scholarly journals Translating Behavior Change Principles Into a Blended Exercise Intervention for Older Adults: Design Study (Preprint)

2017 ◽  
Author(s):  
Sumit Mehra ◽  
Bart Visser ◽  
Tessa Dadema ◽  
Jantine van den Helder ◽  
Raoul HH Engelbert ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Behavior Change ◽  
Self Regulation ◽  
Exercise Program ◽  
Age Related ◽  
Home Based ◽  
Change Principles ◽  
Remote Feedback ◽  
Blended Intervention

BACKGROUND Physical activity can prevent or delay age-related impairments and prolong the ability of older adults to live independently. Community-based programs typically offer classes where older adults can exercise only once a week under the guidance of an instructor. The health benefits of such programs vary. Exercise frequency and the duration of the program play a key role in realizing effectiveness. An auxiliary home-based exercise program can provide older adults the opportunity to exercise more regularly over a prolonged period of time in the convenience of their own homes. Furthermore, mobile electronic devices can be used to motivate and remotely guide older adults to exercise in a safe manner. Such a blended intervention, where technology is combined with personal guidance, needs to incorporate behavior change principles to ensure effectiveness. OBJECTIVE The aim of this study was to identify theory-based components of a blended intervention that supports older adults to exercise at home. METHODS The Medical Research Council framework was used to develop the blended intervention. Insights from focus group, expert panels, and literature were combined into leading design considerations. RESULTS A client-server system had been developed that combined a tablet app with a database in the cloud and a Web-based dashboard that can be used by a personal coach to remotely monitor and guide older adults. The app contains several components that facilitate behavior change—an interactive module for goal setting, the ability to draw up a personal training schedule from a library containing over 50 exercise videos, progress monitoring, and possibilities to receive remote feedback and guidance of a personal coach. CONCLUSIONS An evidence-based blended intervention was designed to promote physical activity among older adults. The underlying design choices were underpinned by behavior change techniques that are rooted in self-regulation. Key components of the tablet-supported intervention were a tailored program that accommodates individual needs, demonstrations of functional exercises, monitoring, and remote feedback. The blended approach combines the convenience of a home-based exercise program for older adults with the strengths of mobile health and personal guidance.

scholarly journals Evaluation of a Blended Physical Activity Intervention for Older Adults: Mixed Methods Study (Preprint)

2019 ◽  
Author(s):  
Sumit Mehra ◽  
Jantine van den Helder ◽  
Bart Visser ◽  
Raoul H H Engelbert ◽  
Peter J M Weijs ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Mixed Methods ◽  
Process Evaluation ◽  
Self Regulation ◽  
Ease Of Use ◽  
The Self ◽  
Added Value ◽  
Home Based ◽  
Blended Intervention

BACKGROUND Physical activity can prolong the ability of older adults to live independently. Home-based exercises can help achieve the recommended physical activity levels. A blended intervention was developed to support older adults in performing home-based exercises. A tablet and a personal coach were provided to facilitate the self-regulation of exercise behavior. OBJECTIVE In line with the Medical Research Council framework, this study aimed to carry out process evaluation of a blended intervention. The objectives were (1) to assess the long-term usability of the tablet adopted in the blended intervention and (2) to explore how the tablet, in conjunction with a personal coach, supported older adults in performing home-based exercises. METHODS The process evaluation was conducted with a mixed-methods approach. At baseline, older adults participating in the blended intervention were asked to fill out a questionnaire about their general experience with information and communication technology (ICT) devices and rate their own skill level. After 6 months, participants filled out the Usefulness, Satisfaction, and Ease of use (USE) questionnaire to assess the usefulness, satisfaction, and ease of use of the tablet. With a random selection of participants, in-depth interviews were held to explore how the tablet and coach supported the self-regulation. The interviews were double coded and analyzed with the directed content analysis method. RESULTS At baseline, 29% (65/224) of participants who started the intervention (mean age 72 years) filled out the ICT survey and 36% (37/103) of participants who used the tablet for 6 months (mean age 71 years) filled out the USE questionnaire. Furthermore, with 17% (18/103) of participants (mean age 73 years), follow-up interviews were held. The results of the baseline questionnaire showed that the large majority of participants already had experience with a tablet, used it regularly, and reported being skillful in operating ICT devices. After 6 months of use, the participants rated the usefulness, satisfaction, and ease of use of the tablet on average as 3.8, 4.2, and 4.1, respectively, on a 5-point scale. The analysis of the interviews showed that the participants felt that the tablet supported action planning, behavior execution, and self-monitoring. On the other hand, especially during the first few months, the personal coach added value during the goal setting, behavior execution, and evaluation phases of self-regulation. CONCLUSIONS The results of the process evaluation showed that older adults who participated in the study were positive about the blended intervention that was designed to support them in performing home-based exercises. Participants reported that the tablet helped them to perform the exercises better, more frequently, and safely. It supported them in various phases of self-regulation. The availability of a personal coach was nevertheless crucial. To support physical activity in older adults, a blended approach is promising.

scholarly journals Evaluation of a Blended Physical Activity Intervention for Older Adults: Mixed Methods Study

10.2196/16380 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e16380 ◽  
Author(s):  
Sumit Mehra ◽  
Jantine van den Helder ◽  
Bart Visser ◽  
Raoul H H Engelbert ◽  
Peter J M Weijs ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Mixed Methods ◽  
Process Evaluation ◽  
Self Regulation ◽  
Ease Of Use ◽  
The Self ◽  
Added Value ◽  
Home Based ◽  
Blended Intervention

Background Physical activity can prolong the ability of older adults to live independently. Home-based exercises can help achieve the recommended physical activity levels. A blended intervention was developed to support older adults in performing home-based exercises. A tablet and a personal coach were provided to facilitate the self-regulation of exercise behavior. Objective In line with the Medical Research Council framework, this study aimed to carry out process evaluation of a blended intervention. The objectives were (1) to assess the long-term usability of the tablet adopted in the blended intervention and (2) to explore how the tablet, in conjunction with a personal coach, supported older adults in performing home-based exercises. Methods The process evaluation was conducted with a mixed-methods approach. At baseline, older adults participating in the blended intervention were asked to fill out a questionnaire about their general experience with information and communication technology (ICT) devices and rate their own skill level. After 6 months, participants filled out the Usefulness, Satisfaction, and Ease of use (USE) questionnaire to assess the usefulness, satisfaction, and ease of use of the tablet. With a random selection of participants, in-depth interviews were held to explore how the tablet and coach supported the self-regulation. The interviews were double coded and analyzed with the directed content analysis method. Results At baseline, 29% (65/224) of participants who started the intervention (mean age 72 years) filled out the ICT survey and 36% (37/103) of participants who used the tablet for 6 months (mean age 71 years) filled out the USE questionnaire. Furthermore, with 17% (18/103) of participants (mean age 73 years), follow-up interviews were held. The results of the baseline questionnaire showed that the large majority of participants already had experience with a tablet, used it regularly, and reported being skillful in operating ICT devices. After 6 months of use, the participants rated the usefulness, satisfaction, and ease of use of the tablet on average as 3.8, 4.2, and 4.1, respectively, on a 5-point scale. The analysis of the interviews showed that the participants felt that the tablet supported action planning, behavior execution, and self-monitoring. On the other hand, especially during the first few months, the personal coach added value during the goal setting, behavior execution, and evaluation phases of self-regulation. Conclusions The results of the process evaluation showed that older adults who participated in the study were positive about the blended intervention that was designed to support them in performing home-based exercises. Participants reported that the tablet helped them to perform the exercises better, more frequently, and safely. It supported them in various phases of self-regulation. The availability of a personal coach was nevertheless crucial. To support physical activity in older adults, a blended approach is promising.

scholarly journals Effects of remote feedback in home-based physical activity interventions for older adults: A systematic review

2013 ◽  
Vol 91 (1) ◽  
pp. 14-24 ◽  
Author(s):  
Hilde Geraedts ◽  
Agnes Zijlstra ◽  
Sjoerd K. Bulstra ◽  
Martin Stevens ◽  
Wiebren Zijlstra
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Older Adults ◽  
Physical Activity Interventions ◽  
Home Based ◽  
Remote Feedback

scholarly journals Strategies to Support Physical Activity Participation in Older Adults With Heart Failure

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 454-454
Author(s):  
Katherine Hall ◽  
Amy Pastva ◽  
Heather King ◽  
Sean Lowers ◽  
Julie Miller ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
Older Adults ◽  
Exercise Program ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Exercise Rehabilitation ◽  
Supervised Exercise ◽  
Home Based ◽  
Health Burdens

Abstract Physical activity (PA) is recommended for people living with heart failure (HF). Despite evidence of its benefits, participation in PA is low in this population, putting them at risk for loss of functional independence and additional health burdens. The aim of this pilot study was to ask older adults living with stable, chronic HF to identify strategies to support regular PA. Patients in an outpatient HF rehabilitation program were recruited to participate in focus groups about their PA knowledge, attitudes, and preferences as part of a stakeholder engagement project. At the beginning of the focus group, participants completed a questionnaire listing 8 potential strategies to optimize PA, and were asked to identify the top 4 strategies that they thought would be most beneficial to support regular PA participation. This was the focus of the current analysis. Thirteen adults with HF (M age=65; 46% female; 62% African American; M BMI=32.6 kg/m2) were enrolled. Top-rated strategies endorsed by participants to support long-term adherence to PA included provision of an exercise guide to support home-based exercise and supplement health provider-supervised exercise sessions (69%), group education classes (64%), completion of fitness assessments at regular intervals (62%), and provision of a transition pathway from an exercise rehabilitation program to a community-based exercise program (62%). The remaining strategies were endorsed by fewer than 50% of participants, and included remote delivery and support options. These results have important implications for future program development and implementation efforts to support PA among older adults with stable, chronic HF.

scholarly journals Impact of the Home Confinement Related to COVID-19 on the Device-Assessed Physical Activity and Sedentary Patterns of Spanish Older Adults

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Ángel I. Fernández-García ◽  
Jorge Marin-Puyalto ◽  
Alba Gómez-Cabello ◽  
Ángel Matute-Llorente ◽  
Jorge Subías-Perié ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Sedentary Behaviour ◽  
Repeated Measures ◽  
Sedentary Time ◽  
Exercise Program ◽  
Sedentary Behaviours ◽  
Home Based ◽  
Phase 0 ◽  
Sedentary Bouts

The main objective of this study was to device-assess the levels of physical activity and sedentary behaviour patterns of older adults during the situation prior to the COVID-19 pandemic, home confinement, and phase-0 of the deescalation. We also aimed to analyse the effectiveness of an unsupervised home-based exercise routine to counteract the potential increase in sedentary behaviour during the periods within the pandemic. A total of 18 noninstitutionalized older adults( 78.4 ± 6.0  y.), members of the Spanish cohort of the EXERNET-Elder 3.0 project, participated in the study. They were recommended to perform an exercise prescription based on resistance, balance, and aerobic exercises during the pandemic. Wrist triaxial accelerometers (ActiGraph GT9X) were used to assess the percentage of sedentary time, physical activity, sedentary bouts and breaks of sedentary time. An ANOVA for repeated measures was performed to analyse the differences between the three different periods. During home quarantine, older adults spent more time in sedentary behaviours ( 71.6 ± 5.3 % ) in comparison with either the situation prior to the pandemic ( 65.5 ± 6.7 % ) or the ending of isolation ( 67.7 ± 7.1 % ) (all p < 0.05 ). Moreover, participants performed less bouts of physical activity and with a shorter duration during home quarantine (both p < 0.05 ). Additionally, no differences in the physical activity behaviours were found between the situation prior to the pandemic and the phase-0 of deescalation. According to our results, the home confinement could negatively affect health due to increased sedentary lifestyle and the reduction of physical activity. Therefore, our unsupervised exercise program does not seem to be a completely effective strategy at least in this period.

Older Adults’ Experiences With the Visual Physio-Feedback Technology and Peer-Led Combined Group and Home-Based Exercises

2020 ◽  
pp. 1-8
Author(s):  
Ladda Thiamwong
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Exercise Program ◽  
Program Completion ◽  
Study Approach ◽  
Home Based ◽  
Cognitive Reframing ◽  
Program Intervention ◽  
Physical Activity Adherence ◽  
Peer Coach

This study aimed to explore older adults’ experience with an in-home Physio-feEdback and Exercise pRogram and explore whether the Physio-feEdback and Exercise pRogram intervention influenced their physical activity adherence. A qualitative study approach was employed, and data were collected using exercise logs, observations, focus groups, and open-ended questions after the program completion. Nineteen participants who engaged in an 8-week Physio-feEdback and Exercise pRogram intervention participated in this study. Thematic analysis was used. Three major concepts of the self-determination theory, including competence, relatedness, and autonomy, were used as guidelines for coding. Results reveal three themes, including: (a) competence-alignment of body and mind and increased awareness about fall risk, (b) relatedness-relationship with peer coach and having fun with friends, and (c) autonomy-integration of exercise into daily activities for staying physically and socially active. Individuals’ need for competence and autonomy can be supported by giving physio-feedback, cognitive reframing, and peer-led exercise, which can enhance physical activity and prevent falls.

scholarly journals Feasibility, Usability and Enjoyment of a Home-based, Multi-component Exercise Program for Musculoskeletal Health Delivered via a Tablet Computer Exercise App for Community-dwelling Older Adults: An 8-week Prospective Pilot Study (Preprint)

2020 ◽  
Author(s):  
Robin M Daly ◽  
Jenny Gianoudis ◽  
Travis Hall ◽  
Niamh Mundell ◽  
Ralph Maddison
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Exercise Prescription ◽  
Exercise Program ◽  
Community Dwelling ◽  
Tablet Computer ◽  
Musculoskeletal Health ◽  
Home Based ◽  
Community Dwelling Older Adults ◽  
Activity Enjoyment

BACKGROUND Many older adults choose and prefer to exercise at home, but to attain the greatest benefits the correct type and dose should be prescribed and adherence maintained. Advances in digital health technologies now provide the opportunity for exercise professionals to deliver and monitor personalized, evidence-based exercise programs to anyone at anytime. OBJECTIVE To evaluate the feasibility, usability and enjoyment of an online exercise prescription application as a platform for exercise professionals to remotely deliver and monitor an individually-tailored, home-based multi-component exercise program (delivered through tablet computers) to older adults living independently in the community. METHODS This was an 8-week, prospective single-arm pilot study in 20 adults aged ≥65 years living independently in the community [10 who owned a tablet computer (tablet owners) and 10 who did not (tablet non-owners)]. All participants were prescribed a home-based, muscle strengthening, weight-bearing impact and challenging balance/mobility program (3 days/week) using a commercial exercise prescription application (app) on a tablet computer. Study endpoints were feasibility (retention, adherence, adverse events), usability (System Usability Scale), physical activity enjoyment (Physical Activity Enjoyment Scale), changes in lower extremity function [Short Physical Performance Battery (SPPB)], and level of physical activity (questionnaire). Process measures related to participants’ experiences and perceptions of the exercise program and online application were also included. RESULTS A total of 19 participants (mean age 70 years) completed the study (19 of 20, 95%) and mean adherence to the exercise program was 84% (95% CI, 70, 97). There were two minor adverse events in two participants from 401 completed sessions. Mean weekly walking time increased by 78 minutes [(95% CI, 0, 156), P=.049] and moderate-vigorous physical activity time by 41 minutes [(95% CI, -8, 90), P=.09]. For SPPB scores, there was a 0.3 point [(95% CI, -0.1, 0.7), P=.17] modest sized (effect size, d=0.42) improvement after 8 weeks. Mean system usability was high (mean  SD, 86  10 with 100 best imaginable]. There was no change in overall physical activity enjoyment scores after 8 weeks, but participants reported that they enjoyed using the online exercise app and the exercise program (median score 4 on a 5-point Likert scale). For all measures, there were no differences between previous tablet owners and non-owners. CONCLUSIONS This pilot feasibility study indicates that it is safe and feasible for community-dwelling older adults to participate in a home-based, multi-component exercise program targeting musculoskeletal health and function that was delivered and monitored remotely by exercise professionals using a tablet-based exercise prescription app.

scholarly journals When Adults Don’t Exercise: Behavioral Strategies to Increase Physical Activity in Sedentary Middle-Aged and Older Adults

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Margie E Lachman ◽  
Lewis Lipsitz ◽  
James Lubben ◽  
Carmen Castaneda-Sceppa ◽  
Alan M Jette
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Behavior Change ◽  
Self Regulation ◽  
Later Life ◽  
Well Being ◽  
Control Beliefs ◽  
Behavioral Strategies ◽  
Middle Aged ◽  
Behavior Change Interventions

Abstract Physical activity is one of the most promising nonpharmacological, noninvasive, and cost-effective methods of health-promotion, yet statistics show that only a small percentage of middle-aged and older adults engage in the recommended amount of regular exercise. This state of affairs is less likely due to a lack of knowledge about the benefits of exercise than to failures of motivation and self-regulatory mechanisms. Many types of intervention programs target exercise in later life, but they typically do not achieve sustained behavior change, and there has been very little increase in the exercise rate in the population over the last decade. The goal of this paper is to consider the use of effective low-cost motivational and behavioral strategies for increasing physical activity, which could have far-reaching benefits at the individual and population levels. We present a multicomponent framework to guide development of behavior change interventions to increase and maintain physical activity among sedentary adults and others at risk for health problems. This involves a personalized approach to motivation and behavior change, which includes social support, goal setting, and positive affect coupled with cognitive restructuring of negative and self-defeating attitudes and misconceptions. These strategies can lead to increases in exercise self-efficacy and control beliefs as well as self- management skills such as self-regulation and action planning, which in turn are expected to lead to long-term increases in activity. These changes in activity frequency and intensity can ultimately lead to improvements in physical and psychological well-being among middle-aged and older adults, including those from underserved, vulnerable populations. Even a modest increase in physical activity can have a significant impact on health and quality of life. Recommendations for future interventions include a focus on ways to achieve personalized approaches, broad outreach, and maintenance of behavior changes.

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