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Meyer J, Ratz T, Pauls A, Hellmers S, Boll S, Fudickar S, Hein A, Bauer JM, Koppelin F, Lippke S, Peters M, Pischke CR, Voelcker-Rehage C, Zeeb H, Forberger S. Designing and applying technology for prevention-Lessons learned in AEQUIPA and its implications for future research and practice. Front Public Health 2022; 10:832922. [PMID: 36339229 PMCID: PMC9627148 DOI: 10.3389/fpubh.2022.832922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 09/16/2022] [Indexed: 01/21/2023] Open
Abstract
Almost all Western societies are facing the challenge that their population structure is changing very dynamically. Already in 2019, ten countries had a population share of at least 20 percent in the age group of 64 years and older. Today's society aims to improve population health and help older people live active and independent lives by developing, establishing, and promoting safe and effective interventions. Modern technological approaches offer tremendous opportunities but pose challenges when preventing functional decline. As part of the AEQUIPA Prevention Research Network, the use of technology to promote physical activity in older people over 65 years of age was investigated in different settings and from various interdisciplinary perspectives, including technology development and evaluation for older adults. We present our findings in three main areas: (a) design processes for developing technology interventions, (b) older adults as a user group, and (c) implications for the use of technology in interventions. We find that cross-cutting issues such as time and project management, supervision of participants, ethics, and interdisciplinary collaboration are of vital importance to the success of the work. The lessons learned are discussed based on the experiences gained in the overall AEQUIPA network while building, particularly on the experiences from the AEQUIPA sub-projects TECHNOLOGY and PROMOTE. Our experiences can help researchers of all disciplines, industries, and practices design, study and implement novel technology-based interventions for older adults to avoid pitfalls and create compelling and meaningful solutions.
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Affiliation(s)
- Jochen Meyer
- OFFIS – Institute for Information Technology, Oldenburg, Germany,*Correspondence: Jochen Meyer
| | - Tiara Ratz
- Jacobs University Bremen, Bremen, Germany
| | - Alexander Pauls
- Section Technology and Health for Humans, Jade University of Applied Sciences Wilhelmshaven/Oldenburg/Elsfleth, Oldenburg, Germany
| | - Sandra Hellmers
- Department of Health Services Research, Assistance Systems and Medical Device Technology, Carl von Ossietzky University, Oldenburg, Germany
| | - Susanne Boll
- OFFIS – Institute for Information Technology, Oldenburg, Germany
| | - Sebastian Fudickar
- Department of Health Services Research, Assistance Systems and Medical Device Technology, Carl von Ossietzky University, Oldenburg, Germany
| | - Andreas Hein
- Department of Health Services Research, Assistance Systems and Medical Device Technology, Carl von Ossietzky University, Oldenburg, Germany
| | - Jürgen M. Bauer
- Center for Geriatric Medicine and Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Frauke Koppelin
- Section Technology and Health for Humans, Jade University of Applied Sciences Wilhelmshaven/Oldenburg/Elsfleth, Oldenburg, Germany
| | | | - Manuela Peters
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - Claudia R. Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Claudia Voelcker-Rehage
- Institute of Sport and Exercise Sciences, University of Muenster, Muenster, Germany,Institute of Human Movement Science and Health, Chemnitz University of Technology, Chemnitz, Germany
| | - Hajo Zeeb
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - Sarah Forberger
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
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Matos Fialho PM, Günther L, Schmitz E, Trümmler J, Willemsen S, Vomhof M, Icks A, Lang A, Kuss O, Weyers S, Pischke CR. Effects of the Population-Based "10,000 Steps Duesseldorf" Intervention for Promoting Physical Activity in Community-Dwelling Adults: Protocol for a Nonrandomized Controlled Trial. JMIR Res Protoc 2022; 11:e39175. [PMID: 36129746 PMCID: PMC11186676 DOI: 10.2196/39175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The World Health Organization recommends 150 minutes of moderate to vigorous physical activity (PA), which translates to approximately 7000 to 10,000 steps per day for adults. In Germany, less than half of the population in this age range meets this recommendation, highlighting the need for population-based intervention approaches for promoting daily PA. OBJECTIVE The complex community-based PA intervention "10,000 Steps Ghent," which was originally developed in Belgium and was shown to be effective for PA promotion, has been adapted for implementation and evaluation in 2 German cities. The original Belgian study is currently being replicated, and we aim to examine the effectiveness of the adapted intervention among adults living in intervention city districts in Duesseldorf when compared with those living in control city districts in Wuppertal, over the course of 1 year. METHODS A controlled intervention trial examining the effects of an intervention addressing multiple levels (eg, individual level: website; organizational level: PA promotion in companies; community level: media campaigns and environmental changes) is being conducted. PA and various secondary outcomes will be assessed in 2 random samples of adults aged 25 to 75 years (n=399 in each city) at baseline and after 1 year. RESULTS Funding for this study was obtained in March 2020. Recruitment for this study and baseline data collection were conducted from May 2021 to March 2022 (as of March 2022, 626 participants were enrolled in the study). The intervention will be implemented in Duesseldorf for 1 year from April 2022 onward, and follow-up assessments will be conducted, starting in May 2023 (until September 2023). Data analysis will be performed in fall 2023, and the results will be published in spring 2024. CONCLUSIONS To our knowledge, this is the first research project (currently underway in Germany) that is aimed at replicating the effects of a complex intervention for PA promotion that was previously shown to be effective in another European country. TRIAL REGISTRATION German Clinical Trials Register DRKS00024873; https://tinyurl.com/4c9e8azh. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/39175.
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Affiliation(s)
- Paula M Matos Fialho
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Liane Günther
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Elena Schmitz
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Jannis Trümmler
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Sorina Willemsen
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Markus Vomhof
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
| | - Andrea Icks
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
| | - Alexander Lang
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Oliver Kuss
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
- Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Simone Weyers
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Claudia R Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
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Fuente-Vidal A, Guerra-Balic M, Roda-Noguera O, Jerez-Roig J, Montane J. Adherence to eHealth-Delivered Exercise in Adults with no Specific Health Conditions: A Scoping Review on a Conceptual Challenge. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10214. [PMID: 36011856 PMCID: PMC9408657 DOI: 10.3390/ijerph191610214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/12/2022] [Accepted: 08/15/2022] [Indexed: 06/15/2023]
Abstract
Adherence has emerged as a focal point and critical determinant of success for physical activity interventions. The term is used for both traditional and digital interventions, and for prescribed and nonprescribed activities. Many other terms for adherence are being used interchangeably, as there is no consensus on its precise conceptualization. This scoping review aimed to advance the definition of adherence to eHealth programs, specifically for the adult population with no specific health conditions. A total of 2983 papers, published between 1 January 2016 and 13 March 2022, were retrieved from different databases (including grey literature). Of those, 13 studies met the eligibility criteria and were included for review. The selected studies used a wide array of technologies and consisted mainly of exercise interventions. Most of the reviewed publications contemplated exercise adherence as a percentage of expected dose. Most (8 out of 13) studies neither assessed nor specified an expected use of the involved technology. Results suggest a need for homogeneity in the conceptualization of adherence to physical activity and exercise, including those interventions delivered digitally.
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Affiliation(s)
- Andrea Fuente-Vidal
- Research Group on Health, Physical Activity and Sport (SAFE), Blanquerna School of Psychology, Education and Sport Sciences, Universitat Ramon Llull, 08022 Barcelona, Spain
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic—Central University of Catalonia (UVic-UCC), 08500 Vic, Spain
| | - Myriam Guerra-Balic
- Research Group on Health, Physical Activity and Sport (SAFE), Blanquerna School of Psychology, Education and Sport Sciences, Universitat Ramon Llull, 08022 Barcelona, Spain
| | | | - Javier Jerez-Roig
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic—Central University of Catalonia (UVic-UCC), 08500 Vic, Spain
| | - Joel Montane
- Research Group on Health, Physical Activity and Sport (SAFE), Blanquerna School of Psychology, Education and Sport Sciences, Universitat Ramon Llull, 08022 Barcelona, Spain
- Blanquerna School of Health Science, Universitat Ramon Llull, 08025 Barcelona, Spain
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Mugler N, Baurecht H, Lam K, Leitzmann M, Jochem C. The Effectiveness of Interventions to Reduce Sedentary Time in Different Target Groups and Settings in Germany: Systematic Review, Meta-Analysis and Recommendations on Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10178. [PMID: 36011821 PMCID: PMC9408392 DOI: 10.3390/ijerph191610178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/07/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Sedentary behavior is an important risk factor for several chronic diseases and is associated with an increased risk of mortality. We assessed the effectiveness of interventions to reduce sedentary time in Germany and provide recommendations on interventions to reduce sedentary time in children and adults. METHODS We comprehensively searched PubMed, Web of Science and the German Clinical Trials Register up to April 2022 for intervention studies targeting sedentary behavior in Germany. We performed a systematic review and qualitative synthesis of the interventions and a meta-analysis in children. RESULTS We included 15 studies comprising data from 4588 participants. The results of included primary studies in adults and children showed inconsistent evidence regarding change in sedentary time, with a majority of studies reporting non-significant intervention effects. The meta-analysis in children showed an increase in sedentary time for children in the control and intervention groups. CONCLUSION We found inconsistent evidence regarding the effectiveness of interventions to reduce time spent sedentary and our meta-analysis showed an increase in sedentary time in children. For children, we recommend physical and social environment interventions with an active involvement of families. For adults, we recommend physical environment interventions, such as height-adjustable desks at work.
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Pischke CR, Voelcker-Rehage C, Ratz T, Peters M, Buck C, Meyer J, von Holdt K, Lippke S. Web-Based Versus Print-Based Physical Activity Intervention for Community-Dwelling Older Adults: Crossover Randomized Trial. JMIR Mhealth Uhealth 2022; 10:e32212. [PMID: 35319484 PMCID: PMC8987962 DOI: 10.2196/32212] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/08/2021] [Accepted: 12/06/2021] [Indexed: 12/20/2022] Open
Abstract
Background Fewer than half of older German adults engage in the recommended levels of endurance training. Objective The study aim is to compare the acceptance and effectiveness of two interventions for physical activity (PA) promotion among initially inactive community-dwelling older adults ≥60 years in a 9-month, crossover randomized trial. Methods Participants were recruited in person and randomized to one of the following interventions for self-monitoring PA: a print-based intervention (PRINT: 113/242, 46.7%) or a web-based intervention (WEB: 129/242, 53.3%). Furthermore, 29.5% (38/129) of those in the web-based intervention group received a PA tracker in addition to WEB (WEB+). After randomization, the participants and researchers were not blinded. The participants’ baseline intervention preferences were retrospectively assessed. All the intervention groups were offered 10 weekly face-to-face group sessions. Afterward, 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 6 months. 3D accelerometers to assess PA and sedentary behavior (SB) at baseline (T0), 3-month follow-up (T1), and 9-month follow-up (T2) were used. Adherence to PA recommendations, attendance of group sessions, and intervention acceptance were assessed using 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 Of the 242 initially recruited participants, 91 (37.6%) were randomized to the WEB group; 38 (15.7%) to the WEB+ group; and 113 (46.7%) to the PRINT group. Overall, 80.6% (195/242) of the participants completed T1. Only 0.4% (1/242) of the participants changed from the WEB group to the PRINT group and 6.2% (15/242) moved from the PRINT group to the WEB group (WEB-WEB: 103/249, (41.4%); PRINT-PRINT: 76/249, 30.5%) when offered to cross over at T1. Furthermore, 66.1% (160/242) of participants completed T2. MVPA in minutes per day increased between baseline and T1, but these within-group changes disappeared after adjusting for covariates. MVPA decreased by 9 minutes per day between baseline and T2 (βtime=−9.37, 95% CI −18.58 to −0.16), regardless of the intervention group (WEB vs PRINT: βgroup*time=−3.76, 95% CI −13.33 to 5.82, WEB+ vs PRINT: βgroup*time=1.40, 95% CI −11.04 to 13.83). Of the participants, 18.6% (38/204) met the PA recommendations at T0, 16.4% (26/159) at T1, and 20.3% (28/138) at T2. For SB, there were no significant group differences or group-by-time interactions at T1 or T2. Intervention acceptance was generally high. The use of intervention material was high to moderate at T1 and decreased by T2. Conclusions There was little movement between intervention groups at T1 when given the choice, and participation was not associated with increases in PA or decreases in SB over time. Trial Registration German Clinical Trials Register DRKS00016073; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00016073
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Affiliation(s)
- Claudia R Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Claudia Voelcker-Rehage
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Muenster, Muenster, Germany
| | - Tiara Ratz
- Department of Psychology and Methods, Jacobs University Bremen, Bremen, Germany
| | - Manuela Peters
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Christoph Buck
- Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Jochen Meyer
- OFFIS - Institute for Information Technology, Oldenburg, Germany
| | - Kai von Holdt
- OFFIS - Institute for Information Technology, Oldenburg, Germany
| | - Sonia Lippke
- Department of Psychology and Methods, Jacobs University Bremen, Bremen, Germany
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Auerswald T, Hendker A, Ratz T, Lippke S, Pischke CR, Peters M, Meyer J, von Holdt K, Voelcker-Rehage C. Impact of Activity Tracker Usage in Combination with a Physical Activity Intervention on Physical and Cognitive Parameters in Healthy Adults Aged 60+: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073785. [PMID: 35409466 PMCID: PMC8997555 DOI: 10.3390/ijerph19073785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 02/01/2023]
Abstract
Regular physical activity (PA) is of central importance for healthy aging and has a well-known impact on helping older adults maintain their cognitive and physical health. Thus, we aimed to compare the effectiveness of two physical activity interventions primarily conducted at home (print-based or web-based vs. web-based plus the use of an activity tracker) on cognitive and physical health parameters in older adults. Data of participants (n = 551, 60–80 years) were analyzed after being randomly allocated to a waitlist control group (CG), a web-based or print-based intervention group (IG) or a web-based intervention group that also included the use of an activity tracker (AG). Measured parameters were grip strength, endurance (two-minute step test), gait speed (four-meter walk test), cognition (Simon task; balanced integration score (BIS), reaction time and accuracy) and physical self-concept (Physical Self-Description Questionnaire (PSDQ)). We found the highest effect sizes in all measured dimensions for AG (grip strength, endurance, gait speed, reaction time, physical self-concept), followed by IG (endurance, gait speed, reaction time, physical self-concept) and CG (endurance, gait speed, BIS). Findings suggest that a combined web-based and activity tracker intervention may improve physical functions, physical self-concept, and cognition in community-dwelling older adults.
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Affiliation(s)
- Tina Auerswald
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, 09126 Chemnitz, Germany;
| | - Anna Hendker
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Muenster, 48149 Muenster, Germany;
| | - Tiara Ratz
- Department of Psychology & Methods, Jacobs University Bremen GmbH, 28759 Bremen, Germany; (T.R.); (S.L.)
| | - Sonia Lippke
- Department of Psychology & Methods, Jacobs University Bremen GmbH, 28759 Bremen, Germany; (T.R.); (S.L.)
| | - Claudia R. Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany;
| | - Manuela Peters
- Leibniz Institute for Prevention Research and Epidemiology–BIPS, 28359 Bremen, Germany;
| | - Jochen Meyer
- OFFIS–Institute for Information Technology, 26121 Oldenburg, Germany; (J.M.); (K.v.H.)
| | - Kai von Holdt
- OFFIS–Institute for Information Technology, 26121 Oldenburg, Germany; (J.M.); (K.v.H.)
| | - Claudia Voelcker-Rehage
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, 09126 Chemnitz, Germany;
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Muenster, 48149 Muenster, Germany;
- Correspondence: ; Tel.: +49-251-83-32461
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Lippke S, Ratz T, Keller FM, Juljugin D, Peters M, Pischke C, Voelcker-Rehage C. Mitigating feelings of loneliness and depression by means of web-based or print-based physical activity interventions: Pooled analysis of two community-based intervention trials (Preprint). JMIR Aging 2022; 5:e36515. [PMID: 35943790 PMCID: PMC9399846 DOI: 10.2196/36515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/20/2022] [Accepted: 05/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Physical activity (PA) is associated with benefits, such as fewer depressive symptoms and loneliness. Web- and print-based PA interventions can help older individuals accordingly. Objective We aimed to test the following research questions: Do PA interventions delivered in a web- or print-based mode improve self-reported PA stage of change, social-cognitive determinants of PA, loneliness, and symptoms of depression? Is subjective age a mediator and stage of change a moderator of this effect? Methods Overall, 831 adults aged ≥60 years were recruited and either allocated to a print-based or web-based intervention group or assigned to a wait-list control group (WLCG) in 2 community-based PA intervention trials over 10 weeks. Missing value imputation using an expectation-maximization algorithm was applied. Frequency analyses, multivariate analyses of variance, and moderated mediation analyses were conducted. Results The web-based intervention outperformed (47/59, 80% of initially inactive individuals being adopters, and 396/411, 96.4% of initially active individuals being maintainers of the recommended PA behavior) the print-based intervention (20/25, 80% of adopters, and 63/69, 91% of maintainers) and the WLCG (5/7, 71% of adopters; 141/150, 94% of maintainers). The pattern regarding adopters was statistically significant (web vs print Z=–1.94; P=.02; WLCG vs web Z=3.8367; P=.01). The pattern was replicated with stages (χ24=79.1; P<.001; contingency coefficient 0.314; P<.001); in the WLCG, 40.1% (63/157) of the study participants moved to or remained in action stage. This number was higher in the groups receiving web-based (357/470, 76%) or print-based interventions (64/94, 68.1%). A significant difference was observed favoring the 2 intervention groups over and above the WLCG (F19, 701=4.778; P<.001; η2=0.098) and a significant interaction of time and group (F19, 701=2.778; P<.001; η2=0.070) for predictors of behavior. The effects of the interventions on subjective age, loneliness, and depression revealed that both between-group effects (F3, 717=8.668; P<.001; η2=0.018) and the interaction between group and time were significant (F3, 717=6.101; P<.001; η2=0.025). In a moderated mediation model, both interventions had a significant direct effect on depression in comparison with the WLCG (web-based: c′ path −0.86, 95% CI −1.58 to −0.13, SE 0.38; print-based: c′ path −1.96, 95% CI −2.99 to −0.92, SE 0.53). Furthermore, subjective age was positively related to depression (b path 0.14, 95% CI 0.05-0.23; SE 0.05). An indirect effect of the intervention on depression via subjective age was only present for participants who were in actor stage and received the web-based intervention (ab path −0.14, 95% CI −0.34 to −0.01; SE 0.09). Conclusions Web-based interventions appear to be as effective as print-based interventions. Both modes might help older individuals remain or become active and experience fewer depression symptoms, especially if they feel younger. Trial Registration German Registry of Clinical Trials DRKS00010052 (PROMOTE 1); https://tinyurl.com/nnzarpsu and DRKS00016073 (PROMOTE 2); https://tinyurl.com/4fhcvkwy International Registered Report Identifier (IRRID) RR2-10.2196/15168
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Affiliation(s)
- Sonia Lippke
- Psychology & Methods, Jacobs University Bremen, Bremen, Germany
| | - Tiara Ratz
- Department of Reproductive Endocrinology, University Hospital Zurich (USZ), University of Zurich (UZH), Zurich, Switzerland
| | | | | | - Manuela Peters
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Claudia Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Claudia Voelcker-Rehage
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Muenster, Muenster, Germany
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Ratz T, Pischke CR, Voelcker-Rehage C, Lippke S. Distinct physical activity and sedentary behavior trajectories in older adults during participation in a physical activity intervention: a latent class growth analysis. Eur Rev Aging Phys Act 2022; 19:1. [PMID: 34986783 PMCID: PMC8903622 DOI: 10.1186/s11556-021-00281-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 12/08/2021] [Indexed: 01/03/2023] Open
Abstract
Background This study aimed to identify latent moderate-to-vigorous intensity physical activity (MVPA) and sedentary behavior (SB) trajectories in older adults participating in a randomized intervention trial and to explore associations with baseline social-cognitive predictors. Methods Data were assessed at baseline (T0, participants were inactive or had recently become active), after a ten-week physical activity intervention (T1), and a second 24-week intervention phase (T2). Latent class growth analysis was used on accelerometer-assessed weekly MVPA and daily SB, respectively (n = 215 eligible participants). Activity changes within trajectory classes and baseline social-cognitive predictor differences between trajectory classes were analyzed. Results A “stable insufficient MVPA” (n = 197, p for difference in MVPA level at T0 and T2 (pT0-T2) = .789, effect size (Cohen’s d) = .03) and a “stable high MVPA” trajectory (n = 18, pT0-T2 = .137, d = .39), as well as a “slightly decreasing high SB” (n = 63, p for difference in SB (pT0-T2) = .022, d = .36) and a “slightly increasing moderate SB” trajectory (n = 152, pT0-T2 = .019, d = .27) emerged. Belonging to the “stable high MVPA” trajectory was associated with higher action planning levels compared to the “stable insufficient MVPA” trajectory (M = 5.46 versus 4.40, d = .50). Belonging to the “decreasing high SB” trajectory was associated with higher action self-efficacy levels compared to the “increasing moderate SB” trajectory (M = 5.27 versus 4.72, d = .33). Conclusions Change occurred heterogeneously in latent (not directly observed) subgroups, with significant positive trajectories only observed in the highly sedentary. Trial registration German Registry of Clinical Trials, DRKS00016073, Registered 10 January 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s11556-021-00281-x.
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Affiliation(s)
- Tiara Ratz
- Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany.
| | - Claudia R Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Claudia Voelcker-Rehage
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Muenster, Muenster, Germany
| | - Sonia Lippke
- Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany
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Abstract
Hintergrund Regelmäßige körperliche Aktivität ist von zentraler Bedeutung für gesundes Altern. Allerdings halten in Deutschland weniger als ein Viertel der ab 65-Jährigen die Aktivitätsempfehlungen der Weltgesundheitsorganisation ein. Ziel der Arbeit In zwei Studienphasen (PROMOTE I und II) wurden web- und print-basierte Programme zur Förderung körperlicher Aktivität älterer Erwachsener ab 60 Jahren entwickelt und mittels randomisierter Interventionsstudien analysiert und evaluiert. Ziel dieses Beitrags ist es, die daraus resultierenden Empfehlungen und Materialien, die im Rahmen einer Toolbox für Anbieter:innen von Bewegungsprogrammen im kommunalen Setting angeboten werden, vorzustellen. Material und Methoden Insgesamt erhielten 651 Personen über 10 Wochen Zugang zu der web- oder print-basierten „Fit im Nordwesten“-Bewegungsintervention. In der zweiten Studienphase (PROMOTE II) wurde das Programm mithilfe eines partizipativen Ansatzes an bisher inaktive Ältere angepasst. Die Zufriedenheit mit der Intervention und die Effektivität hinsichtlich des Bewegungsverhaltens wurden wissenschaftlich evaluiert. Ergebnisse Die „Fit im Nordwesten“-Toolbox umfasst theoriebasierte, praxisrelevante und wissenschaftlich evaluierte Handlungsempfehlungen für die Förderung der körperlichen Aktivität älterer Erwachsener ab 60 Jahren. Die bereitgestellten Dokumentensets enthalten Materialien für 1) die Vor- und Nachbereitung, 2) die Durchführung eines zehnwöchigen Bewegungsprogramms, 3) die langfristige Aufrechterhaltung des Bewegungsverhaltens und 4) die Begleitung für Theorie und Praxis. Schlussfolgerung Bisher existierten kaum wissenschaftlich evaluierte Materialien für die praktische Nutzung in der Bewegungsförderung. Die „Fit im Nordwesten“-Toolbox kann die zukünftige Anwendung in Bewegungsprogrammen für ältere Erwachsene unterstützen.
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