scholarly journals Addressing physical, functional, and physiological outcomes in older adults via integrated mHealth intervention

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 934-935
Author(s):  
Melba Hernandez-Tejada ◽  
Sundaravadivel Balasubramanian ◽  
John Bian ◽  
Mohan Madisetti ◽  
Alexis Nagel ◽  
...  
Keyword(s):  
Older Adults ◽  
Large Scale ◽  
Behavioral Activation ◽  
Controlled Trial ◽  
Lessons Learned ◽  
Lower Income ◽  
Physical Strength ◽  
Mhealth Intervention ◽  
Potential Benefits ◽  
Physiological Outcomes

Abstract Objective We evaluated components of an integrated mobile (m)Health-based intervention "Activate for Life" (AFL) on health outcomes in lower-income older adults (65 years and older). Method: AFL incorporates balance (Otago; OG), physical strength (Gentle Yoga and Yogic Breathing; GYYB), and mental engagement (Behavioral Activation; BA) components. Thirty participants were randomly allocated to one of three Arms (n=10 per each arm): OG (Arm 1), (OG+GYYB (Arm2), or OG+GYYB+BA (Arm 3, or full AFL). Groups were evaluated for physical, functional and physiological endpoints at baseline, and posttreatment (12-weeks and/or 3-month follow up). Results Improvements over time in pain interference and 1,5 Ag biomarker were noted for all groups. No significant changes were observed in other physical, functional and physiological measures. DiscussionThis study illustrated potential benefits of the AFL intervention on the health of lower-income older adults and lessons learned from this pilot will be used to make improvements for a large-scale randomized controlled trial.

scholarly journals The ACHIEVE Trial: Lessons Learned From Nesting a Randomized Controlled Trial Within an Observational Cohort Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 811-811
Author(s):  
Jennifer Deal ◽  
Nicholas Reed ◽  
David Couper ◽  
Kathleen Hayden ◽  
Thomas Mosley ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Observational Study ◽  
Cognitive Decline ◽  
Controlled Trial ◽  
Lessons Learned ◽  
Community Dwelling ◽  
Randomized Controlled ◽  
Study Staff ◽  
Increased Risk

Abstract Hearing impairment in older adults is linked to accelerated cognitive decline and a 94% increased risk of incident dementia in population-based observational studies. Whether hearing treatment can delay cognitive decline is unknown but could have substantial clinical and public health impact. The NIH-funded ACHIEVE randomized controlled trial of 977 older adults aged 70-84 years with untreated mild-to-moderate hearing loss, is testing the efficacy of hearing treatment versus health education on cognitive decline over 3 years in community-dwelling older adults (Clinicaltrials.gov Identifier: NCT03243422.) This presentation will describe lessons learned from ACHIEVE’s unique study design. ACHIEVE is nested within a large, well-characterized multicenter observational study, the Atherosclerosis Risk in Communities Study. Such nesting within an observational study maximizes both operational and scientific efficiency. With trial results expected in 2022, this presentation will focus on the benefits gained in design and recruitment/retention, including dedicated study staff, well-established protocols, and established study staff-participant relationships. Part of a symposium sponsored by Sensory Health Interest Group.

scholarly journals Fidelity of Implementation of Prospera Digital: Evaluation of a Multi-Site mHealth Intervention Aimed at Improving Maternal Health Outcomes in Mexico

2019 ◽  
Vol 3 (10) ◽  
Author(s):  
Pablo Gaitán-Rossi ◽  
Selene De la Cerda Lobato ◽  
Alma Cecilia Pérez Navarro ◽  
Arturo Aguilar Esteva ◽  
Manett Rocío Vargas García ◽  
...  
Keyword(s):  
Large Scale ◽  
Controlled Trial ◽  
Fidelity Of Implementation ◽  
Childhood Development ◽  
Health Providers ◽  
Evaluation Team ◽  
Mhealth Intervention ◽  
Randomized Controlled ◽  
Digital Evaluation ◽  
Program Differentiation

ABSTRACT Background Infrastructure and human capital limitations motivate the design of mHealth programs, but their large-scale implementation may be challenging in a development context. Prospera Digital (PD) is a pilot mHealth intervention aiming to improve maternal and child health and nutrition designed as a randomized controlled trial with 3 treatment arms. It was implemented during 2015–2017 in 326 treatment clinics located in 5 states in Mexico. Objective Assess, with an external evaluation, PD's fidelity of implementation using 6 dimensions: adherence, quality, responsiveness, intervention complexity, facilitation strategies, and program differentiation. Methods Benchmark for implementation was first established by interviewing PD's developers. Extensive fieldwork in the 5 states was then conducted to assess its fidelity in heterogeneous contexts. The evaluation team visited 39 health clinics to assess the initial sign-up events and conduct a follow-up. Overall, the team made 28 closed observations; conducted 17 focus groups; and interviewed 74 health providers, 10 community leaders, and 92 beneficiaries. Field notes from the implementation team on all clinics were also examined. Results Co-ordination between the Health and Social Development ministries was adequate, although some health providers were not informed about PD. Program developers added useful implementation strategies during roll-out to reinforce sign-up events. Key quality facilitators were the clarity and relevance of the messages from the short messages service. Beneficiaries expressed high satisfaction with PD. In contrast, implementation barriers to adherence in some localities might reduce the potential impact of PD. Program differentiation was low between the 3 treatment arms. Conclusions PD is a promising strategy to contribute to the promotion of early childhood development in Mexico. Implementation science evaluation can help improve the quality of large-scale mHealth interventions by anticipating barriers and providing insights on how to increase performance. This is especially relevant to inform impact evaluation in development contexts. The trial was registered at the American Economic Association's registry for randomized controlled trials with trial registry number ‘AEARCTR-0001035’.

Towards Acceptance Engineering in ICT for Older Adults

i-com ◽  
2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Anna Kötteritzsch ◽  
Kathrin Gerling ◽  
Martin Stein
Keyword(s):  
Older Adults ◽  
Technology Acceptance ◽  
User Acceptance ◽  
Lessons Learned ◽  
Older Individuals ◽  
Actual Usage ◽  
The Past ◽  
Novel Technology ◽  
Potential Benefits ◽  
Available Information

AbstractResearch on technology acceptance presents different theories and models to predict the intention to use and actual usage of a system. However, even when applying these concepts to the design of novel technology, there is still a lack of acceptance among many older individuals. In the past years, we gathered experience in developing and evaluating technology for older adults. Throughout multiple engineering cycles, we repeatedly encountered issues impacting user acceptance. Based on our research, we argue that low acceptance can be ascribed to all phases of the engineering process, and thus, should be systematically applied to technology engineering. By considering research on technology acceptance among older adults, and presenting our own experiences in how older adults accept ICT, we introduce 12 lessons learned when designing ICT for older adults (understanding acceptance, evaluating the importance of user acceptance, pursuing the own goals, consulting with the user, considering all available information, connecting potential benefits, balancing different views, considering mediating factors, making use of emerging artifacts, being sensitive to one’s own actions, avoiding misunderstanding, and communicating clearly). We conclude with a proposition on how to implement these lessons into acceptance engineering throughout the engineering lifecycle.

scholarly journals The First Intervention Study for LGBTQ+ Older Adults With Dementia and Caregivers: COVID-19 Lessons Learned

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 112-112
Author(s):  
Karen Fredriksen Goldsen ◽  
Linda Teri ◽  
Hyun-Jun Kim ◽  
Charles Emlet ◽  
Ryan Petros ◽  
...  
Keyword(s):  
Older Adults ◽  
Culturally Responsive ◽  
Intervention Study ◽  
Retention Rate ◽  
Controlled Trial ◽  
Lessons Learned ◽  
Technology Support ◽  
Disadvantaged Communities ◽  
Aging Services ◽  
Home Technology

Abstract LGBTQ+ older adults face significant health disparities with higher rates of cognitive impairment and social isolation. Yet, the cognitive health needs of LGBTQ+ adults and caregivers have not been adequately addressed in clinical trials and services. In this presentation, we will share findings from Aging with Pride: IDEA (Innovations in Dementia Empowerment and Action), the first randomly controlled trial (RCT) intervention study designed to improve quality of life of LGBTQ+ adults living with dementia and caregivers, and to reduce institutionalization. In this presentation, we will share preliminary efficacy findings, the effectiveness of culturally responsive approaches, and Covid-19 adaptations, including delivery by virtual chat rather than in-home, technology training, ensuring safety of virtual intervention components, and providing on-going technology support. Preliminary findings suggest a higher intervention retention rate in the virtual delivery as compared to in-home. This study illustrates innovative ways to serve disadvantaged communities in dementia care and aging services.

scholarly journals The Elusive Path Toward Measuring Health Outcomes: Lessons Learned From a Pseudo-Randomized Controlled Trial of a Large-Scale Mobile Health Initiative

10.2196/14668 ◽  
2019 ◽  
Vol 7 (8) ◽  
pp. e14668 ◽  
Author(s):  
Patricia Mechael ◽  
Nadi Nina Kaonga ◽  
Subhashini Chandrasekharan ◽  
Muthu Perumal Prakash ◽  
Joanne Peter ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Child Health ◽  
Health Outcomes ◽  
Mobile Health ◽  
Large Scale ◽  
Controlled Trial ◽  
Lessons Learned ◽  
Randomized Controlled ◽  
The Impact ◽  
And Child Health

Mobile health (mHealth) offers new opportunities to improve access to health services and health information. It also presents new challenges in evaluating its impact, particularly in linking the use of a technology intervention that aims to improve health behaviors with the health outcomes that are impacted by changed behaviors. The availability of data from a multitude of sources (paper-based and electronic) provides the conditions to facilitate making stronger connections between self-reported data and clinical outcomes. This commentary shares lessons and important considerations based on the experience of applying new research frameworks and incorporating maternal and child health records data into a pseudo-randomized controlled trial to evaluate the impact of mMitra, a stage-based voice messaging program to improve maternal, newborn, and child health outcomes in urban slums in India.

scholarly journals Online research in older adults: lessons learned from conducting an online randomized controlled trial

2011 ◽  
Vol 24 (4) ◽  
pp. 269-275 ◽  
Author(s):  
Eun-Shim Nahm ◽  
Barker Bausell ◽  
Barbara Resnick ◽  
Barbara Covington ◽  
Patricia F. Brennan ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Lessons Learned ◽  
Online Research ◽  
Randomized Controlled

scholarly journals Comparison of Recruitment Strategies for Engaging Older Minority Adults: Results From Take Heart

2019 ◽  
Vol 75 (5) ◽  
pp. 922-928 ◽  
Author(s):  
Jessica E Ramsay ◽  
Cainnear K Hogan ◽  
Mary R Janevic ◽  
Rebecca R Courser ◽  
Kristi L Allgood ◽  
...  
Keyword(s):  
Older Adults ◽  
Behavioral Interventions ◽  
Controlled Trial ◽  
Management Program ◽  
Lessons Learned ◽  
Low Ses ◽  
Community Members ◽  
Face To Face ◽  
Urban Minority ◽  
Trial Testing

Abstract Background Few published studies report lessons learned for recruiting older adults from racial/ethnic minority, low SES communities for behavioral interventions. In this article, we describe recruitment processes and results for Take Heart, a randomized controlled trial testing the effectiveness of an adapted heart disease self-management program for primarily African American, urban, low SES adults 50 years or older living in Detroit. Methods Older adults were recruited via community-based (CB), electronic medical record (EMR), and in-person hospital clinic (HC) methods. Recruitment processes, demographic characteristics of enrolled participants, yield and cost, lessons learned, and best practices for each method are described. Results Within 22 months, 1,478 potential participants were identified, 1,223 were contacted and 453 enrolled, resulting in an overall recruitment yield of 37%. The CB method had the highest yield at 49%, followed by HC at 36% and EMR at 16%. Of six CB approaches, information sessions and flyers had the highest yields at 60% and 59%, respectively. The average cost of recruiting and enrolling one participant was $142. Conclusions CB, EMR, and HC methods each made important contributions to reaching our recruitment goal. The CB method resulted in the highest recruitment yield, while EMR had the lowest. Face-to-face interaction with community members and hiring a community health worker were particularly useful in engaging this population. Further research is needed to confirm these findings in urban, minority, low SES populations of older adults.

scholarly journals Challenges faced and lessons learned A multi-component prospective memory training program for Malaysian older adults

2018 ◽  
Vol 12 (2) ◽  
pp. 189-195
Author(s):  
Azin Farzin ◽  
Rahimah Ibrahim ◽  
Zainal Madon ◽  
Hamidon Basri
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Prospective Memory ◽  
Controlled Trial ◽  
Practical Method ◽  
Lessons Learned ◽  
Memory Training ◽  
Cultural Issues ◽  
Randomized Controlled ◽  
The Impact

Abstract The surrounding circumstances and environments of Malaysian older adults could make conducting interventions (mainly in terms of clinical or randomized controlled trials) a challenge. Working with older adults and facing cultural issues could be challenging. Objective: This paper illustrates a significant perspective of some of the challenges faced while conducting a randomized controlled trial exploring the impact of a multi-component intervention that included strategy- and process-based prospective memory (PM) training among Malaysian older adults. Methods: The current study was a randomized controlled trial (RCT) and therefore the challenges were presented in accordance with the CONSORT statement style. Results: A discussion on how these issues were addressed is provided. Conclusion: Some suggestions were presented to help researchers plan and create interventions for similar studies and to support a practical method of addressing all related challenges.

scholarly journals Guided Self-Help Behavioral Activation Intervention for Geriatric Depression: Protocol for Pilot Randomized Controlled Trial

10.2196/18259 ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. e18259
Author(s):  
Xiaoxia Wang ◽  
Xiaoyan Zhou ◽  
Hui Yang
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Randomized Controlled Trial ◽  
Health Center ◽  
Behavioral Activation ◽  
Mental Health Center ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Self Help ◽  
Pilot Randomized Controlled Trial

Background Aging is a social concern. The increased incidence of depression in older populations in China poses a challenge to the health care system. Older adults who are depressed often suffer from a lack of motivation. Behavioral activation treatment, an evidence-based guided self-help treatment, is effective in reducing anhedonia and amotivation in depression; however, the efficacy of guided self-help behavioral activation in older adults with depression is not yet known. Objective The aim of this study is to pilot a self-help guided intervention for the treatment of depression in older adults. Methods This study has been designed as a pilot randomized controlled trial with inpatients (n=60; to be randomly allocated 1:1) between the ages of 60 and 70 and who have major depressive disorder. Patients attending clinical psychological clinics at the Mental Health Center of Chongqing will be randomized to either receive guided self-help behavioral activation (intervention) or to be on a 6-week waiting list (control). Participants in the treatment group will receive 6 sessions of guided self-help behavioral activation delivered over the telephone. The waiting list control group will receive the intervention after a period of 6 weeks. Exclusion criteria will be individuals who are at significant risk of harming themselves or others, who have a primary mental health disorder other than depression, or who have an intellectual disability that would hamper their ability to participate in the intervention. Effects of the treatment will be observed using outcomes in 3 domains: (1) clinical outcomes (symptom severity, recovery rate), (2) process variables (patient satisfaction, attendance, dropout), and (3) economic outcomes (cost and resource use). We will also examine mediators of outcomes in terms of patient variables (behavioral activation or inhibition motivation). We hypothesize that guided self-help behavioral activation will have a beneficial effect. Results The study was approved by the research ethics committee of the Mental Health Center of Chongqing in November 2019. As of July 2020, recruitment had not yet begun. Data collection is expected to be completed by December 2020. Data analysis is expected to be completed by June 2021. Results will then be disseminated to patients, to the public, to clinicians, and to researchers through publications in journals and presentations at conferences. Conclusions This will be the first study in China to investigate guided self-help interventions for patients who are older adults and who are depressed, a group which is currently underrepresented in mental health research. The intervention is modular and adapted from an empirically supported behavioral activation treatment for depression. The generalizability and broad inclusion criteria are strengths. Trial Registration Chinese Clinical Trial Register ChiCTR1900026066; http://www.chictr.org.cn/showprojen.aspx?proj=43548 International Registered Report Identifier (IRRID) PRR1-10.2196/18259

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