TY  - JOUR
AU  - Pischke, Claudia R
AU  - Voelcker-Rehage, Claudia
AU  - Ratz, Tiara
AU  - Peters, Manuela
AU  - Buck, Christoph
AU  - Meyer, Jochen
AU  - von Holdt, Kai
AU  - Lippke, Sonia
PY  - 2022
DA  - 2022/3/23
TI  - Web-Based Versus Print-Based Physical Activity Intervention for Community-Dwelling Older Adults: Crossover Randomized Trial
JO  - JMIR Mhealth Uhealth
SP  - e32212
VL  - 10
IS  - 3
KW  - physical activity
KW  - older adults
KW  - eHealth
KW  - print-based intervention
KW  - web-based intervention
KW  - physical activity promotion
KW  - healthy aging
KW  - preferences
KW  - randomized trial
KW  - mobile phone
AB  - 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 
SN  - 2291-5222
UR  - https://mhealth.jmir.org/2022/3/e32212
UR  - https://doi.org/10.2196/32212
UR  - http://www.ncbi.nlm.nih.gov/pubmed/35319484
DO  - 10.2196/32212
ID  - info:doi/10.2196/32212
ER  -