Currently submitted to: JMIR mHealth and uHealth
Date Submitted: Mar 11, 2020
Open Peer Review Period: Mar 10, 2020 - May 5, 2020
(currently open for review)
Engagement, acceptability, usability and preliminary efficacy of a self-monitoring mHealth intervention to reduce sedentary behavior in older adults: a mixed-methods study
Although healthy aging can be stimulated by the reduction of sedentary behavior, few interventions are available for older adults. Previous studies suggest that self-monitoring might be a promising behavior change technique to reduce older adults’ sedentary behavior. However, little is known about older adults’ experiences with a self-monitoring based intervention aimed at the reduction of sedentary behavior.
The aim of the current study is to evaluate engagement, acceptability, usability and preliminary efficacy of a self-monitoring mHealth intervention developed to reduce older adults’ sedentary behavior.
A mixed-methods study was performed among 28 community-dwelling older adults. The three-week intervention consisted of general sedentary behavior information, and visual and tactile feedback on participants’ sedentary behavior. Semi-structured interviews were conducted to explore engagement with, and acceptability and usability of the intervention. Sedentary time, standing time, and number of steps were measured using the thigh-worn activPAL accelerometer before and after the intervention. System usage data of the app were recorded. Quantitative data were analyzed using descriptive statistics and paired samples T-tests; while qualitative data were thematically analyzed and presented using pen profiles.
Participants mainly reported positive feelings regarding the intervention, such as motivating, surprising, and interesting. They commonly reported that the intervention changed their thinking (i.e. they became more aware of their sedentary behavior), but not their behavior. There were mixed opinions on the kind of feedback (i.e. tactile vs visual) that they preferred. The intervention was considered easy to use, and the design was described as clear. Some problems were noticed regarding attaching and wearing the self-monitoring device. System usage data showed that the median frequency of consulting the application widely differed among participants, ranging from 0 to 20 times a day. Sitting and standing time were very similar at pre and post measurements (P = 0.91 and P = 0.76 respectively) and there was a small improvement in steps of around 400 per day (P = 0.50).
Although the intervention was well perceived by the majority of older adults, no reductions in sedentary time were found. Possible explanations for the lack of reductions might be the short intervention duration, or the fact that only bringing the habitual sedentary behavior into conscious awareness might not be sufficient to achieve behavior change. Clinical Trial: ClinicalTrials.gov; Identification Number: NCT04003324; https://clinicaltrials.gov/ct2/show/NCT04003324
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