Humanoid-Technology Driven Health Enhancing Physical Activity
Condition: Community-dwelling Older Adults
Study type: Interventional

Summary: 
      Ensuring the health and well-being of older individuals is a global problem. The application
      of emerging technology is increasingly advocated to improve health outcomes, yet the
      investigators need to identify how feasible and acceptable this is among users. One example
      of these emerging technologies is humanoid technologies. Humanoid technologies are
      human-resembling digital objects that can be projected using head-mounted displays to be worn
      by users. This study seeks to assess the impact of humanoid technologies (HTs) in the form of
      digital health coaches to enhance the physical activity of community-dwelling older adults in
      the Philippines. The quasi-experimental study will assess the participants' intention for
      technology use and the participants experience of the intervention (acceptability, barriers,
      and facilitators). Specifically, this study will compare the impact of the Humanoid
      Technology-driven Health Enhancing Physical Activity program versus a standard physical
      activity program (video-based) on physical performance, cognitive function, and quality of
      life among older adults in two 'senior centers' in the Philippines. The study will also
      identify older adults' preferences for an ideal Humanoid Technology-driven Health Enhancing
      Physical Activity and the participants intention to use it via survey. An embedded
      qualitative study will explore participants' perceptions of the acceptability, barriers, and
      facilitators of the Humanoid Technology-driven Health Enhancing Physical Activity program.
    

Detailed description: 
      A quasi-experimental research design with embedded qualitative interviews will be used to
      understand the impact of Humanoid Technology-driven Health Enhancing Physical Activity among
      community-dwelling Filipino older adults and compare the effects of Humanoid
      Technology-driven Health Enhancing Physical Activity versus the current Health Enhancing
      Physical Activity (live coaching and video-based) on the participants' physical, cognitive
      status, and Quality of Life.

      The investigators will assess the preferences of the older adults prior to the intervention
      to identify the participants specific wishes and choices (e.g., music, gender of the humanoid
      technology coach). To achieve this, the investigators will follow the conjoint analysis
      methods in healthcare as follows: (a) defining intervention attributes and levels based on
      literature evidence and (b) designing the attributes and levels as components of the program,
      and (c) designing the conjoint survey questionnaire. The computer-based survey questionnaire
      using the Sawtooth software will be distributed to participants.

      The investigators have identified two community senior centers affiliated with the local
      government unit to participate in this quasi-experimental study. One community senior center
      will serve as the experimental site and the second community senior center will serve as the
      control site. Older adults will be recruited at each site for study participation.

      The eligible participants will be purposively selected from the regular attendees at the
      study sites using the inclusion criteria: (1) ambulatory, (2) can follow simple instructions,
      (3) normal eyes functioning without low vision (or at most with corrective lenses), and (4)
      willingness to participate in the program with signed informed consent. Older adults who are
      considered not suitable to participate by the community physician using the local guidelines
      will be excluded. A total of 128 or 64 older adults in each center, will be recruited via
      posters at community senior centers. Afterward, the treatments will be assigned to each of
      the two senior center sites for the quasi-experimental study. Only the participants from the
      experimental group shall be involved in the usability evaluations and six from the
      experimental group for the qualitative study.

      The intervention period will run for 1 month consisting of the first two weeks of the
      twice-weekly (Tuesday and Thursday) schedule to be followed by the second 2 weeks of three
      times weekly (Monday, Wednesday, Friday) schedule. Each session will last approximately 1.5
      hours, including orientation, warm-up, and stretching. All participants will be supervised by
      the health team and trained personnel at the senior center and follow a standard protocol.
      The investigators will compare the participants physical, cognitive status, and Quality of
      Life measures before and after the intervention using standardized methods.

      After the intervention, the investigators will ask the older adults in the experimental group
      to answer a survey related to the usability of the program and the participants intention to
      participate in the program in the future. The investigators will select six participants from
      the experimental group for an interview to know the participants perception of the
      intervention, particularly related to its acceptability, barriers, and facilitator.

      As with other studies involving technologies, potential risks include loss of autonomy,
      privacy, data protection, safety, isolation prevention, and user over-stressing. To minimize
      the risks, proper orientation will be held. The research team will undergo training and
      acquire good clinical practice certificate. Procedures will align with the currently accepted
      standards by the (local) Philippine Department of Health, the research team will recruit
      social workers and healthcare providers to monitor the interventions and for potential health
      and wellness issues during the study. Reporting untoward events will comply with the current
      protocol and standards.
    

Intervention name(s): Virtual coach
Intervention type(s): Behavioral
Intervention description(s): The virtual coch will be displayed to the participants using an optical see-through head-mounted display
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: Health enhancing physical activity; Virtual coach