Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jun 18, 2021
Open Peer Review Period: Jun 18, 2021 - Aug 13, 2021
Date Accepted: Feb 8, 2022
(closed for review but you can still tweet)
The effectiveness of a computer-tailored web-based physical activity intervention using Fitbits in older adults: The Active for Life randomised controlled trial
ABSTRACT
Background:
Physical activity is an integral part of healthy aging, yet most adults aged 65+ years are not sufficiently active. Preliminary evidence suggests that web-based interventions with tailored advice and Fitbits may be well suited for older adults.
Objective:
To examine the effectiveness of ‘Active for Life,’ a 12-week web-based physical activity intervention with 6 sessions of computer-tailored advice for older adults in Australia.
Methods:
A total of 243 participants were randomly assigned to one of three trial arms: 1) tailoring + Fitbit, 2) tailoring only, or 3) a wait-list control. The tailored advice was based on either participants’ Fitbit data (tailoring + Fitbit participants) or self-reported physical activity (tailoring only participants). The main outcome was change in wrist-worn accelerometer (Actigraph GT9X) measured moderate to vigorous physical activity (MVPA) from baseline to week 12. A generalised linear mixed model analysis was conducted with a gamma distribution and log link to compare MVPA changes over time within each trial arm, and to compare MVPA changes over time between each trial arm.
Results:
The 12-week assessment was completed by 166 participants (32% attrition). There was an overall time by group interaction for MVPA, but this did not meet the criteria for significance (p=.05). There were no significant within group changes for MVPA over time in the tailoring + Fitbit group (+3%, 95%CI= -24%, +40%) or the tailoring only group (-4%, 95%CI= -24%, +30%), however a significant decline was seen in the control group (-35%, 95%CI= -52%, -11%). The tailoring + Fitbit group increased their MPVA 59% (+6%, +138%) more than the control group. Satisfaction with the advice (tailoring + Fitbit: 5.62±0.89, Tailoring only: 5.75±0.75 out of 7) and session completions (tailoring + Fitbit: 4.72±2.04, Tailoring only: 4.23±2.25 out of 6) supported acceptability of both interventions, however there were no differences between groups. Intervention usability was scored significantly higher in the tailoring + Fitbit group (tailoring + Fitbit: 64.55±13.59, Tailoring only: 57.04±2.58 out of 100).
Conclusions:
A computer-tailored physical activity intervention with Fitbit integration was acceptable and effective at maintaining MVPA in comparison to a control group in older adults. Clinical Trial: Australian and New Zealand Clinical Trials Registry: ACTRN12618000646246
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