Translating Behavior Change Principles Into a Blended Exercise Intervention for Older Adults: Design Study

Sumit Mehra; Bart Visser; Tessa Dadema; Jantine van den Helder; Raoul Hh Engelbert; Peter Jm Weijs; Ben Ja Kröse

doi:10.2196/resprot.9244

Translating Behavior Change Principles Into a Blended Exercise Intervention for Older Adults: Design Study

JMIR Res Protoc. 2018 May 2;7(5):e117. doi: 10.2196/resprot.9244.

Authors

Sumit Mehra^{1

2

3}, Bart Visser⁴, Tessa Dadema⁴, Jantine van den Helder^{4

5}, Raoul Hh Engelbert^{4

6}, Peter Jm Weijs^{5

7}, Ben Ja Kröse^{2

3}

Affiliations

¹ Applied Psychology, Faculty of Applied Social Sciences and Law, Amsterdam University of Applied Sciences, Amsterdam, Netherlands.
² Digital Life - CREATE-IT Applied Research, Faculty of Digital Media and Creative Industries, Amsterdam University of Applied Sciences, Amsterdam, Netherlands.
³ Informatics Institute, Faculty of Science, University of Amsterdam, Amsterdam, Netherlands.
⁴ Amsterdam Center for Innovative Health Practice, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands.
⁵ Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, Netherlands.
⁶ Department of Rehabilitation, Amsterdam Movement Sciences, Academic Medical Center, Amsterdam, Netherlands.
⁷ Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, Amsterdam, Netherlands.

Abstract

Background: Physical activity can prevent or delay age-related impairments and prolong the ability of older adults to live independently. Community-based programs typically offer classes where older adults can exercise only once a week under the guidance of an instructor. The health benefits of such programs vary. Exercise frequency and the duration of the program play a key role in realizing effectiveness. An auxiliary home-based exercise program can provide older adults the opportunity to exercise more regularly over a prolonged period of time in the convenience of their own homes. Furthermore, mobile electronic devices can be used to motivate and remotely guide older adults to exercise in a safe manner. Such a blended intervention, where technology is combined with personal guidance, needs to incorporate behavior change principles to ensure effectiveness.

Objective: The aim of this study was to identify theory-based components of a blended intervention that supports older adults to exercise at home.

Methods: The Medical Research Council framework was used to develop the blended intervention. Insights from focus group, expert panels, and literature were combined into leading design considerations.

Results: A client-server system had been developed that combined a tablet app with a database in the cloud and a Web-based dashboard that can be used by a personal coach to remotely monitor and guide older adults. The app contains several components that facilitate behavior change-an interactive module for goal setting, the ability to draw up a personal training schedule from a library containing over 50 exercise videos, progress monitoring, and possibilities to receive remote feedback and guidance of a personal coach.

Conclusions: An evidence-based blended intervention was designed to promote physical activity among older adults. The underlying design choices were underpinned by behavior change techniques that are rooted in self-regulation. Key components of the tablet-supported intervention were a tailored program that accommodates individual needs, demonstrations of functional exercises, monitoring, and remote feedback. The blended approach combines the convenience of a home-based exercise program for older adults with the strengths of mobile health and personal guidance.

Keywords: activities of daily living; aged; behavior control; exercise; frail elderly; health behavior; mobile devices; remote consultation; tablet computers; telemedicine; treatment adherence and compliance.

©Sumit Mehra, Bart Visser, Tessa Dadema, Jantine van den Helder, Raoul HH Engelbert, Peter JM Weijs, Ben JA Kröse. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 02.05.2018.