Darcy Ummels

General discussion | 145 7 discussions about the meaningful use of activity trackers. During this study, the MISS Activity was mostly used to assess physical activity and to support changes in physical activity levels by setting physical activity goals. In addition, this information supported the healthcare professionals’ clinical reasoning (e.g. diagnosing the coping mechanism). Prior to the recent COVID ‐ 19 regulations, therapists expressed an understanding of how to use the activity tracker in a meaningful way and planned changes to better integrate the activity tracker in their daily clinical practices. However, the proposed changes could not be fully applied due to the closing of the rehabilitation centre because of COVID ‐ 19 restrictions. Methodological considerations Within this section, certain overall methodological considerations are discussed: the structure of the performed phases, the selection of activity trackers, the target population, determining the validity of activity trackers and the umbrella concept ‘feasibility’. The structure of the performed phases A strength of this dissertation is its structure; the performed phases in the different chapters form a natural sequential construct. Since little was known about the clinometric properties of commercially available activity trackers in the healthcare of (older) adults with a chronic disease and older adults with or without chronic diseases, this was assessed first. Based on the results of phase one, phase two was constructed, and the MISS Activity was developed. To use the knowledge acquired, in phase three, the MISS Activity was implemented in daily clinical practice. For each phase, the research designs were chosen based on the research question and stage, which led to a variety of research designs. A common feature of the designs was the active participation of all stakeholders during the studies. The active participation of relevant stakeholders enhances implementation in daily practice, as well as the relevance and generalisability of a product. 8,9 One limitation might be that this study did not examine the effectiveness of activity trackers in healthcare. However, the steps that were performed in this dissertation were a prerequisite to be able to study this effectiveness in future research. The selection of activity trackers The selection of the activity trackers in phase one was based on requirements set in collaboration with physiotherapists. After an extensive search of all commercially