Abstract
BackgroundChronic obstructive pulmonary disease (COPD) is prevalent among older adults. Promoting physical activity and increasing exercise capacity are recommended for all individuals with COPD. Pulmonary rehabilitation is the standard of care to improve exercise capacity, although there are barriers that hinder accessibility. Technology has the potential to overcome some of these barriers, but it is unclear how aging adults with a chronic disease like COPD perceive technology-based platforms to support their disease self-management.ObjectiveGuided by the unified theory of acceptance and use of technology, the current retrospective secondary analysis explores if age moderates multiple factors that influence an individual with COPD’s openness toward an internet-mediated, pedometer-based physical activity intervention.MethodsAs part of an efficacy study, participants with COPD (N=59) were randomly assigned to use an internet-mediated, pedometer-based physical activity intervention for 12 weeks. At completion, they were asked about their experience with the intervention using a survey, including their performance expectancy and effort expectancy, facilitating conditions (ie, internet use frequency and ability), and use of the intervention technology. Logistic regression and general linear modeling examined the associations between age and these factors.ResultsParticipants ranged in age from 49 to 89 years (mean 68.66, SD 8.93). Disease severity was measured by forced expiratory volume in the first second percent predicted (mean 60.01, SD 20.86). Nearly all participants (54/59) believed the intervention was useful. Regarding effort expectancy, increasing age was associated with reporting that it was easy to find the time to engage in the intervention. Regarding facilitating conditions, approximately half of the participants believed the automated step count goals were too high (23/59) and many did not feel comfortable reaching their goals (22/59). The probability of these perceptions increased with age, even after accounting for disease severity. Age was not associated with other facilitating conditions or use of the technology.ConclusionsAge does not influence performance expectancy or use of technology with an internet-mediated, pedometer-based physical activity intervention. Age is associated with certain expectations of effort and facilitating conditions. Consideration of age of the user is needed when personalizing step count goals and time needed to log in to the website.Trial RegistrationClinicalTrials.gov NCT01772082; https://clinicaltrials.gov/ct2/show/NCT01772082
Highlights
Chronic Obstructive Pulmonary Disease and eHealthChronic obstructive pulmonary disease (COPD), prevalent mainly in older adults, is the fourth leading cause of death in the United States [1]
Age is associated with certain expectations of effort and facilitating conditions
Pulmonary rehabilitation is the standard of care to increase physical activity and exercise capacity; there are barriers to conventional pulmonary rehabilitation, including distance and time required to travel to medical center–based in-person sessions
Summary
Chronic Obstructive Pulmonary Disease and eHealthChronic obstructive pulmonary disease (COPD), prevalent mainly in older adults, is the fourth leading cause of death in the United States [1]. Pulmonary rehabilitation is the standard of care to increase physical activity and exercise capacity; there are barriers to conventional pulmonary rehabilitation, including distance and time required to travel to medical center–based in-person sessions. Technology-based interventions may support self-management behaviors, such as engagement in physical activity [8]. Chronic obstructive pulmonary disease (COPD) is prevalent among older adults. Promoting physical activity and increasing exercise capacity are recommended for all individuals with COPD. Pulmonary rehabilitation is the standard of care to improve exercise capacity, there are barriers that hinder accessibility. Technology has the potential to overcome some of these barriers, but it is unclear how aging adults with a chronic disease like COPD perceive technology-based platforms to support their disease self-management
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