The use of technology to promote health behavior change in older adults

By Dr. Sara Powell (1) & Dr. Christine Pellegrini (2)

(1) Post-doctoral fellow, Department of Exercise Science & Technology Center to Promote Healthy Lifestyles, University of South Carolina in Columbia, SC

(2) Assistant professor, Technology Center to Promote Healthy Lifestyles, University of South Carolina in Columbia, SC

As we age, we tend to become less physically active. Physical inactivity is associated with elevated risk for a variety of diseases including all-cause mortality, cardiovascular disease, cancer, and type 2 diabetes. In addition to these chronic conditions, excess sedentary behavior and physical inactivity are associated with functional decline, physical frailty, quality of life, and disability. One recent trend in health behavior change research among older adults is the use of various forms of health technology (I.e. wearable activity trackers or smartphone apps) for tracking physical activity, and dietary intake. Given the increase of technology-based interventions to promote health behaviors, it is important to consider the potential challenges of using technology in a population of older adults.  Common challenges in working with this population include low technology efficacy, complexity of technology use, and physical limitations. Recently, we have explored the use of health-related technology interventions among adults and older adults who have had total knee replacements and can provide insight regarding ways to overcome some of these challenges.

One goal we commonly have within our interventions is to increase participant self-efficacy to facilitate behavior change.  However, technology efficacy may not be as high in this population due to less frequent use or frustration with the complexity of some devices and apps. Additionally, with the rapid rate of change of technology, older adults may be resistant to trying new technologies as change can cause anxiety and self-doubt. We strive to ensure participants feel comfortable with the technology prior to the start of the intervention and provide continued support and encouragement throughout the intervention period.

Tip: Don’t be afraid to pick up the phone! Though it might be easier to email information, establishing a sense of rapport using a form of communication they are comfortable with can increase confidence and promote study retention.

A second challenge of using technology with older adults relates to the complexity of use. Some individuals may not understand what “syncing” a device means or how to do it. Others will undoubtedly forget their login information. The overload of new information, learning how to use the device, and having to remember specific information to simply log in can cause frustration and confusion. When working with older adults and technology, we focus on being patient and providing one-on-one attention with a detailed tutorial upfront.

Tip: In-person meetings at the start of a project work best for startup. If that isn’t possible, handouts with step-by-step instructions and pictures are a useful supplement. Also encourage participants to write down their login information and keep it in a place where it’s always accessible – the fridge works great!

Physical limitations pose another potential challenge for using technology. PEW Research Center found that 2 out of 5 older adults have physical limitations that make using technology more difficult. One concern is related to difficulty putting on a wearable device due to limited manual dexterity. Those with arthritis, pain, or physically limiting diseases may have trouble pushing down a snap or fastening a band. Visual impairments may be an additional limiting factor, especially with reading small text on an app or wearable device. We have found tailoring the intervention to the physical needs of the population is an important factor when working with older adults. By increasing their physical comfort level with the device, this will aid in boosting self-efficacy for use – knocking out two challenges with one double tap!

Tip: This may mean choosing a wearable device that has different types of fastening options or picking an app that has adjustable font size to accommodate various needs.

When deciding which forms of technology to use within interventions among older adults, it is important to keep these challenges in mind. Accounting for apprehension of technology use, complexity of the app or device, and physical limitations when choosing what technology to use can help participants feel more comfortable, promote technology efficacy, and increase likelihood of behavioral change adherence over the long-term. We are optimistic this will provide participants with the tools to make a lasting change toward a healthier lifestyle one step at a time.

Questions:

• What are some ways you engage older participants using technology to change health behaviors?
• How can we incorporate technology into intervention designs to keep up with the research trends while catering to the efficacy levels and needs of participants using the technology?
• What challenges have you faced when working with technology-based interventions?

Bio:

Sara M. Powell, PhD, is a post-doctoral fellow in the Department of Exercise Science and a member of the Technology Center to Promote Healthy Lifestyles at the University of South Carolina in Columbia, SC. She is interested in the use of technology to change health behaviors, primarily those including physical activity or weight loss.  Email: sroth@mailbox.sc.edu

 

 

Christine A. Pellegrini, PhD, is an assistant professor of exercise science and a member of the Technology Center to Promote Healthy Lifestyles at the University of South Carolina in Columbia, SC. Her work focuses on the development and implementation of technology-supported behavioral interventions target diet, physical activity, and sedentary behavior among various populations, including those with mobility limitations. Email: cpellegrini@sc.edu Twitter: @cpellegrini11