Results of MyPlan 2.0 on Physical Activity in Older Belgian Adults: Randomized Controlled Trial

Delfien Van Dyck, Karel Herman, Louise Poppe, Geert Crombez, Ilse De Bourdeaudhuij, Freja Gheysen, Delfien Van Dyck, Karel Herman, Louise Poppe, Geert Crombez, Ilse De Bourdeaudhuij, Freja Gheysen

Abstract

Background: The beneficial effects of physical activity (PA) for older adults are well known. However, few older adults reach the health guideline of 150 min per week of moderate-to-vigorous PA (MVPA). Electronic health (eHealth) interventions are effective in increasing PA levels in older adults in the short term but, rarely, intermediate-term effects after a period without the support of a website or an app have been examined. Furthermore, current theory-based interventions focus mainly on preintentional determinants, although postintentional determinants should also be included to increase the likelihood of successful behavior change.

Objective: This study aimed to investigate the effect of the theory-based eHealth intervention, MyPlan 2.0, focusing on pre- and postintentional determinants on both accelerometer-based and self-reported PA levels in older Belgian adults in the short and intermediate term.

Methods: This study was a randomized controlled trial with three data collection points: baseline (N=72), post (five weeks after baseline; N=65), and follow-up (three months after baseline; N=65). The study took place in Ghent, and older adults (aged ≥65 years) were recruited through a combination of random and convenience sampling. At all the time points, participants were visited by the research team. Self-reported domain-specific PA was assessed using the International Physical Activity Questionnaire, and accelerometers were used to objectively assess PA. Participants in the intervention group got access to the eHealth intervention, MyPlan 2.0, and used it independently for five consecutive weeks after baseline. MyPlan 2.0 was based on the self-regulatory theory and focused on both pre- and postintentional processes to increase PA. Multilevel mixed-models repeated measures analyses were performed in R (R Foundation for Statistical Computing).

Results: Significant (borderline) positive intervention effects were found for accelerometer-based MVPA (baseline-follow-up: intervention group +5 min per day and control group -5 min per day; P=.07) and for accelerometer-based total PA (baseline-post: intervention group +20 min per day and control group -24 min per day; P=.05). MyPlan 2.0 was also effective in increasing self-reported PA, mainly in the intermediate term. A positive intermediate-term intervention effect was found for leisure-time vigorous PA (P=.02), moderate household-related PA (P=.01), and moderate PA in the garden (P=.04). Negative intermediate-term intervention effects were found for leisure-time moderate PA (P=.01) and cycling for transport (P=.07).

Conclusions: The findings suggest that theory-based eHealth interventions focusing on pre- and postintentional determinants have the potential for behavior change in older adults. If future studies including larger samples and long-term follow-up can confirm and clarify these findings, researchers and practitioners should be encouraged to use a self-regulation perspective for eHealth intervention development.

Trial registration: Clinicaltrials.gov NCT03194334; https://ichgcp.net/clinical-trials-registry/NCT03783611.

Keywords: eHealth; elderly; exercise; self-regulation.

Conflict of interest statement

Conflicts of Interest: None declared.

©Delfien Van Dyck, Karel Herman, Louise Poppe, Geert Crombez, Ilse De Bourdeaudhuij, Freja Gheysen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 07.10.2019.

Figures

https://www.ncbi.nlm.nih.gov/pmc/articles/instance/6803893/bin/jmir_v21i10e13219_fig1.jpg
Study design of MyPlan 2.0. IPAQ: International Physical Activity Questionnaire.
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/6803893/bin/jmir_v21i10e13219_fig2.jpg
Overview of the electronic health intervention MyPlan 2.0. PA: physical activity.
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/6803893/bin/jmir_v21i10e13219_fig3.jpg
Participant flow diagram.

References

    1. Bean JF, Vora A, Frontera WR. Benefits of exercise for community-dwelling older adults. Arch Phys Med Rehabil. 2004 Jul;85(7 Suppl 3):S31–42; quiz S43. doi: 10.1016/j.apmr.2004.03.010.
    1. Katzmarzyk PT, Lee I, Martin CK, Blair SN. Epidemiology of physical activity and exercise training in the United States. Prog Cardiovasc Dis. 2017;60(1):3–10. doi: 10.1016/j.pcad.2017.01.004.
    1. McPhee JS, French DP, Jackson D, Nazroo J, Pendleton N, Degens H. Physical activity in older age: perspectives for healthy ageing and frailty. Biogerontology. 2016 Jun;17(3):567–80. doi: 10.1007/s10522-016-9641-0.
    1. Musich S, Wang SS, Hawkins K, Greame C. The frequency and health benefits of physical activity for older adults. Popul Health Manag. 2017 Jun;20(3):199–207. doi: 10.1089/pop.2016.0071.
    1. Schutzer KA, Graves BS. Barriers and motivations to exercise in older adults. Prev Med. 2004 Nov;39(5):1056–61. doi: 10.1016/j.ypmed.2004.04.003.
    1. World Health Organization. 2011. [2018-12-18]. Global Recommendations on Physical Activity for Health: 65 Years and Above .
    1. Centers for Disease Control and Prevention. 2013. [2019-08-19]. Physical Activity: Data and Statistics .
    1. Gisle L, Demarest S. Health Interview Survey. 2013. [2018-12-18]. Gezondheidsenquete 2013 - Rapport 2: Gezondheidsgedrag en Leefstijl .
    1. King AC, Rejeski WJ, Buchner DM. Physical activity interventions targeting older adults. A critical review and recommendations. Am J Prev Med. 1998 Nov;15(4):316–33. doi: 10.1016/S0749-3797(98)00085-3.
    1. Cowan LT, van Wagenen SA, Brown BA, Hedin RJ, Seino-Stephan Y, Hall PC, West JH. Apps of steel: are exercise apps providing consumers with realistic expectations?: a content analysis of exercise apps for presence of behavior change theory. Health Educ Behav. 2013 Apr;40(2):133–9. doi: 10.1177/1090198112452126.
    1. Lippke S, Ziegelmann JP. Theory-based health behaviour change: developing, testing, and applying theories for evidence-based interventions. Appl Psychol. 2008;57(4):698–716. doi: 10.1111/j.1464-0597.2008.00339.x.
    1. Maes S, Karoly P. Self-regulation assessment and intervention in physical health and illness: a review. Appl Psychol. 2005 Apr;54(2):267–99. doi: 10.1111/j.1464-0597.2005.00210.x.
    1. Chase JD. Physical activity interventions among older adults: a literature review. Res Theory Nurs Pract. 2013;27(1):53–80. doi: 10.1891/1541-6577.27.1.53.
    1. Sniehotta FF, Scholz U, Schwarzer R. Bridging the intention–behaviour gap: planning, self-efficacy, and action control in the adoption and maintenance of physical exercise. Psychol Health. 2005 Apr;20(2):143–60. doi: 10.1080/08870440512331317670.
    1. van Dyck D, Plaete J, Cardon G, Crombez G, de Bourdeaudhuij I. Effectiveness of the self-regulation ehealth intervention 'MyPlan1.0' on physical activity levels of recently retired Belgian adults: a randomized controlled trial. Health Educ Res. 2016 Oct;31(5):653–64. doi: 10.1093/her/cyw036.
    1. Plaete J, de Bourdeaudhuij I, Verloigne M, Crombez G. Acceptability, feasibility and effectiveness of an eHealth behaviour intervention using self-regulation: 'MyPlan'. Patient Educ Couns. 2015 Jul 26;:-. doi: 10.1016/j.pec.2015.07.014. (epub ahead of print)(forthcoming)(forthcoming)(forthcoming)
    1. Ritterband LM, Gonder-Frederick LA, Cox DJ, Clifton AD, West RW, Borowitz SM. Internet interventions: in review, in use, and into the future. Prof Psychol: Res Pract. 2003;34(5):527–34. doi: 10.1037/0735-7028.34.5.527.
    1. Collins LM, Murphy SA, Strecher V. The multiphase optimization strategy (MOST) and the sequential multiple assignment randomized trial (SMART): new methods for more potent ehealth interventions. Am J Prev Med. 2007 May;32(5 Suppl):S112–8. doi: 10.1016/j.amepre.2007.01.022.
    1. Cushing CC, Steele RG. A meta-analytic review of ehealth interventions for pediatric health promoting and maintaining behaviors. J Pediatr Psychol. 2010 Oct;35(9):937–49. doi: 10.1093/jpepsy/jsq023.
    1. Degroote L, Plaete J, de Bourdeaudhuij I, Verloigne M, van Stappen V, de Meester A, Poppe L, van der Mispel C, Crombez G. The effect of the ehealth intervention 'MyPlan 1.0' on physical activity in adults who visit general practice: a quasi-experimental trial. Int J Environ Res Public Health. 2018 Jan 30;15(2):E228. doi: 10.3390/ijerph15020228.
    1. Plaete J, de Bourdeaudhuij I, Verloigne M, Oenema A, Crombez G. A self-regulation ehealth intervention to increase healthy behavior through general practice: protocol and systematic development. JMIR Res Protoc. 2015 Dec 22;4(4):e141. doi: 10.2196/resprot.4835.
    1. Muellmann S, Forberger S, Möllers T, Bröring E, Zeeb H, Pischke CR. Effectiveness of ehealth interventions for the promotion of physical activity in older adults: a systematic review. Prev Med. 2018 Mar;108:93–110. doi: 10.1016/j.ypmed.2017.12.026.
    1. Kannus P. Preventing osteoporosis, falls, and fractures among elderly people. Promotion of lifelong physical activity is essential. Br Med J. 1999 Jan 23;318(7178):205–6. doi: 10.1136/bmj.318.7178.205.
    1. Rzewnicki R, Auweele YV, de Bourdeaudhuij I. Addressing overreporting on the international physical activity questionnaire (IPAQ) telephone survey with a population sample. Public Health Nutr. 2003 May;6(3):299–305. doi: 10.1079/PHN2002427.
    1. Poppe L, van der Mispel C, de Bourdeaudhuij I, Verloigne M, Shadid S, Crombez G. Users' thoughts and opinions about a self-regulation-based ehealth intervention targeting physical activity and the intake of fruit and vegetables: a qualitative study. PLoS One. 2017;12(12):e0190020. doi: 10.1371/journal.pone.0190020.
    1. Vandelanotte C, Spathonis KM, Eakin EG, Owen N. Website-delivered physical activity interventions a review of the literature. Am J Prev Med. 2007 Jul;33(1):54–64. doi: 10.1016/j.amepre.2007.02.041.
    1. Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003 Aug;35(8):1381–95. doi: 10.1249/01.MSS.0000078924.61453.FB.
    1. van Dyck D, Cardon G, Deforche B, de Bourdeaudhuij I. IPAQ interview version: convergent validity with accelerometers and comparison of physical activity and sedentary time levels with the self-administered version. J Sports Med Phys Fitness. 2015;55(7-8):776–86.
    1. International Physical Activity Questionnaires (IPAQ) 2015. [2019-08-28]. Guidelines for Data Processing and Analysis of the International Physical Activity Questionnaire .
    1. Freedson PS, Melanson E, Sirard J. Calibration of the Computer Science and Applications Inc accelerometer. Med Sci Sports Exerc. 1998 May;30(5):777–81. doi: 10.1097/00005768-199805000-00021.
    1. Bates D, Maechler M, Bolker B, Walker S. The Comprehensive R Archive Network. 2014. [2018-12-20]. lme4: Linear Mixed-Effects Models using 'Eigen' and S4 .
    1. Chakraborty H, Gu H. RTI International. 2009. [2018-12-20]. A Mixed Model Approach for Intent-to-Treat Analysis in Longitudinal Clinical Trials With Missing Values .
    1. Cleary TJ, Zimmerman BJ. Self-regulation empowerment program: a school-based program to enhance self-regulated and self-motivated cycles of student learning. Psychol Sch. 2004 May;41(5):537–50. doi: 10.1002/pits.10177.
    1. Irvine AB, Gelatt VA, Seeley JR, Macfarlane P, Gau JM. Web-based intervention to promote physical activity by sedentary older adults: randomized controlled trial. J Med Internet Res. 2013 Feb 5;15(2):e19. doi: 10.2196/jmir.2158.
    1. Tucker P, Gilliland J. The effect of season and weather on physical activity: a systematic review. Public Health. 2007 Dec;121(12):909–22. doi: 10.1016/j.puhe.2007.04.009.
    1. Plaete J, de Bourdeaudhuij I, Verloigne M, Crombez G. The use and evaluation of self-regulation techniques can predict health goal attainment in adults: an explorative study. PeerJ. 2016;4:e1666. doi: 10.7717/peerj.1666. doi: 10.7717/peerj.1666.
    1. European Commission. 2015. [2018-12-20]. People in the EU: Who Are We and How Do We Live? .

Source: PubMed

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