JMIR Publications

ABSTRACT

Background:

Engaging in an adequate amount of physical activity (PA) serves as a protective factor against frailty. While previous PA interventions have shown effectiveness in improving physical functioning outcomes, they have not consistently demonstrated success in sustaining PA behavioral changes. This study aimed to explore the feasibility and potential effects of an integrative mHealth intervention that combines outdoor exercise facilities, a mobile application, and workshop components in improving PA behavior and other health outcomes among frail community-dwelling older adults.

Objective:

The primary aim of this pilot randomized controlled trial (RCT) was to explore the feasibility and acceptability of this integrative mHealth intervention among pre-frail and frail community-dwelling older adults. The secondary aim was to explore the potential effects of the intervention with respect to sustaining PA levels and improving mental well-being and exercise self-efficacy among these older adults.

Methods:

A two-armed pilot feasibility randomized controlled trial was conducted. Seventy-five inactive pre-frail or frail community-dwelling older adults (aged > 55 years) were randomized to the intervention group (n = 19), which received four weekly educational workshops in a university and a mobile application to support their use of outdoor exercise facilities in their neighborhood, or the control group (n = 19), which received four weekly health education workshops with exercise experiential sessions tailored for frail older adults. Individual semi-structured interviews were conducted with, and a self-developed questionnaire was administered to, 14 intervention group participants to determine the acceptability of the intervention.

Results:

The mean age of the participants was 71.8 (standard deviation: 9.34) years, and 71% were female. Thirty-four participants (89%) completed the study (18/19 in the control group; 16/19 in the intervention group). Workshop attendance was 93% in the intervention group and 95% in the control group. Self-reported adherence to the unsupervised outdoor practical session and app engagement were 71% and 69%, respectively. Two adverse events were reported in the intervention group, and none in the control group. As hypothesized, secondary outcome analyses revealed that both groups exhibited increased PA levels immediately post-intervention; however, only the intervention group had maintained the increase at the 3-month follow-up. Additionally, favorable changes in mental well-being and exercise self-efficacy were observed in the intervention group. Both feasibility and acceptability data revealed areas of improvement that should be addressed before another trial.

Conclusions:

This study provides initial proof-of-concept data on the integrative mHealth intervention; however, amendments are needed to improve user adherence to the app and outdoor practice before another trial. Clinical Trial: This trial was registered on ClinicalTrials.gov (NCT06326710) on March 22, 2024.