None listed
Conditions
Brief summary
MovingTogether is a health promotion program for socially isolated, older adults that targets modifiable risk factors including physical inactivity and balance to improve mental and physical health outcomes. The program is delivered online, through a private Facebook group. Allied health professionals e.g. exercise physiologists and a dietician provide education, individual guidance and promote social connection within the group. Topics covered include increasing physical activity, decreasing sedentary behaviour, healthy eating, goal setting and balance training. The balance training portion of the program is covered by the inclusion of NeuRA’s StandingTall app. Our previous pilot study demonstrated feasibility, acceptability and preliminary effectiveness. With the general protocol maintained and improvements made to program design since, we hypothesise that the program will be effective in comparison to a control group.
Interventions
The MovingTogether health promotion program
Participants will join a private Facebook group, monitored by the facilitators at least once every weekday over the 10-week period. Targeted education and resources will be provided to participants through the Facebook group throughout the program and facilitators will encourage discussion between all members of the group, regarding a variety of lifestyle topics. Topics will include behaviour change, overcoming barriers, reducing sedentary behaviour,
The MovingTogether health promotion program Participants will join a private Facebook group, monitored by the facilitators at least once every weekday over the 10-week period. Targeted education and resources will be provided to participants through the Facebook group throughout the program and facilitators will encourage discussion between all members of the group, regarding a variety of lifestyle topics. Topics will include behaviour change, overcoming barriers, reducing sedentary behaviour, increasing physical activity, increasing structured exercise, balance training and healthy eating. Education on a single topic will be the focus of a single week (two weeks in the case of the health eating topic) and new material will be released every week. These educational material have an designed specifically for this study by allied health professionals (Accredited Exercise Physiologists and a Dietician). These materials include a range of written resources and videos and will be conveyed using the private discussion forum on Facebook. Private Facebook groups will be used in the intervention for facilitators to share educational posts and encourage discussion between participants about shared experience. The main aim of the group is to foster social connection and support between participants. The group will include 40 individuals in order to promote social connection and increase the potential for individualised time with allied health facilitators. Some participants may be satisfied simply reading posts and not responding. There is no minimum engagement or time that participants are required to spend in the group. There will be recommendations such as spending 2hrs per week training balance, however participants can spend more or less time on activities than is recommended. Additionally, participants can choose to join an optional weekly 20-30min tele-health group call via Zoom, led by an ESSA accredited exercise physiologist (AEP) and a dietician when nutrition is the focus. The purpose of these calls is to promote social connection between participants and to follow up and create discussion about the provided educational materials. As these calls are optional, attendance will not be noted. Adherence to exercise is not an outcome of the study. An informal approach will be taken to encourage adherence, where researchers will ask individuals during telehealth calls and private messaging to reflect exercise engagement through goal setting and habit formation education. They will also be encouraged to share their reflections with the group if they feel comfortable doing so. Changes in physical activity levels more broadly, as opposed to adherence to a specific exercise program will be assessed pre- and post-intervention to allow researchers to understand the effect of the program on influencing physical activity participation. Participants will also have access to the StandingTall eHealth website, providing home-based exercise to improve balance and reduce fall risk. StandingTall is a pre-existing website, however is yet to be release for public use. Researchers have evaluated StandingTall through a randomised controlled trial and found it to reduce fall risk over a 24 month period of use. Individuals will be provided with access to the program and a manual on setting up and using the application. All participants will be encouraged to gradually aim to complete 2hrs of balance training using the app per week and website analytics will track adherence data, however use of the app is optional. Exercises include side steps, step ups and single leg balance. At the conclusion of the 10-week program, StandingTall will continue to be accessible to participants if they wish. Total access will last for 24 months, as this is the length of time that has be found to be beneficial for participants. The Facebook group will also still remain accessible. Both the group and StandingTall will continue without input from facilitators. However, participants are encouraged to maintain social connections independently.
Sponsors
UNSW
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
60 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
i) 60+ years ii) Proficient in written and spoken English iii) Living in the community, in Australia iv) Mobilise indoors without the use of a walking aid v) Have internet, Facebook and either computer, laptop or iPad/tablet access vi) Self-reported to be currently participating in less than 150 min of moderate to vigorous intensity physical activity per week
Exclusion criteria
i) Have high levels of psychological distress (score of >30 on the K10) and are not seeking professional mental health treatment or have had a change in psychotropic medications in the last 4 weeks. These individuals are excluded because this program is not intended to be a mental health treatment program. ii) High risk of suicidal behaviour (score of >21 on the SIDAS) unless deemed eligible to participate by a psychologist. These individuals are excluded because this program is not intended to be a mental health treatment. iii) Absolute contraindications to exercise as assessed by accredited exercise physiologists using the American College of Sports Medicine (ACSM) guidelines. Exclusion of individuals meeting this criterion is due to safety. We could not allow them to participate in this physical activity program if exercise may pose a safety risk to them. Those with relative contraindications will be excluded if they are unable to obtain a clearance to exercise letter from their doctor. v) Currently participating in a falls prevention program vi) Severe cognitive impairment (score of >8) on the Short Portable Mental Status Questionnaire (SPMSQ)
Outcome results
None listed