Learning From Older Adults to Promote Independent Physical Activity Using Mobile Health (mHealth)

Abstract

Background: Healthy aging is critically important for several reasons, including economic impact and quality of life. As the population of older adults rapidly increases, identifying acceptable ways to promote healthy aging is a priority. Technologies that can facilitate health promotion and risk reduction behaviors may be a solution, but only if these mobile health (mHealth) tools can be used by the older adult population. Within the context of a physical activity intervention, this study gathered participant's opinions about the use of an mHealth device to learn about acceptance and to identify areas for improvement.Methods: The Independent Walking for Brain Health study (NCT03058146) was designed to evaluate the effectiveness of a wearable mHealth technology in facilitating adherence to a physical activity prescription among participants in free-living environments. An Exit Survey was conducted following intervention completion to gauge participant's perceptions and solicit feedback regarding the overall study design, including exercise promotion strategies and concerns specific to the technology (e.g., privacy), that could inform more acceptable mHealth interventions in the future. The Digital Health Checklist and Framework was used to guide the analysis focusing on the domains of Privacy, Access and Usability, and Data Management.Results: Participants (n = 41) were in their early 70's (mean = 71.6) and were predominantly female (75.6%) and White (92.7%). Most were college educated (16.9 years) and enjoyed using technology in their everyday life (85.4%). Key challenges included privacy concerns, device accuracy, usability, and data access. Specifically, participants want to know what is being learned about them and want control over how their identifiable data may be used. Overall, participants were able to use the device despite the design challenges.Conclusions: Understanding participant's perceptions of the challenges and concerns introduced by mHealth is important, as acceptance will influence adoption and adherence to the study protocol. While this study learned from participants at studycompletion, we recommend that researchers consider what might influence participant acceptance of the technology (access, data management, privacy, risks) and build these into the mHealth study design process. We provide recommendations for future mHealth studies with older adults.

eHealth Platforms to Promote Autonomous Life and Active Aging: A Scoping Review

“…The following age ranges were found in these studies: over 40 years [ 38 ], over 55 years [ 43 ], over 60 years [ 46 , 49 ], and over 65 years [ 37 , 39 , 42 , 44 , 45 , 50 ]. One only mentioned the group of older adults, without specifying an age limit [ 40 , 41 , 47 , 48 ].…”

“…The included 14 articles were published between 2008 and 2021. They were conducted in several countries: Consortium Italy, Switzerland, Spain, and Romania ( n = 1) [ 37 ]; The Netherlands ( n = 1) [ 38 ]; USA ( n = 1) [ 39 ]; Consortium Spain, USA, Greece, Ireland, and Italy ( n = 1) [ 40 ]; Consortium UK, The Netherlands, Spain, Germany, Austria, France, and Belgium ( n = 1) [ 41 ]; Greece ( n = 1) [ 42 ]; USA ( n = 1) [ 43 ]; Germany ( n = 1) [ 44 ]; Consortium Spain, Sweden, and Greece ( n = 1) [ 45 ]; Belgium ( n = 1) [ 46 ]; Consortium The Netherlands and Italy ( n = 1) [ 47 ]; Consortium Switzerland and The Netherlands ( n = 1) [ 48 ]; Consortium Norway, Germany, and The Netherlands ( n = 1) [ 49 ]; Italy ( n = 1) [ 50 ]. Five studies were experimental studies (Randomized Controlled Trials—RCTs) [ 38 , 43 , 44 , 45 , 49 ], eight studies were descriptive studies [ 37 , 39 , 40 , 41 , 42 , 46 , 47 , 50 ], and one was a cross-sectional study [ 48 ] Table 1 .…”

“…Other studies addressed the use of mHealth interventions based on self-monitoring to promote older adults’ active life [ 39 , 46 , 49 ].…”

“…The mHealth device-Independent Walking for Brain Health is a heart rate tracker that can be programmed through its app to set custom heart rate target zones equivalent to moderate intensity physical activity for each person. The device was programmed to vibrate and flash different colored lights (blue = below zone, green = in zone, red = zone above) when participants were deviating from their individually prescribed target heart rate zones [ 39 ].…”

“…Aging imposes an economic burden on society due to the increasing needs resulting from age-related decline in physical, mental, and cognitive health. Healthy aging has become a public health priority to maintain the quality of life and autonomy of older adults [ 39 , 46 ].…”