Faculty of Psychology, Open University of The Netherlands, 6419 AT Heerlen, The Netherlands.
Faculty of Educational Sciences, Open University of The Netherlands, 6419 AT Heerlen, The Netherlands.
Int J Environ Res Public Health. 2020 Apr 10;17(7):2590. doi: 10.3390/ijerph17072590.
eHealth interventions aimed at improving physical activity (PA) can reach large populations with few resources and demands on the population as opposed to centre-based interventions. Active Plus is a proven effective computer-tailored PA intervention for the older adult population focusing on PA in daily life. This manuscript describes the effects of the Active Plus intervention ( = 260) on PA of older adults with chronic illnesses (OACI), compared to a waiting list control group ( = 325). It was part of a larger randomized controlled trial (RCT) on the effects of the Active Plus intervention on cognitive functioning. OACI (≥65 years) with at least one chronic illness were allocated to one of the conditions. Intervention group participants received PA advice. Baseline and follow-up measurements were assessed after 6 and 12 months. Intervention effects on objectively measured light PA (LPA) and moderate-to-vigorous PA (MVPA) min/week were analysed with multilevel linear mixed-effects models adjusted for the clustered design. Intervention effects on self-reported MVPA min/week on common types of PA were analysed with two-part generalized linear mixed-effects models adjusted for the clustered design. The dropout rate was 19.1% after 6 months and 25.1% after 12 months. Analyses showed no effects on objectively measured PA. Active Plus increased the likelihood to perform self-reported cycling and gardening at six months and participants who cycled increased their MVPA min/week of cycling. Twelve months after baseline the intervention increased the likelihood to perform self-reported walking and participants who cycled at 12 months increased their MVPA min/week of cycling. Subgroup analyses showed that more vulnerable participants (higher degree of impairment, age or body mass index) benefitted more from the intervention on especially the lower intensity PA outcomes. In conclusion, Active Plus only increased PA behaviour to a limited extent in OACI 6 and 12 months after baseline measurements. The Active Plus intervention may yet be not effective enough by itself in OACI. A blended approach, where this eHealth intervention and face-to-face contact are combined, is advised to improve the effects of Active Plus on PA in this target group.
电子健康干预措施旨在通过较少的资源和对人群的需求来提高身体活动(PA),而不是以中心为基础的干预措施。Active Plus 是一种经过验证的针对老年人群体的有效计算机定制 PA 干预措施,侧重于日常生活中的 PA。本文描述了 Active Plus 干预措施(n = 260)对患有慢性病的老年成年人(OACI)PA 的影响,与等待名单对照组(n = 325)相比。它是一项更大的随机对照试验(RCT)的一部分,该试验研究了 Active Plus 干预措施对认知功能的影响。≥65 岁且至少患有一种慢性病的 OACI 被分配到其中一种条件下。干预组参与者接受了 PA 建议。在 6 个月和 12 个月后评估了基线和随访测量结果。使用多水平线性混合效应模型分析了干预对客观测量的轻度 PA(LPA)和中度至剧烈 PA(MVPA)min/周的影响,该模型针对聚类设计进行了调整。使用两部分广义线性混合效应模型分析了干预对常见类型 PA 的自我报告 MVPA min/周的影响,该模型针对聚类设计进行了调整。6 个月后,辍学率为 19.1%,12 个月后为 25.1%。分析显示,干预对客观测量的 PA 没有影响。Active Plus 增加了 6 个月时自我报告的骑车和园艺活动的可能性,并且骑车的参与者增加了每周骑车的 MVPA min。基线后 12 个月,干预增加了自我报告的步行活动的可能性,并且 12 个月时骑车的参与者增加了每周骑车的 MVPA min。亚组分析表明,更脆弱的参与者(更高程度的损伤、年龄或身体质量指数)从干预中受益更多,特别是在较低强度的 PA 结果方面。总之,在基线测量后 6 个月和 12 个月,Active Plus 仅在一定程度上增加了 OACI 的 PA 行为。单独使用 Active Plus 干预措施对 OACI 的效果可能还不够。建议采用混合方法,将这种电子健康干预措施与面对面接触相结合,以提高该目标群体中 Active Plus 对 PA 的效果。