Van Dyck Delfien, Herman Karel, Poppe Louise, Crombez Geert, De Bourdeaudhuij Ilse, Gheysen Freja
Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Research Foundation - Flanders, Brussels, Belgium.
J Med Internet Res. 2019 Oct 7;21(10):e13219. doi: 10.2196/13219.
The beneficial effects of physical activity (PA) for older adults are well known. However, few older adults reach the health guideline of 150 min per week of moderate-to-vigorous PA (MVPA). Electronic health (eHealth) interventions are effective in increasing PA levels in older adults in the short term but, rarely, intermediate-term effects after a period without the support of a website or an app have been examined. Furthermore, current theory-based interventions focus mainly on preintentional determinants, although postintentional determinants should also be included to increase the likelihood of successful behavior change.
This study aimed to investigate the effect of the theory-based eHealth intervention, MyPlan 2.0, focusing on pre- and postintentional determinants on both accelerometer-based and self-reported PA levels in older Belgian adults in the short and intermediate term.
This study was a randomized controlled trial with three data collection points: baseline (N=72), post (five weeks after baseline; N=65), and follow-up (three months after baseline; N=65). The study took place in Ghent, and older adults (aged ≥65 years) were recruited through a combination of random and convenience sampling. At all the time points, participants were visited by the research team. Self-reported domain-specific PA was assessed using the International Physical Activity Questionnaire, and accelerometers were used to objectively assess PA. Participants in the intervention group got access to the eHealth intervention, MyPlan 2.0, and used it independently for five consecutive weeks after baseline. MyPlan 2.0 was based on the self-regulatory theory and focused on both pre- and postintentional processes to increase PA. Multilevel mixed-models repeated measures analyses were performed in R (R Foundation for Statistical Computing).
Significant (borderline) positive intervention effects were found for accelerometer-based MVPA (baseline-follow-up: intervention group +5 min per day and control group -5 min per day; P=.07) and for accelerometer-based total PA (baseline-post: intervention group +20 min per day and control group -24 min per day; P=.05). MyPlan 2.0 was also effective in increasing self-reported PA, mainly in the intermediate term. A positive intermediate-term intervention effect was found for leisure-time vigorous PA (P=.02), moderate household-related PA (P=.01), and moderate PA in the garden (P=.04). Negative intermediate-term intervention effects were found for leisure-time moderate PA (P=.01) and cycling for transport (P=.07).
The findings suggest that theory-based eHealth interventions focusing on pre- and postintentional determinants have the potential for behavior change in older adults. If future studies including larger samples and long-term follow-up can confirm and clarify these findings, researchers and practitioners should be encouraged to use a self-regulation perspective for eHealth intervention development.
Clinicaltrials.gov NCT03194334; https://clinicaltrials.gov/ct2/show/NCT03783611.
体育活动（PA）对老年人的益处众所周知。然而，很少有老年人达到每周150分钟中等至剧烈体育活动（MVPA）的健康指南标准。电子健康（eHealth）干预措施在短期内可有效提高老年人的体育活动水平，但很少有研究考察在没有网站或应用程序支持的一段时间后的中期效果。此外，当前基于理论的干预措施主要关注前意向性决定因素，尽管也应纳入后意向性决定因素以增加行为成功改变的可能性。
本研究旨在调查基于理论的电子健康干预措施MyPlan 2.0在短期和中期对比利时老年成年人基于加速度计和自我报告的体育活动水平的前意向性和后意向性决定因素的影响。
本研究是一项随机对照试验，有三个数据收集点：基线（N = 72）、干预后（基线后五周；N = 65）和随访（基线后三个月；N = 65）。研究在根特进行，通过随机抽样和便利抽样相结合的方式招募老年人（年龄≥65岁）。在所有时间点，研究团队都会拜访参与者。使用国际体育活动问卷评估自我报告的特定领域体育活动，并使用加速度计客观评估体育活动。干预组的参与者可以使用电子健康干预措施MyPlan 2.0，并在基线后连续五周独立使用。MyPlan 2.0基于自我调节理论，侧重于前意向性和后意向性过程以增加体育活动。在R（R统计计算基金会）中进行多水平混合模型重复测量分析。
在基于加速度计的MVPA方面发现了显著（临界）的积极干预效果（基线 - 随访：干预组每天增加5分钟，对照组每天减少5分钟；P = 0.07），在基于加速度计的总体育活动方面也有显著效果（基线 - 干预后：干预组每天增加20分钟，对照组每天减少24分钟；P = 0.05）。MyPlan 2.0在增加自我报告的体育活动方面也有效，主要是在中期。在休闲时间剧烈体育活动（P = 0.02）、与家务相关的适度体育活动（P = 0.01）和花园中的适度体育活动（P = 0.04）方面发现了积极的中期干预效果。在休闲时间适度体育活动（P = 0.01）和交通骑行（P = 0.07）方面发现了消极的中期干预效果。
研究结果表明，关注前意向性和后意向性决定因素的基于理论的电子健康干预措施有可能改变老年人的行为。如果未来包括更大样本和长期随访的研究能够证实并阐明这些发现，应鼓励研究人员和从业者在电子健康干预开发中采用自我调节视角。
Clinicaltrials.gov NCT03194334；https://clinicaltrials.gov/ct2/show/NCT03783611。
