Explaining Online Fraud Victimization of Older Adults via Cyber Routines and Lifestyles

The paper compares victim group characteristics: the differences between individuals under 55 and 55 and older, victimized by online fraud committed by a stranger. We test Cyber-Routine Activities Theory (cyber-RAT; Choi, 2008). In addition to active online lifestyle and computer familiarity, we include in the analysis independent variables such as living arrangements, occupation, and the willingness to report and ask for help. A representative sample of US citizens 18 or older was collected using a Dynata research panel in October 2020. We utilized one-way ANOVA on ranks for testing whether older and younger victims’ characteristics can be derived from the same independent variables. We find that older victims differ in characteristics from younger victims. Those who live alone or in a marriage with no children, and retired are significantly less victimized by online fraud than those who live with a partner and children and having full-time jobs. Besides, they are less likely to report their victimization, and their online activities and computer familiarity make them more vulnerable to online fraud than younger adults. Our findings suggest that older victims need prevention and intervention solutions designed especially for them. In an aging society, individuals will be increasingly active online and in the job market. Employers must provide internet security training for employees on manipulative online scams. Crime prevention programs must include awareness-raising on the role of reporting and how to ask for help. Relatives, friends, and caretakers need to be trained in preventing and early recognizing online fraud impacting older adults.

Using Technology for Prescription and Adherence in an Alzheimer’s Prevention Program

Healthy lifestyle change is difficult to adopt and maintain without support. Often physicians recommend exercise to their patients, but have limited means to support this change. A major goal of our study is to provide physicians with a simple method of referring patients to a program that supports adoption and maintenance of exercise that meets recommended guidelines for older adults. The Lifestyle Empowerment for Alzheimer’s Prevention program (LEAP! Rx) is a yearlong intervention to support cognitively normal older adults in adoption and maintenance of moderate to vigorous exercise, a key prevention factor for Alzheimer’s disease. The program uses the electronic medical record and builds relationships with physicians to identify patients eligible to participate. It electronically communicates about patients’ progress back to referring physicians to facilitate ongoing physician-patient interaction. Participants receive exercise coaching to reach their weekly exercise goals and have access to online lifestyle education classes (e.g., nutrition, sleep, stress management). The study is currently enrolling (n= 121 enrolled; mean age 71.4; 12% non-white, 4% Hispanic/Latino, and 83% female). Physician referrals originate from five clinics represented by 48 physicians. The study design will actively compare the physician referral process to self-referrals from the community (n=20). We have adapted the protocol to the conditions of the pandemic including online exercise coaching and support. This presentation will discuss successes and lessons learned from this novel method of recruitment and adherence to exercise.

Navigating the online world of lifestyle health information: an adolescent perspective (Preprint)

BACKGROUND Adolescence is a critical life stage characterised by an interplay of biological, social and environmental factors. Such factors influence lifestyle health related trajectories, including dietary behaviours, physical activity levels, body weight and sleep hygiene. Generation Z (born 1995-2015) are the most internet-dependent and technologically savvy generation in history with increasing rates of smartphone ownership in both developed and developing nations. Gaps exist in our understanding of what online platforms adolescents are using and the barriers and facilitators of these platforms to seek lifestyle health information. OBJECTIVE We evaluated adolescents’ perceptions on the use of contemporary digital platforms (websites, social media platforms and smartphone apps) to seek information or advice related to lifestyle heath. METHODS Virtual focus groups were held via Zoom teleconference between July to August 2021. Eligible participants were 13-18 years, living in Australia and had searched for online lifestyle health information in the previous three months. For this study, lifestyle health information referred to key behaviours and risk factors for chronic disease, namely, diet, physical activity, weight management and sleep. Participants were recruited through an existing database of research participants and networks of the research team. Focus groups were analysed using the Framework approach, where data is systematically searched to recognize patterns in the data and manage, analyse and identify themes. Focus group audio files were transcribed verbatim and independently coded by two researchers (RR, SJ). Through an iterative and reflexive process, a final coding matrix was agreed on by all researchers and used to thematically analyse the data. RESULTS Five focus groups were held (n=32, mean age 16.3(1.4), 18/32, 56% female, 13/32, 41% spoke language other than English at home). Thematic analysis revealed participants searched for information both actively (e.g., on Google or YouTube) and passively (e.g., scrolling social media and using existing apps preloaded to their smartphone such as Apple ‘Health’, Samsung ‘Health’ or ‘Google Fit’ apps). Participants identified that the most helpful information was well-organised in terms of aesthetic appeal and layout, came from a credible and reliable source (e.g. any sponsorships disclosed) and expressed the need for the information to be relatable. Mixed views were reported for the application of lifestyle health information found online. Some participants reported behaviour change, while others noted that certain advice was hard to maintain and incorporate into their lifestyle. CONCLUSIONS This study highlights the abundance and complexity of lifestyle health information online for adolescents. Adolescents in the digital age seek access to information that is appealing, credible, relevant and actionable for lifestyle health behaviours. To appeal to the needs of adolescents, future interventions for adolescents relating to lifestyle health must consider co-design methodological approaches. Furthermore, the regulation of lifestyle health information available online warrants further investigation.

Reach, engagement and effectiveness of in-person and online lifestyle change programs to prevent diabetes

Background COVID-19 has accelerated interest in and need for online delivery of healthcare. We examined the reach, engagement and effectiveness of online delivery of lifestyle change programs (LCP) modelled after the Diabetes Prevention Program (DPP) in a multistate, real-world setting. Methods Longitudinal, non-randomized study comparing online and in-person LCP in a large multistate sample delivered over 1 year. Sample included at-risk adults (n = 26,743) referred to online (n = 9) and in-person (n = 11) CDC-recognized LCP from a multi-state registry (California, Florida and Colorado) between 2015 and 2018. The main outcome was effectiveness (proportion achieving > 5% weight loss) at one-year. Our secondary outcomes included reach (proportion enrolled among referred) and engagement (proportion ≥ 9 sessions by week 26). We used logistic regression modelling to assess the association between participant- and setting -level characteristics with meaningful weight loss. Results Online LCP effectiveness was lower, with 23% of online participants achieving > 5% weight loss, compared with 35% of in-person participants (p < 0.001). More adults referred to online programs enrolled (56% vs 51%, p < 0.001), but fewer engaged at 6-months (attendance at ≥9 sessions 46% vs 66%, p < 0.001) compared to in-person participants. Conclusions Compared to adults referred to in-person LCP, those referred to online LCP were more likely to enroll and less likely to engage. Online participants achieved modest meaningful weight loss. Online delivery of LCP is an attractive strategy to deliver and scale DPP, particularly with social distancing measures currently in place. However, it is unclear how to optimize delivery models for maximal impact given trade-offs in reach and effectiveness.

324 - Twelve-month progress of online intervention to prevent cognitive decline: Maintain Your Brain

Authors:Henry Brodaty, Megan Heffernan, Gavin Andrews, Kaarin Anstey, Maria Fiatarone Singh, Louisa Jorm, Nicola Lautenschlager, Anthony Maeder, John McNeill, Perminder Sachdev, Michael Valenzuela, Maintain Your Brain Collaborative Team.Abstract:In the absence of disease modifying interventions for Alzheimer’s disease (AD) and other dementias there is an increased interest in dementia prevention. An issue for population-based lifestyle preventative approaches is scalability. An internet-based multicomponent Maintain Your Brain (MYB) randomised trial is currently underway.Invitations to participate in Maintain Your Brain were emailed or mailed to people aged 55-77 years from the 45 and Up study, a population-based cohort study of one in ten people aged 45 years and older (n = 267,000). To be enrolled into the study participants were required to have risk factors that made them eligible for at least one of the available modules. Modules were designed to address physical inactivity and health risks associated with inactivity (Physical Activity), adherence to a Mediterranean-type diet and health risks associated with poor nutrition (Nutrition), cognitive activity (Brain Training) and mental wellbeing (Peace of Mind).During recruitment 96,418 invitations were sent and 14,064 (14%) provided consent. Of those who completed baseline over 90% were eligible for at least two modules of the intervention. Overall, 6,236 (44%) were enrolled resulting in an overall recruitment rate of 6%, or 50% of those eligible at screening. The final sample was 64% female with a mean age of 64.9yrs (SD = 5.8, range 55-77 yrs) and mean years of education of 12.9yrs (SD = 3.0, range 2-22 yrs).Recruitment rates in MYB were comparable to other clinical trials targeting older people and who included online recruitment strategies. This is promising for the willingness of participants to engage with trials that use online rather than traditional in-person methods. Although the baseline withdrawal number (3%) remained stable after randomisation (4%), a further 25% of participants did not attempt any activities. These rates continued at the annual assessments when 4% withdrew, 31% completed no follow-up activities, 14% partially completed and 55% completed all.Online lifestyle interventions have capacity to reach broad segments of the 55-77 year old population, the majority of whom may benefit from support activities shown to be effective in reducing risk of cognitive decline and ultimately delay onset of dementia. The challenge with this new approach is encouraging continued engagement with the program over time.

Impact of a Blended Periconception Lifestyle Care Approach on Lifestyle Behaviors: Before-and-After Study

Background Periconception lifestyle behaviors affect maternal, paternal, offspring, and transgenerational health outcomes. Previous research in other target populations has shown that personalized lifestyle interventions, in which face-to-face counseling and eHealth (“blended care”) are combined, may effectively target these lifestyle behaviors. Objective We aimed to assess the effectiveness of a periconceptional lifestyle intervention on the improvement of specific lifestyle components. Methods A blended periconception lifestyle care approach was developed, combining the outpatient lifestyle counseling service “Healthy Pregnancy” with the eHealth platform “Smarter Pregnancy” (www.smarterpregnancy.co.uk) in which lifestyle was coached for 24 weeks. All couples contemplating pregnancy or already pregnant (≤12 weeks of gestation) who visited the outpatient clinics of the Department of Obstetrics and Gynecology at the Erasmus University Medical Center (Erasmus MC), Rotterdam, the Netherlands, between June and December 2018, were invited to participate. We measured changes in lifestyle behaviors at weeks 12 and 24 compared with baseline. Generalized estimating equations were used to analyze the changes in lifestyle behaviors over time. Subgroup analyses were performed for women with obesity (BMI ≥30 kg/m2), women pregnant at the start of the intervention, and those participating as a couple. Results A total of 539 women were screened for eligibility, and 450 women and 61 men received the blended periconception intervention. Among the participating women, 58.4% (263/450) were included in the preconception period. Moreover, 78.9% (403/511) of the included participants completed the online lifestyle coaching. At baseline, at least one poor lifestyle behavior was present in most women (379/450, 84.2%) and men (58/61, 95.1%). In the total group, median fruit intake increased from 1.8 to 2.2 pieces/day (P<.001) and median vegetable intake increased from 151 to 165 grams/day (P<.001) after 24 weeks of online coaching. The probability of taking folic acid supplementation among women increased from 0.97 to 1 (P<.001), and the probability of consuming alcohol and using tobacco in the total group decreased from 0.25 to 0.19 (P=.002) and from 0.20 to 0.15 (P=.63), respectively. Overall, the program showed the strongest effectiveness for participating couples. Particularly for vegetable and fruit intake, their consumption increased from 158 grams/day and 1.8 pieces/day at baseline to 190 grams/day and 2.7 pieces/day at the end of the intervention, respectively. Conclusions We succeeded in including most participating women in the preconception period. A high compliance rate was achieved and users demonstrated improvements in several lifestyle components. The blended periconception lifestyle care approach seems to be an effective method to improve lifestyle behaviors. The next step is to further disseminate this approach and to perform a randomized trial to compare the use of blended care with the provision of only eHealth. Additionally, the clinical relevance of these results will need to be substantiated further.

Impact of a Blended Periconception Lifestyle Care Approach on Lifestyle Behaviors: Before-and-After Study (Preprint)

BACKGROUND Periconception lifestyle behaviors affect maternal, paternal, offspring, and transgenerational health outcomes. Previous research in other target populations has shown that personalized lifestyle interventions, in which face-to-face counseling and eHealth (“blended care”) are combined, may effectively target these lifestyle behaviors. OBJECTIVE We aimed to assess the effectiveness of a periconceptional lifestyle intervention on the improvement of specific lifestyle components. METHODS A blended periconception lifestyle care approach was developed, combining the outpatient lifestyle counseling service “Healthy Pregnancy” with the eHealth platform “Smarter Pregnancy” (www.smarterpregnancy.co.uk) in which lifestyle was coached for 24 weeks. All couples contemplating pregnancy or already pregnant (≤12 weeks of gestation) who visited the outpatient clinics of the Department of Obstetrics and Gynecology at the Erasmus University Medical Center (Erasmus MC), Rotterdam, the Netherlands, between June and December 2018, were invited to participate. We measured changes in lifestyle behaviors at weeks 12 and 24 compared with baseline. Generalized estimating equations were used to analyze the changes in lifestyle behaviors over time. Subgroup analyses were performed for women with obesity (BMI ≥30 kg/m²), women pregnant at the start of the intervention, and those participating as a couple. RESULTS A total of 539 women were screened for eligibility, and 450 women and 61 men received the blended periconception intervention. Among the participating women, 58.4% (263/450) were included in the preconception period. Moreover, 78.9% (403/511) of the included participants completed the online lifestyle coaching. At baseline, at least one poor lifestyle behavior was present in most women (379/450, 84.2%) and men (58/61, 95.1%). In the total group, median fruit intake increased from 1.8 to 2.2 pieces/day (<i>P</i>&lt;.001) and median vegetable intake increased from 151 to 165 grams/day (<i>P</i>&lt;.001) after 24 weeks of online coaching. The probability of taking folic acid supplementation among women increased from 0.97 to 1 (<i>P</i>&lt;.001), and the probability of consuming alcohol and using tobacco in the total group decreased from 0.25 to 0.19 (<i>P</i>=.002) and from 0.20 to 0.15 (<i>P</i>=.63), respectively. Overall, the program showed the strongest effectiveness for participating couples. Particularly for vegetable and fruit intake, their consumption increased from 158 grams/day and 1.8 pieces/day at baseline to 190 grams/day and 2.7 pieces/day at the end of the intervention, respectively. CONCLUSIONS We succeeded in including most participating women in the preconception period. A high compliance rate was achieved and users demonstrated improvements in several lifestyle components. The blended periconception lifestyle care approach seems to be an effective method to improve lifestyle behaviors. The next step is to further disseminate this approach and to perform a randomized trial to compare the use of blended care with the provision of only eHealth. Additionally, the clinical relevance of these results will need to be substantiated further.

Nákupní preference mladé generace a on-line nakupování

The young generation born in the mid-1990s and later is referred to as Generation Z. As the only post-war generation, they grew entirely on the World Wide Web and has been increasingly associated with the rapid increase in daily use of technology on a daily basis. Mainly the Internet and smart mobile phones have become an indispensable part of their lives and are often used in consumer preferences and during shopping. The paper focuses on the analysis and evaluation of selected results of Generation Z research in the Czech Republic in relation to shopping behaviour and on-line shopping. In terms of methodology, the research is based on an extensive quantitative questionnaire survey among members of a given generation in the Czech Republic. The results show that Generation Z a bit surprisingly prefers shopping in a brick-and-mortar store compared to online shopping. On the other hand, Czech young population not surprisingly spends the largest expenditures on food, entertainment, clothing and footwear, housing and travel, and this product mix is also reflected in the frequency of visits. This finding may be important for retailers and managers because, despite the ever-increasing implementation of smart technologies and an online lifestyle across all generations, brick-and-mortar businesses are still competitive to face this trend.

Anthropometric outcomes after one year of remote counselling of overweight and obese adults by dietitians

IntroductionThe high prevalence of overweight and obese adults in Switzerland (men: 55.5%; women: 31%) and the development of associated comorbidities requires innovative primary health care interventions. Smartphone applications offer interesting possibilities. However, most are not designed for use in nutritional counselling. Oviva developed an application for dietitians to support overweight or obese clients, online. The aim of the following research was to compare short- and long-term anthropometric effects of a one-year, online, lifestyle intervention by dietitians with overweight or obesity adults.MethodsThe pilot study, conducted in the German-speaking region of Switzerland, started in April 2016 and was completed in May 2018. Initially, 43 overweight and obese individuals were included, 36 completed the study. During this intervention, participants received individualized, remote counselling from dietitians through the application Oviva. Interactions focused on increasing motivation, providing feedback regarding photo-based food logs and education that was aligned with the individual's lifestyle goals. In addition to the primary outcome of weight change, the following anthropometric outcomes were examined: body mass index (BMI), waist circumference and body fat. The study measured changes from baseline at three and twelve months (M0/M3/M12).ResultsOver the course of the study, the median weight loss was 4.9 kg (-21.9–7.5 kg) and 58% of participants achieved a weight loss of ≥ 5%. Additional anthropometric measurements showed the following results (median (min–max)) at timepoints M0/M3/M12: body weight (kg) M0: 83.5 (67.7–105)/M3: 80.3 (64.5–105)/M12: 78.7 (62.8–107.5); BMI (kg/m2): M0:30.2 (26.4–33)/M3: 28.4 (24.3–33.5)/M12: 28.0 (24.1–33.5); waist circumference (cm) M0: 92 (74–112)/M3: 85.9 (73.3–108)/M12: 86.5 (78.5–110.5); and body fat (%) M0: 40.5 (27.8–48.5)/M3: 39.0 (22.2–45.0)/M12: 37.9 (21.3–46.9). A significant improvement was observed in all measurements from M0–M3 and M0–M12. A non-significant trend was observed between M3 and M12 in the measurements, except for waist circumference.DiscussionThese promising results suggest new approaches to support overweight and obese adults in changing their lifestyle through assistance by dietitians in Switzerland. Nevertheless, long-term, randomized control trials are needed to examine its efficacy and cost-effectiveness. Additionally, this type of remote counselling offers greater flexibility for clients who are unable and/or unwilling to engage in face-to-face counselling and thus, also has the potential to increase patient adherence, in order to attain sustained weight loss.