Results of MyPlan 2.0 on Physical Activity in Older Belgian Adults: Randomized Controlled Trial.

BACKGROUND: The beneficial effects of physical activity (PA) for older adults are well known. However, few older adults reach the health guideline of 150 min per week of moderate-to-vigorous PA (MVPA). Electronic health (eHealth) interventions are effective in increasing PA levels in older adults in the short term but, rarely, intermediate-term effects after a period without the support of a website or an app have been examined. Furthermore, current theory-based interventions focus mainly on preintentional determinants, although postintentional determinants should also be included to increase the likelihood of successful behavior change. OBJECTIVE: This study aimed to investigate the effect of the theory-based eHealth intervention, MyPlan 2.0, focusing on pre- and postintentional determinants on both accelerometer-based and self-reported PA levels in older Belgian adults in the short and intermediate term. METHODS: This study was a randomized controlled trial with three data collection points: baseline (N=72), post (five weeks after baseline; N=65), and follow-up (three months after baseline; N=65). The study took place in Ghent, and older adults (aged ≥65 years) were recruited through a combination of random and convenience sampling. At all the time points, participants were visited by the research team. Self-reported domain-specific PA was assessed using the International Physical Activity Questionnaire, and accelerometers were used to objectively assess PA. Participants in the intervention group got access to the eHealth intervention, MyPlan 2.0, and used it independently for five consecutive weeks after baseline. MyPlan 2.0 was based on the self-regulatory theory and focused on both pre- and postintentional processes to increase PA. Multilevel mixed-models repeated measures analyses were performed in R (R Foundation for Statistical Computing). RESULTS: Significant (borderline) positive intervention effects were found for accelerometer-based MVPA (baseline-follow-up: intervention group +5 min per day and control group -5 min per day; P=.07) and for accelerometer-based total PA (baseline-post: intervention group +20 min per day and control group -24 min per day; P=.05). MyPlan 2.0 was also effective in increasing self-reported PA, mainly in the intermediate term. A positive intermediate-term intervention effect was found for leisure-time vigorous PA (P=.02), moderate household-related PA (P=.01), and moderate PA in the garden (P=.04). Negative intermediate-term intervention effects were found for leisure-time moderate PA (P=.01) and cycling for transport (P=.07). CONCLUSIONS: The findings suggest that theory-based eHealth interventions focusing on pre- and postintentional determinants have the potential for behavior change in older adults. If future studies including larger samples and long-term follow-up can confirm and clarify these findings, researchers and practitioners should be encouraged to use a self-regulation perspective for eHealth intervention development. TRIAL REGISTRATION: Clinicaltrials.gov NCT03194334; https://clinicaltrials.gov/ct2/show/NCT03783611.

Cognitive Functioning as a Moderator in the Relationship Between the Perceived Neighborhood Physical Environment and Physical Activity in Belgian Older Adults.

Objective: To investigate whether the relationship of neighborhood environmental factors with physical activity (PA) is moderated by cognitive functioning in Belgian older adults. Methods: Seventy-one older adults completed validated questionnaires on PA and environmental perceptions, wore an accelerometer, and completed a computerized assessment of cognitive functioning. Moderated linear regression analyses were conducted in SPSS 24.0. Results: Overall cognitive functioning significantly moderated the associations of traffic safety and street connectivity with PA. Detailed analyses showed that these factors were only positively associated with PA in older adults with lower cognitive functioning. In addition, particularly, performance on tests assessing visuospatial and episodic memory moderated these associations. Discussion: Living in traffic-safe neighborhoods with short and many alternative routes might motivate older adults with lower cognitive functioning to be active. As such, the increase in PA might improve their cognitive abilities. This knowledge is crucial for health practitioners to develop effective PA promotion initiatives.