Exploring The Feasibility Of Digital Voice Assistants For Delivery Of A Home-Based Exercise Intervention In Older Obese Adults With Type 2 Diabetes Mellitus: Randomised Controlled Trial
ABSTRACT
Background:
Current clinical guidelines for the management of type 2 diabetes mellitus (T2DM) in older adults recommend the use of anti-hyperglycaemic medications, monitoring of blood glucose levels (BGLs), regular exercise and a healthy diet to improve glycaemic control and reduce associated co-morbidities. However, adherence to traditional exercise programs is poor (<35%). Common barriers to adherence include fear of hypoglycaemia, and the need for BGL monitoring prior to exercise. Digital health strategies offer great promise for the management of T2DM as they can facilitate patient-practitioner communication, support self-management and improve access to healthcare services for underserved populations. We have developed a novel web-based software program allowing practitioners to create tailored interventions and deliver them to patients via digital voice assistants (DVAs) in their own homes.
Objective:
To evaluate the feasibility of a 12-week home-based personalised lifestyle intervention delivered and monitored by digital voice-assistants (DVAs) for obese older adults with type 2 diabetes mellitus (T2DM).
Methods:
50 obese older adults aged 50-75 years with oral hypoglycaemic agent-treated T2DM were randomised to intervention (DVA, n=25) or a control group (n=25). Participants allocated to DVA were prescribed a home-based muscle strengthening exercise program (~20-30-minute sessions) and healthy eating intervention, delivered via DVAs (Alexa Echo-Show 8) using newly developed software (“Buddy Link”). Control group participants received generalised physical activity information via email. Outcomes were feasibility, DVA usability (System Usability Scale) and objectively assessed physical activity and sedentary time (wrist-worn accelerometers).
Results:
Forty-five (90%) participants completed the study. Mean±SD adherence to prescribed exercise was 85±43% with no intervention-related adverse events. System usability was rated above average (70.4±16.9 out of 100). Compared with controls, the DVA group significantly decreased sedentary time (mean difference [95% CI] -67 [-113, -21] mins/day) and increased moderate-intensity activity (+25 [1, 48] mins/day.
Conclusions:
A home-based lifestyle intervention delivered and monitored by health professionals using DVAs was feasible for reducing sedentary behaviour and increasing moderate-intensity activity in obese older adults with T2DM. Clinical Trial: ANZCTR Registration No. 12621000307808 https://www.anzctr.org.au/
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