Sedentary Behavior
Conditions
Keywords
Older adults, Walking, Fitbit
Brief summary
Older adults are a growing population, with projections to reach 83.7 million by 2050. Furthermore, older adults are the most sedentary and least physically active adult population. It is estimated that nearly 90% of older adults 65 years of age or older do not meet the recommended levels of physical activity. Evidence suggests great health benefits can be achieved for older adults who are the most sedentary, and that replacing sitting with even light intensity walking can be beneficial. The overarching goal of the project is to develop an inexpensive and scalable tool to increase volume of physical activity in our target population, older adults living in a residential facility. MapTrek is a web-based application that allows participants to take a virtual walk in interesting locations around the world while tracking their progress against the progress of other older adults living in a retirement community. Steps are counted using a commercially available accelerometer (e.g., Fitbit), and participants see their progress overlaid on Google Maps.
Detailed description
All participants will be provided with a Fitbit activity monitor and instructed to wear it 24 hours/day (except for bathing/swimming time) on their wrist for 12 weeks. Participants will participate in four team-based walking races, each two weeks long. Participants will view their team progress on TV monitors placed in various locations at the Oaknoll facility. The Oaknoll leadership has given the research team approval to do this at their facility. The monitors will present aggregated team data and will not report any individual data that could link back to the individual participant. At the end of the 8 week active intervention, research team members will meet with participants at Oaknoll to administer an exit/process evaluation survey. The exit survey will ask about psychosocial predictors of physical activity as well as participants thoughts and opinions of the MapTrek game. This survey should take approximate 10-15 minutes to complete. The participants will then be asked to wear the Fitbit for four more weeks without playing MapTrek, which will act as a control condition since this is a single-arm study. The specific aims of the study are: 1. To determine the efficacy of MapTrek for improving physical activity levels of older adults living in a residential facility from baseline to 8 weeks. 2. To determine the efficacy of MapTrek for improving psychosocial outcomes(e.g., self-efficacy, social support, outcome expectations, social isolation) among older adults living in a residential facility from baseline to 8 weeks.
Interventions
BEHAVIORALMapTrek
Participants will receive a Fitbit activity monitor and access to the MapTrek game which will be visible on monitors set up in the residential facility.
Sponsors
National Institutes of Health (NIH)
National Center for Advancing Translational Sciences (NCATS)
University of Iowa
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
25 Years to 100 Years
Healthy volunteers
Yes
Inclusion criteria
* To be eligible, participants much be between 25 and 100 years of age, physically able to walk without limitations
Exclusion criteria
* Patients with cognitive or physical limitations that prohibit walking and visual or cognitive impairments causing inability to read.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Physical Activity | 8 weeks | Daily steps |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Self-efficacy | 8 weeks | Self-efficacy was measured with the Self-Efficacy for Exercise scale, a 13-item questionnaire designed to assess participants' self-efficacy related to their ability to continue exercising in the face of barriers. |
| Social Support | 8 weeks | Social support for physical activity was measured with a modified version of the Social Support and Exercise Survey. The Social Support and Exercise Survey is a 12-item (originally 13 item) questionnaire that assesses the level of support from family and friends that participants have in making health behavior changes (exercise) |
| Outcome Expectations | 8 weeks | Outcome expectations were measured with the Outcome Expectations for Exercise Scale. The Outcome Expectations for Exercise is a valid and reliable 9-item scale that assesses the participant's outcome expectations and benefits associated with exercise. |
| Social Isolation | 8 weeks | Social isolation was measured with a modified version of the Friendship Scale. The Friendship Scale is a 5-item (originally 6-item) scale that assesses 6 dimensions contributing to social isolation |
Countries
United States
Participant flow
Recruitment details
Participants were recruited from June 17, 2019 to June 27, 2019, by word of mouth and through advertisements posted on digital monitors located throughout the retirement community.
Pre-assignment details
After providing their consent to participate, participants were asked to complete a baseline survey and provided a Fitbit activity monitor to wear for a minimum of 7 days to assess their baseline physical activity.
Participants by arm
| Arm | Count |
|---|---|
| MapTrek MapTrek: Participants will receive a Fitbit activity monitor and access to the MapTrek game which will be visible on monitors set up in the residential facility. | 54 |
| Total | 54 |
Baseline characteristics
| Characteristic | MapTrek |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 54 Participants |
| Age, Categorical Between 18 and 65 years | 0 Participants |
| Age, Continuous | 81.2 years |
| Outcome Expectations | 4.4 units on a scale STANDARD_DEVIATION 0.6 |
| Physical Activity | 5438 Steps/day |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 1 Participants |
| Race (NIH/OMB) White | 53 Participants |
| Region of Enrollment United States | 54 participants |
| Self-efficacy | 73.2 units on a scale STANDARD_DEVIATION 14.1 |
| Sex: Female, Male Female | 44 Participants |
| Sex: Female, Male Male | 10 Participants |
| Social Isolation | 17.9 units on a scale STANDARD_DEVIATION 2.4 |
| Social Support | 2.2 units on a scale STANDARD_DEVIATION 0.7 |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 54 |
| other Total, other adverse events | 0 / 54 |
| serious Total, serious adverse events | 0 / 54 |
Outcome results
Primary
Physical Activity
Daily steps
Time frame: 8 weeks
| Arm | Measure | Value (MEAN) |
|---|---|---|
| MapTrek | Physical Activity | 6681 Steps/day |
Comparison: In order to test the effect of the intervention on physical activity, linear mixed models examined changes in steps per day from study baseline (week 0) to the end of the active intervention (week 8).p-value: <0.01Mixed Models Analysis
Secondary
Outcome Expectations
Outcome expectations were measured with the Outcome Expectations for Exercise Scale. The Outcome Expectations for Exercise is a valid and reliable 9-item scale that assesses the participant's outcome expectations and benefits associated with exercise.
Time frame: 8 weeks
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| MapTrek | Outcome Expectations | 4.4 mean score (1-5 range) lower=better | Standard Deviation 0.6 |
Secondary
Self-efficacy
Self-efficacy was measured with the Self-Efficacy for Exercise scale, a 13-item questionnaire designed to assess participants' self-efficacy related to their ability to continue exercising in the face of barriers.
Time frame: 8 weeks
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| MapTrek | Self-efficacy | 67.4 cumulative score (0-90); higher=better | Standard Deviation 15.2 |
Secondary
Social Isolation
Social isolation was measured with a modified version of the Friendship Scale. The Friendship Scale is a 5-item (originally 6-item) scale that assesses 6 dimensions contributing to social isolation
Time frame: 8 weeks
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| MapTrek | Social Isolation | 17.6 cumulative score (4-20) higher=better | Standard Deviation 2.7 |
Secondary
Social Support
Social support for physical activity was measured with a modified version of the Social Support and Exercise Survey. The Social Support and Exercise Survey is a 12-item (originally 13 item) questionnaire that assesses the level of support from family and friends that participants have in making health behavior changes (exercise)
Time frame: 8 weeks
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| MapTrek | Social Support | 2.2 mean score (0-4 range); higher=better | Standard Deviation 0.8 |