A Web-Based and Print-Delivered Computer-Tailored Physical Activity Intervention for Older Adults: Pretest-Posttest Intervention Study Comparing Delivery Mode Preference and Attrition

Abstract

Background Web-based interventions can play an important role in promoting physical activity (PA) behavior among older adults. Although the effectiveness of these interventions is promising, they are often characterized by low reach and high attrition, which considerably hampers their potential impact on public health. Objective The aim of this study was to identify the participant characteristics associated with the preference for a Web-based or a printed delivery mode and to determine whether an association exists between delivery modes or participant characteristics and attrition in an intervention. This knowledge may enhance implementation, sustainability of participation, and effectiveness of future interventions for older adults. Methods A real-life pretest-posttest intervention study was performed (N=409) among community-living single adults who were older than 65 years, with physical impairments caused by chronic diseases. Measurements were taken at baseline and 3 months after the start of the intervention. Hierarchical logistic regression was used to assess demographic and behavioral characteristics (age, gender, body mass index, educational attainment, degree of loneliness, and PA level), as well as psychosocial characteristics (social support for PA, modeling, self-efficacy, attitude, and intention) related to delivery mode preference at baseline and attrition after 3 months. Results The printed delivery mode achieved higher participation (58.9%, 241/409) than the Web-based delivery mode (41.1%, 168/409). Participation in the Web-based delivery mode was associated with younger age (B=–0.10; SE 0.02; Exp (B)=0.91; P<.001) and higher levels of social support for PA (B=0.38; SE 0.14; Exp (B)=1.46; P=.01); attrition was associated with participation in the Web-based delivery mode (B=1.28; SE 0.28; Exp (B)=3.58; P<.001) and low educational attainment (B=–0.53; SE 0.28; Exp (B)=0.59; P=.049). Conclusions A total of 41% of the participants chose the Web-based delivery mode, thus demonstrating a potential interest of single older adults with physical impairments in Web-based delivered interventions. However, attrition was demonstrated to be higher in the Web-based delivery mode, and lower educational attainment was found to be a predictor for attrition. Characteristics predicting a preference for the printed delivery mode included being older and receiving less social support. Although Web-based delivery modes are generally less expensive and easier to distribute, it may be advisable to offer a printed delivery mode alongside a Web-based delivery mode to prevent exclusion of a large part of the target population. Trial Registration Netherlands Trial Register NTR2297; https://www.trialregister.nl/trial/2173 International Registered Report Identifier (IRRID) RR2-DOI: 10.2196/resprot.8093

Turn on, Tune in, and Drop out: Predictors of Attrition in a Prospective Observational Cohort Study on Psychedelic Use

“…Previous studies have indicated that younger age [16][17][18][19], lower educational levels [20][21][22][23][24][25][26], and unemployment [24,27,28] are among the most reliable predictors of premature termination of studies or discontinuation of treatment compliance in several contexts. Psychological variables associated with poor compliance and retention include poor mental health [29][30][31][32][33][34] and low conscientiousness scores [35,36], and there is some evidence that high extraversion [37] and low agreeableness [1,38] might also be risk factors for dropout.…”

Web-Based Versus Print-Based Physical Activity Intervention for Community-Dwelling Older Adults: Crossover Randomized Trial

“…Furthermore, previous research has shown that preferences for intervention modality may vary by age, sex, BMI, or social or living environment [ 15 , 22 , 23 ]. Younger individuals seem to prefer eHealth to print-based interventions [ 22 , 23 ], whereas older or female individuals or those with an adverse weight status appear to be more likely to favor print-based interventions [ 22 ].…”

“…Furthermore, previous research has shown that preferences for intervention modality may vary by age, sex, BMI, or social or living environment [ 15 , 22 , 23 ]. Younger individuals seem to prefer eHealth to print-based interventions [ 22 , 23 ], whereas older or female individuals or those with an adverse weight status appear to be more likely to favor print-based interventions [ 22 ]. Unfortunately, in our study, we were not able to investigate variations by sociodemographic characteristics because only 7% of the sample changed groups at follow-up, and preference was not assessed at baseline, but only retrospectively.…”

“…Furthermore, the influence of individual preferences for intervention modality and variances in the impact on intervention outcomes is still not well understood [ 20 , 21 ]. Previous studies suggest that preferences may vary by age, sex, BMI, or social or living environment [ 15 , 22 , 23 ]. For example, preference for a web-based intervention was positively related to younger age [ 22 , 23 ] and high internet use and was negatively associated with the female sex.…”

“…Previous studies suggest that preferences may vary by age, sex, BMI, or social or living environment [ 15 , 22 , 23 ]. For example, preference for a web-based intervention was positively related to younger age [ 22 , 23 ] and high internet use and was negatively associated with the female sex. Conversely, older women with obesity were more likely to choose print-based interventions [ 22 ].…”