Publish By:Peter Vermeiren
The health benefits of physical activity are well known, yet few of us achieve the 150 minutes of moderate intensity physical activity per week recommended by the World Health Organization (World Health Organization [WHO], 2010). In addition to walking more and sitting less, older adults should also be working on their strength and balance in order to prevent age-related functional decline (National Health Service [NHS], 2015). We know that tailored interventions can be successful, so researchers in the PreventIT project are working on developing and trialling two behaviour change interventions, targeting risk factors for functional decline, that are tailored to the needs and preferences of the individual. The interventions have been designed to change behaviour, supporting young older adults to form long term physical activity habits.
The European Horizon 2020 Project ‘PreventIT’ (Grant Agreement Number: 689238) has adapted the Lifestyle-integrated Functional Exercise (LiFE) programme, which reduced falls in people 75 years and over (Clemson et al., 2012), for a younger cohort (aLiFE). The aLiFE programme incorporates more challenging strength and balance/agility tasks, as well as specific recommendations for increasing physical activity in the target group, aged 60-70 years. Personalised advice is given on how to integrate strength, balance and physical activities into daily life, in a way which should not be time consuming. Participants plan and monitor their strength, balance and physical activities, with support from a Trainer making home visits, using a paper-based manual. aLiFE has been operationalised to be delivered using smartphones and smartwatches (eLiFE), providing the opportunity to send timely encouraging messages and real-time feedback to the user. Guidance and instruction is provided through videos and text within the PreventIT app and participants plan and monitor their strength, balance and physical activities using the app.
Smartphones and smartwatches are used by an increasing number of people, with thousands of smartphone applications available to promote healthy lifestyles. However, few of these applications are evidence based, meaning that their contribution to overcoming the challenges presented by an ageing population is limited. PreventIT has taken the original LiFE concept and further developed the behaviour change elements, explicitly relating and mapping them to Social Cognitive Theory (Schwarzer, 2008) and specific Behaviour Change Techniques (Michie et al., 2013). Goal setting, planning, prompts and real-time feedback are used to deliver a person-centred experience for participants in the intervention.
The PreventIT mHealth intervention (eLiFE) focusses on behaviour change from initiation to long-term maintenance, addressing the different phases of adopting a healthier lifestyle. As such, it makes a strong contribution to the developing field of evidence-based mHealth. The interventions (aLiFE and eLiFE) are currently being trialled in a three-arm feasibility randomised controlled trial in Norway, the Netherlands and Germany, with results eagerly awaited!
Clemson, L., Fiatarone Singh, M. A., Bundy, A., Cumming, R. G., Manollaras, K., O’Loughlin, P., & Black, D. (2012). Integration of balance and strength training into daily life activity to reduce rate of falls in older people (the LiFE study): randomised parallel trial. BMJ (Clinical Research Ed.), 345e4547. doi:10.1136/bmj.e4547
Michie, S., Richardson, M., Johnston, M., Abraham, C., Francis, J., Hardeman, W., & … Wood, C. E. (2013). The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: Building an international consensus for the reporting of behavior change interventions. Annals Of Behavioral Medicine, 46(1), 81-95. doi:10.1007/s12160-013-9486-6
National Health Service. (2015). Physical activity guidelines for older adults. Retrieved from: https://www.nhs.uk/Livewell/fitness/Pages/physical-activity-guidelines-for-older-adults.aspx
Schwarzer, R. (2008). Modeling health behavior change: How to predict and modify the adoption and maintenance of health behaviors. Applied Psychology: An International Review, 57(1), 1-29. doi:10.1111/j.1464-0597.2007.00325.x
World Health Organization. (2010). Recommendations on Physical Activity for Health. Retrieved from: http://apps.who.int/iris/bitstream/10665/44399/1/9789241599979_eng.pdf
Dr Lis Boulton, Research Associate, PreventIT Project, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester