Evaluation of a Blended Physical Activity Intervention for Older Adults: Mixed Methods Study

Abstract

Background Physical activity can prolong the ability of older adults to live independently. Home-based exercises can help achieve the recommended physical activity levels. A blended intervention was developed to support older adults in performing home-based exercises. A tablet and a personal coach were provided to facilitate the self-regulation of exercise behavior. Objective In line with the Medical Research Council framework, this study aimed to carry out process evaluation of a blended intervention. The objectives were (1) to assess the long-term usability of the tablet adopted in the blended intervention and (2) to explore how the tablet, in conjunction with a personal coach, supported older adults in performing home-based exercises. Methods The process evaluation was conducted with a mixed-methods approach. At baseline, older adults participating in the blended intervention were asked to fill out a questionnaire about their general experience with information and communication technology (ICT) devices and rate their own skill level. After 6 months, participants filled out the Usefulness, Satisfaction, and Ease of use (USE) questionnaire to assess the usefulness, satisfaction, and ease of use of the tablet. With a random selection of participants, in-depth interviews were held to explore how the tablet and coach supported the self-regulation. The interviews were double coded and analyzed with the directed content analysis method. Results At baseline, 29% (65/224) of participants who started the intervention (mean age 72 years) filled out the ICT survey and 36% (37/103) of participants who used the tablet for 6 months (mean age 71 years) filled out the USE questionnaire. Furthermore, with 17% (18/103) of participants (mean age 73 years), follow-up interviews were held. The results of the baseline questionnaire showed that the large majority of participants already had experience with a tablet, used it regularly, and reported being skillful in operating ICT devices. After 6 months of use, the participants rated the usefulness, satisfaction, and ease of use of the tablet on average as 3.8, 4.2, and 4.1, respectively, on a 5-point scale. The analysis of the interviews showed that the participants felt that the tablet supported action planning, behavior execution, and self-monitoring. On the other hand, especially during the first few months, the personal coach added value during the goal setting, behavior execution, and evaluation phases of self-regulation. Conclusions The results of the process evaluation showed that older adults who participated in the study were positive about the blended intervention that was designed to support them in performing home-based exercises. Participants reported that the tablet helped them to perform the exercises better, more frequently, and safely. It supported them in various phases of self-regulation. The availability of a personal coach was nevertheless crucial. To support physical activity in older adults, a blended approach is promising.

A randomized controlled trial into the cognitive effects of a computer-tailored physical activity intervention in older adults with chronic disease(s)

“…A blended approach is increasingly being applied in both healthcare and mental healthcare [71]. There are already some examples of blended approach interventions aimed at promoting PA in older adults [73,74]. However, only a few studies exist, and results are mixed.…”

Digitally Supported Dietary Protein Counseling Changes Dietary Protein Intake, Sources, and Distribution in Community-Dwelling Older Adults

“…Our experience shows that self-efficacy and competence in e-health use can be increased within this population by incorporating time to adapt to the electronic device. Even older adults with no previous device experience were able to participate [ 18 , 48 ]. Our systematically designed intervention is a major strength, because of engagement of the end user, and pilots have been performed before the trial.…”

The most used questionnaires for evaluating telemedicine services

“…Then, the Service User Technology Acceptability Questionnaire (SUTAQ) (n = 3, 5.5%) [27][28][29], the Client Satisfaction Questionnaire (CSQ) (n = 3, 5.5%) [30][31][32], the Questionnaire for User Interaction Satisfaction (QUIS) (n = 3, 5.5%) [33][34][35], the System Usability Scale (SUS) questionnaire (n = 3, 5.5%) [36][37][38], the Patient Satisfaction Questionnaire (PSQ) (n = 3, 5.5%) [22,39,40], the Telemedicine Satisfaction and Usefulness Questionnaire (TSUQ) (n = 2, 3.5%) [41,42], the Patient Assessment of Communication during Telemedicine (PACT) questionnaire (n = 2, 3.5%) [43,44], the Post Study System Usability Questionnaire (PSSUQ) (n = 2, 3.5%) [19,45] and the Technology Acceptance Model (TAM) (n = 2, 3.5%) [46,47] were the most used questionnaires, respectively. The rest of the articles had used other questionnaires (n = 18, 34%) [14,19,46,[48][49][50][51][52][53][54][55][56][57][58][59][60][61][62]] and 4 articles had used more than one questionnaire.…”