Darcy Ummels

130 | Chapter 6 period, they set their own physical activity goals, often to 10,000 steps per day. They argued that this goal is often communicated in society as a healthy number of steps per day, but it was hard to reach and when they did not use the activity trackers, they relapsed into their old behavior. Reasons mentioned by the therapists why patients did not manage their physical activity goals or altered their goals were, among others, that patients were not ready for a behavioral change or the intervention period was too short. Therefore, they decided to expand the intervention period to a minimum of three weeks instead of the suggested one or two weeks in the draft manual and to tailor the physical activity goal of the activity tracker more to goals on participation level (e.g., increase step count to be able to walk with friends). This was altered in both the manual and flowchart. ‘We lowered the goal but in some way it didn’t feel right. I just couldn’t do it, I couldn’t manage to take some rest, being active is part of my lifestyle.’ Patient 11, female, 35 years (semi ‐ structured interview) ‘People were very goal ‐ oriented and kept walking to reach their goal, but they lost motivation because they got bored, but if they do something they liked it to easily reach 4,000 or 5,000 steps.’ PS Therapist 2 (reflection session) Discussion This study aimed to support healthcare professionals and patients with embedding an activity tracker in the daily clinical practice of a specialized mental healthcare center. It also aimed to gain knowledge about the implementation process of an activity tracker in clinical practice. In order to do so, an action research design was used. Both healthcare professionals and patients were positive about the use of activity trackers and experienced it as an added value in therapy. The action research approach with multiple iterations supported the learning and reflection process of the therapists on their own behavior and in learning from and with each other. In this way, they were able to discover the opportunities of the activity tracker within their context. In actuality, the support of the researchers during the reflection sessions was needed to achieve sufficient depth. The therapists were able to embed the MISS Activity in daily clinical practice using the pain functioning model as a theoretical framework. They formulated specific exclusion criteria for patients, adapted the flowchart on when to use the activity tracker and with which assessment and intervention goals, used the activity tracker to support identifying coping mechanism, and formulated guidance on how to discuss (the data of) the activity tracker. During the third reflection session, new insights were