENEFIT program and get to follow the latest news and publications in the field? Click here for the BENEFIT website.

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