Technology support challenges and recommendations for adapting an evidence-based exercise program for virtual delivery to older adults: Mixed-methods study (Preprint)

2021 ◽  
Author(s):  
Nancy Gell ◽  
Elise Hoffman ◽  
Kushang Patel
Keyword(s):  
Older Adults ◽  
Technical Assistance ◽  
Exercise Program ◽  
Barriers And Facilitators ◽  
Support Needs ◽  
Evidence Based ◽  
Technology Support ◽  
Symptomatic Knee Osteoarthritis ◽  
Technology Orientation ◽  
Exercise Classes

BACKGROUND Tele-exercise has emerged as a way for older adults to participate in group exercise during the COVID-19 pandemic. Yet, little is known about the technology support needs of older adults for accessing tele-exercise. OBJECTIVE Examine the interests and needs of older adults for transition to tele-exercise, 2) Identify barriers and facilitators of tele-exercise uptake and continued participation, and 3) Describe technology support challenges and successes encountered among older adults beginning tele-exercise. METHODS We used an exploratory sequential mixed method study design. Participants were older adults with symptomatic knee osteoarthritis (n=44) who started participating in remotely delivered Enhance Fitness. Prior to the start of classes, a subsample of participants (n=10) completed semi-structured phone interviews about technology support needs and barriers and facilitators for technology adoption. All participants completed surveys including the PROMIS-57, the Senior Technology Acceptance Model scale, and a technology needs assessment. The study team recorded technology challenges encountered when participants engaged in tele-exercise classes and attendance rates. RESULTS Four themes emerged from the interviews: Participants desire features in a tele-exercise program that foster accountability; importance of direct access to helpful people who can troubleshoot and provide guidance with technology; opportunities to participate in high value activities motivates willingness to persevere through technology concerns; and belief in the ability to learn new things supersedes technology-related anxiety. Among participants in the tele-exercise classes (mean age 74.0 years ± 6.3; 86.4% female; mean of 2.5 ± 0.9 chronic conditions), 70.5% had a computer with a webcam, but 40.9% had little or no experience with videoconferencing. Initial technology orientation sessions lasted, on average, 19.3 (±10.3) minutes and 23.9% required a follow-up assistance call. During the first two weeks of tele-exercise, 47.6% required technical assistance which decreased to 11.9% for weeks 3-16. Median attendance was 100% for the first six sessions and 93% for the subsequent 42 sessions. CONCLUSIONS With appropriate support, older adults can successfully participate in tele-exercise. Recommendations include individualized technology orientation sessions, experiential learning, and availability of stand-by technical assistance, particularly during the first two weeks of classes. Continued development of best practices in this area may allow previously hard-to reach populations of older adults to participate in health-enhancing, evidence-based exercise programs. CLINICALTRIAL NCT04099394

scholarly journals Rapid Transition to Telehealth Group Exercise and Functional Assessments in Response to COVID-19

2020 ◽  
Vol 6 ◽  
pp. 233372142098031
Author(s):  
Stephen C. Jennings ◽  
Kenneth M. Manning ◽  
Janet Prvu Bettger ◽  
Katherine M. Hall ◽  
Megan Pearson ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Performance ◽  
Exercise Program ◽  
Performance Testing ◽  
Group Exercise ◽  
Health Maintenance ◽  
Functional Assessments ◽  
Wide Scale ◽  
Rapid Transition ◽  
Exercise Classes

Exercise is critical for health maintenance in late life. The COVID-19 shelter in place and social distancing orders resulted in wide-scale interruptions of exercise therapies, placing older adults at risk for the consequences of decreased mobilization. The purpose of this paper is to describe rapid transition of the Gerofit facility-based group exercise program to telehealth delivery. This Gerofit-to-Home (GTH) program continued with group-based synchronous exercise classes that ranged from 1 to 24 Veterans per class and 1 to 9 classes offered per week in the different locations. Three hundred and eight of 1149 (27%) Veterans active in the Gerofit facility-based programs made the transition to the telehealth delivered classes. Participants’ physical performance testing continued remotely as scheduled with comparisons between most recent facility-based and remote testing suggesting that participants retained physical function. Detailed protocols for remote physical performance testing and sample exercise routines are described. Translation to remote delivery of exercise programs for older adults could mitigate negative health effects.

scholarly journals “HE EXPLAINED IT TO ME AND I ALSO DID IT MYSELF”: HOW OLDER ADULTS GET HELP WITH DIGITAL TECHNOLOGY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S866-S866
Author(s):  
Amanda E Hunsaker ◽  
Minh Hao Nguyen ◽  
Jaelle Fuchs ◽  
Teodora Djukaric ◽  
Larissa Hugentobler ◽  
...  
Keyword(s):  
Older Adults ◽  
Digital Media ◽  
Digital Technology ◽  
Qualitative Interviews ◽  
Support Needs ◽  
Technology Support ◽  
Community Based ◽  
Coding Schemes ◽  
Great Ease ◽  
Open Coding

Abstract Older adults comprise a highly heterogeneous group that engages with digital media in varying ways, therefore a large variation in technology support needs is likely. This study examines the nature of support for using digital media among older adults. We conducted in-depth qualitative interviews with older adults (age 59+) in Hungary, the Netherlands, and Switzerland (N=58) in 2019 exploring: (1) whether and how older adults receive support in using digital media; and (2) older adults’ perceptions of whether the support they receive meets their needs. We began with open coding, then conducted consensus meetings to identify themes and coding schemes, and wrote memos to share findings and ensure reliability across coders. We find that older adults voice a highly varying range of need for technical support as well as varying instances of both receiving and not receiving technical help. Participants report receiving help from different informal (e.g. spouses) and formal (e.g. computer classes) sources. However, support may not be immediate, posing challenges for older adults who depend on the availability of their support sources. Importantly, we also find that there are older adults who are quite self-sufficient in the ways they use digital technology. For older adults needing support, greater access to community-based support may help those without satisfactory options in their own social circle. Given our findings that older adults can have great ease with solving technology-related problems, peer-driven support networks where older adults can offer support to others may be an effective approach to providing digital technology guidance.

scholarly journals Delivering a Tai Chi Intervention to Adults Aging with Mobility Disabilities Using Zoom

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 425-425
Author(s):  
Elena Remillard ◽  
Kara Cohen ◽  
Lelah Cochran ◽  
Tracy Mitzner
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Tai Chi ◽  
Lessons Learned ◽  
Evidence Based ◽  
Physical And Mental Health ◽  
Virtual Group ◽  
Exercise Classes ◽  
Made In

Abstract Many individuals aging with mobility disabilities experience barriers to participating in physical activity, including transportation challenges and the need for specialized instruction. Since the COVID-19 pandemic began, these participation barriers have been amplified due to lockdowns and restrictions. Tele-technologies, including videoconferencing platforms like Zoom, can facilitate access to exercise classes from one’s home. Virtual group exercise classes that incorporate social interaction have particular potential to support the physical and mental health of this population. This session will highlight lessons learned from launching the ‘Tele Tai Chi’ study, in which we are delivering an evidence-based Tai Chi program (Tai Chi for Arthritis) via Zoom to small group classes of older adults with long-term mobility disabilities. We will describe adaptations made in translating the in-person program to an interactive, online class, and provide an overview of a ‘Telewellness’ Tool that provides guidelines for using Zoom to deliver exercise classes to older adults.

scholarly journals “He Explained It to Me and I Also Did It Myself”: How Older Adults Get Support with Their Technology Uses

2019 ◽  
Vol 5 ◽  
pp. 237802311988786 ◽  
Author(s):  
Amanda Hunsaker ◽  
Minh Hao Nguyen ◽  
Jaelle Fuchs ◽  
Teodora Djukaric ◽  
Larissa Hugentobler ◽  
...  
Keyword(s):  
Older Adults ◽  
Digital Media ◽  
Adult Children ◽  
Qualitative Interviews ◽  
Heterogeneous Group ◽  
Support Needs ◽  
Technology Support ◽  
Wide Range ◽  
Wide Availability

Given that older adults constitute a highly heterogeneous group that engages with digital media in varying ways, there is likely to be large variation in technology support needs, something heretofore unaddressed in the literature. Drawing on in-depth qualitative interviews with a multinational sample of older adults, the authors explore the support needs of older adults for using digital media, including their perceptions of whether the support they receive meets their needs. Participants obtained assistance from both informal (e.g., adult children) and formal (e.g., computer classes) sources. However, the support given can lack immediacy, leaving older adults dependent on others’ availability to provide it. Educational approaches that emphasize individualized support and wide availability might allow an improved experience for a population that is increasingly online with an interest in a wide range of activities.

scholarly journals Implementation of an Evidence-Based Exercise Program for Older Adults in South Florida

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Richard C. Palmer ◽  
Anamica Batra ◽  
Chelsie Anderson ◽  
Timothy Page ◽  
Edgar Vieira ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Exercise Program ◽  
South Florida ◽  
Community Dwelling ◽  
Evidence Based ◽  
Functional Fitness ◽  
Body Strength ◽  
High Satisfaction ◽  
Wide Scale

Introduction. This study aimed to examine how well an evidence-based physical activity program could be translated for wide scale dissemination and adoption to increase physical activity among community-dwelling older adults.Methods. Between October 2009 and December 2012, reach, fidelity, dosage, ease of implementation, and barriers to translation of EnhanceFitness (EF) were assessed. To assess effectiveness, a pretest-posttest design was used to measure increases in functional fitness (chair stands, arm curls, and the up-and-go test).Results. Fourteen community-based agencies offered 126 EF classes in 83 different locations and reached 4,490 older adults. Most participants were female (72%). Thirty-eight percent of participants did not complete the initial 16-week EF program. The 25% who received the recommended dose experienced an increase in upper and lower body strength and mobility. Further, participants reported high satisfaction with the program.Conclusion. EF was successfully implemented in a variety of settings throughout South Florida and reached a large number of older adults. However, challenges were encountered in ensuring that those who participated received a program dose that would lead to beneficial gains in functional fitness.

scholarly journals A Survey of Older Adults’ Perspectives of In-Person and Virtual Parkinson’s-Specific Exercise Classes

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 932-932
Author(s):  
Holly Bennett ◽  
Jennifer Vincenzo ◽  
Chris Oholendt
Keyword(s):  
Older Adults ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Online Survey ◽  
Exercise Program ◽  
Computer Usage ◽  
Computer Access ◽  
Specific Exercise ◽  
Virtual Classes ◽  
Exercise Classes

Abstract Due to COVD-19, many health/wellness programs transitioned from in-person to virtual. This mixed methods study aims to explore older adults with Parkinson’s disease (PD) perceptions of in-person versus virtual Parkinson’s-specific exercise classes. Attitudes, perceptions, and experiences were determined through focus groups (n=9; Male=4; aged 75 years) among older adults with PD and an online survey (n=23; Male=14; aged 74 years). Eighteen respondents attended both in-person and virtually (n=18; Male=9). Four respondents only attended in-person, citing reasons such as difficulty with computer access to virtual classes, limited internet, easier accessibility to in-person classes, and physical injury preventing attendance to any classes. Respondents who participated in both delivery methods preferred virtual classes. Time, convenience, comfort at home, and not having to navigate transportation barriers supported participants’ preference for virtual classes. The majority of respondents indicated their fatigue and mental health were either unchanged or improved. Eighty-nine percent reported improved mobility since attending either class; specifically, in balance (n=8), flexibility (n=7), and coordination (n=3). Older adults with PD who attended both classes had minimal difficulty with computer usage and accessing the virtual program with only one participant reporting difficulty transitioning from in-person to virtual classes. Seventy percent stated they would enjoy a combination of on-site and virtual programming. Eighty-nine percent and seventy-seven perfect felt the virtual-based program was safe and beneficial, respectively. Participants who transitioned from an in-person to a virtual exercise program for people with Parkinson’s disease felt the program was safe, effective, and improved or prevented declines in their mobility.

scholarly journals Feasibility and Acceptability of Tele-Enhance Fitness in Older Adults With Knee Osteoarthritis

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 282-282
Author(s):  
Elise Hoffman ◽  
Neta Simon ◽  
Nancy Gell ◽  
Kushang Patel
Keyword(s):  
Older Adults ◽  
Knee Osteoarthritis ◽  
Social Cognitive Theory ◽  
Social Cognitive ◽  
Cognitive Theory ◽  
Exercise Program ◽  
Mixed Methods Study ◽  
Evidence Based ◽  
Interactive Instruction ◽  
Key Stakeholders

Abstract Enhance Fitness (EF) is an evidence-based, group exercise program for older adults. When COVID-19 halted in-person EF classes nationally, we adapted EF for remote delivery (tele-EF) by engaging key stakeholders. To determine feasibility and acceptability of tele-EF, we conducted a mixed methods study among 42 older adults (≥65 years) with knee osteoarthritis. Participants attended EF classes for 1-hour, 3 days/week for 4-5 months (1-3 months in-person EF and 2-4 months in tele-EF). Attendance for in-person EF was 80.0% versus 91.0% for tele-EF. Nearly all participants (95.2%) reported that they were satisfied or very satisfied with tele-EF. Qualitative exit interview data mapped well onto Social Cognitive Theory constructs. With tele-EF, participants found that livestream classes facilitated accountability and self-efficacy to participate in exercise and that interactive instruction provided encouragement and support to exercise. Thus, tele-EF is a viable remotely-delivered exercise program for older adults that retains many features of in-person EF.

scholarly journals AN ASSESSMENT OF GERIATRIC TTRAINING AND SUPPORT NEEDS FOR CAREGIVERS AND HEALTH CARE PROFESSIONALS IN RURAL TEXAS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S931-S932
Author(s):  
Susanna Luk-Jones ◽  
Jennifer J Severance ◽  
Doni Green ◽  
Donald Smith ◽  
Roslin Jose
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Health Care ◽  
Memory Loss ◽  
Support Needs ◽  
Evidence Based ◽  
Rural Counties ◽  
Evidence Based Programs ◽  
With Memory

Abstract Of the 254 counties in Texas, 69% are rural, and three out of every four counties are designated as whole or partial Primary Care Health Professional Shortage Areas. Rural counties in Texas have a higher proportion of older adults compared to metropolitan counties, and rural older adults with Alzheimer’s Disease and their caregivers face unique challenges of limited access to healthcare and lower earnings, resulting in more health-related problems. As part of a HRSA Geriatrics Workforce Enhancement Program, an academic medical center, two Area Agencies on Aging in North Texas, and an Alzheimer’s Association Chapter partnered to expand access to evidence-based programs into surrounding rural counties for older adults and caregivers of persons with Alzheimer’s Disease. An interdisciplinary workgroup developed focus group questionnaires for older adults, caregivers, and health care providers in rural areas to identify perceived needs, barriers to accessing services, and strategic partnerships. The North Central Texas Council of Governments conducted 11 focus groups in late 2018 and early 2019. Of these, seven consisted of family members caring for persons with memory loss. Four consisted of professionals who treat persons with memory loss. Transcription and thematic analysis identified key themes of training needs (both providers’ and laypersons’), resource needs, providers’ best practices, barriers to quality care, and other support needs. Practice implications of the findings include cross-sector partners and integrating telehealth platforms for program delivery. Collaboration between academic and community partners can expand access to evidence-based programs for rural and other underserved communities and address areas of need.

Champions of an Older Adult Exercise Program: Believers, Promoters, and Recruiters

2016 ◽  
Vol 37 (6) ◽  
pp. 728-744 ◽  
Author(s):  
Christina E. Miyawaki ◽  
Basia Belza ◽  
Marlana J. Kohn ◽  
Miruna Petrescu-Prahova
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Exercise Program ◽  
Evidence Based ◽  
Group Exercise ◽  
Program Delivery ◽  
Vital Part ◽  
Successful Program ◽  
Program Adoption ◽  
Evidence Based Programs

Champions, who support, market, and promote programs, are a vital part of successful program adoption, implementation, and maintenance. Enhance®Fitness (EF) is an evidence-based, community-delivered group exercise program for older adults. Using semistructured phone interviews with 20 participants, 17 instructors, and 15 staff, we explored the roles of champions in adopting, implementing, and maintaining EF at YMCA-affiliated sites. Interviews revealed EF champions play critical roles in program dissemination. Champions are outgoing, passionate, and enthusiastic about EF. They believe in the program and its benefits (believers), are “walking advertisements” (promoters), and have magnetic personalities, persuading newcomers to join (recruiters). EF champions were not purposefully selected but naturally arose during the course of program delivery. Community sites adopting evidence-based programs can foster and support champions by engaging with them, and capitalizing on their energy as an emerging resource throughout the adoption, implementation, and maintenance of programs.

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