An eHealth Intervention to Promote Physical Activity and Social Network of Single, Chronically Impaired Older Adults: Adaptation of an Existing Intervention Using Intervention Mapping

Abstract

BackgroundEspecially for single older adults with chronic diseases, physical inactivity and a poor social network are regarded as serious threats to their health and independence. The Active Plus intervention is an automated computer-tailored eHealth intervention that has been proven effective to promote physical activity (PA) in the general population of adults older than 50 years.ObjectiveThe aim of this study was to report on the methods and results of the systematic adaptation of Active Plus to the wishes and needs of the subgroup of single people older than 65 years who have one or more chronic diseases, as this specific target population may encounter specific challenges regarding PA and social network.MethodsThe Intervention Mapping (IM) protocol was used to systematically adapt the existing intervention to optimally suit this specific target population. A literature study was performed, and quantitative as well as qualitative data were derived from health care professionals (by questionnaires, n=10) and the target population (by focus group interviews, n=14), which were then systematically integrated into the adapted intervention.ResultsAs the health problems and the targeted behavior are largely the same in the original and adapted intervention, the outcome of the needs assessment was that the performance objectives remained the same. As found in the literature study and in data derived from health professionals and focus groups, the relative importance and operationalization of the relevant psychosocial determinants related to these objectives are different from the original intervention, resulting in a refinement of the change objectives to optimally fit the specific target population. This refinement also resulted in changes in the practical applications, program components, intervention materials, and the evaluation and implementation strategy for the subgroup of single, chronically impaired older adults.ConclusionsThis study demonstrates that the adaptation of an existing intervention is an intensive process in which adopting the IM protocol is an invaluable tool. The study provides a broad insight in adapting interventions aimed at single older adults with a chronic disease. It is concluded that even when the new target population is a sizable segment of the original target population, the adapted intervention still needs considerable changes to optimally fit the needs and situational differences of the narrower target population.

The Effect of Active Plus, a Computer-Tailored Physical Activity Intervention, on the Physical Activity of Older Adults with Chronic Illness(es)—A Cluster Randomized Controlled Trial

“…Boekhout et al [34] adapted the intervention using the intervention mapping protocol for a chronically ill older adult (≥65 years) population. Based on a literature study, focus groups with the target population, and interviews with experts, it was concluded that the general determinants for PA in OACI were quite identical to general older adults.…”

“…In the present study, the intervention was tailored to two extra common chronic illnesses (neuromuscular and vascular disorders), and information on the risks of sedentary behaviour and benefits of PA for cognitive functioning were extended. A more detailed description of the intervention content and the process of adaption on the original and adapted Active Plus intervention can be found elsewhere [32,34,45].…”

“…BMI is defined as the body mass divided by the square of body height. The degree of impairment is measured with a self-report questionnaire [34]. The participant stated for 14 common chronic illnesses (i.e., cardiovascular, osteoarthritis) and physical conditions (i.e., hearing or visually impaired) to what degree he/she is limited in his/her PA behaviour by one of the illnesses mentioned or by another illness not mentioned.…”

“…Based on this knowledge, the computer-tailored PA stimulating intervention Active Plus was developed for people aged over 50 years [32,33]. At a later stage, the eHealth program was adapted to a more elderly (≥65 years) population who often suffered from chronic illnesses [34]. Active Plus participants receive 3 personalised PA advice letters (online or print delivered) in 4 months.…”

Electronic Health Program to Empower Patients in Returning to Normal Activities After General Surgical and Gynecological Procedures: Intervention Mapping as a Useful Method for Further Development (Preprint)

“…These studies used the IM protocol in the same manner as we did in this study. They decided to further build on the methodological choices made in the previously developed intervention by adjusting and improving the existing intervention for a new study population [71][72]. Methodological choices made in step two and three of the IM process of developing the original 'ikherstel'-intervention, as described in the IM article of Vonk Noordegraaf et al, are considered effective and therefore used again in this IM procedure [19].…”