Activating factors during digital physical activity interventions for older adults - A systematic review (Preprint)
Authors: Bentlage Ellen , Nyamadi Jr John , Dubbeldam Rosemary 
Published: December 2022

BACKGROUND

The use of information and communication technology (ICT) tools to promote physical activity among older adults is growing considerable interest. Older adults are becoming more ICT literate and their interaction with ICT tools such as websites, phones, and mobile applications, create the opportunity for these tools to be used to promote physical activation. Physical interventions can be delivered supervised, unsupervised, or facilitated and they can contain various behavioural change techniques (BCT) to equip the user with the activating factors ‘skills’, ‘knowledge’ and ‘motivation’ to change the user’s behaviour. However, in the various interventions using ICT tools to improve physical activity among older adults, usage, and effectiveness of activating factors have not yet been explored in depth.

OBJECTIVE

First, this study aims to identify which of the activation factors skills, knowledge and motivation were covered in the physical activity promoting ICT interventions for older adults and which BCT were used to address them. Second objective is to classify the user interaction interfaces and delivery modes, which promote these activation factors.

METHODS

The search engines from PubMed, Web of Science and ScienceDirect were searched to identify articles, examining the effectiveness of ICT interventions for promoting physical activity in older adults. References were selected, data extracted and reviewed independently by two reviewers. The risk of bias was assessed, and any conflict was addressed by a third separate reviewer. Selected articles included older adults aged 55 years and older without pre-existing medical diseases and other physical or mental conditions that can hinder movement.

RESULTS

353 records were retrieved, and 13 studies met all inclusion criteria. Articles differed in themes, time scale, intervention interface, and outcome measures, therefore a quantitative data synthesis was not feasible. The activation factor ‘motivation’ was the most promoted from all trials (33 times). In most cases, an app and a smartwatch were used for `tracking physical activity, receiving personalised feedback based on the individual goals` to nourish motivation. After that, ‘skills’ (25 times) and ‘knowledge’ (17 times) were addressed. Face-to-face interaction was most used to target user’s skills with `instructions how to perform the behaviour` and exchange knowledge via `educating them on the health consequences of insufficient physical activity`. Overall, integrating all activation factors and using multiple intervention delivery modes especially for addressing the motivation proved most effective in improving physical activity.

CONCLUSIONS

This study has highlighted commonly used BCT and their preferred modes of delivery. Future studies on ICT physical interventions should combine subjective and objective outcome measures, as well as including measures for usability of the technology. These could make the results more homogeneous and suitable for meta-analysis in future.