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Wu S, Li G, Shi B, Ge H, Chen S, Zhang X, He Q. Comparative effectiveness of interventions on promoting physical activity in older adults: A systematic review and network meta-analysis. Digit Health 2024; 10:20552076241239182. [PMID: 38601186 PMCID: PMC11005496 DOI: 10.1177/20552076241239182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 02/27/2024] [Indexed: 04/12/2024] Open
Abstract
Background Despite the well-established health benefits of physical activity, a large population of older adults still maintain sedentary life style or physical inactivity. This network meta-analysis (NMA) aimed to compare the effectiveness of wearable activity tracker-based intervention (WAT), electronic and mobile health intervention (E&MH), structured exercise program intervention (SEP), financial incentive intervention (FI) on promoting physical activity and reducing sedentary time in older adults. Methods The systematic review based on PRISMA guidelines, a systematic literature search of PubMed, Web of Science, Google Scholar, EMbase, Cochrane Library, Scopus were searched from inception to December 10th 2022. The randomized controlled trials (RCT) were included. Two reviewers independently conducted study selection, data extraction, risk of bias and certainty of evidence assessment. The effect measures were standard mean differences (SMD) and 95% confidence interval (CI) in daily steps, moderate-to-vigorous physical activity (MVPA) and sedentary time. Results A total of 69 studies with 14,120 participants were included in the NMA. Among these included studies, the results of daily steps, MVPA and sedentary time was reported by 55, 25 and 15 studies, respectively. The NMA consistency model analysis suggested that the following interventions had the highest probability (surface under the cumulative ranking, SUCRA) of being the best when compared with control: FI + WAT for daily steps (SUCRA = 96.6%; SMD = 1.32, 95% CI:0.77, 1.86), WAT + E&MH + SEP for MVPA (SUCRA = 91.2%; SMD = 0.94, 95% CI: 0.36, 1.52) and WAT + E&MH + SEP for sedentary time (SUCRA = 80.3%; SMD = -0.50, 95% CI: -0.87, -0.14). The quality of the evidences of daily steps, MVPA and sedentary time was evaluated by very low, very low and low, respectively. Conclusions In this NMA, there's low quality evidence that financial incentive combined with wearable activity tracker is the most effective intervention for increasing daily steps of older adults, wearable activity tracker combined with electronic and mobile health and structured exercise program is the most effective intervention to help older adults to increase MVPA and reduce sedentary time.
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Affiliation(s)
- Shuang Wu
- School of Physical Education, Shandong University, Jinan, China
| | - Guangkai Li
- School of Physical Education, Shandong University, Jinan, China
| | - Beibei Shi
- School of Physical Education, Shandong University, Jinan, China
| | - Hongli Ge
- School of Physical Education, Shandong University, Jinan, China
| | - Si Chen
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xianliang Zhang
- School of Physical Education, Shandong University, Jinan, China
| | - Qiang He
- School of Physical Education, Shandong University, Jinan, China
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Choma EA, Hayes S, Lewis BA, Rothman AJ, Wyman JF, Guan W, McMahon SK. Technical Assistance Received by Older Adults to Use Commercially Available Physical Activity Monitors (Ready Steady 3.0 Trial): Ad-Hoc Descriptive Longitudinal Study. JMIR Mhealth Uhealth 2023; 11:e47891. [PMID: 37997772 PMCID: PMC10690145 DOI: 10.2196/47891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/11/2023] [Accepted: 09/22/2023] [Indexed: 11/25/2023] Open
Abstract
Background Despite evidence that regular physical activity (PA) among older adults confers numerous health and functional benefits, PA participation rates are low. Using commercially available wearable PA monitors (PAMs) is one way to augment PA promotion efforts. However, while expert recommendations exist for the specific information needed at the beginning of PAM ownership and the general ongoing need for structures that support as-needed technical troubleshooting, information is lacking about the type, frequency, and modes of assistance needed during initial and long-term ownership. Objective This paper describes problems reported and technical assistance received by older adults who used PAMs during the 18 months they participated in a community-based PA trial: Ready Steady 3.0 (RS3). Methods This was an ad-hoc longitudinal analysis of process variables representing technical problems reported and assistance received by 113 RS3 study participants in the 18 months after their orientation to PAMs. Variables included date of contact, problem(s) reported, mode of technical assistance, and whether the equipment was replaced. The descriptive analysis included frequencies and incidence rates of distinct contacts, types of problems, and technical assistance modes. Results On average, participants were aged 77 (SD 5.2) years. Most identified as female (n=87, 77%), reported experience using smartphones (n=92, 81.4%), and used the PAM between 2 and 18 months. Eighty-two participants (72.6%) reported between 1 to 9 problems with using PAMs, resulting in a total of 150 technical assistance contacts with a mean of 1.3 (SD 1.3) contacts. The incidence rate of new, distinct contacts for technical assistance was 99 per 100 persons per year from 2018 to 2021. The most common problems were wearing the PAM (n=43, 28.7%), reading its display (n=23, 15.3%), logging into its app (n=20, 13.3%), charging it (n=18, 12%), and synchronizing it to the app (n=16, 10.7%). The modalities of technical assistance were in person (n=53, 35.3%), by telephone (n=51, 34%), by email (n=25, 16.7%), and by postal mail (n=21, 14%). Conclusions In general, the results of this study show that after receiving orientation to PAMs, problems such as uncomfortable wristbands, difficulty using the PAM or its related app, and obtaining or interpreting relevant personal data were occasionally reported by participants in RS3. Trained staff helped participants troubleshoot and solve these technical problems primarily in person or by phone. Results also underscore the importance of involving older adults in the design, usability testing, and supportive material development processes to prevent technical problems for the initial and ongoing use of PAMs. Clinicians and researchers should further assess technical assistance needed by older adults, accounting for variations in PAM models and wear time, while investigating additional assistance strategies, such as proactive support, short GIF videos, and video calls.
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Affiliation(s)
- Elizabeth A Choma
- Department of Physical Therapy, Whitworth University, SpokaneWA, United States
| | - Shannon Hayes
- School of Nursing, University of Minnesota, MinneapolisMN, United States
| | - Beth A Lewis
- School of Kinesiology, University of Minnesota, MinneapolisMN, United States
| | - Alexander J Rothman
- Department of Psychology, University of Minnesota, MinneapolisMN, United States
| | - Jean F Wyman
- School of Nursing, University of Minnesota, MinneapolisMN, United States
| | - Weihua Guan
- Division of Biostatistics, School of Public Health, University of Minnesota, MinneapolisMN, United States
| | - Siobhan K McMahon
- School of Nursing, University of Minnesota, MinneapolisMN, United States
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Nagata JM, Alsamman S, Smith N, Yu J, Ganson KT, Dooley EE, Wing D, Baker FC, Pettee Gabriel K. Social epidemiology of Fitbit daily steps in early adolescence. Pediatr Res 2023; 94:1838-1844. [PMID: 37353663 PMCID: PMC10624619 DOI: 10.1038/s41390-023-02700-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 05/10/2023] [Accepted: 05/30/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND Sociodemographic disparities in adolescent physical activity have been documented but mostly rely on self-reported data. Our objective was to examine differences in device-based step metrics, including daily step count (steps d-1), by sociodemographic factors among a diverse sample of 10-to-14-year-old adolescents in the US. METHODS We analyzed prospective cohort data from Year 2 (2018-2020) of the Adolescent Brain Cognitive Development (ABCD) Study (N = 6460). Mixed-effects models were conducted to estimate associations of sociodemographic factors (sex, sexual orientation, race/ethnicity, household income, parental education, and parental marital status) with repeated measures of steps d-1 over the course of 21 days. RESULTS Participants (49.6% female, 39.0% racial/ethnic minority) accumulated an average of 9095.8 steps d-1. In mixed-effects models, 1543.6 more steps d-1 were recorded for male versus female sex, Black versus White race (328.8 more steps d-1), heterosexual versus sexual minority sexual orientation (676.4 more steps d-1), >$200,000 versus <$25,000 household income (1003.3 more steps d-1), and having married/partnered parents versus unmarried/unpartnered parents (326.3 more steps d-1). We found effect modification by household income for Black adolescents and by sex for Asian adolescents. CONCLUSIONS Given sociodemographic differences in adolescent steps d-1, physical activity guidelines should focus on key populations and adopt strategies optimized for adolescents from diverse backgrounds. IMPACT Sociodemographic disparities in physical activity have been documented but mostly rely on self-reported data, which can be limited by reporting and prevarication bias. In this demographically diverse sample of 10-14-year-old early adolescents in the U.S., we found notable and nuanced sociodemographic disparities in Fitbit steps per day. More daily steps were recorded for male versus female sex, Black versus White race, heterosexual versus sexual minority, >$100,000 versus <$25,000 household income, and having married/partnered versus unmarried/unpartnered parents. We found effect modification by household income for Black adolescents and by sex for Asian adolescents.
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Affiliation(s)
- Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, CA, USA.
| | - Sana Alsamman
- Department of Pediatrics, University of California, San Francisco, CA, USA
| | - Natalia Smith
- Department of Pediatrics, University of California, San Francisco, CA, USA
| | - Jiayue Yu
- Department of Pediatrics, University of California, San Francisco, CA, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Erin E Dooley
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David Wing
- Exercise and Physical Activity Resource Center, University of California, San Diego, CA, USA
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, CA, USA
- Herbert Wertheim School of Public Health and Human Longevity Science, La Jolla University of California, San Diego, La Jolla, CA, USA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
- School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Kelley Pettee Gabriel
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
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Lee J, Ryu H. Usability of a new digital walking program for older adults: a pilot study. BMC Geriatr 2023; 23:193. [PMID: 37003966 PMCID: PMC10066025 DOI: 10.1186/s12877-023-03739-y] [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: 06/07/2022] [Accepted: 01/09/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Walking has been emphasized as an important solution for preventing isolation among older adults, especially given the coronavirus disease 2019 (COVID-19) pandemic, and various methods are being proposed to promote walking in this population. In this study, a walking exercise program for the elderly was developed using various latest technologies, and the effectiveness and influencing factors of the program were evaluated. METHOD The walking program for older adults was designed using mHealth devices, social media application, and gamified elements to prevent isolation. Twelve participants were recruited via an online community of retired individuals. This one-year study involved a one-group repeated measures experimental design; an online questionnaire was conducted four times along with a focus group interview. RESULT The results showed that the e-health literacy of the 12 participants increased, while Wearable Device App Literacy/Usability, digital health self-efficacy, and walking program evaluation showed a decline. In the focus group interview, participants expressed their appreciation for this program, ways to overcome its limitations, and expectations for the next program. CONCLUSION This study confirmed the positive effect of the online walking program for retired older adults, indicating that an online-offline convergence program suitable for the "COVID-19 era" will be necessary in the future.
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Affiliation(s)
- Jisan Lee
- Department of Nursing, Gangneung-Wonju National University, Wonju, Republic of Korea
| | - Hyeongju Ryu
- Department of Nursing, Konkuk University, Chungju, Republic of Korea.
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Garcia Reyes EP, Kelly R, Buchanan G, Waycott J. Understanding Older Adults' Experiences With Technologies for Health Self-management: Interview Study. JMIR Aging 2023; 6:e43197. [PMID: 36943333 PMCID: PMC10131633 DOI: 10.2196/43197] [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: 10/03/2022] [Revised: 02/13/2023] [Accepted: 02/13/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Many older adults now use technologies such as wearable devices and telehealth services to support their health and well-being while living independently at home. However, older adults vary in how they use these technologies, and there is a lack of knowledge regarding the motivations that influence their acceptance and use of health-related technologies in home environments. OBJECTIVE This study aimed to understand the types of technologies that older adults use to support their health and the factors that motivate them to use their chosen technologies to support their health. In addition, we aimed to understand the factors that enable the effective use of technologies for health self-management and to identify the barriers that can negatively affect the adoption of technologies. METHODS A total of 22 older adults participated in semistructured interviews regarding their experiences of using technologies for health self-management. Interview transcripts were analyzed through an in-depth thematic analysis. RESULTS The interviews revealed that a range of technologies, such as videoconferencing software, fitness trackers, and other devices, were being used by older adults to support their health. Interviews showed that participants were motivated to use technologies to monitor health issues, to stay active and connected, and to record and change their behavior in the light of foreseen risks related to their future health status. Enablers that facilitated the effective use of technologies include social and organizational influence, convenient access to health care and safety provided by the technology, and easy setup and low cost of the technology. Barriers include information overload and a sense of futility about future health decline; telehealth being an inadequate substitute for in-person consultation; concerns about trust related to privacy and accuracy; and technologies being stigmatizing, uncomfortable to use, expensive, and unfamiliar. CONCLUSIONS This study suggested that older adults were using a variety of technologies to prevent or prepare for future health decline, evidencing a resilient attitude toward health and aging. In addition, older adults were willing to continue using the technology when there was a perceived need. The enabler mentioned by most participants was the social and organizational influence that included health care staff, family, friends, and organizations. This analysis provides a better understanding of how older adults use technologies to support their health and can guide the provision of appropriate health technologies for them.
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Affiliation(s)
- Elsy Paola Garcia Reyes
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia
| | - Ryan Kelly
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia
| | - George Buchanan
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia
| | - Jenny Waycott
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia
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O’Brien J, Mason A, Cassarino M, Chan J, Setti A. Older Women's Experiences of a Community-Led Walking Programme Using Activity Trackers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189818. [PMID: 34574741 PMCID: PMC8468609 DOI: 10.3390/ijerph18189818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/10/2021] [Accepted: 09/14/2021] [Indexed: 11/16/2022]
Abstract
Promoting physical activity amongst older adults represents a major public health goal and community-led exercise programmes present benefits in promoting active lifestyles. Commercial activity trackers potentially encourage positive behaviour change with respect to physical exercise. This qualitative study investigated the experiences and attitudes of older adults following a 6-week community-led walking programme utilising activity trackers. Eleven community-dwelling older women aged 60+ completed individual phone interviews following their involvement in the programme. The programme, codesigned with a group of senior citizens, equipped participants with wrist-worn activity trackers and included biweekly check-in sessions with a researcher to monitor progress and support motivation. Interviews explored participants’ experiences of the programme and of using activity trackers for the purpose of becoming more active. A thematic analysis produced three main themes: ‘programme as a source of motivation’, ‘user experiences with the technology’ and ‘views on social dimension of the programme’. Overall, participants highlighted the self-monitoring function of activity trackers as most beneficial for their exercise levels. This study provides insights into the personal and social factors perceived by older adults in relation to being part of a community-led programme using activity trackers. It highlights the role of the programme and trackers in maintaining motivation to stay active.
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Affiliation(s)
- Jessica O’Brien
- School of Applied Psychology, University College Cork, T23 XA50 Cork, Ireland; (M.C.); (J.C.); (A.S.)
- Correspondence:
| | - Amy Mason
- Department of Physical Education and Sport Science, University of Limerick, V94 TPX Limerick, Ireland;
| | - Marica Cassarino
- School of Applied Psychology, University College Cork, T23 XA50 Cork, Ireland; (M.C.); (J.C.); (A.S.)
| | - Jason Chan
- School of Applied Psychology, University College Cork, T23 XA50 Cork, Ireland; (M.C.); (J.C.); (A.S.)
| | - Annalisa Setti
- School of Applied Psychology, University College Cork, T23 XA50 Cork, Ireland; (M.C.); (J.C.); (A.S.)
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