scholarly journals Implementation and Effects of Information Technology-Based and Print-Based Interventions to Promote Physical Activity Among Community-Dwelling Older Adults: Protocol for a Randomized Crossover Trial (Preprint)

2019 ◽  
Author(s):  
Claudia R Pischke ◽  
Claudia Voelcker-Rehage ◽  
Manuela Peters ◽  
Tiara Ratz ◽  
Hermann Pohlabeln ◽  
...  

BACKGROUND Despite the known health benefits of physical activity (PA), less than half and less than one-third of older adults in Germany reach the PA recommendations for endurance training and strength training, respectively, of the World Health Organization. The aim of this study is to investigate the implementation and effectiveness over the course of 9 months of two interventions (information technology [IT]-based vs print-based) for PA promotion among initially inactive older adults in a randomized, crossover trial. This study is part of a large research consortium (2015-2021) investigating different aspects of PA promotion. The IT-based intervention was previously developed and refined, while the print-based intervention was newly developed during this funding phase. OBJECTIVE We aim to compare the effectiveness and examine the preferences of study participants regarding both delivery modes. METHODS Our target sample size was 390 initially inactive community-dwelling older adults aged ≥60 years at baseline (3-month follow-up [T1]: expected n=300; 9-month follow-up [T2]: expected n=240) who were randomized to one of two interventions for self-monitoring PA: IT-based (50%) or print-based (50%) intervention. In addition, 30% of the IT-based intervention group received a PA tracker. At T1, participants in both groups could choose whether they prefered to keep their assigned intervention or cross over to the other group for the following 6 months (T2). Participants’ intervention preferences at baseline were collected retrospectively to run a post hoc matched-mismatched analysis. During the initial 3-month intervention period, both intervention groups were offered weekly group sessions that were continued monthly between T1 and T2. A self-administered questionnaire and 3D accelerometers were employed to assess changes in PA between baseline, T1, and T2. Adherence to PA recommendations, attendance at group sessions, and acceptance of the interventions were also tracked. RESULTS The funding period started in February 2018 and ends in January 2021. We obtained institutional review board approval for the study from the Medical Association in Bremen on July 3, 2018. Data collection was completed on January 31, 2020, and data cleaning and analysis started in February 2020. We expect to publish the first results by the end of the funding period. CONCLUSIONS Strategies to promote active aging are of particular relevance in Germany, as 29% of the population is projected to be ≥65 years old by 2030. Regular PA is a key contributor to healthy aging. This study will provide insights into the acceptance and effectiveness of IT-based vs print-based interventions to promote PA in initially inactive individuals aged ≥60 years. Results obtained in this study will improve the existing evidence base on the effectiveness of community-based PA interventions in Germany and will inform efforts to anchor evidence-based PA interventions in community structures and organizations via an allocation of permanent health insurance funds. CLINICALTRIAL German Registry of Clinical Trials DRKS00016073; https://tinyurl.com/y983586m INTERNATIONAL REGISTERED REPORT DERR1-10.2196/15168

10.2196/15168 ◽  
2020 ◽  
Vol 9 (4) ◽  
pp. e15168
Author(s):  
Claudia R Pischke ◽  
Claudia Voelcker-Rehage ◽  
Manuela Peters ◽  
Tiara Ratz ◽  
Hermann Pohlabeln ◽  
...  

Background Despite the known health benefits of physical activity (PA), less than half and less than one-third of older adults in Germany reach the PA recommendations for endurance training and strength training, respectively, of the World Health Organization. The aim of this study is to investigate the implementation and effectiveness over the course of 9 months of two interventions (information technology [IT]-based vs print-based) for PA promotion among initially inactive older adults in a randomized, crossover trial. This study is part of a large research consortium (2015-2021) investigating different aspects of PA promotion. The IT-based intervention was previously developed and refined, while the print-based intervention was newly developed during this funding phase. Objective We aim to compare the effectiveness and examine the preferences of study participants regarding both delivery modes. Methods Our target sample size was 390 initially inactive community-dwelling older adults aged ≥60 years at baseline (3-month follow-up [T1]: expected n=300; 9-month follow-up [T2]: expected n=240) who were randomized to one of two interventions for self-monitoring PA: IT-based (50%) or print-based (50%) intervention. In addition, 30% of the IT-based intervention group received a PA tracker. At T1, participants in both groups could choose whether they prefered to keep their assigned intervention or cross over to the other group for the following 6 months (T2). Participants’ intervention preferences at baseline were collected retrospectively to run a post hoc matched-mismatched analysis. During the initial 3-month intervention period, both intervention groups were offered weekly group sessions that were continued monthly between T1 and T2. A self-administered questionnaire and 3D accelerometers were employed to assess changes in PA between baseline, T1, and T2. Adherence to PA recommendations, attendance at group sessions, and acceptance of the interventions were also tracked. Results The funding period started in February 2018 and ends in January 2021. We obtained institutional review board approval for the study from the Medical Association in Bremen on July 3, 2018. Data collection was completed on January 31, 2020, and data cleaning and analysis started in February 2020. We expect to publish the first results by the end of the funding period. Conclusions Strategies to promote active aging are of particular relevance in Germany, as 29% of the population is projected to be ≥65 years old by 2030. Regular PA is a key contributor to healthy aging. This study will provide insights into the acceptance and effectiveness of IT-based vs print-based interventions to promote PA in initially inactive individuals aged ≥60 years. Results obtained in this study will improve the existing evidence base on the effectiveness of community-based PA interventions in Germany and will inform efforts to anchor evidence-based PA interventions in community structures and organizations via an allocation of permanent health insurance funds. Trial Registration German Registry of Clinical Trials DRKS00016073; https://tinyurl.com/y983586m International Registered Report Identifier (IRRID) DERR1-10.2196/15168


2021 ◽  
Vol 12 ◽  
pp. 215013272110477
Author(s):  
Oscar H. Del Brutto ◽  
Robertino M. Mera ◽  
Denisse A. Rumbea ◽  
Pedro Pérez ◽  
Bettsy Y. Recalde ◽  
...  

Background: Information on the body composition of inhabitants of remote communities during the SARS-CoV-2 pandemic is limited. Using a longitudinal population-based study design, we assessed the association between SARS-CoV-2 infection and changes in body composition. Methods: Community-dwelling older adults living in a rural Ecuadorian village received body composition determinations before and 1 year after the pandemic as well as serological tests for detection of SARS-CoV-2 antibodies. The independent association between SARS-CoV-2 infection and abnormalities in body composition at follow-up was assessed by fitting linear mixed models for longitudinal data. Results: Of 327 enrolled individuals, 277 (85%) received baseline and follow-up body composition determinations, and 175 (63%) of them became SARS-CoV-2 seropositive. Overall, diet and physical activity deteriorated during the follow-up. Multivariate random-effects generalized least squares regression models that included the impact of time and seropositivity on follow-up body composition, showed that neither variable contributed to a worsening in body composition. Multivariate logistic regression models disclosed that the serological status at follow-up cannot be predicted by differences in body composition and other baseline covariates. Conclusions: Study results suggest no increased susceptibility to SARS-CoV-2 infection among older adults with abnormal body composition and no significant changes as a result of worse physical activity and dietary habits or seropositivity during the length of the study. Together with a previous study in the same population that showed decrease in hand-grip strength after SARS-CoV-2, results confirm that dynapenia (and not sarcopenia) is associated with SARS-CoV-2 infection in older adults.


2021 ◽  
Author(s):  
Claudia Pischke ◽  
Claudia Voelcker-Rehage ◽  
Tiara Ratz ◽  
Manuela Peters ◽  
Christoph Buck ◽  
...  

BACKGROUND Despite the crucial role of regular physical activity (PA) for preventing chronic non-communicable diseases, fewer than half of older adults in Germany engage in the recommended levels of endurance training. OBJECTIVE The aim of this study was to compare acceptance and effectiveness of two interventions (web- vs. print-based) for PA promotion among initially inactive community-dwelling older adults aged 60 years and above in a nine-month randomized trial with a cross-over design. METHODS Participants were recruited offline and randomized to one of the following interventions for self-monitoring PA: (a) a print-based intervention (PRINT n=113), (b) a web-based intervention (WEB, n=129). Thirty percent (n=38) of those in group (b) received a PA tracker in addition to WEB (WEB+, (c)). After randomization, participants and researchers were not blinded. Participants’ intervention preferences at baseline were assessed retrospectively. All intervention groups were offered ten weekly face-to-face group sessions led by trained assistants. Afterwards, participants could choose to stay in their group or cross over to one of the other groups and group sessions were continued monthly for another six months. Three-dimensional accelerometers to assess PA and sedentary behavior (SB) at baseline (T0), three-month (T1) and nine-month follow-ups (T2) were employed. Adherence to PA recommendations, attendance of group sessions, and acceptance of the interventions were assessed via self-administered paper-based questionnaires. Linear mixed models were used to calculate differences in moderate-to-vigorous PA (MVPA) and SB between time points and intervention groups. RESULTS One-hundred and ninety-five participants completed T1. Only n=1 changed from WEB to PRINT and n=15 moved from PRINT to WEB (WEB-WEB: n=103, PRINT-PRINT: n=76) when offered to cross over at T1. One-hundred and sixty participants completed T2. MVPA in min per day increased between baseline and T1, but these within-group changes in time disappeared after adjusting for covariates. MVPA decreased by 9 min per day between baseline and T2 (βtime = -9.37, 95% CI: [-18.58; -0.16]), regardless of intervention group (WEB vs. PRINT: βgroup*time = -3.76, 95% CI: [-13.33; 5.82], WEB+ vs. PRINT: βgroup*time = 1.40, 95% CI: [-11.04; 13.83]). Nineteen percent of the participants met PA recommendations at T0, 20% at T1, and 20% at T2. For SB, there were no significant group differences and group-by-time interactions, neither at T1 nor at T2. Intervention acceptance was generally high. Use of intervention material was high to moderate at T1 (e.g., the PA diary was used by over 65% at least once a week) and decreased by T2 (40-50% in PRINT and in WEB used the PA diary at least once a week, and 58% in WEB+). CONCLUSIONS Despite high levels of acceptance of web- and print-based interventions for PA promotion and little movement between groups at T1, when given the choice, participation was not associated with increases in PA or decreases in SB over time. CLINICALTRIAL German Clinical Trials Register DRKS00016073 (Date of registration 10–01-2019).


2019 ◽  
Vol 5 ◽  
pp. 233372141988069
Author(s):  
Walter E. Palmer ◽  
Vicki S. Mercer

Objective: To (a) evaluate effects of the Matter of Balance (MOB) program on self-reported physical activity (PA) in older adults as measured by the program’s activity (MOB-PA) measure and the Rapid Assessment of Physical Activity, Part 1 (RAPA1) and (b) for a separate Community cohort, explore correlations between MOB-PA and RAPA1 scores and step counts obtained using accelerometry. Methods: Community-dwelling older adults recruited from upcoming MOB classes and from in-person contacts comprised MOB ( N = 56) and Community ( N = 23) cohorts, respectively. For the MOB cohort, paired t tests were computed for baseline and follow-up MOB-PA and RAPA1 scores. For the Community cohort, Pearson’s correlations between self-reported PA and step counter measures were calculated. Results: Self-reported PA did not change following MOB participation. The MOB-PA had substantial ceiling effects, which weakened relationships with step counter data. Discussion: No evidence was found that MOB participation increased PA. The MOB-PA may not be appropriate for measuring activity levels.


Author(s):  
Esther García-Esquinas ◽  
Rosario Ortolá ◽  
David Martínez-Gómez ◽  
Javier Damián ◽  
Matthew Prina ◽  
...  

Abstract Background Increasing physical activity (PA) and reducing sedentary behaviour (SB) have been associated with healthy ageing, but their effects when adjusted for reverse causation and selection bias remain unclear. Methods A deficits accumulation (DA) index based on the number and severity of 51 health deficits (0–100%) was calculated at baseline and three biannual follow-up visits, in a representative cohort of 3 228 community-dwelling older adults in Spain. Average differences in DA index by previous recreational PA, household PA, mentally-active SB and passive SB were estimated using marginal structural models with inverse probability of exposure and censoring weights. Results Compared with participants with previous recreational PA of 10–19.9 metabolic equivalent hours/week (MET-hours/week), average differences in DA index (95% confidence intervals) were 0.19 (−1.09, 1.48), 0.69 (−0.23, 1.61), −0.66 (−1.34, 0.02), −0.87 (−1.59, −0.13) and −0.55 (−1.37, 0.28) for 0, 0.1–9.9, 20–29.9, 30–39.9 and ≥40 MET-hours/week, respectively (P for trend = 0.006). Household PA showed no effect on subsequent DA after adjusting for reverse causation. Women, but not men, who spent 7–14.9, 15–20.9 and ≥21 h/week on mentally active SB had DA decreases of 0.09 (−1.00, 1.19), 1.08 (−0.28, 2.45) and 2.17 (0.58, 3.75), respectively, compared with 1–6.9 h/week (P for trend = 0.005); whereas women who spent 3–3.9, 4–4.9 and ≥5 h/day on passive SB showed DA increases of 0.41 (−0.52, 1.35), 1.35 (0.13, 2.57) and 2.13 (0.78, 3.47), respectively, compared with 2–2.9 h/day (P for trend = 0.001). Conclusions The proposed methodology allows estimation of the causal effects of PA and SB on ageing, by simulating a random assignment in which all subjects have the same probability of exposure.


2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Wenjing Zhao ◽  
Bei Pan ◽  
Sachiko Sasaki ◽  
Shigekazu Ukawa ◽  
Emiko Okada ◽  
...  

Abstract Background Previous studies reported that physical activity (PA) could prevent frailty, but the longitudinal evidence between PA volume and frailty is scarce. Additionally, the impact of daily walking time on the risk of frailty is unclear. This study aimed to examination the association of incident frailty with PA volume and daily walking time among Japanese community-dwelling older adults. Methods About 485 participants aged 70–74 years from the Japan Gerontological Evaluation Study were included in this study. Frailty was assessed at baseline and 3 years later by using the Kaigo-Yobo Checklist. PA was assessed using the short-term International Physical Activity Questionnaire. Logistic regression was performed to calculate relative risk (RR) with 95% confidence intervals (CIs) after adjusting for potential confounders. Results After 3 years of follow-up, 46 new frailty cases were recorded. The association of frailty incidence with both PA volume and daily walking time presented a U-shaped curve, albeit not statistically significant. After adjusting for potential confounding factors, walking for 0.5–1 h per day displayed a greater association with decreased frailty risk (RR, 0.35; 95% CI, 0.12–0.98) than higher levels of daily walking time. We did not observe an association between PA volume and subsequent frailty. Conclusions Walking for 0.5–1 hour/day significantly decreases frailty risk. Incorporating a moderate level of regular walking into the daily lives of older adults may postpone the onset of frailty and improve the ageing process. Further studies are needed to investigate the impact of higher PA levels on frailty risk.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 788-788
Author(s):  
Milan Chang ◽  
Hrafnhildur Eymundsdottir ◽  
Alfons Ramel ◽  
Sigurveig Sigurdardottir ◽  
Vilmundur Gudnasson ◽  
...  

Abstract Background Depressive symptoms in older adults are associated with socioeconomic status (SES), medical care, and physical activity. However, there is little evidence on the longitudinal association between level of leisure activity (LA) and physical activity (PA) with depressive symptoms among community-dwelling older adults in Iceland. The study examined an association of LA and PA at baseline with high depressive symptoms (HGDS) assessed after 5 years of follow-up among community-dwelling older adults. Methods A large community-based population residing in Reykjavik, Iceland participated in a longitudinal study with 5 years of follow-up (n=2957, 58% women, 74.9±4.8 yrs). Those with HGDS or dementia at baseline were excluded from the analysis. The reported activity was categorized into 2 groups as no-activity versus any-activity. Depressive symptoms were assessed by the 15-item Geriatric Depression Scale (GDS) on average 5 years later. Results After adjusting for demographic and health-related risk factors, those who reported having any LA had significantly fewer HGDS after the follow-up of 5 years (6 or higher GDS scores, Odds Ratio (OR) = 0.46, 95% Confidence Interval (CI): 0.27 ~ 0.76, P = 0.003). However, reporting any PA at baseline was not significantly associated with HGDS (OR = 0.71, 95% CI: 0.51 ~ 1.00, P = 0.053). Conclusion Our study shows that any LA among older adults is associated with having less depressive symptoms 5 years later among community-dwelling older adults while having any PA was not associated with depressive symptoms after 5 years of follow-up.


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