Abstract
Background“Push” components of mobile health interventions may be promising to create conscious awareness of habitual sedentary behavior; however, the effect of these components on the near-time, proximal outcome, being breaks in sedentary behavior immediately after receiving a push notification, is still unknown, especially in older adults.ObjectiveThe aims of this study are to examine if older adults break their sedentary behavior immediately after receiving personalized haptic feedback on prolonged sedentary behavior and if the percentage of breaks differs depending on the time of the day when the feedback is provided.MethodsA total of 26 Flemish older adults (mean age 64.4 years, SD 3.8) wore a triaxial accelerometer (Activator, PAL Technologies Ltd) for 3 weeks. The accelerometer generated personalized haptic feedback by means of vibrations each time a participant sat for 30 uninterrupted minutes. Accelerometer data on sedentary behavior were used to estimate the proximal outcome, which was sedentary behavior breaks immediately (within 1, 3, and 5 minutes) after receiving personalized haptic feedback. Generalized estimating equations were used to investigate whether or not participants broke up their sedentary behavior immediately after receiving haptic feedback. A time-related variable was added to the model to investigate if the sedentary behavior breaks differed depending on the time of day.ResultsA total of 2628 vibrations were provided to the participants during the 3-week intervention period. Of these 2628 vibrations, 379 (14.4%), 570 (21.7%), and 798 (30.4%) resulted in a sedentary behavior break within 1, 3 and 5 minutes, respectively. Although the 1-minute interval did not reveal significant differences in the percentage of breaks depending on the time at which the haptic feedback was provided, the 3- and 5-minute intervals did show significant differences in the percentage of breaks depending on the time at which the haptic feedback was provided. Concretely, the percentage of sedentary behavior breaks was significantly higher if personalized haptic feedback was provided between noon and 3 PM compared to if the feedback was provided between 6 and 9 AM (odds ratio 1.58, 95% CI 1.01-2.47, within 3 minutes; odds ratio 1.78, 95% CI 1.11-2.84, within 5 minutes).ConclusionsThe majority of haptic vibrations, especially those in the morning, did not result in a break in the sedentary behavior of older adults. As such, simply bringing habitual sedentary behavior into conscious awareness seems to be insufficient to target sedentary behavior. More research is needed to optimize push components in interventions aimed at the reduction of the sedentary behavior of older adults.Trial RegistrationClinicalTrials.gov NCT04003324; https://clinicaltrials.gov/ct2/show/NCT04003324
Highlights
Evidence shows that older adults are the most sedentary segment of the population [1]
More research is needed to optimize push components in interventions aimed at the reduction of the sedentary behavior of older adults
This finding contrasts sharply with the range of mobile health (mHealth) interventions aimed at the promotion of physical activity [6], and it is very disappointing, as a recent meta-analysis showed a significantly higher decrease in sedentary behavior following mHealth interventions compared to traditional interventions in all age groups [7]
Summary
Evidence shows that older adults (aged ≥60 years) are the most sedentary segment of the population [1] They spend approximately 80% of their awake time (8-12 hours per day) in sedentary activities [2]. 9 interventions could be detected in a systematic review [4], of which only 1 was a mobile health (mHealth) intervention [5] This finding contrasts sharply with the range of mHealth interventions aimed at the promotion of physical activity [6], and it is very disappointing, as a recent meta-analysis showed a significantly higher decrease in sedentary behavior following mHealth interventions compared to traditional interventions in all age groups [7]. Self-monitoring can be integrated in mHealth interventions; these interventions offer great potential to reduce sedentary behavior
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