Physical activity and the transition to retirement: A mixed-method systematic review

BackgroundIt has been argued that transition points in life, such as the approach towards and early years of retirement, present key opportunities for interventions to improve the health of the population. Interventions that may change or preserve activity levels around the time of retirement have the potential to provide benefits in terms of increased health and well-being for people in later life. Research has highlighted health inequalities in health statuses in the retired population and in response to interventions.ObjectiveWe aimed to conduct a systematic review and meta-synthesis of the types and effectiveness of interventions to increase physical activity among people around the time of retirement. We also aimed to identify factors that may underpin the effectiveness or acceptability of interventions, and how issues of health inequalities may be addressed.Data sourcesThe following electronic databases were searched: (1) MEDLINE; (2) Applied Social Sciences Index and Abstracts; (3) The Cochrane Library (including The Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, Health Technology Assessment Database); (4) Cumulative Index to Nursing and Allied Health Literature; (5) Science Citation Index; (6) Social Science Citation Index; (7) PsycINFO; (8) Evidence for Policy and Practice Information and Co-ordinating Centre; (9) SPORTDiscus; (10) Social Policy and Practice; (11) Health Management Information Consortium; and (12) Sociological Abstracts. We also searched for grey literature, checked reference lists of included papers and screened other reviews.Review methodsA systematic review of quantitative and qualitative literature was carried out between February 2014 and April 2015. The searches aimed to identify, first, evidence of effectiveness of interventions for older adults at the point of transition to retirement and, second, data relating to perceptions of barriers and facilitators to intervention effectiveness. A meta-synthesis of the two types of evidence was also carried out to provide further interpretation of the review findings.ResultsA systematic search of the literature identified a large number of potentially relevant studies. Of these, 103 studies examining the effectiveness of interventions and 55 qualitative papers met the criteria for inclusion. A review of the effectiveness literature indicated a dearth of studies that investigate interventions that specifically examine the transition to retirement. More general studies in older adults indicated that a range of interventions might be effective for people around retirement age. The qualitative literature indicated the importance of considering the appeal and enjoyment, and social aspects, of interventions. Although there were a range of different measures in use, many were self-reported and few studies included an evaluation of sedentary time. A meta-synthesis across the data types indicated that elements reported as significant by participants did not always feature in the interventions.LimitationsOwing to the lack of evidence relating to the retirement transition, we examined the literature relating to older adults. The applicability of these data to people around retirement age may need consideration.ConclusionsAlthough the retirement transition is considered a significant point of life change, only a small volume of literature has reported interventions specifically in this period. The included literature suggests that interventions should take account of views and preferences of the target population and evaluate effectiveness by measuring meaningful outcomes and using a control group design.Study registrationThis study is registered as PROSPERO CRD42014007446.FundingThe National Institute for Health Research Public Health Research programme.

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Promoting Physical Activity Through Conversational Agents: Mixed-Method Systematic Review (Preprint)

10.2196/preprints.25486 ◽

2020 ◽

Author(s):

Tiffany Christina Luo ◽

Adrian Aguilera ◽

Courtney Lyles ◽

Caroline Astrid Figueroa

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Mixed Methods ◽

Language Processing ◽

Mixed Method ◽

Health Behavior Change ◽

Open Science ◽

Virtual Agents ◽

Conversational Agents ◽

Privacy Measures

BACKGROUND Regular physical activity is crucial to wellbeing, but healthy habits are difficult to create and maintain. Interventions delivered via conversational agents (eg, chatbots or virtual agents) are a novel and potentially accessible way to promote physical activity. Thus, it is important to understand the evolving landscape of research utilizing conversational agents. OBJECTIVE This mixed-method systematic review aimed to 1) summarize the usability and effectiveness of conversational agents in promoting physical activity, 2) describe common theories and intervention components utilized, 3) identify areas for further development, and 4) make recommendations for conversational agents targeting health behavior change. METHODS We conducted a mixed-method systematic review. We searched 7 electronic databases (PsycINFO, PubMed, Embase, CINAHL, ACM Digital Library, Scopus, and Web of Science) for quantitative, qualitative, and mixed methods studies that conveyed primary research on automated conversational agents designed to increase physical activity. Two reviewers independently screened studies and assessed methodological quality using the Mixed Methods Appraisal Tool (MMAT). Data on intervention impact and effectiveness, treatment characteristics, and challenges were extracted and analyzed using parallel-results convergent synthesis and narrative summary. RESULTS In total, 255 studies were identified, 20 of which met our inclusion criteria. Overall, conversational agents had moderate usability and feasibility and were effective in promoting physical activity. However, quality of evidence varied. Common challenges facing interventions were repetitive program content, high attrition, technical issues, safety, and privacy. CONCLUSIONS Conversational agents hold promise for physical activity interventions. However, there is a lack of rigorous research on long-term intervention effectiveness and patient safety. Future interventions should be based in evidence-informed theories and treatment approaches, and they should address users’ desires for program variety, safety and privacy measures, natural language processing, and delivery via mobile devices. CLINICALTRIAL The protocol for this systematic review was registered in the Open Science Framework (OSF) registries (osf.io/p4v6y).

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