From: Non-face-to-face physical activity interventions in older adults: a systematic review
Print and phone interventions | |||||
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Reference | Study design | Demographics | Intervention components | PA measures | Results |
Ball et al. [39] | RCT | 66 physically underactive adults (45–78 years, 73% female), Australia | 12 weeks print, and print plus phone individual PA counselling; SCT, TTM; self-monitoring, goal setting, incentives, tailored feedback for print plus phone group | CHAMPS: global PA scores, MET-min/wk for PA and walking measured at baseline, 12 and 16 weeks | Significant increase of global PA scores from baseline to 12 weeks maintained after 16 weeks, • significant increase in MET-min/wk maintained after 16 weeks, • significant increase in MET-min/wk for walking from baseline to 12 weeks and from 12 weeks to 16 weeks in print plus phone group |
Castro et al. [40] | RCT | 140 sedentary adults (50–65 years, 43% female, 15.6 years ±2.7 years education), USA | 12 months mail only, and mail plus phone PA maintenance intervention after 12 months PA adoption intervention; SCT; motivation, self-monitoring, relapse prevention and overcoming barriers, tailored feedback | Self-report exercise adherence and activity log: monthly exercise adherence based on prescribed exercise sessions recorded for 12 months | During maintenance period PA levels remained over baseline, • mail only intervention with significantly higher PA maintenance |
Greaney et al. [41] | RCT | 966 adults (≥60 years, 71.4% female, 12.9 ± 2.9 years education), USA | Written material, newsletters, Expert System Assessment and coaching calls for 12 months; TTM; stage specific tailored feedback, encouragement | YPAS: exercise, household and recreational PA during typical week in previous month, YPAS score (higher score: more active), measured at baseline, 12 and 24 months | No significant change in YPAS scores (baseline: 46; 12 months: 46; 24 months: 47); |
Hooker et al. [42] | Community intervention at 13 sites (not randomized) | 447 sedentary or irregular active adults (≥50 years, 78.3% female, 27.2% higher education), USA | 18 phone calls in 12 months after initial face-to-face meeting where individual PA plan was developed; SCT; tailored support and feedback | CHAMPS: total PA energy expenditure, total hours PA and PA frequency per week measured at baseline, 6 and 12 months | Significant median increase in PA energy expenditure (baseline-6 months: 644 kcal/wk; baseline-12 months: 707 kcal/wk), • significant median increase in total PA hours (baseline-6 months: 2.75 h/wk; baseline-12 months: 3 h/wk), • significant increase in PA frequency (baseline-6 months: 3 times/wk; baseline-12 months: 4 times/wk), • no changes between 6 and 12 months |
King et al. [26] | RCT | 189 underactive adults (≥55 years, 69.3% female, 16.2 ± 1.9 years education), USA | 12 months PA phone counselling by human counsellor, or by computer controlled interactive system supplemented by info mailings and pedometer; SCT, TTM; tailoring, self-monitoring | Stanford 7-Days Physical Activity Recall: energy expenditure and weekly minutes in moderate-vigorous PA; CHAMPS measured at baseline, 6 and 12 months; Accelerometer for 7 d (26% of sample) recording moderate PA | Significantly greater mean energy expenditure and mean PA minutes per week in intervention groups compared to controls (6/12 months), • significantly more days of 30 minutes moderate-vigorous PA per week in intervention groups (6/12 months), • significantly more participants met WHO PA recommendation in intervention groups (6/12 months), • significantly more PA based on accelerometer counts in intervention groups |
Kolt et al. [43] | RCT | 186 low active adults (≥65 years, 66.2% female, 44.1% higher education), New Zealand | Eight PA counselling calls in 3 months; TTM; individual goal setting, providing knowledge and motivation, problem solving and relapse prevention, tailoring | Auckland Heart Study Physical Activity Questionnaire: PA frequency per fortnight (leisure, walking, occupational, domestic) and number of minutes per time measured at baseline, 3, 6 and 12 months | Significantly more total leisure time PA in intervention group compared to controls from baseline to 3 months (48.9 min/wk, SE 21.6 min/wk), • significantly more total leisure time in intervention group from baseline to 12 months (86.6 min/wk), • significantly more participants in intervention group met PA recommendations after 12 months compared to control group |
Lee et al. [44] | RCT | 270 inactive adults (65–74 years, 65.3% female, 32.3% higher education), Australia | Interactive booklet and individual PA counselling calls for 12 weeks (five phone calls); participatory action research; tailoring, goal setting, self-monitoring, motivation | IPAQ short form: frequency (days, times) and duration (minutes) of walking and PA per week measured at baseline and 12 weeks | Significant differences between intervention and control group in recreational walking and PA at post intervention, • significant gain in recreational walking and PA (27 minutes/wk) in intervention group |
Martinson et al. [27] | RCT | 1049 moderately active adults (50–70 years, 72.4% female, 66.7% higher education), USA | 7 phone sessions in 6 months, followed by monthly and bimonthly calls in year one and two; control group with information material and 4 newsletters; SCT; relapse prevention, self-management (goal setting, problem solving, identification of barriers, self-monitoring, environmental cues), tailoring | CHAMPS: total kcal/wk, weekly kcal spent in moderate to vigorous PA; meeting PA guidelines measured at baseline, 6, 12 and 24 months | Significantly more participants in intervention group reported more kcal/wk expended at 6 (p < 0.03) and 24 months (p < 0.01) follow-up, • intervention group continued to increase kcal/wk expenditure over 24 months, • intervention group participants reported significantly more kcal/wk expenditure in PA than controls at 6 (p < 0.03), 12 (p < 0.04) and 24 months (p < 0.01), • significantly more intervention group participants maintained PA at 6 (p < 0.001), 12 (p < 0.03), and 24 months (p < 0.001) |
RCT | 1971 adults (≥50 years, 57% female, 52% middle or higher education), Holland | Three computer tailored PA advice letters; or additional environmental focused information on PA opportunities in neighborhood plus access to e-buddy system for 4 months; SCT, I-Change Model, TTM, health action process approach, precaution adoption process model, self-regulation theory, self-determination theory; tailoring | Dutch Short Questionnaire to assess Health enhancing PA: total weekly PA and total weekly PA minutes, compliance to PA guidelines, self-rated PA level measured at baseline, 3, 6 and 12 months follow-up | Significant increase in total PA at 3 months with further increase at 6 months in intervention groups compared to controls, • intervention groups complied with PA guidelines 1.6 times (3 months) and 2.5 times (6 months) more than controls, • insufficiently active | |
intervention participants more likely to have initiated | |||||
PA at 3 months than controls with further increase at 6 months, • significant increase in total days/wk of sufficient PA in intervention groups from baseline (4.2 ± 2.2) to 12 months (4.7 ± 2.0) with medium effect sizes, • only intervention with PA opportunities information significantly effective (small effect) in increasing total PA min/wk | |||||
Walker et al. [45] | Randomized by site community-based controlled clinical trial | 225 rural, irregular active older adults (50–69 years, 100% female, 35% higher education), USA | 18 tailored PA newsletters and instructional video versus generic PA newsletters for 12 months; SCT; tailoring, motivation, overcoming barriers, goal setting | Modified 7-Day Activity Recall: daily PA minutes, daily PA kcal expended, weekly time engaged in strength/flexibility training measured at baseline, 6 and 12 months | Intervention and control group significantly increased on all PA measures from baseline to 6 months, • both groups significantly increased weekly stretching and strength exercise from baseline to 12 months, • only tailored group significantly increased daily moderate or higher intensity PA minutes (337.65 ± 675.4 min/wk – 509.88 ± 749.5 min/wk, p < .001) |
Wilcox et al. [46] | Community study of previously tested intervention (quasi experiment) | 2503 underactive adults (≥50 years, 80% female, 33% higher education) recruited from different sites over four years, USA | Six months phone PA counselling; SCT, tailoring, goal setting, self-monitoring, motivation | CHAMPS: min/wk spent in moderate to vigorous PA, total PA, meeting PA guidelines measured at baseline and 6 months | Significant PA increase and significant increase of participants meeting PA guidelines (p < .001) |
Internet interventions | |||||
Hageman et al. [10] | RCT | 31 inactive adults (50–69 years, 100% female, 51.7% higher education), USA | Three tailored versus non-tailored online newsletters in 3 months; SCT; tailored information based on baseline assessment for one group | Modified 7-day Activity recall: daily energy expenditure, weekly PA minutes measured at baseline and 3 months | Non-significant decrease in energy expenditure (mean decrease of calories expended daily 6.4%) and weekly PA minutes (mean decrease 6.4%) for both groups |
Irvine et al. [28] | RCT | 405 sedentary adults (≥55 years, 69% female, 82% some college education), USA | 12 weeks multiple visit stand-alone internet intervention with text and videos; Theory of Planned Behavior (TPB); goal setting, tailoring | Self-developed tool measuring weekly PA frequency and PA minutes applied at baseline, 12 and 24 weeks | Large PA gains from baseline to 12 weeks (eta square = 0.17), • Medium to large effect sizes for cardiovascular, stretching, strengthening, balance activities and weekly PA minutes from baseline to 12 weeks maintained after 24 weeks |
Ammann et al. [47] | Quasi experiment | 235 adults (60–89 years, 57% female, 72.3% higher education), Australia | Website for individual PA advice, 1 week online; TPB, TTM; tailored feedback | Active Australia Survey: PA levels (duration, frequency of walking, PA in previous week), total PA minutes, PA sessions measured at baseline, 1 week and 1 month | Significant increase in total weekly PA minutes and PA sessions from baseline to 1 month (327 min ±335 min to 404 min ± 345 min; 8.3 sessions ±7.2 sessions to 10.1 session ±7.6 sessions), • non-significant increase in walking minutes, moderate and vigorous intensity PA |
Other media interventions | |||||
King et al. [48] | RCT | 37 inactive adults (≥55 years, 43.4% female, 16.8 ± 2.2 years education), USA | Educational material, and daily PA feedback delivered via PDA for 8 weeks; or written material only; SCT; tailored PA goal setting and feedback | CHAMPS: minutes/wk spent in moderate to vigorous PA, total PA, meeting PA guidelines measured at baseline and 8 weeks | Significantly higher 8-week moderate PA minutes in PDA group compared to controls (PDA mean = 310.6, SD 267.4 minutes; control mean = 125.5, SD 267.8 minutes; p = 0.048) and caloric expenditure in kcal/kg/wk in moderate PA (PDA mean = 19.1, SD 16.8 kcal/kg/wk; control mean = 7.8, SD 16.8 kcal/kg/wk; p = 0.05) |
Reger et al. [38] | 2 community longitudinal study (quasi experiment) | 463 adults (50–65 years, 68% female, 24.7% higher education), USA | Promoting walking in Wheeling, USA using paid media (newspaper, TV, radio) and public relations events for 8 weeks; TPB, elaboration likelihood model for advertisements | Behavioral observation of walking: counting walkers at popular walking sites; self-developed PA questionnaire: weekly days of brisk walking and moderate to vigorous PA, hours and minutes devoted to activity per day measured at baseline and 8 weeks | Significant (23%) increase in walking in intervention community compared to 6% decrease in comparison community (p < 0.0001, OR = 1.31, 95% CI = 1.14-1.50), • 32.2% met walking guidelines (150 minutes/wk) in the intervention community compared to 18% in comparison community (p < 0.05, OR = 2.12, 95% CI = 1.41–2.24), • no significant effects in other PA |