A Web-Based and Print-Delivered Computer-Tailored Physical Activity Intervention for Older Adults

Pretest-Posttest Intervention Study Comparing Delivery Mode Preference and Attrition

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Web-based interventions can play an important role in promoting physical activity (PA) behavior among older adults. Although the effectiveness of these interventions is promising, they are often characterized by low reach and high attrition, which considerably hampers their potential impact on public health.

OBJECTIVE: The aim of this study was to identify the participant characteristics associated with the preference for a Web-based or a printed delivery mode and to determine whether an association exists between delivery modes or participant characteristics and attrition in an intervention. This knowledge may enhance implementation, sustainability of participation, and effectiveness of future interventions for older adults.

METHODS: A real-life pretest-posttest intervention study was performed (N=409) among community-living single adults who were older than 65 years, with physical impairments caused by chronic diseases. Measurements were taken at baseline and 3 months after the start of the intervention. Hierarchical logistic regression was used to assess demographic and behavioral characteristics (age, gender, body mass index, educational attainment, degree of loneliness, and PA level), as well as psychosocial characteristics (social support for PA, modeling, self-efficacy, attitude, and intention) related to delivery mode preference at baseline and attrition after 3 months.

RESULTS: The printed delivery mode achieved higher participation (58.9%, 241/409) than the Web-based delivery mode (41.1%, 168/409). Participation in the Web-based delivery mode was associated with younger age (B=-0.10; SE 0.02; Exp (B)=0.91; P<.001) and higher levels of social support for PA (B=0.38; SE 0.14; Exp (B)=1.46; P=.01); attrition was associated with participation in the Web-based delivery mode (B=1.28; SE 0.28; Exp (B)=3.58; P<.001) and low educational attainment (B=-0.53; SE 0.28; Exp (B)=0.59; P=.049).

CONCLUSIONS: A total of 41% of the participants chose the Web-based delivery mode, thus demonstrating a potential interest of single older adults with physical impairments in Web-based delivered interventions. However, attrition was demonstrated to be higher in the Web-based delivery mode, and lower educational attainment was found to be a predictor for attrition. Characteristics predicting a preference for the printed delivery mode included being older and receiving less social support. Although Web-based delivery modes are generally less expensive and easier to distribute, it may be advisable to offer a printed delivery mode alongside a Web-based delivery mode to prevent exclusion of a large part of the target population.

TRIAL REGISTRATION: Netherlands Trial Register NTR2297; https://www.trialregister.nl/trial/2173.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-DOI: 10.2196/resprot.8093.

Original languageEnglish
Article number13416
Pages (from-to)e13416
Number of pages16
JournalJournal of Medical Internet Research
Volume21
Issue number8
DOIs
Publication statusPublished - 28 Aug 2019

Fingerprint

Social Support
Loneliness
Health Services Needs and Demand
Self Efficacy
Netherlands
Body Mass Index
Chronic Disease
Public Health
Logistic Models
Demography

Keywords

  • BEHAVIOR
  • EHEALTH INTERVENTIONS
  • EMPLOYEE FITNESS PROGRAM
  • EXERCISE
  • HEALTH INTERVENTIONS
  • LONELINESS
  • ONLINE
  • PARTICIPATION
  • SOCIAL SUPPORT
  • VALIDITY
  • Web-based intervention
  • attrition
  • older adults
  • physical activity
  • print-delivered intervention

Cite this

@article{ea26306362c54952822edb3e1d9f442e,
title = "A Web-Based and Print-Delivered Computer-Tailored Physical Activity Intervention for Older Adults: Pretest-Posttest Intervention Study Comparing Delivery Mode Preference and Attrition",
abstract = "BACKGROUND: Web-based interventions can play an important role in promoting physical activity (PA) behavior among older adults. Although the effectiveness of these interventions is promising, they are often characterized by low reach and high attrition, which considerably hampers their potential impact on public health.OBJECTIVE: The aim of this study was to identify the participant characteristics associated with the preference for a Web-based or a printed delivery mode and to determine whether an association exists between delivery modes or participant characteristics and attrition in an intervention. This knowledge may enhance implementation, sustainability of participation, and effectiveness of future interventions for older adults.METHODS: A real-life pretest-posttest intervention study was performed (N=409) among community-living single adults who were older than 65 years, with physical impairments caused by chronic diseases. Measurements were taken at baseline and 3 months after the start of the intervention. Hierarchical logistic regression was used to assess demographic and behavioral characteristics (age, gender, body mass index, educational attainment, degree of loneliness, and PA level), as well as psychosocial characteristics (social support for PA, modeling, self-efficacy, attitude, and intention) related to delivery mode preference at baseline and attrition after 3 months.RESULTS: The printed delivery mode achieved higher participation (58.9{\%}, 241/409) than the Web-based delivery mode (41.1{\%}, 168/409). Participation in the Web-based delivery mode was associated with younger age (B=-0.10; SE 0.02; Exp (B)=0.91; P<.001) and higher levels of social support for PA (B=0.38; SE 0.14; Exp (B)=1.46; P=.01); attrition was associated with participation in the Web-based delivery mode (B=1.28; SE 0.28; Exp (B)=3.58; P<.001) and low educational attainment (B=-0.53; SE 0.28; Exp (B)=0.59; P=.049).CONCLUSIONS: A total of 41{\%} of the participants chose the Web-based delivery mode, thus demonstrating a potential interest of single older adults with physical impairments in Web-based delivered interventions. However, attrition was demonstrated to be higher in the Web-based delivery mode, and lower educational attainment was found to be a predictor for attrition. Characteristics predicting a preference for the printed delivery mode included being older and receiving less social support. Although Web-based delivery modes are generally less expensive and easier to distribute, it may be advisable to offer a printed delivery mode alongside a Web-based delivery mode to prevent exclusion of a large part of the target population.TRIAL REGISTRATION: Netherlands Trial Register NTR2297; https://www.trialregister.nl/trial/2173.INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-DOI: 10.2196/resprot.8093.",
keywords = "BEHAVIOR, EHEALTH INTERVENTIONS, EMPLOYEE FITNESS PROGRAM, EXERCISE, HEALTH INTERVENTIONS, LONELINESS, ONLINE, PARTICIPATION, SOCIAL SUPPORT, VALIDITY, Web-based intervention, attrition, older adults, physical activity, print-delivered intervention",
author = "Boekhout, {Janet Maria} and Peels, {Denise Astrid} and Berendsen, {Brenda Angela Juliette} and Catherine Bolman and Lilian Lechner",
note = "{\circledC}Janet Maria Boekhout, Denise Astrid Peels, Brenda Angela Juliette Berendsen, Catherine Bolman, Lilian Lechner. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 28.08.2019.",
year = "2019",
month = "8",
day = "28",
doi = "10.2196/13416",
language = "English",
volume = "21",
pages = "e13416",
journal = "Journal of Medical Internet Research",
issn = "1439-4456",
publisher = "JMIR PUBLICATIONS, INC",
number = "8",

}

TY - JOUR

T1 - A Web-Based and Print-Delivered Computer-Tailored Physical Activity Intervention for Older Adults

T2 - Pretest-Posttest Intervention Study Comparing Delivery Mode Preference and Attrition

AU - Boekhout, Janet Maria

AU - Peels, Denise Astrid

AU - Berendsen, Brenda Angela Juliette

AU - Bolman, Catherine

AU - Lechner, Lilian

N1 - ©Janet Maria Boekhout, Denise Astrid Peels, Brenda Angela Juliette Berendsen, Catherine Bolman, Lilian Lechner. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 28.08.2019.

PY - 2019/8/28

Y1 - 2019/8/28

N2 - BACKGROUND: Web-based interventions can play an important role in promoting physical activity (PA) behavior among older adults. Although the effectiveness of these interventions is promising, they are often characterized by low reach and high attrition, which considerably hampers their potential impact on public health.OBJECTIVE: The aim of this study was to identify the participant characteristics associated with the preference for a Web-based or a printed delivery mode and to determine whether an association exists between delivery modes or participant characteristics and attrition in an intervention. This knowledge may enhance implementation, sustainability of participation, and effectiveness of future interventions for older adults.METHODS: A real-life pretest-posttest intervention study was performed (N=409) among community-living single adults who were older than 65 years, with physical impairments caused by chronic diseases. Measurements were taken at baseline and 3 months after the start of the intervention. Hierarchical logistic regression was used to assess demographic and behavioral characteristics (age, gender, body mass index, educational attainment, degree of loneliness, and PA level), as well as psychosocial characteristics (social support for PA, modeling, self-efficacy, attitude, and intention) related to delivery mode preference at baseline and attrition after 3 months.RESULTS: The printed delivery mode achieved higher participation (58.9%, 241/409) than the Web-based delivery mode (41.1%, 168/409). Participation in the Web-based delivery mode was associated with younger age (B=-0.10; SE 0.02; Exp (B)=0.91; P<.001) and higher levels of social support for PA (B=0.38; SE 0.14; Exp (B)=1.46; P=.01); attrition was associated with participation in the Web-based delivery mode (B=1.28; SE 0.28; Exp (B)=3.58; P<.001) and low educational attainment (B=-0.53; SE 0.28; Exp (B)=0.59; P=.049).CONCLUSIONS: A total of 41% of the participants chose the Web-based delivery mode, thus demonstrating a potential interest of single older adults with physical impairments in Web-based delivered interventions. However, attrition was demonstrated to be higher in the Web-based delivery mode, and lower educational attainment was found to be a predictor for attrition. Characteristics predicting a preference for the printed delivery mode included being older and receiving less social support. Although Web-based delivery modes are generally less expensive and easier to distribute, it may be advisable to offer a printed delivery mode alongside a Web-based delivery mode to prevent exclusion of a large part of the target population.TRIAL REGISTRATION: Netherlands Trial Register NTR2297; https://www.trialregister.nl/trial/2173.INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-DOI: 10.2196/resprot.8093.

AB - BACKGROUND: Web-based interventions can play an important role in promoting physical activity (PA) behavior among older adults. Although the effectiveness of these interventions is promising, they are often characterized by low reach and high attrition, which considerably hampers their potential impact on public health.OBJECTIVE: The aim of this study was to identify the participant characteristics associated with the preference for a Web-based or a printed delivery mode and to determine whether an association exists between delivery modes or participant characteristics and attrition in an intervention. This knowledge may enhance implementation, sustainability of participation, and effectiveness of future interventions for older adults.METHODS: A real-life pretest-posttest intervention study was performed (N=409) among community-living single adults who were older than 65 years, with physical impairments caused by chronic diseases. Measurements were taken at baseline and 3 months after the start of the intervention. Hierarchical logistic regression was used to assess demographic and behavioral characteristics (age, gender, body mass index, educational attainment, degree of loneliness, and PA level), as well as psychosocial characteristics (social support for PA, modeling, self-efficacy, attitude, and intention) related to delivery mode preference at baseline and attrition after 3 months.RESULTS: The printed delivery mode achieved higher participation (58.9%, 241/409) than the Web-based delivery mode (41.1%, 168/409). Participation in the Web-based delivery mode was associated with younger age (B=-0.10; SE 0.02; Exp (B)=0.91; P<.001) and higher levels of social support for PA (B=0.38; SE 0.14; Exp (B)=1.46; P=.01); attrition was associated with participation in the Web-based delivery mode (B=1.28; SE 0.28; Exp (B)=3.58; P<.001) and low educational attainment (B=-0.53; SE 0.28; Exp (B)=0.59; P=.049).CONCLUSIONS: A total of 41% of the participants chose the Web-based delivery mode, thus demonstrating a potential interest of single older adults with physical impairments in Web-based delivered interventions. However, attrition was demonstrated to be higher in the Web-based delivery mode, and lower educational attainment was found to be a predictor for attrition. Characteristics predicting a preference for the printed delivery mode included being older and receiving less social support. Although Web-based delivery modes are generally less expensive and easier to distribute, it may be advisable to offer a printed delivery mode alongside a Web-based delivery mode to prevent exclusion of a large part of the target population.TRIAL REGISTRATION: Netherlands Trial Register NTR2297; https://www.trialregister.nl/trial/2173.INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-DOI: 10.2196/resprot.8093.

KW - BEHAVIOR

KW - EHEALTH INTERVENTIONS

KW - EMPLOYEE FITNESS PROGRAM

KW - EXERCISE

KW - HEALTH INTERVENTIONS

KW - LONELINESS

KW - ONLINE

KW - PARTICIPATION

KW - SOCIAL SUPPORT

KW - VALIDITY

KW - Web-based intervention

KW - attrition

KW - older adults

KW - physical activity

KW - print-delivered intervention

U2 - 10.2196/13416

DO - 10.2196/13416

M3 - Article

VL - 21

SP - e13416

JO - Journal of Medical Internet Research

JF - Journal of Medical Internet Research

SN - 1439-4456

IS - 8

M1 - 13416

ER -