A personalised smartphone-delivered just-in-time adaptive intervention (JITABug) to increase physical activity in older adults: A feasibility pilot study (Preprint)

2021 ◽  
Author(s):  
Jacqueline Louise Mair ◽  
Lawrence Hayes ◽  
Amy Campbell ◽  
Duncan Buchan ◽  
Chris Easton ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Data Collection ◽  
Real Time ◽  
Behaviour Change ◽  
Time Of Day ◽  
Activity Level ◽  
Just In Time ◽  
Activity Tracker ◽  
Wearable Activity Tracker

BACKGROUND Just-in-time-adaptive-interventions (JITAIs) provide real-time ‘in the moment’ behaviour change support to people when they need it most. JITAIs could be a viable way to provide personalised physical activity support to older adults in the community. However, it is unclear how feasible it is to remotely deliver a physical activity intervention via a smartphone to older adults, or how acceptable older adults would find a JITAI targeting physical activity in everyday life. OBJECTIVE (1) to describe the development of “JITABug”, a personalised smartphone and activity tracker delivered JITAI designed to support older adults to increase or maintain their physical activity level; (2) to explore the acceptability of JITABug in a free-living setting, and (3) to assess the feasibility of conducting an effectiveness trial of the JITABug intervention. METHODS The intervention development process was underpinned by the Behaviour Change Wheel. The intervention consisted of a wearable activity tracker (Fitbit) and a companion smartphone app (JITABug) which delivered goal setting, planning, reminders, and just-in-time adaptive messages to encourage achievement of personalised physical activity goals. Message delivery was tailored based on time of day, real-time physical activity tracker data, and weather conditions. We tested the feasibility of remotely delivering the JITAI with older adults in a 6-week trial using a mixed-methods approach. Data collection involved assessment of physical activity by accelerometery and activity tracker, self-reported mood and mental wellbeing via ecological momentary assessment, and contextual information on physical activity via voice memos. Feasibility and acceptability outcomes included: (1) recruitment capability and adherence to the intervention; (2) intervention delivery ‘in the wild’; (3) appropriateness of data collection methodology; (4) adverse events and; (5) participant satisfaction. RESULTS Of 46 recruited older adults (aged 56-72 years old), 65% completed the intervention. The intervention was successfully delivered as intended; 27 participants completed the intervention independently, 94% of physical activity messages were successfully delivered, and 99% of Fitbit and 100% of weather data calls were successful. Wrist-worn accelerometer data were obtained from 96% at baseline and 96% at follow up. On average, participants recorded 8/16 (50%) voice memos, 3/8 (38%) mood assessments, and 2/4 (50%) wellbeing assessments via the app. Overall acceptability of the intervention was very good (77% satisfaction). Participant feedback suggested that more diverse and tailored physical activity messages, app usage reminders, technical refinements regarding real-time data syncing, and an improved user interface could improve the intervention and make it more appealing. CONCLUSIONS This study suggests that a smartphone delivered JITAI utilizing a wearable activity tracker is an acceptable way to support physical activity in older adults in the community. Overall, the intervention is feasible, however based on user feedback, the JITABug app requires further technical refinements that may enhance usage, engagement, and user satisfaction before moving to effectiveness trials. CLINICALTRIAL Non-Applicable

‘No one ever asked us’: a feasibility study assessing the co-creation of a physical activity programme with adolescent girls

2019 ◽  
Vol 27 (3) ◽  
pp. 34-43
Author(s):  
Méabh Corr ◽  
Elaine Murtagh
Keyword(s):  
Physical Activity ◽  
Data Collection ◽  
Behaviour Change ◽  
Adolescent Girls ◽  
Retention Rate ◽  
Controlled Trial ◽  
Activity Level ◽  
Health Concern ◽  
Post Intervention ◽  
Behaviour Change Wheel

Background: Globally, the poor activity level of adolescent girls is a public health concern. Little research has involved adolescents in the design of interventions. This study assessed the feasibility of involving girls in the co-creation of an activity programme. Methods: Thirty-one students (15–17 years old) were recruited from a post-primary school. The Behaviour Change Wheel guided intervention design, providing insights into participants’ capability, opportunity and motivation for change. Step counts and self-reported physical activity levels were recorded pre- and post-intervention. Feasibility benchmarks assessed recruitment, data collection, acceptability and adherence. Results: Activity and educational sessions were delivered for six weeks during physical education class. Average attendance was 87% (benchmark = 80%). Eligibility was 61% (benchmark = 60%). There was a 100% retention rate (benchmark = 90%). All participants ( n = 31) completed baseline measures and 71% ( n = 22) completed post-measures. 54% ( n = 17) of students completed pedometer measurements, with 32% ( n = 10) having complete data. Average daily steps were 13,121 pre-intervention and 14,128 post-intervention ( p > 0.05). Data collection was feasible, receiving a mean score > 4/5 (benchmark > 3.5/5). Conclusions: The Behaviour Change Wheel can be used to co-create an activity programme with adolescent girls. Predetermined benchmarks, except for pedometer recordings, were reached or exceeded, providing evidence for the need of a randomised controlled trial to test effectiveness.

scholarly journals Enhancing the Physical Activity Levels of Frail Older Adults with a Wearable Activity Tracker-Based Exercise Intervention: A Pilot Cluster Randomized Controlled Trial

2021 ◽  
Vol 18 (19) ◽  
pp. 10344
Author(s):  
Justina Y. W. Liu ◽  
Rick Y. C. Kwan ◽  
Yue-Heng Yin ◽  
Paul H. Lee ◽  
Judy Yuen-man Siu ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Exercise Intervention ◽  
Community Dwelling ◽  
Activity Levels ◽  
Frail Older Adults ◽  
Activity Tracker ◽  
Physical Activity Levels ◽  
Wearable Activity Tracker

A wearable activity tracker (WAT) incorporated with behavioral change techniques (BCTs) increases physical activity in younger adults; however, its effectiveness with frail older adults is unknown. The feasibility and preliminary effects of a WAT-based exercise intervention to increase physical activity levels in frail older adults was investigated in this pilot study involving 40 community-dwelling frail older adults. The experimental group received a 14-week WAT-based group exercise intervention and a 3-month follow-up, while the control group only received similar physical training and all BCTs. The recruitment rate was 93%, and the average attendance rate was 85.2% and 82.2% in the WAT and control groups, respectively, establishing feasibility. Adherence to wearing the WAT was 94.2% and 92% during the intervention and follow-up periods, respectively. A significant interaction effect between time and group was found in all physical assessments, possibly lasting for 3 months post-intervention. However, no significant difference between groups was observed in any daily activity level by the ActiGraph measurement. The majority of the WAT group’s ActiGraph measurements reverted to baseline levels at the 1-month follow-up. Thus, the WAT-based exercise program has potential for employment among community-dwelling frail older adults, but sustaining the effects after the intervention remains a major challenge.

scholarly journals Effect of commercial wearables and digital behaviour change resources on the physical activity of adolescents attending schools in socio-economically disadvantaged areas: the RAW-PA cluster-randomised controlled trial

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Nicola D. Ridgers ◽  
Anna Timperio ◽  
Kylie Ball ◽  
Samuel K. Lai ◽  
Helen Brown ◽  
...  
Keyword(s):  
Physical Activity ◽  
Behaviour Change ◽  
Control Group ◽  
Activity Levels ◽  
Wait List ◽  
Wait List Control Group ◽  
Post Intervention ◽  
Wait List Control ◽  
Activity Tracker ◽  
Wearable Activity Tracker

Abstract Background There has been increasing interest in using wearable activity trackers to promote physical activity in youth. This study examined the short- and longer-term effects of a wearable activity tracker combined with digital behaviour change resources on the physical activity of adolescents attending schools in socio-economically disadvantaged areas. Methods The Raising Awareness of Physical Activity (RAW-PA) Study was a 12-week, multicomponent intervention that combined a Fitbit Flex (and accompanying app), and online digital behaviour change resources and weekly challenges delivered via Facebook. RAW-PA was evaluated using a cluster-randomised controlled trial with 275 adolescents (50.2% female; 13.7 ± 0.4 years) from 18 Melbourne secondary schools (intervention n = 9; wait-list control group n = 9). The primary outcome was moderate- to vigorous-intensity physical activity (MVPA), measured using hip-worn ActiGraph accelerometers. The secondary outcome was self-reported physical activity. Data were collected at baseline, 12-weeks (immediately post-intervention), and 6-months post-intervention (follow-up). Multilevel models were used to determine the effects of the intervention on daily MVPA over time, adjusting for covariates. Results No significant differences were observed between intervention and wait-list control adolescents’ device-assessed MVPA immediately post-intervention. At 6-months post-intervention, adolescents in the intervention group engaged in 5 min (95% CI: − 9.1 to − 1.0) less MVPA per day than those in the wait-list control group. Males in the intervention group engaged in 11 min (95% CI: − 17.6 to − 4.5) less MVPA than males in the wait-list control group at 6-months post-intervention. No significant differences were observed for females at either time point. For self-reported physical activity, no significant effects were found at 12-weeks and 6-months post-intervention. Conclusions Combining a wearable activity tracker with digital behaviour change resources and weekly challenges did not increase inactive adolescents’ accelerometer-derived and self-reported physical activity levels immediately post-intervention. This contrasts previous research that has suggested wearable activity tracker may increase youth physical activity levels in the short-term. Lower engagement in MVPA 6-months post-intervention was observed for males but not for females, though it is unclear why this finding was observed. The results suggest wearable activity trackers, in combination with supporting materials, may not be effective for increasing physical activity levels in adolescents. Trial registration ACTRN12616000899448. Australian and New Zealand Clinical Trials Registry. Registered 7 July 2016.

Physical Activity Level and Motor Aptitude: Motor Domains and Identification Capacity of Brazilian Insufficiently Active Older Adults

2020 ◽  
Vol 13 ◽  
Author(s):  
Lucia Maria Andreis ◽  
Fernando de Aguiar Lemos ◽  
Lorenna Walesca de Lima Silva ◽  
Cassiana Luiza Pistorello Garcia ◽  
Gabrielli Veras ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Physical Activity Level ◽  
Area Under The Curve ◽  
The Elderly ◽  
Activity Level ◽  
General Motor ◽  
Body Scheme ◽  
Significant Difference ◽  
Global Coordination

Background: A decrease in the physical activity level in old age is common, which results in an increase in the number of falls and chronic conditions. Associated with that occurs the decline in motor skills as a result of the deficit in the interaction of cognitive and motor processes. Physical activity level can be associated differently with each motor domains. Objective: We analyzed the relationship between physical activity level and motor aptitude, and to identify which motor domains were most sensitive to detect insufficiently active level in older adults. Methods: Participated in the study 385 elderly people of both sexes. For the evaluation of the subjects were adopted the International Questionnaire on Physical Activity and the Motor Scale for Older Adults. Results: The majority of the elderly were active. In the comparison of motor aptitude between active and insufficiently active (IAC) elders a significant difference was found in the Global Coordination, Balance, Body Scheme and General Motor Aptitude. From the analysis of the area under the curve (AUC), we verified that these domains also were the ones that presented adequate diagnostic accuracy to identify IAC elderly. Besides that active elderly have presented the General Motor Aptitude classified within normality while the IAC below the normal. Conclusion: Our data suggest that IAC older adults present lower motor aptitude than the active elderly, especially in the domains of Global Coordination, Balance, Body Scheme and General Motor Aptitude, and that these domains were sensitive to indicate IAC older adults.

scholarly journals Associations between objectively measured physical activity, sedentary behaviour and time in bed among 75+ community-dwelling Danish older adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Li-Tang Tsai ◽  
Eleanor Boyle ◽  
Jan C. Brønd ◽  
Gry Kock ◽  
Mathias Skjødt ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Sedentary Behavior ◽  
Sedentary Behaviour ◽  
Sleep Duration ◽  
Activity Level ◽  
Time In Bed ◽  
Objectively Measured ◽  
Objectively Measured Physical Activity ◽  
Vector Magnitude

Abstract Background Older adults are recommended to sleep 7–8 h/day. Time in bed (TIB) differs from sleep duration and includes also the time of lying in bed without sleeping. Long TIB (≥9 h) are associated with self-reported sedentary behavior, but the association between objectively measured physical activity, sedentary behavior and TIB is unknown. Methods This study was based on cross-sectional analysis of the Healthy Ageing Network of Competence (HANC Study). Physical activity and sedentary behaviour were measured by a tri-axial accelerometer (ActiGraph) placed on the dominant wrist for 7 days. Sedentary behavior was classified as < 2303 counts per minute (cpm) in vector magnitude and physical activity intensities were categorized, as 2303–4999 and ≥ 5000 cpm in vector magnitude. TIB was recorded in self-reported diaries. Participants were categorized as UTIB (usually having TIB 7–9 h/night: ≥80% of measurement days), STIB (sometimes having TIB 7–9 h/night: 20–79% of measurement days), and RTIB (rarely having TIB 7–9 h/night: < 20% of measurement days). Multinominal regression models were used to calculate the relative risk ratios (RRR) of being RTIB and STIB by daily levels of physical activity and SB, with UTIB as the reference group. The models were adjusted for age, sex, average daily nap length and physical function. Results Three hundred and fourty-one older adults (median age 81 (IQR 5), 62% women) were included with median TIB of 8 h 21 min (1 h 10 min)/day, physical activity level of 2054 (864) CPM with 64 (15) % of waking hours in sedentary behavior. Those with average CPM within the highest tertile had a lower RRR (0.33 (0.15–0.71), p = 0.005) for being RTIB compared to those within the lowest tertile of average CPM. Accumulating physical activity in intensities 2303–4999 and ≥ 5000 cpm/day did not affect the RRR of being RTIB. RRR of being RTIB among highly sedentary participants (≥10 h/day of sedentary behavior) more than tripled compared to those who were less sedentary (3.21 (1.50–6.88), p = 0.003). Conclusions For older adults, being physically active and less sedentary was associated with being in bed for 7–9 h/night for most nights (≥80%). Future longitudinal studies are warranted to explore the causal relationship sbetween physical activity and sleep duration.

Effects of Sex and Physical Activity Level on Serum Biomarker-Based Physiological Dysregulation: The Impact to Predict Frailty and Mortality in the Quebec NuAge Cohort

Gerontology ◽  
2021 ◽  
pp. 1-14
Author(s):  
Ahmed Ghachem ◽  
Frédérik Dufour ◽  
Tamas Fülöp ◽  
Pierrette Gaudreau ◽  
Alan A. Cohen
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Kidney Function ◽  
Oxygen Transport ◽  
Physical Activity Level ◽  
Rate Of Change ◽  
Activity Level ◽  
Men And Women ◽  
Physiological Dysregulation ◽  
The Impact

<b><i>Background:</i></b> Age-related changes in biological processes such as physiological dysregulation (the progressive loss of homeostatic capacity) vary considerably among older adults and may influence health profiles in late life. These differences could be related, at least in part, to the impact of intrinsic and extrinsic factors such as sex and physical activity level (PAL). <b><i>Objectives:</i></b> The objectives of this study were (1) to assess the magnitude and rate of changes in physiologi­cal dysregulation in men and women according to PAL and (2) to determine whether/how sex and PAL mediate the apparent influence of physiological dysregulation on health outcomes (frailty and mortality). <b><i>Methods:</i></b> We used data on 1,754 community-dwelling older adults (age = 74.4 ± 4.2 years; women = 52.4%) of the Quebec NuAge cohort study. Physiological dysregulation was calculated based on Mahalanobis distance of 31 biomarkers regrouped into 5 systems: oxygen transport, liver/kidney function, leukopoiesis, micronutrients, and lipids. <b><i>Results:</i></b> As expected, mean physiological dysregulation significantly increased with age while PAL decreased. For the same age and PAL, men showed higher levels of physiological dysregulation globally in 3 systems: oxygen transport, liver/kidney function, and leukopoiesis. Men also showed faster global physiological dysregulation in the liver/kidney and leukopoiesis systems. Overall, high PAL was associated with lower level and slower rate of change of physiological dysregulation. Finally, while mortality and frailty risk significantly increased with physiological dysregulation, there was no evidence for differences in these effects between sexes and PAL. <b><i>Conclusion:</i></b> Our results showed that both sex and PAL have a significant effect on physiological dysregulation levels and rates of change. Also, although a higher PAL was associated with lower level and slower rate of change of physiological dysregulation, there was no evidence that PAL attenuates the effect of physiological dysregulation on subsequent declines in health at the end of life. Substantial work remains to understand how modifiable behaviors impact the relationship between physiological dysregulation, frailty, and mortality in men and women.

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