Exploring Breaks in Sedentary Behavior of Older Adults Immediately After Receiving Personalized Haptic Feedback: Intervention Study

Abstract

Background “Push” components of mobile health interventions may be promising to create conscious awareness of habitual sedentary behavior; however, the effect of these components on the near-time, proximal outcome, being breaks in sedentary behavior immediately after receiving a push notification, is still unknown, especially in older adults. Objective The aims of this study are to examine if older adults break their sedentary behavior immediately after receiving personalized haptic feedback on prolonged sedentary behavior and if the percentage of breaks differs depending on the time of the day when the feedback is provided. Methods A total of 26 Flemish older adults (mean age 64.4 years, SD 3.8) wore a triaxial accelerometer (Activator, PAL Technologies Ltd) for 3 weeks. The accelerometer generated personalized haptic feedback by means of vibrations each time a participant sat for 30 uninterrupted minutes. Accelerometer data on sedentary behavior were used to estimate the proximal outcome, which was sedentary behavior breaks immediately (within 1, 3, and 5 minutes) after receiving personalized haptic feedback. Generalized estimating equations were used to investigate whether or not participants broke up their sedentary behavior immediately after receiving haptic feedback. A time-related variable was added to the model to investigate if the sedentary behavior breaks differed depending on the time of day. Results A total of 2628 vibrations were provided to the participants during the 3-week intervention period. Of these 2628 vibrations, 379 (14.4%), 570 (21.7%), and 798 (30.4%) resulted in a sedentary behavior break within 1, 3 and 5 minutes, respectively. Although the 1-minute interval did not reveal significant differences in the percentage of breaks depending on the time at which the haptic feedback was provided, the 3- and 5-minute intervals did show significant differences in the percentage of breaks depending on the time at which the haptic feedback was provided. Concretely, the percentage of sedentary behavior breaks was significantly higher if personalized haptic feedback was provided between noon and 3 PM compared to if the feedback was provided between 6 and 9 AM (odds ratio 1.58, 95% CI 1.01-2.47, within 3 minutes; odds ratio 1.78, 95% CI 1.11-2.84, within 5 minutes). Conclusions The majority of haptic vibrations, especially those in the morning, did not result in a break in the sedentary behavior of older adults. As such, simply bringing habitual sedentary behavior into conscious awareness seems to be insufficient to target sedentary behavior. More research is needed to optimize push components in interventions aimed at the reduction of the sedentary behavior of older adults. Trial Registration ClinicalTrials.gov NCT04003324; https://clinicaltrials.gov/ct2/show/NCT04003324

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

“…The results of this study that demonstrated a majority of haptic vibrations, especially those in the morning, did not result in a break in the sedentary behavior of older adults. As such, simply bringing habitual sedentary behavior into conscious awareness seems to be insufficient to target sedentary behavior [ 60 ]. In turn, O’Caoimh et al (2018) [ 47 ] found that health literacy and ICT literacy (eHealth) were useful in helping older people to access such services.…”

“…In addition, the healthy aging perspective includes the physical, social, and cognitive domains, as well as healthy environments to promote healthy lifestyles, well-being, and social participation [ 25 , 60 ].…”

The role of socio-demographic factors and physical functioning in the intra- and interpersonal variability of older adults’ sedentary time: an observational two-country study

“…Moreover, older adults already indicated that they were not eager to interrupt/reduce their television time, which is a typical evening activity [ 53 ]. Indeed, a recent study, investigating breaks in older adults’ sedentary behavior immediately after receiving personalized haptic feedback, showed that older adults were most likely to interrupt their sedentary behavior in the afternoon [ 54 ]. To draw firm conclusions on the optimal time period to provide sedentary behavior support, future researchers are recommended to combine data collection on when older adults are susceptible to sedentary behavior, and when older adults are willing to receive, process and utilize support [ 13 , 14 ].…”

Understanding for whom, under which circumstances and how sedentary behavior interventions for older adults work: A Realist Review

“…To break the habit of SB, several studies suggested that older adults need to become aware about the automaticity of their behavior 39,46,99 . Providing feedback on behavior and stimulating older adults to monitor their own behavior are frequently used BCT's that might lead to an increased awareness 39,40,45,49,56,62,84,88 . However, only bringing habitual behavior into conscious awareness seems insufficient to generate behavior change 39,49,57 .…”

“…reading the paper or eating lunch) 113 . As a result, interventions that prompt people to interrupt their SB actually ask people to interrupt achieving their goals which might lead to frustrations 113 and negative intervention outcomes 49,62,75,79 . In order to make the most out of the mechanism of prompting, it is crucial to examen the most appropriate timing to provide a prompt to interrupt SB 40,113 .…”