What it takes to reduce sitting at work: a pilot study on the effectiveness and correlates of a multicomponent intervention.

OBJECTIVE: This study aimed to assess the feasibility and effects of a simple-to-implement multicomponent intervention to reduce sedentary time of office workers. METHODS: Six groups of eight to ten office workers took part in the two-week Leicht Bewegt intervention. Participants completed questionnaires at baseline (T0, n = 52), after 2 weeks (T1, n = 46), and after 5 weeks (T2, n = 38), including subjective sedentary measures and social-cognitive variables based on the health action process approach (HAPA). Objective sedentary measures were obtained using activPAL trackers. RESULTS: The intention to reduce sedentary behavior during work increased significantly from T0 to T1. Participants' objective and subjective sitting time decreased significantly from T0 to T1, corresponding to an average decrease per 8-h-workday of 55 min (d = - .66) or 74 min (d = - 1.14), respectively. This reduction persisted (for subjective sitting time) at T2 (d = - 1.08). Participants indicated a high satisfaction with the intervention. CONCLUSIONS: The Leicht Bewegt intervention offers a feasible and effective opportunity to reduce sedentary behavior at work. Randomized controlled trials including longer follow-up time periods are needed to validate its benefits in different workplaces.

"If this is what it means to be old ": a mixed methods study on the effects of age simulation on views on aging and perceptions of age-related impairments.

Age simulation suits are a promising tool to increase empathy and to promote positive attitudes toward older adults. However, studies have largely focused on (young) healthcare professionals, are probably biased by social desirability, and have not addressed participants' views of the aging process triggered by the simulation. The current work combines two studies addressing effects of aging suits on both general and personal views on aging among heterogeneous samples, and exploring spontaneous associations during the simulation. In study 1, N = 165 adults (M = 37.1 years, SD = 15.4, range 18-74 years) answered questionnaires containing general views regarding older adults ("old people are…") as well as personal perceptions ("aging means to me…") before and after wearing an aging suit. In study 2, young adults (N = 22; M = 24.8 years, SD = 4.3, range 20-38 years) and middle-aged adults (N = 41; M = 60.8 years, SD = 6.9, range 40-75 years) carried out established geriatric assessments with and without aging suit, and spontaneous impressions on the instant aging experience were recorded. Findings indicated negative shifts in both general and personal views on aging measures in both age groups (d = .30 to d = .44). Analyses of qualitative data resulted in seven main themes, e.g., "strain/coordination", "future me", "empathy/insight". Group comparisons revealed higher frequencies of future-self related thoughts among middle-aged adults, whereas younger adults mentioned predominantly physical effects of the suit. In conclusion, applying age simulation suits might evoke unintended negative views on aging. In comparison with young adults, middle-aged adults showed broader reflections including thoughts related to emotions, future-self, and potential struggles of older people.

Determinants of physical activity during cancer treatment: a longitudinal exploration of psycho-cognitive variables and physician counseling.

Individuals with cancer are recommended to engage in regular physical activity (PA) even during cancer therapy. The aim of this study was to explore how patient-reported physician PA counseling influences their PA intention and behavior in addition to psycho-cognitive determinants derived from the theory of planned behavior (TPB). A longitudinal study during cancer treatment was conducted among N = 115 patients with breast, prostate, or colorectal cancer (Mage = 58.0, SD = 11.5; 55.7% female). The median time since diagnosis was 2 months, and 19.1% were diagnosed with metastases. Participants provided information on PA counseling by their physicians and on psycho-cognitive variables of the TPB at three measurement points. Additionally, they wore accelerometers for seven days at baseline and three months later. Nearly half of participants (48%) reported basic PA counseling and 30% reported in-depth PA counseling. Patients in poorer health and with lower education reported significantly less in-depth counseling. In addition to patient self-efficacy in performing PA, only in-depth physician PA counseling, but not basic physician counseling, predicted intention for PA four weeks later. Patients' PA three months after baseline was predicted by patients' PA at baseline and their intention for PA. Overall, the PA level at baseline was identified as the most important predictor of PA three months later. Nevertheless, physicians seem to have the ability to increase their cancer patients' intention for PA by in-depth counseling.

Postponing sleep after a stressful day: Patterns of stress, bedtime procrastination, and sleep outcomes in a daily diary approach.

Sleep problems and stress are common among students and are associated with negative effects on academic performance as well as mental and physical health risks, but studies exploring mediating factors between stress and sleep on a daily basis are scarce. This study aimed to investigate the relationship of daily stress, Bedtime procrastination (BP) (i.e., postponing bedtime without external reasons), and sleep outcomes controlling for trait factors such as self-control. N = 96 students at a German university (M = 22.2 years, SD = 4.0) wore a sleep-tracking wearable (Fitbit Charge HR) for two weeks to assess sleep duration and to calculate the gap between the intended time to go to sleep and the objectively measured time of falling asleep. Stress, intended time to go to sleep, and sleep quality were assessed via daily diaries. Established questionnaires were used to measure trait self-control, trait BP, and smartphone addiction. Multilevel analyses indicated that more stress experienced during the day was associated with more BP (b = 2.32, p = 0.008), shorter sleep duration (b = -3.46, p = 0.003), and lower sleep quality (b = 1.03, p = 0.005) after controlling for several trait factors. The association of daily stress with sleep outcomes (quality and duration) was partly mediated by BP. Our findings indicate that BP might be one factor that contributes to stress-linked decreases in sleep duration and quality. Potential reasons for stress-related later time to fall asleep-like higher physiological arousal or stress-related worries-should be investigated in future studies.

Aging in 10 Minutes: Do Age Simulation Suits Mimic Physical Decline in Old Age? Comparing Experimental Data with Established Reference Data.

INTRODUCTION: Age simulation suits are increasingly used in health care education. However, empirical evidence that quantifies the simulated performance losses in established geriatric tests and compares those declines with reference data of older adults is scarce. METHODS: In a standardized lab setting, we compared performance of N = 61 participants (46 middle-aged, 15 young adults) with and without age simulation suit, for example in the Timed Up and Go Test (+dual task), Short Physical Performance Battery, grip strength, and 30-Second-Chair- Standing Test. Additionally, we compared the results with suit to established reference values of older adults in different age groups. RESULTS: Reduced performance was observed in both groups when wearing the suit, yet to different degrees dependent on the assessment and user age. For one, larger declines were observed in more challenging and complex tasks across age groups. In addition, comparisons with reference values revealed age-differential "instant aging" effects. DISCUSSION: A simulated "fourth age," where frailty and impairments are accumulating, was not reached in the majority of assessments, especially not among younger participants. In conclusion, existing age simulation suits may have some educational and empathy potential, but so far, they fail in simulating the age period with most serious functional loss.

Who uses technical aids in old age? Exploring the implementation of technology-based home modifications in Europe.

Introduction: Home modifications and features, e.g., handrails or ramps for people using wheelchairs, should allow residents with functional limitations to maintain social participation, health, and wellbeing for aging in place. However, there is little evidence in relation to the individual characteristics shaping this implementation of technology-based home modifications. Current studies often focus on describing the distribution of certain implementations in households but do not provide information on factors predicting the implementation or detailed and multifaceted data on associations with characteristics of the older user. This article, therefore, examines the use of well-established technological aids and home modifications (e.g., ramps, handrails, automatic doors, bathroom or kitchen modifications, chair lifts, and alerting devices) in the households of older adults in Europe. We refer to Lawton's and Nahemow's concept of personal-environment fit and describe the use of technical aids across 18 countries, analyze associations with individual characteristics and social resources, and compare those associations and variance explanation between older adults in their third age ("young-old", 65-79 years) and older adults in their fourth age ("old-old", 80+). Methods: Drawing on representative data from the Survey of Health, Ageing, and Retirement in Europe (SHARE), wave 6, a total of N = 38,553 older adults aged 65-105 years (M = 74.4 years, SD = 7.1; 55% women) were analyzed by performing hierarchical logistic regression analyses. Results: Indicators of functioning explained the highest proportion of variance, followed by social resources, and variance explanation was higher for the fourth age than for the third age. In particular, older adults with physical limitations, a larger social network, and those who received care from a child outside the household were more likely to have home modifications installed. Discussion: The study provides an overview of associations of diverse variables with assistive devices and modifications in the home and can serve as a starting point for public health activities concerning the heterogeneity of people aged 65 years and older.

Effects of mental contrasting on sleep and associations with stress: A randomized controlled trial.

Mental contrasting with implementation intentions (MCII) has been successfully applied to improve health-related behaviors (e.g. exercise). We explored its effectiveness to improve sleep outcomes beyond effects of sleep hygiene (SH) information, and investigated associations with stress. Eighty university employees (mean age: 29.6, SD = 4.5) were randomized to either a MCII + SH or a SH-only condition. During a baseline-week and a post-intervention week, sleep duration (Fitbit Alta and self-report), sleep quality, and stress were assessed daily and saliva was collected to assess the cortisol awakening response (CAR). In total, self-reported sleep quality and duration increased, but there was no meaningful condition*week interaction for sleep parameters or CAR. Higher average stress was associated with shorter sleep duration and lower sleep quality. Within-person, days with higher stress were followed by nights with lower sleep quality. Despite overall improvements, effects of MCII were not confirmed. MCII might be less effective to improve behaviors which are less controllable.

Improving Sleep Among Teachers: an Implementation-Intention Intervention.

BACKGROUND: Insufficient sleep is common among teachers and is associated with diverse health risks. This study aimed to predict intention and sleep duration by applying the Theory of Planned Behavior (TPB) and to examine the effectiveness of an implementation-intention intervention to improve sleep duration and quality. METHOD: Sixty-nine teachers (M = 36.8 years, SD = 10.4) were assigned to an active control group (CG) or intervention group (IG). At baseline, TPB variables were assessed and participants of the IG received instructions to develop implementation intentions to reach the goal of sleeping 8 h on average. During a 3-week intervention period, all participants wore an activity tracker (Fitbit Charge HR) to measure sleep duration and kept diaries to assess sleep quality, physical activity, and stress. After 1 month, a 1-week follow-up, including a booster for the IG, was conducted. RESULTS: Forty-two percent of variance in sleep duration were explained by control variables, past behavior, perceived behavioral control, and intention. Mixed ANOVAS with baseline covariates found a large main effect with longer sleep duration in the IG. A time x group interaction suggested that only the IG slept significantly longer in the follow-up period compared to the intervention period. For sleep quality, a medium-sized main effect for study group was found and a time x group interaction indicated higher sleep quality in the IG for week 3 and the follow-up. CONCLUSION: The TPB was effective in predicting sleep intention and duration. Implementation intentions accompanied by daily monitoring and a booster appear to be promising for improving sleep.

Acceptance of digital health services among older adults: Findings on perceived usefulness, self-efficacy, privacy concerns, ICT knowledge, and support seeking.

Background: Over the last decade, the rapid advancements in information and communication technologies (ICTs) have also driven the development of digital health services and applications. Older adults could particularly benefit from these technologies, but they still have less access to the Internet and less competence in using it. Based on the empirical literature on technology acceptance among older adults, this study examines the relations of perceived usefulness, self-efficacy, privacy concerns, ICT knowledge, and support seeking (family, informal, formal/institutional) with older adults' intention to adopt new digital health services. Methods: The study included 478 older adults who participated in an online or paper/pencil questionnaire (M = 70.1 years, SD = 7.8; 38% male). Sociodemographic characteristics, subjective health status, and variables related to technology acceptance were assessed. Results: Latent structural equation modeling revealed that higher perceived usefulness, higher self-efficacy regarding digital health technologies, and lower privacy concerns contributed to a higher intention to use digital health services among older adults. Contrary to our expectations, general ICT knowledge was not a significant predictor. Older adults who reported seeking more support regarding technology problems from family members and formal/institutional settings also reported higher usage intentions, whereas informal support was not as relevant. Furthermore, higher age was associated with higher perceived usefulness and lower self-efficacy. Discussion: Future studies should further explore mediating factors for intention and actual use of digital health services and develop educational programs including follow-up assessments.

Effects of age simulation suits on psychological and physical outcomes: a systematic review.

Age simulation suits (ASS) are widely used to simulate sensory and physical restrictions that typically occur as people age. This review has two objectives: first, we synthesize the current research on ASS in terms of the observed psychological and physical effects associated with ASS. Second, we analyze indicators able to estimate the validity of ASS in simulating "true" ageing processes. Following the PRISMA guidelines, eight electronic databases were searched (BASE, Cinhal, Cochrane, Google Scholar, ProQuest, PsychINFO, Pubmed, and Web of Science). Qualitative and quantitative studies addressing effects of ASS interventions regarding psychological outcomes (i.e., empathy, attitudes) or physical parameters (i.e., gait, balance) were included. The Mixed Methods Appraisal Tool was applied for quality assessment. Of 1890 identified citations, we included 94 for full-text screening and finally 26 studies were examined. Publication years ranged from 2001 to 2021. Study populations were predominantly based on students in health-related disciplines. Results suggest that ASS can initiate positive effects on attitudes toward (d weighted = 0.33) and empathy for older adults (d weighted = 0.54). Physical performance was significantly reduced; however, there is only little evidence of a realistic simulation of typical ageing processes. Although positive effects of ASS are supported to some extent, more diverse study populations and high-quality controlled designs are needed. Further, validation studies examining whether the simulation indeed reflects "real" ageing are needed and should build on reference data generated by standardized geriatric assessments or adequate comparison groups of older adults. Prospero registration: 232686. Supplementary Information: The online version contains supplementary material available at 10.1007/s10433-022-00722-1.

Using wearables to promote physical activity in old age : Feasibility, benefits, and user friendliness.

BACKGROUND: Wearables provide new opportunities to promote physical activity also among older adults but data on effectiveness and user friendliness are rare. OBJECTIVE: The effects of a comprehensive self-regulative intervention on moderate to vigorous physical activity (MVPA) and number of steps were examined using commercially available activity trackers. Acceptance regarding the devices was analysed in various domains. METHODS: In this study 80 older adults (mean = 67.03 years, standard deviation = 3.97 years; 59% women) wore a Fitbit Charge HR for 21 days including a baseline, a postintervention and a follow-up week. The intervention comprised feedback, goal setting and planning and 50% of the participants were additionally randomized to a role model component. Social cognitive predictors based on the health action process approach (HAPA) and user experience were assessed via questionnaires. RESULTS: The MVPA increased by an average of 19 min per week and steps by 1317 per day. An additional benefit of the role model component could be observed for MVPA. In the follow-up, the intervention effect was still significant for the number of steps, while MVPA dropped back to baseline. Multilevel models including HAPA variables explained small but significant amounts of variance in MVPA (8% within-person, 26% between-person) and steps (11% within-person, 12% between-person). User experience was rated as very high. CONCLUSION: Providing an intervention based on established behavior change techniques and self-monitoring via wearables seems to be effective for increasing physical activity among older adults. The HAPA variables seem to play a limited role to explain activity levels. Acceptance of wearables can be expected to be high.

"Aging Means to Me That I Feel Lonely More Often"? An Experimental Study on the Effects of Age Simulation Regarding Views on Aging.

Over the last decades, educational programs involving age simulation suits (ASS) emerged with the ambition to further the understanding of age-related loss experiences, enhance empathy and reduce negative attitudes toward older adults in healthcare settings and in younger age groups at large. However, the impact of such "instant aging" interventions on individuals' personal views on aging have not been studied yet. The aim of the current study is to address possible effects of ASS interventions on multiple outcomes related to views on aging, i.e., aging-related cognitions (i.e., expectations regarding social losses), awareness of age-related change (AARC) and age stereotypes. Moreover, we explore effects on broader constructs with relevance to aging, i.e., perceived obsolescence, risk perceptions, as well as desired support through technology. In a within-subjects design, N = 40 participants (M = 61.4 years, SD = 6.16) went through a series of established geriatric assessments (i.e., Timed up and Go) with and without an ASS. Views on aging constructs were assessed in standardized questionnaires before and after the ASS intervention. Changes in aging-related cognitions were observed, with more negative expectations regarding social integration and continuous development after wearing the ASS. AARC and age stereotypes did not change from pre- to post-assessment, but participants reported an increased susceptibility to age-associated impairments and stronger feelings of obsolescence. Those participants who exhibited higher difficulties in geriatric assessments while wearing the suit reported higher openness to be supported by intelligent assistive devices or robots afterwards. We conclude that ASS interventions should only be combined with education on losses and gains during the aging process to prevent negative effects on individual views on aging. On the other hand, potentials regarding technology acceptance and formation of intentions to engage in prevention and health behaviors among middle-aged to young-old adults are discussed.

Predictors of Performance in Everyday Technology Tasks in Older Adults With and Without Mild Cognitive Impairment.

Background and Objectives: The ability to use everyday technology has become a key competence for conducting activities of daily living, maintaining an autonomous life, as well as participating in society. However, studying this issue in older adults needs more attention, particularly among those with mild cognitive impairment (MCI). Research Design and Methods: We assessed the performance of N = 80 older adults (M = 73 years) in a range of tasks representing important life domains, i.e., using a blood pressure monitor, a mobile phone, and an eBook reader. Thirty-nine participants had been diagnosed with MCI by experienced geropsychiatrists and 41 healthy controls were matched for age, sex, and education. Standardized observation based on video-recording and coding was combined with cognitive testing and assessment of social-cognitive variables (self-efficacy, perceived obsolescence, attitudes towards technology). Results: Cognitively healthy participants outperformed those with MCI regarding completion time and errors. An interaction effect of device and study group indicated larger differences in completion time for tasks with multilayered interfaces. In hierarchical regression models, aggregated cognitive factors (fluid and memory component) predicted performance and interactions with education level emerged. Obsolescence, addressing a perceived lack of competence to cope with modern society, mediated the effect of cognitive status on performance, both regarding time (partial mediation, adj.R2 = 28%) and errors (full mediation, adj.R2 = 23%). Discussion and Implications: Findings show that social-cognitive factors contribute to differences in performance on everyday technology tasks in addition to cognitive abilities. Training programs may profit from considering respective individual resources or limitations in the cognitive, personality-related or emotional-motivational domain.

Older adults' performance in technology-based tasks: cognitive ability and beyond.

Considering both demographic and technological changes in society, the potential of technology to support older adults has recently attracted much attention. For physically frail individuals with cognitive impairment, user-friendly technologies may facilitate activities of daily living. The current study assessed the performance of older adults without cognitive impairment (n = 27) and with mild cognitive impairment (n = 26) using three types of technology. Relationships between performance in the technology-based tasks and cognitive abilities (e.g., visual-spatial abilities), personality characteristics (e.g., self-efficacy), and previous technology experience were examined using a mixed-methods approach including video analyses and psychological testing. Findings underscore that both cognitive abilities and personality-related characteristics contribute to individual differences in users' performance. Nuanced knowledge of older adults' specific difficulties, abilities, and resources may help improve the fit between user needs and technological requirements, with implications for technology developers and practitioners.