Elderly Health Promotion and Physical Activity
Condition: Behavior, Health
Study type: Interventional

Summary: 
      Nurses have an important place in establishing health promotion practices and policies for
      the elderly to help older adults manage their lifestyles. For health promotion programs to
      produce reliable results, health promotion programs that will improve public health must be
      model/theory-based. In line with all these data, although technology applications have been
      used more and more in recent years, studies with a high level of evidence on the effects of
      multi-intervention on physical activity and health improvement in the elderly are
      insufficient. This study will be examined the effects of home visit education, mobile
      application (Google Fit), group walking, and phone reminder attempts for the elderly between
      the ages of 60-70, based on Pender's Health Promotion Model, on physical activity and health
      promotion after 6 months of follow-up.
    

Detailed description: 
      The proportion of the elderly population is gradually increasing worldwide and in our
      country. Along with the increasing elderly population, many health problems are also
      developing and it is seen that the diagnosis and treatment processes cause high financial
      expenditures. Prevention of chronic diseases, which can reduce the quality of life and
      independence of elderly individuals and become an important burden for health systems, has
      become a necessity. Almost all of the chronic diseases are caused by a negative lifestyle and
      inadequate health promotion efforts. Similar common diseases and causes of death in our
      country and in the world are mostly cardiovascular diseases, cancer, diabetes and infectious
      diseases. The modifiable causes of these diseases are also similar. These are tobacco use,
      nutritional deficiencies, stress and lack of physical activity. Positive health behaviors
      (nutrition, physical activity, not smoking, stress management) to be gained to individuals
      can reduce the incidence of these diseases. For this reason, health promotion programs have
      an important place in bringing positive health behaviors to the individual, family and
      society. One of the best ways to improve the health of the elderly is physical activity. WHO
      recommends regular physical activity for all older adults, 3 or more days a week of moderate
      or higher-intensity variety of multi-component physical activity. A minimal exercise
      supervision through weekly visits and/or phone calls is recommended to improve the effects of
      home-based exercise. The use of a pedometer has been shown to significantly increase physical
      activity in the elderly when a step goal is set. Another piece of evidence has been found
      that group-based interventions promote the maintenance of targeted behaviors through peer
      support. Digital behavior change interventions related to physical activity in the elderly
      (activity meters, pedometer, use of mobile applications, smart wristbands, smart watches)
      show that they are beneficial for monitoring and promoting physical activity and improving
      the health of the elderly. Thanks to mobile applications such as Google Fit, health data such
      as physical activity can be easily tracked, monitored and recorded. It is important to adopt
      a health promotion approach that allows older individuals to increase their control over
      their health and accepts healthy aging as a part of aging. In the Eleventh Development Plan
      of our country, it is aimed to increase the quality of life of the elderly population by
      creating an environment where the elderly can live independently, actively and healthily in
      line with their own preferences, and take part in economic and social life. Nurses have an
      important place in establishing health promotion practices and policies for the elderly to
      help older adults manage their lifestyles. In order for health promotion programs to produce
      reliable results, it is very important that health promotion programs that will improve
      public health are model/theory-based. In line with all these data, although technology
      applications have been used more and more in recent years, studies with a high level of
      evidence on the effects of multi-intervention on physical activity and health improvement in
      the elderly are insufficient. In this study, the effects of home visit education, mobile
      application (Google Fit), group walk, phone reminder attempts for the elderly between the
      ages of 60-70, based on Pender's Health Promotion Model, on physical activity and health
      promotion after 6 months of follow-up. will be examinedIn line with all these data, although
      technology applications have been used more and more in recent years, studies with a high
      level of evidence on the effects of multi-intervention on physical activity and health
      improvement in the elderly are insufficient. In this study, the effects of home visit
      education, mobile application (Google Fit), group walk, and phone reminder attempts for the
      elderly between the ages of 60-70, based on Pender's Health Promotion Model, on physical
      activity and health promotion after 6 months of follow-up will be reviewed.

      Method: The project was planned in a pretest-posttest randomized controlled experimental
      type. The study will be carried out in Melikşah, Havzan and Konevi Pensioners' Club in Meram
      district of Konya between June 2022 and December 2022. In determining the sample size, based
      on the study in the literature, the number of samples was determined as 66 in the
      experimental and control groups, 33 in each group, taking into account the 95% power level
      and possible losses (20% drop out). Information Form, Elderly Health Promotion Scale, and
      Elderly Physical Fitness and Exercise Activity Scale will be used to collect study data.
      Subjects meeting the inclusion criteria who gave informed consent will be randomly assigned
      to groups using the block randomization technique.

      Management: At the beginning of the study, the Information Form, the Elderly Health Promotion
      Scale and the Physical Fitness and Exercise Activity Scale of the Elderly Individuals, which
      were the pre-test data, will be collected face to face by the assistant researcher from the
      elderly individuals aged 60-70 who came to Melikşah, Havzan and Konevi Retirement Club,
      paying attention to the pandemic conditions; At the end of the 6th month, an independent
      researcher will fill in the Elderly Health Promotion Scale and the Elderly Physical Fitness
      and Exercise Activity Scale.

      Application:

        -  Pre-tests of the Information Form, Elderly Health Promotion Scale and the Physical
           Fitness and Exercise Activity Scale of Elderly Individuals will be applied by obtaining
           the informed consent of the elderly people who gave their consent to participate in the
           study. The elderly who consented to participate will be assigned to either the
           experimental or control group according to the block randomization list previously
           prepared by an independent statistician.

        -  At the first meeting, mobile phone contact information of the elderly will be obtained
           and planning will be made for the first home visit at a time when the elderly are
           suitable. Physical activity training will be provided during the home visit. A brochure
           including healthy lifestyle habits, health responsibility, exercise, nutrition, oral
           hygiene and social support behaviors will be provided for general health promotion
           awareness. The Google Fit application, which is a mobile application, will be downloaded
           to the phones of the people and installed together, and how to use the application will
           be explained and the application will be made. The visit will take a maximum of 40
           minutes. A visit was planned for six elderly people in one day and home visits were
           planned to be completed in a total of six days for the entire experimental group. The
           data (step count and physical activity duration) of the day before the 2nd week, 10th
           week and 6th month of the attempt will be recorded from the Google Fit application.

        -  A reminder message will be sent by phone. From the 2nd week of the initiatives, a
           message will be sent every Monday at 10:00. Message content "For your health, you should
           exercise at least 30 minutes a week for a total of 150 minutes." will be.

        -  Group Walking: Groups of five people will be formed for the group walking (as the number
           of people to be included in the experimental group is 33, one of the group will be three
           people) and it will be completed in seven days. The walking will be done in a light
           paced manner and the purpose of the walking is to see the number of steps in the mobile
           application and to increase their motivation with the group. People will be invited to
           the Melikşah park for the group walking. They will be reminded to bring their phones
           with them.

        -  Control group: There is no health-related practice in the pensioners' club. No
           intervention will be made in the control group. After the experimental group's attempts
           are completed, a home visit is planned for the control group, and it is planned to make
           physical activity training, brochure, google fit application installation attempts.
    

Intervention name(s): home visit, health education, mobile application, group walk, message
Intervention type(s): Other
Intervention description(s): Home visit: Elderly individuals will be visited once at home. During the home visit, training will be given on the slide about physical activity. A brochure will be provided for general health promotion awareness. Counseling will also be provided during the home visit process.
Google Fit Application: During the home visit, the application will be downloaded to the phone of the elderly, and a document will be given about the use of the application after the usage is explained. The researcher will support those who have problems with the application in the following weeks.
Group walking: The walk, which will be done once, will be done in a light paced manner, and the purpose of the walk is to see the number of steps in the mobile application and to increase their motivation with the group.
Message: Message content "For your health, you should exercise at least 30 minutes a week for a total of 150 minutes." will be.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Other
Keywords: health promotion; physical activity; health promotion model; mobile application