JMIR Publications

ABSTRACT

Background:

Mobile applications (apps) and peer support in physical activity promotion are known to be effective in older adults. Physical activity improves physical function in older adults. Previously, we investigated the feasibility and impact of using digital peer-supported apps (DPSAs) to increase physical activity among older adults over a period of 3 months. However, the long-term feasibility and impact for sustainable behavior change remain unknown.

Objective:

To evaluate the 12-month feasibility of DPSA and changes in physical activity and physical function among older Japanese adults.

Methods:

Methods:

This nonrandomized controlled trial recruited older adults aged ≥65 years from two programs designed to increase physical activity. Participants chose either the intervention (app program and exercise instruction) or control (exercise instruction only) groups. Only participants who had completed the 3-month intervention and wished to participate in the 12-month follow-up intervention study were included. DPSA feasibility was assessed with retention and adherence rates. Physical activity was assessed using accelerometers to measure daily step count, light-intensity physical activity, moderate-to-vigorous-intensity physical activity, and sedentary behavior, while physical function was assessed using grip strength and 30-second chair-stand test (CS-30). In both groups, accelerometer measurements were obtained every 3 months over 12 months for a total of five time points, including at baseline; physical function was measured at three time points: at baseline, 3 months, and 12 months later.

Results:

The follow-up study included 44 of 66 participants from the 3-month intervention study, with 26 and 18 participants in the intervention and 18 control groups, respectively. The 12-month retention rate for the DPSA intervention group participants was 73% (19/26); for the 41 participants including those who decided not to participate in the follow-up study was 46% (19/41). The adherence rate was 85.9%. The average number of step counts per day (standard error) in the intervention group increased from 7455 (790) to 9196 (802) steps after 12 months, with significant differences at 12 months (P=.048) and at 12 months before and after DPSA (P=.02). No significant difference was found in the control group. Both the intervention and control groups demonstrated a significant improvement from pre-intervention to 12 months in CS-30 (intervention: P<.001, control: P=.03). The CS-30 score (standard error) increased from 20.4 (1.4) to 26.9 (1.4) for the intervention group (P<.001) and from 19.6 (1.4) to 23.5 (1.6) for the control group (P=.02) at 12 months.

Conclusions:

Long-term use of DPSA improved lower extremity function and step count, although only a limited number of older adults had long-term access to DPSA. Identifying ways in which more older adults can use DPSAs for extended periods of time is required; randomized controlled trials should be conducted to ascertain the long-term effects of DPSAs on physical activity and function in older adults. Clinical Trial: University Hospital Medical Information Network (UMIN000050618)