User Experience, Actual Use, and Effectiveness of an Information Communication Technology-Supported Home Exercise Program for Pre-Frail Older Adults

Weering, Marit Dekker-van; Jansen-Kosterink, Stephanie; Frazer, Sanne; Vollenbroek-Hutten, Miriam Marie Rosé

doi:10.3389/fmed.2017.00208

Cited by 52 publications

(56 citation statements)

References 30 publications

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“…Further, the clinically relevant higher attrition rate in the PB group (p = .078), could be related to the two recruitment strategies, further discussed as a methodological consideration. Similar attrition rates as ours, of approximately 20%, has been reported in evaluations of other digital exercise interventions over 3-4 months [18,29,30]. For the ActiveLifestyle study the control group used a paper programme where attrition rate was 41%, slightly higher than ours [18].…”

Section: Attrition and Attitudesupporting

confidence: 81%

“…Considering these dissimilarities, The ActiveLifestyle study [18] indicated similar adherence as in our study: Users of the App with social features had 73% mean adherence of recommended exercise time, the App without social features had 68%, and the Paper programme (control) 54%. In a similar way Dekkeret al [29] reported 68% adherence in a 12 weeks ICT-supported self-management programme, offering an individually tailored fall prevention exercise programme. In comparison, an exergaming intervention iStoppFalls [30], reported 38% adherence as the proportion of participants reaching 1 h exercise per week during their four months intervention.…”

Section: Adherencementioning

confidence: 84%

“…Additionally, the monthly reviews of the DP diaries were not realised in the penultimate month (as the data was not provided to the research assistant), causing a plausible risk that the adherence for the second part of the study in the DP group was affected. Other studies have used the actual connectivity of the app or exergame to monitor adherence [18,29,30], but the question rise if an over reporting of adherence may occur, when e.g. every connection to show someone the programme or go back and repeat watching a section, will be reported as exercise.…”

Section: Methodological Considerationsmentioning

confidence: 99%

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Older adults’ preferences for, adherence to and experiences of two self-management falls prevention home exercise programmes: a comparison between a digital programme and a paper booklet

et al. 2020

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Background: Fall prevention exercise programmes are known to be effective, but access to these programmes is not always possible. The use of eHealth solutions might be a way forward to increase access and reach a wider population. In this feasibility study the aim was to explore the choice of programme, adherence, and self-reported experiences comparing two exercise programmesa digital programme and a paper booklet. Methods: A participant preference trial of two self-managed fall prevention exercise interventions. Community-dwelling adults aged 70 years and older exercised independently for four months after one introduction meeting. Baseline information was collected at study start, including a short introduction of the exercise programme, a short physical assessment, and completion of questionnaires. During the four months intervention period, participants self-reported their performed exercises in an exercise diary. At a final meeting, questionnaires about their experiences, and post-assessments, were completed. For adherence analyses data from diaries were used and four subgroups for different levels of participation were compared. Exercise maintenance was followed up with a survey 12 months after study start. Results: Sixty-seven participants, with mean age 77 ± 4 years were included, 72% were women. Forty-three percent chose the digital programme. Attrition rate was 17% in the digital programme group and 37% in the paper booklet group (p = .078). In both groups 50-59% reported exercise at least 75% of the intervention period. The only significant difference for adherence was in the subgroup that completed ≥75% of exercise duration, the digital programme users exercised more minutes per week (p = .001). Participants in both groups were content with their programme but digital programme users reported a significantly higher (p = .026) degree of being content, and feeling supported by the programme (p = .044). At 12 months follow-up 67% of participants using the digital programme continued to exercise regularly compared with 35% for the paper booklet (p = .036).

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Section: Attrition and Attitudesupporting

confidence: 81%

Section: Adherencementioning

confidence: 84%

Section: Methodological Considerationsmentioning

confidence: 99%

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Older adults’ preferences for, adherence to and experiences of two self-management falls prevention home exercise programmes: a comparison between a digital programme and a paper booklet

et al. 2020

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Section: Adherencementioning

confidence: 84%

Older adults' preferences for, adherence to and experiences of two self-management falls prevention home exercise programmes: A comparison between a digital programme and a paper booklet

Månsson

Lundin-Olsson

Skelton

et al. 2020

Preprint

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Background: Fall prevention exercise programmes are known to be effective, but access to these programmes is not always possible. The use of eHealth solutions might be a way forward to increase access and reach a wider population. In this feasibility study the aim was to explore the choice of programme, adherence, and self-reported experiences comparing two exercise programmes – a digital programme and a paper booklet.Methods: A participant preference trial of two self-managed fall prevention exercise interventions. Community-dwelling adults aged 70 years and older exercised independently for four months after one introduction meeting. Baseline information was collected at study start, including a short introduction of the exercise programme, a short physical assessment, and completion of questionnaires. During the four months intervention period, participants self-reported their performed exercises in an exercise diary. At a final meeting, questionnaires about their experiences, and post-assessments, were completed. For adherence analyses data from diaries were used and four subgroups for different levels of participation were compared. Exercise maintenance was followed up with a survey 12 months after study start.Results: Sixty-seven participants, with mean age 77±4 years were included, 72% were women. Forty-three percent chose the digital programme. Attrition rate was 17% in the digital programme group and 37% in the paper booklet group (p=.078). In both groups 50-59% reported exercise at least 75% of the intervention period. The only significant difference for adherence was in the subgroup that completed ≥75% of exercise duration, the digital programme users exercised more minutes per week (p=.001). Participants in both groups were content with their programme but digital programme users reported a significantly higher (p=.026) degree of being content, and feeling supported by the programme (p=.044). At 12 months follow-up 67% of participants using the digital programme continued to exercise regularly compared with 35% for the paper booklet (p=.036).Conclusions: Exercise interventions based on either a digital programme or a paper booklet can be used as a self-managed, independent fall prevention programme. There is a similar adherence in both programmes during a 4-month intervention, but the digital programme seems to facilitate long-term maintenance in regular exercise.Trial registration: ClinTrial: NCT02916849

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“…A digital platform that served as the data repository for a patient allowed for the following main functionalities: messaging among the key actors for a patient’s care (the patient, professional caregivers, family members, and informal caregivers), sending data to and retrieving data from a patient’s electronic medical record (EMR) and other digital applications, and the provision and processing of patient-centered surveys. A web-based service provided the Otago fall prevention program [ 19 ] (used for improving physical health [ 20 ]) through video instruction, accompanied by written instructions and a voice-over that pronounced these written instructions. Patients could indicate the difficulty they had with exercises; based upon this feedback, the service decided whether (1) they could continue to the next level of the Otago program after completing a week, (2) they would remain at the same level, or (3) they would go down a level.…”

Section: Introductionmentioning

confidence: 99%

Identifying the Value of an eHealth Intervention Aimed at Cognitive Impairments: Observational Study in Different Contexts and Service Models

Jurkeviciute¹,

Velsen²,

Eriksson³

et al. 2020

J Med Internet Res

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Background Value is one of the central concepts in health care, but it is vague within the field of summative eHealth evaluations. Moreover, the role of context in explaining the value is underexplored, and there is no explicit framework guiding the evaluation of the value of eHealth interventions. Hence, different studies conceptualize and operationalize value in different ways. Objective The objective of our study is to identify contextual factors that determine similarities and differences in the value of an eHealth intervention between 2 contexts. We also aim to reflect on and contribute to the discussion about the specification, assessment, and relativity of the “value” concept in the evaluation of eHealth interventions. Methods The study concerned a 6-month eHealth intervention targeted at elderly patients (n=107) diagnosed with cognitive impairment in Italy and Sweden. The intervention introduced a case manager role and an eHealth platform to provide remote monitoring and coaching services to the patients. A model for evaluating the value of eHealth interventions was designed as monetary and nonmonetary benefits and sacrifices, based on the value conceptualizations in eHealth and marketing literature. The data was collected using the Mini–Mental State Examination (MMSE), the clock drawing test, and the 5-level EQ-5D (EQ-5D-5L). Semistructured interviews were conducted with patients and health care professionals. Monetary data was collected from the health care and technology providers. Results The value of an eHealth intervention applied to similar types of populations but differed in different contexts. In Sweden, patients improved cognitive performance (MMSE mean 0.85, SD 1.62, P<.001), reduced anxiety (EQ-5D-5L mean 0.16, SD 0.54, P=.046), perceived their health better (EQ-5D-5L VAS scale mean 2.6, SD 9.7, P=.035), and both patients and health care professionals were satisfied with the care. However, the Swedish service model demonstrated an increased cost, higher workload for health care professionals, and the intervention was not cost-efficient. In Italy, the patients were satisfied with the care received, and the health care professionals felt empowered and had an acceptable workload. Moreover, the intervention was cost-effective. However, clinical efficacy and quality of life improvements have not been observed. We identified 6 factors that influence the value of eHealth intervention in a particular context: (1) service delivery design of the intervention (process of delivery), (2) organizational setup of the intervention (ie, organizational structure and professionals involved), (3) cost of different treatments, (4) hourly rates of staff for delivering the intervention, (5) lifestyle habits of the population (eg, how physically active they were in their daily life and if they were living alone or with family), and (6) local preferences on the quality of patient care. Conclusions Value in the assessments of eHealth interventions need to be considered beyond economic terms, perceptions, or behavior changes. To obtain a holistic view of the value created, it needs to be operationalized into monetary and nonmonetary outcomes, categorizing these into benefits and sacrifices.

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User Experience, Actual Use, and Effectiveness of an Information Communication Technology-Supported Home Exercise Program for Pre-Frail Older Adults

Cited by 52 publications

References 30 publications

Older adults’ preferences for, adherence to and experiences of two self-management falls prevention home exercise programmes: a comparison between a digital programme and a paper booklet

Older adults’ preferences for, adherence to and experiences of two self-management falls prevention home exercise programmes: a comparison between a digital programme and a paper booklet

Older adults' preferences for, adherence to and experiences of two self-management falls prevention home exercise programmes: A comparison between a digital programme and a paper booklet

Identifying the Value of an eHealth Intervention Aimed at Cognitive Impairments: Observational Study in Different Contexts and Service Models

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