Evaluation of a Blended Physical Activity Intervention for Older Adults: A Mixed-Method Study (Preprint)

BACKGROUND Physical activity can prolong the ability of older adults to live independently. Home-based exercises can help achieve the recommended levels. A blended intervention was developed to support older adults in performing home-based exercises. A tablet and a personal coach were provided to facilitate the self-regulation of exercise behavior. OBJECTIVE In line with the Medical Research Council Framework, the aim of the study was to carry out a process evaluation of the blended intervention. The objectives were a) to assess the long-term usability of the tablet used in the blended intervention and b) to explore how the tablet, in conjunction with a personal coach, supported older adults in performing home-based exercises. METHODS The process evaluation was conducted with a mixed-methods approach. At baseline, older adults participating in the blended intervention were asked to fill out a questionnaire about their general experience with ICT devices and rate their own skill level. After 6 months participants filled out the USE-questionnaire to assess the usefulness, satisfaction and ease of use of the tablet. With a random selection of participants in-depth interviews were held to explore how the tablet and coach supported the self-regulation. The interviews were double coded and analyzed with the Directed Content Analysis method. RESULTS At baseline 29% of the participants (65/224) that started the intervention filled out the ICT-survey and 36% of the participants (37/103) that used the tablet for 6 months filled out the USE questionnaire. Furthermore, with 17% of the participants (18/103) follow-up interviews were held. The average ages of the samples were respectively 72, 71 and 73 years old. The results of the baseline questionnaire showed that the large majority already had experience with a tablet, used it regularly and reported to be skillful in operating ICT devices. After 6 months of use, the participants rated the usefulness, satisfaction and ease of use of the tablet on average as 3.8, 4.2 and 4.1 on a 5-point scale respectively. The analysis of the interviews show that participants felt that the tablet supported action planning, behavior execution and self-monitoring. On the other hand, especially during the first few months, the personal coach had added value during the goal setting, behavior execution and evaluation phases of self-regulation. CONCLUSIONS The results of the process evaluation have shown older adults that participated in the study are positive about a blended intervention that was designed to support them in performing home-based exercises. Participants reported that the tablet helped them to perform the exercises better, more frequent and safely. It supported them in various phases of self-regulation. The availability of personal coach was nevertheless crucial. To support physical activity in older adults a blended approach is promising. CLINICALTRIAL