JMIR Publications

ABSTRACT

Background:

Due to demographic change the number of older people is increasing. Older age is often accompanied by limitations in terms of mobility, nutrition and independence. Routine, preventive monitoring of these areas is rare, as care systems struggle with staff shortages and limited resources. Technical assistance systems offer a way to support older people (≥70 years) in self-assessing their health parameters and in consequence keep independence. We developed the AS-Tra system which combines an app with a measurement and training station (MuTS) to identify deficits and risks in the areas of nutrition and mobility in older adults at an early stage.

Objective:

This paper presents the pilot study of the AS-Tra system with the aim of evaluating its usability and testing the feasibility of collecting health-related data of older adults (70+) with early / mild deficiencies in nutritional state and physical functionality in preparation for a future randomized controlled trial (RCT).

Methods:

The system was developed as a complex intervention in accordance with the Medical Research Council (MRC) framework. In this pilot study, the participants used the system four weeks. The assessments (grip strength, Timed ‘Up and Go’, 5-Time Chair Rise) were conducted at the baseline (BL) as well as after one, two and four weeks (T0, T1, T2). At BL, inclusion criteria, baseline characteristics, MNA-SF and SPPB were recorded. Participants received a tablet containing the app and an activity sensor to measure physical activity for seven days. At T0, next to the assessments, the training exercises were introduced and carried out. At T1 the assessments were repeated, along with registering a 3-day food diary in the tablet app and the activity sensor data was evaluated. At T2, the final assessments, including MNA-SF, SPPB, SUS, and feedback questionnaires as well as the ‘Evaluation Overall System’-questionnaire (EOS) (evaluation of all subcomponents on a scale of 1 to 5) were collected. Throughout the entire period of use, participants were asked to train independently in MuTS at least once a week. They regularly kept a food diary using the tablet app and were asked to provide feedback on the app and MuTS in form of an ‘Experience Report’-questionnaire (ER), in which it is asked which elements caused problems and which were particularly easy.

Results:

Ten participants (80 ± 5 years, 50% female) participated in this study, of which one droped-out between T0 and T1. The SUS score was good (79 ± 13.4). The MuTS devices had minor technical problems (in <17% of the usage) according to the ER, while 57% of the users experienced instability issues with the food diary in the tablet app. Overall, ratings of the system were very good with good with slightly lower ratings (2–3 out of 5) for the tablet app and regular use.

Conclusions:

The usability of the technical assistance system used in this study was rated as good. The data collection with questionnaires, sensors, and automated assessments proved feasible. The biggest challenge was the tablet-based food diary which still needs improvement, before the effectiveness of the AS-Tra system regarding mobility and nutritional status will be evaluated in a RCT.