The Journey to Improving Health  

Tracking our behaviors has been directly linked to an improvement in health outcomes (1) and we are keen for you and your clients to have this facility at your fingertips. Soon we will be launching an app to provide you with instant access to all your food sensitivity reports. Feedback to your clients will be quick, accessible, and visually appealing. Your client has the facility to track their symptoms daily and chart their progress at the click of a button.  

Benefits of Tracking 

Tracking is a process that requires active, personal involvement. Keeping clients hopeful, interested, and focused. Once they have discerned that progress is being made it will help them sustain the challenging work required for real change.  

According to Trial Facts (2) almost 100% of internet users aged from 18 to 49 search for health information online, so as practitioners we are presented with the constant challenge of both keeping abreast of research and keeping in real-time contact with our clients.  

How many of us currently use tracking techniques to improve our patient’s health outcomes? In 2013 The Pew Research Centre ran a project (PIP) to examine the effects of self-tracking behaviours on personal health management (1).   

They discovered that 69% of US adults track their health, monitoring either health symptoms such as pain or frequency of headache, or their weight, their exercise routine, or their diet. Of those that track, half keep a score “in their heads,” one third keep written notes and one in five use technology such as an app on a smartphone. The report highlighted that routine self-tracking, as opposed to occasional, event-triggering tracking is more likely to result in positive changes to health management approaches.   

Self-regulation and Self-responsibility  

It may be interesting to ask your clients which, if any, tracking methods they currently use. It may provide information on their aims and their personal commitment to change. The Pip research suggests that if you perceive your health to be worsening then you are more likely to engage in routine self-tracking activities, and if you have had a recent Accident and Emergency visit then you will demonstrate higher rates of self-tracking as you became more vigilant with your health (1).  

Our self-discipline and self-regulation ‘muscles’ increasingly require constant flexing as we resist temptation at every turn to eat ‘fast’ and cheaply to fuel our day, and to ‘rest’ in front of devices rather than seek distraction in physical or social activity. We have all become familiar with real-time, portable devices to help motivate us individually. Devices such as Fitbits, Garmin, and Apple watches to record our daily physical activity. While considering a device, we should ask ourselves and our clients what we need as individuals. Are we looking to increase performance, or are we pursuing a goal, or working on our resilience, or are we focused on medical relapse prevention?   

Motivation means to be moved into action, and if our motivations vary within each of us at various times, what is the push of a motive or the pull of an incentive goal towards a desired end state for each of us? As Henry Ford  said, ‘whether you think you can, or think you can’t, you’re right’.  

Embracing Technology for Health Tracking   

Consider weight loss as a real time goal for many. A recently published study (3) successfully used a mobile app to challenge dietary perceptions surrounding time- restricted eating and weight change. It provided evidence that the frequency and size of meals was a stronger determinant of weight loss or gain than the time between the first and last meal. The total number of daily large meals were associated with increased weight over the six-year follow up, and fewer smaller meals were associated with decreased weight. It revealed that shorter times between waking and the first meal, and longer times between the last meal and sleep appeared to correlate with less weight increase. Would this information motivate you or your clients to eat less at meals, to always have a meal close to waking and to eat as early as possible in the evening if weight loss is the goal?  

 Longitudinal surveys, using personal tracking, can highlight important behavioural trends such as a research paper which asked participating adults with type 1 and type 2 diabetes mellitus to record their dietary, physical activity and sleeping behaviour during the Covid pandemic (4). It revealed interesting trends providing evidence for potential future interventions, such as those with type 2 diabetes making a less conscious effort to get outside and exercise daily, consuming more convenience foods, but drinking less alcohol.  

Tracking supports adherence to medical protocols and is highly relevant in all areas of the health industry with research successfully supporting its value alongside smoking cessation, (5) weight loss (6), women’s health (7), sleep (8) and  habitual, damaging behaviours such as scratching (9,10), with varying levels of success depending on the condition and the degree of patient compliance.   

Of critical value, tracking encourages a necessary shift towards self-regulation and self-responsibility (11,12) by creating awareness of personal habits and routines that may be beneficial or detrimental to health. Awareness is the first step to any change as the process of self-reflection is initiated. This awareness is part of the client’s journey to improved health.  Longer-term reflection allows for patterns of behaviour to be identified and the potential for change to be explored, as the client makes the psychological shift from health quest mode to persistent and beneficial behaviours for life.  

Taking Control of Your Health Journey 

 Self-measurement techniques have long been a part of medical practice in both therapy and diagnostics so where does the use of our app fit in? The idea is that it will further encourage patient empowerment due to active participation and a sense of taking control of their health journey, helping them to follow their IgG guided elimination diet.    The physical and psychological rewards of active patient participation in their own care cannot be overestimated (13)  and technology platforms such as apps can play an important role, particularly in supporting long-term behavioural change. Keep an eye out for the launch!  

References in full 

1. Fox et al.  Tracking for Health. PEW RESEARCH CENTERJANUARY 28, 2013. https://www.pewresearch.org/internet/2013/01/28/tracking-for-health/  
    
2. Finney Rutten LJ, Blake KD, Greenberg-Worisek AJ, Allen SV, Moser RP, Hesse BW. Online Health Information Seeking Among US Adults: Measuring Progress Toward a Healthy People 2020 Objective. Public Health Rep. 2019 Nov/Dec;134(6):617-625. doi: 10.1177/0033354919874074. Epub 2019 Sep 12. PMID: 31513756; PMCID: PMC6832079.  
    
3. Bennett. W, et al, 2013.Association of Eating and Sleeping Intervals With Weight Change Over Time: The Daily24 Cohort. published18 Jan 2023. https://doi.org/10.1161/JAHA.122.026484Journal of the American Heart Association. 2023;12: e026484 
    
4. Summers C, Lima Do Vale M, Haines L, Armes S, Bradfield J, Crocombe D, Ray S. A web-based survey assessing perceived changes in diet, physical activity and sleeping behaviours in adults with type 1 and type 2 diabetes during the COVID-19 pandemic in the UK. BMJ Nutr Prev Health. 2022 Jul 19;5(2):137-144. doi: 10.1136/bmjnph-2021-000391. PMID: 36619338; PMCID: PMC9813628. 
    
5. Michie S, Kotz D, van Schayck OC, Selladurai A, West R. Characterising smoking cessation smartphone applications in terms of behaviour change techniques, engagement and ease-of-use features. Transl Behav Med. 2016;6(3):410-417. doi:10.1007/s13142-015-0352-x  
    
6.  Laing BY, Mangione CM, Tseng CH, et al. Effectiveness of a smartphone application for weight loss compared with usual care in overweight primary care patients: a randomized, controlled trial. Ann Intern Med. 2014;161(10 Suppl): S5-S12. doi:10.7326/M13-3005  
    
7. Hayman, Melanie et al. “Quality, Features, and Presence of Behavior Change Techniques in Mobile Apps Designed to Improve Physical Activity in Pregnant Women: Systematic Search and Content Analysis.” JMIR mHealth and uHealth vol. 9,4 e23649. 7 Apr. 2021, doi:10.2196/23649  
    
8. Walch Olivia J., Cochran Amy, Forger Daniel B. A global quantification of “normal” sleep schedules using smartphone data. Science Advances. 2016;2(5): e1501705.  
    
9. Melin L, Frederiksen T, Noren P, Swebilius BG. Behavioural treatment of scratching in patients with atopic dermatitis. Br J Dermatol. 1986 Oct;115(4):467-74. doi: 10.1111/j.1365-2133.1986.tb06241.x. PMID: 3778815.  
    
10. Norén P, Hagströmer L, Alimohammadi M, Melin L. The positive effects of habit reversal treatment of scratching in children with atopic dermatitis: a randomized controlled study. Br J Dermatol. 2018 Mar;178(3):665-673. doi: 10.1111/bjd.16009. Epub 2018 Jan 24. PMID: 28940213. 
     
11. Khan, M. and Maes, P. (2021) ‘Tracking Diverse Feelings and Activities Encourages Self-guided Holistic Behavior Change’, Asian CHI Symposium 2021. doi: 10.1145/3429360.3468190.  
     
12. Funer, F. (2021) ‘On the way to the digital homo vitruvianus? Medical self-tracking and digital health applications (DiGA) between empowerment and loss of control/Auf dem Weg zum digitalen homo vitruvianus? Medizinisches Selftracking und digitale Gesundheitsanwendungen (DiGA) zwischen Empowerment und Kontrollverlust’, Ethik in der Medizin, 33(1), p. 13. doi: 10.1007/s00481-020-00602-1.  
     
13. Sarasohn-Kahn et al, A Role for Patients: The Argument for Self-Care. American Journal of Preventive Medicine.  Volume 44, Issue 1, Supplement 1, January 2013, Pages S16-S18. https://doi.org/10.1016/j.amepre.2012.09.019