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促进老年人社会参与的移动应用效果:随机对照试验。

Effects of a Mobile App to Promote Social Participation on Older Adults: Randomized Controlled Trial.

机构信息

Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.

Research Department, Institute for Health Economics and Policy, Tokyo, Japan.

出版信息

J Med Internet Res. 2024 Sep 30;26:e64196. doi: 10.2196/64196.

Abstract

BACKGROUND

Social participation is crucial for healthy aging, improving physical and mental health, cognitive function, and quality of life among older adults. However, social participation tends to decline with age due to factors like loss of social networks and health issues. Mobile health apps show promise in promoting healthy behaviors among older adults, but their effectiveness in increasing social participation remains understudied.

OBJECTIVE

This randomized controlled trial aimed to evaluate the efficacy of a mobile app called Encouragement of Social Participation (ESP, "Shakai Sanka no Susume;" Hitachi) in promoting social participation and physical activity among community-dwelling older adults.

METHODS

The study recruited 181 community-dwelling adults aged 60 years or older from 2 municipalities in Japan and through a web-based research panel. Participants were randomly assigned to either the intervention group (n=87), which used the ESP app for 12 weeks, or the control group (n=94), which used only Google Fit. The ESP app incorporated features such as self-monitoring of social participation, personalized feedback, gamification elements, and educational content. Primary outcomes were changes in social participation frequency over the previous 2 months and changes in step counts, measured at baseline and week 12. Secondary outcomes included changes in specific types of social activities and subjective well-being. Data were analyzed using analysis of covariance and linear mixed-effects models.

RESULTS

The intervention group showed a significantly greater increase in social participation frequency compared with the control group (adjusted difference 3.03; 95% CI 0.17-5.90; P=.04). Specifically, the intervention group demonstrated higher frequencies of participation in hobbies (adjusted difference: 0.82; 95% CI 0.01-1.63) and cultural clubs (adjusted difference 0.65; 95% CI 0.07-1.23) compared with the control group. However, there were no significant differences in weekly step counts between the groups. Subgroup analyses suggested potentially larger effects among participants who were older than 70 years, female, had lower educational attainment, and were recruited from community settings, although only females and the lower educational attainment subgroups demonstrated 95% CIs that did not encompass zero.

CONCLUSIONS

The ESP mobile app effectively promoted social participation among community-dwelling older adults, particularly in hobbies and cultural club activities. However, it did not significantly impact physical activity levels as measured by step counts. These findings suggest that mobile apps can be valuable tools for encouraging social engagement in older populations, potentially contributing to healthy aging. Future research should focus on optimizing app features to maintain long-term engagement and exploring strategies to enhance physical activity alongside social participation.

TRIAL REGISTRATION

University Medical Information Network Clinical Trial Registry UMIN000049045; https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000055781.

摘要

背景

社会参与对于老年人的健康老龄化、改善身心健康、认知功能和生活质量至关重要。然而,由于社交网络的丧失和健康问题等因素,老年人的社会参与往往会随着年龄的增长而下降。移动健康应用程序在促进老年人的健康行为方面显示出了希望,但它们在增加社会参与方面的有效性仍有待研究。

目的

本随机对照试验旨在评估一种名为 Encouragement of Social Participation(ESP,“Shakai Sanka no Susume;”日立)的移动应用程序在促进社区居住的老年人的社会参与和身体活动方面的效果。

方法

该研究从日本的两个市招募了 181 名年龄在 60 岁或以上的社区居住的成年人,并通过一个基于网络的研究小组。参与者被随机分配到干预组(n=87),使用 ESP 应用程序 12 周,或对照组(n=94),仅使用 Google Fit。ESP 应用程序结合了自我监测社会参与、个性化反馈、游戏化元素和教育内容等功能。主要结局是前 2 个月社会参与频率的变化,以及基线和第 12 周步计数的变化。次要结局包括特定类型的社会活动和主观幸福感的变化。使用协方差分析和线性混合效应模型分析数据。

结果

干预组的社会参与频率明显高于对照组(调整差异 3.03;95%置信区间 0.17-5.90;P=.04)。具体来说,干预组在参与爱好(调整差异:0.82;95%置信区间 0.01-1.63)和文化俱乐部(调整差异 0.65;95%置信区间 0.07-1.23)方面的频率更高。然而,两组之间每周的步数没有显著差异。亚组分析表明,在年龄大于 70 岁、女性、教育程度较低以及从社区招募的参与者中,可能有更大的效果,尽管只有女性和教育程度较低的亚组显示出 95%置信区间不包括零。

结论

ESP 移动应用程序有效地促进了社区居住的老年人的社会参与,特别是在爱好和文化俱乐部活动方面。然而,它对步计数测量的身体活动水平没有显著影响。这些发现表明,移动应用程序可以成为鼓励老年人参与社交的有价值的工具,可能有助于健康老龄化。未来的研究应侧重于优化应用程序功能,以保持长期参与,并探索增强身体活动和社会参与的策略。

试验注册

大学医学信息网络临床试验注册 UMIN000049045;https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000055781。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0243/11474115/ffd928487cf8/jmir_v26i1e64196_fig1.jpg

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