JMIR Publications

ABSTRACT

Background:

Online interventions can play an important role in promoting physical activity (PA) behavior among older adults. Although the effectiveness of these online interventions is promising, they often suffer from a low reach and high attrition, thereby threatening their potential public health impact.

Objective:

This study assesses which participant characteristics are associated with either an online or a printed delivery mode preference, and whether delivery mode or participant characteristics are associated with attrition of an intervention. This knowledge may enhance implementation, sustainability of participation and effectiveness of future interventions for older adults.

Methods:

A real life pre-test, post-test intervention study was performed (N = 409) among community living single older adults aged over 65 years with physical impairments caused by chronic diseases. Measurements were taken at baseline and three months after the start of the intervention. Hierarchical logistic regression was used to assess demographic and behavioral characteristics (age, gender, BMI, educational attainment, degree of loneliness and PA-level) as well as psychosocial characteristics (social support for PA, modeling, self-efficacy, attitude and intention) related to delivery mode preference at baseline and attrition after 3 months.

Results:

The printed delivery mode achieved a higher participation (59%) than the online delivery mode (41%). Participating in the online delivery mode was associated with younger age (B = -0.10; SE = 0.02; Exp (B) = 0.91; p = 0.000) and higher levels of social support for PA (B = 0.38; SE = 0.14; Exp (B) = 1.46; p = 0.01). Attrition was associated with participating in the online delivery mode (B = 1.28, SE = 0.28, Exp(B) = 3.58; p = 0.000) and with low educational attainment (B = -0.53, SE = 0.28, Exp(B) = 0.59; p = 0.049).

Conclusions:

41% of the participants chose to start in the online delivery mode, thus demonstrating a potential interest of single older adults with physical impairments in online delivered interventions. However, attrition was demonstrated to be higher in the online delivery mode and a lower educational attainment was found to be a predictor for attrition in the online delivery mode. Moreover, certain characteristics predict a preference for a printed delivery mode, i.e. being older and receiving less social support. Although online delivery modes are generally less expensive and easier to distribute, it may be advisable to offer a printed delivery mode alongside an online delivery mode to prevent exclusion of a large part of the target population.