23
views
0
recommends
+1 Recommend
1 collections
    0
    shares

      To submit your manuscript to JMIR, please click here

      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Evaluation of a Blended Physical Activity Intervention for Older Adults: Mixed Methods Study

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Physical activity can prolong the ability of older adults to live independently. Home-based exercises can help achieve the recommended physical activity levels. A blended intervention was developed to support older adults in performing home-based exercises. A tablet and a personal coach were provided to facilitate the self-regulation of exercise behavior.

          Objective

          In line with the Medical Research Council framework, this study aimed to carry out process evaluation of a blended intervention. The objectives were (1) to assess the long-term usability of the tablet adopted in the blended intervention and (2) to explore how the tablet, in conjunction with a personal coach, supported older adults in performing home-based exercises.

          Methods

          The process evaluation was conducted with a mixed-methods approach. At baseline, older adults participating in the blended intervention were asked to fill out a questionnaire about their general experience with information and communication technology (ICT) devices and rate their own skill level. After 6 months, participants filled out the Usefulness, Satisfaction, and Ease of use (USE) questionnaire to assess the usefulness, satisfaction, and ease of use of the tablet. With a random selection of participants, in-depth interviews were held to explore how the tablet and coach supported the self-regulation. The interviews were double coded and analyzed with the directed content analysis method.

          Results

          At baseline, 29% (65/224) of participants who started the intervention (mean age 72 years) filled out the ICT survey and 36% (37/103) of participants who used the tablet for 6 months (mean age 71 years) filled out the USE questionnaire. Furthermore, with 17% (18/103) of participants (mean age 73 years), follow-up interviews were held. The results of the baseline questionnaire showed that the large majority of participants already had experience with a tablet, used it regularly, and reported being skillful in operating ICT devices. After 6 months of use, the participants rated the usefulness, satisfaction, and ease of use of the tablet on average as 3.8, 4.2, and 4.1, respectively, on a 5-point scale. The analysis of the interviews showed that the participants felt that the tablet supported action planning, behavior execution, and self-monitoring. On the other hand, especially during the first few months, the personal coach added value during the goal setting, behavior execution, and evaluation phases of self-regulation.

          Conclusions

          The results of the process evaluation showed that older adults who participated in the study were positive about the blended intervention that was designed to support them in performing home-based exercises. Participants reported that the tablet helped them to perform the exercises better, more frequently, and safely. It supported them in various phases of self-regulation. The availability of a personal coach was nevertheless crucial. To support physical activity in older adults, a blended approach is promising.

          Related collections

          Most cited references29

          • Record: found
          • Abstract: found
          • Article: found
          Is Open Access

          Meta-analysis of internet-delivered interventions to increase physical activity levels

          Many internet-delivered physical activity behaviour change programs have been developed and evaluated. However, further evidence is required to ascertain the overall effectiveness of such interventions. The objective of the present review was to evaluate the effectiveness of internet-delivered interventions to increase physical activity, whilst also examining the effect of intervention moderators. A systematic search strategy identified relevant studies published in the English-language from Pubmed, Proquest, Scopus, PsychINFO, CINHAL, and Sport Discuss (January 1990 – June 2011). Eligible studies were required to include an internet-delivered intervention, target an adult population, measure and target physical activity as an outcome variable, and include a comparison group that did not receive internet-delivered materials. Studies were coded independently by two investigators. Overall effect sizes were combined based on the fixed effect model. Homogeneity and subsequent exploratory moderator analysis was undertaken. A total of 34 articles were identified for inclusion. The overall mean effect of internet-delivered interventions on physical activity was d = 0.14 (p = 0.00). Fixed-effect analysis revealed significant heterogeneity across studies (Q = 73.75; p = 0.00). Moderating variables such as larger sample size, screening for baseline physical activity levels and the inclusion of educational components significantly increased intervention effectiveness. Results of the meta-analysis support the delivery of internet-delivered interventions in producing positive changes in physical activity, however effect sizes were small. The ability of internet-delivered interventions to produce meaningful change in long-term physical activity remains unclear.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Resistance exercise for muscular strength in older adults: a meta-analysis.

            The effectiveness of resistance exercise for strength improvement among aging persons is inconsistent across investigations, and there is a lack of research synthesis for multiple strength outcomes. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. A meta-analysis was conducted to determine the effect of resistance exercise (RE) for multiple strength outcomes in aging adults. Randomized-controlled trials and randomized or non-randomized studies among adults > or = 50 years, were included. Data were pooled using random-effect models. Outcomes for 4 common strength tests were analyzed for main effects. Heterogeneity between studies was assessed using the Cochran Q and I(2) statistics, and publication bias was evaluated through physical inspection of funnel plots as well as formal rank-correlation statistics. A linear mixed model regression was incorporated to examine differences between outcomes, as well as potential study-level predictor variables. Forty-seven studies were included, representing 1079 participants. A positive effect for each of the strength outcomes was determined however there was heterogeneity between studies. Regression revealed that higher intensity training was associated with greater improvement. Strength increases ranged from 9.8 to 31.6 kg, and percent changes were 29+/-2, 24+/-2, 33+/-3, and 25+/-2, respectively for leg press, chest press, knee extension, and lat pull. RE is effective for improving strength among older adults, particularly with higher intensity training. Findings therefore suggest that RE may be considered a viable strategy to prevent generalized muscular weakness associated with aging. 2010 Elsevier Ireland Ltd. All rights reserved.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              A review of eHealth interventions for physical activity and dietary behavior change.

              To review eHealth intervention studies for adults and children that targeted behavior change for physical activity, healthy eating, or both behaviors. Systematic literature searches were performed using five databases: MEDLINE, PsychInfo, CINAHL, ERIC, and the Cochrane Library to retrieve articles. Articles published in scientific journals were included if they evaluated an intervention for physical activity and/or dietary behaviors, or focused on weight loss, used randomized or quasi-experimental designs, measured outcomes at baseline and a follow-up period, and included an intervention where participants interacted with some type of electronic technology either as the main intervention or an adjunct component. All studies were published between 2000 and 2005. Eighty-six publications were initially identified, of which 49 met the inclusion criteria (13 physical activity publications, 16 dietary behaviors publications, and 20 weight loss or both physical activity and diet publications), and represented 47 different studies. Studies were described on multiple dimensions, including sample characteristics, design, intervention, measures, and results. eHealth interventions were superior to comparison groups for 21 of 41 (51%) studies (3 physical activity, 7 diet, 11 weight loss/physical activity and diet). Twenty-four studies had indeterminate results, and in four studies the comparison conditions outperformed eHealth interventions. Published studies of eHealth interventions for physical activity and dietary behavior change are in their infancy. Results indicated mixed findings related to the effectiveness of eHealth interventions. Interventions that feature interactive technologies need to be refined and more rigorously evaluated to fully determine their potential as tools to facilitate health behavior change.
                Bookmark

                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J. Med. Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                July 2020
                23 July 2020
                : 22
                : 7
                : e16380
                Affiliations
                [1 ] Applied Psychology Faculty of Applied Social Sciences and Law Amsterdam University of Applied Sciences Amsterdam Netherlands
                [2 ] CREATE-IT Applied Research Faculty of Digital Media and Creative Industries Amsterdam University of Applied Sciences Amsterdam Netherlands
                [3 ] Informatics Institute Faculty of Science University of Amsterdam Amsterdam Netherlands
                [4 ] Center of Expertise Urban Vitality Faculty of Health Amsterdam University of Applied Sciences Amsterdam Netherlands
                [5 ] Center of Expertise Urban Vitality Faculty of Sports and Nutrition Amsterdam University of Applied Sciences Amsterdam Netherlands
                [6 ] Department of Rehabilitation Amsterdam University Medical Centers University of Amsterdam Amsterdam Netherlands
                [7 ] Department of Nutrition and Dietetics Amsterdam University Medical Centers VU University Amsterdam Netherlands
                [8 ] Amsterdam Public Health Research Institute Amsterdam University Medical Centers VU University Amsterdam Netherlands
                Author notes
                Corresponding Author: Sumit Mehra s.mehra@ 123456hva.nl
                Author information
                https://orcid.org/0000-0001-8996-1956
                https://orcid.org/0000-0002-3071-7251
                https://orcid.org/0000-0002-8559-9715
                https://orcid.org/0000-0002-6923-8696
                https://orcid.org/0000-0001-8281-0426
                https://orcid.org/0000-0003-1237-0618
                Article
                v22i7e16380
                10.2196/16380
                7413279
                32459652
                fb38ee8f-6ba6-41a1-8ee9-3245d11d2c9e
                ©Sumit Mehra, Jantine van den Helder, Bart Visser, Raoul H H Engelbert, Peter J M Weijs, Ben J A Kröse. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 23.07.2020.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 24 September 2019
                : 6 January 2020
                : 11 February 2020
                : 14 May 2020
                Categories
                Original Paper
                Original Paper

                Medicine
                frail elderly,aged,activities of daily living,exercise,health behavior,telemedicine,mobile devices,tablet computers,usability testing,evaluation

                Comments

                Comment on this article