Technology for Behavioral Change in Rural Older Adults with Obesity

Batsis, John A.; Naslund, John A.; Zagaria, Alexandra B.; Kotz, David; Dokko, Rachel; Bartels, Stephen J.; Carpenter‐Song, Elizabeth

doi:10.1080/21551197.2019.1600097

Cited by 27 publications

(47 citation statements)

References 49 publications

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“…Perceived ease of use is one of the domains that has higher level in our results. This is in line with the findings of a recent study [ 40 ] and related to the fact that, while technology use has been increasing also in elderly people, they still need additional information and support to adopt it [ 41 ]. A recent study showed that commercial wearable devices are reliable for measuring physical activity level in elderly patients in real-life setting [ 42 ].…”

Section: Discussionsupporting

confidence: 90%

Monitoring Patients Reported Outcomes after Valve Replacement Using Wearable Devices: Insights on Feasibility and Capability Study: Feasibility Results

Ocagli

Lorenzoni

Lanera

et al. 2021

IJERPH

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Wearable devices (WDs) can objectively assess patient-reported outcomes (PROMs) in clinical trials. In this study, the feasibility and acceptability of using commercial WDs in elderly patients undergoing transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR) will be explored. This is a prospective observational study. Participants were trained to use a WD and a smartphone to collect data on their physical activity, rest heart rate and number of hours of sleep. Validated questionnaires were also used to evaluate these outcomes. A technology acceptance questionnaire was used at the end of the follow up. In our participants an overall good compliance in wearing the device (75.1% vs. 79.8%, SAVR vs. TAVR) was assessed. Half of the patients were willing to continue using the device. Perceived ease of use is one of the domains that scored higher in the technology acceptance questionnaire. In this study we observed that the use of a WD is accepted in our frail population for an extended period. Even though commercial WDs are not tailored for clinical research, they can produce useful information on patient behavior, especially when coordinated with intervention tailored to the single patient.

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Section: Discussionsupporting

confidence: 90%

Monitoring Patients Reported Outcomes after Valve Replacement Using Wearable Devices: Insights on Feasibility and Capability Study: Feasibility Results

Ocagli

Lorenzoni

Lanera

et al. 2021

IJERPH

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“…This analysis focuses on insights about obesity stigma in three different stakeholder groups (rural, community-dwelling older adults, clinicians, and community leaders), an approach that enhances credibility via the triangulation of perspectives (Creswell et al, 2004). Full methods are previously reported (Batsis et al, 2019). Participants resided in areas designated as nonmetropolitan areas.…”

Section: Methodsmentioning

confidence: 99%

The Use and Meaning of the Term Obesity in Rural Older Adults: A Qualitative Study

et al. 2020

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The term “obesity” is associated with societal stigma and discrimination. Eight individual semi-structured interviews and five focus groups with 29 community-dwelling, rural older adults with obesity, seven primary care clinicians, and four rural community leaders were completed using purposive and snowball sampling. Clinicians perceived that older adults are less affected by obesity stigma than younger adults, yet this was not observed by community leaders; however, older participants with obesity reported that they often felt ashamed and/or stigmatized because of their weight. There was also a disconnect between clinician and older adult understanding of obesity. For older adults with obesity, the word “obesity” was associated with negative connotations. Just as physiological aspects of obesity persist into older adulthood, so do psychological aspects, such as perceptions of stigma. The use of the word “obesity” in medical settings may hinder communication between clinician and older participants. Heightened awareness may change the dialogue around obesity.

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“…Weight and nutrition are key priorities in Rural Healthy People 2020 [14] as rural care is affected by lower healthcare access, [15] a complex natural and built environment, [14] healthcare provider workforce shortages, and a lack of rural-specific programs [16]. Barriers also include a need for social connectedness, access, and program availability [17]. Previous weight loss efforts in rural areas generally have been achieved through in-person interventions, phone calls, community-health workers, or peer coaching [18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Feasibility and acceptability of a technology-based, rural weight management intervention in older adults with obesity

et al. 2021

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Background Older adults with obesity residing in rural areas have reduced access to weight management programs. We determined the feasibility, acceptability and preliminary outcomes of an integrated technology-based health promotion intervention in rural-living, older adults using remote monitoring and synchronous video-based technology. Methods A 6-month, non-randomized, non-blinded, single-arm study was conducted from October 2018 to May 2020 at a community-based aging center of adults aged ≥65 years with a body mass index (BMI) ≥30 kg/m2. Weekly dietitian visits focusing on behavior therapy and caloric restriction and twice-weekly physical therapist-led group strength, flexibility and balance training classes were delivered using video-conferencing to participants in their homes. Participants used a Fitbit Alta HR for remote monitoring with data feedback provided by the interventionists. An aerobic activity prescription was provided and monitored. Results Mean age was 72.9±3.9 years (82% female). Baseline anthropometric measures of weight, BMI, and waist circumference were 97.8±16.3 kg, 36.5±5.2 kg/m2, and 115.5±13.0 cm, respectively. A total of 142 participants were screened (n=27 ineligible), and 53 consented. There were nine dropouts (17%). Overall satisfaction with the trial (4.7+ 0.6, scale: 1 (low) to 5 (high)) and with Fitbit (4.2+ 0.9) were high. Fitbit was worn an average of 81.7±19.3% of intervention days. In completers, mean weight loss was 4.6±3.5 kg or 4.7±3.5% (p< 0.001). Physical function measures of 30-s sit-to-stand repetitions increased from 13.5±5.7 to 16.7±5.9 (p< 0.001), 6-min walk improved by 42.0±77.3 m (p=0.005) but no differences were observed in gait speed or grip strength. Subjective measures of late-life function improved (3.4±4.7 points, p< 0.001). Conclusions A technology-based obesity intervention is feasible and acceptable to older adults with obesity and may lead to weight loss and improved physical function. Clinical trial registration Registered on Clinicaltrials.gov #NCT03104205. Registered on April 7, 2017. First participant enrolled on October 1st, 2018.

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Technology for Behavioral Change in Rural Older Adults with Obesity

Cited by 27 publications

References 49 publications

Monitoring Patients Reported Outcomes after Valve Replacement Using Wearable Devices: Insights on Feasibility and Capability Study: Feasibility Results

Monitoring Patients Reported Outcomes after Valve Replacement Using Wearable Devices: Insights on Feasibility and Capability Study: Feasibility Results

The Use and Meaning of the Term Obesity in Rural Older Adults: A Qualitative Study

Feasibility and acceptability of a technology-based, rural weight management intervention in older adults with obesity

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