A 12-Month Digital Peer-Supported App Intervention to Promote Physical Activity Among Community-Dwelling Older Adults: Follow-Up Study of a Nonrandomized Controlled Trial
Bibliographic record
Abstract
Background: Mobile apps and peer support are known to effectively promote physical activity in older adults, which, in turn, improves physical function. Previously, we investigated the feasibility and impact of using digital peer-supported apps (DPSAs) to increase physical activity among older adults over a 3-month period. However, the long-term feasibility and impact on sustainable behavior change remain unknown. Objective: This study aims to evaluate the 12-month feasibility of the DPSA and to obtain preliminary estimates of its effects on physical activity and physical function among older Japanese adults. Methods: This nonrandomized controlled trial recruited older adults aged 65 years or older from 2 physical activity programs. Participants chose either the intervention (app program + exercise instruction) group or the control (exercise instruction only) group. Only those participants who had completed the 3-month intervention and wished to continue in the 12-month follow-up intervention study were included. DPSA feasibility was assessed using retention and adherence rates. Physical activity was assessed using accelerometers, capturing daily step count, light-intensity activity, moderate to vigorous intensity activity, and sedentary behavior. Physical function was evaluated using grip strength and the 30-second chair stand test (CS-30). Accelerometer measurements were collected every 3 months over 12 months (5 time points, including baseline), whereas physical function was measured at baseline, 3 months, and 12 months. Results: The follow-up study included 44 of 66 participants from the 3-month intervention study, with 26 participants in the intervention group and 18 participants in the control group. The 12-month retention rate for participants in the DPSA intervention group was 73% (19/26), whereas the retention rate among all 41 participants, including those who chose not to participate in the follow-up study, was 46% (19/41). The adherence rate was 85.9%. The average number of steps per day (95% CI) in the intervention group changed before and after DPSA use (P=.048). We observed an increase of 1736 (β=1736, 95% CI 232-3241) steps per day compared with baseline. No significant change was observed in the control group. There were significant within-group differences in CS-30 scores for both intervention (P<.001) and control (P=.03) groups over the 12-month period. Specifically, there was a significant change in CS-30 scores (95% CI) between the baseline and 12-month assessments for the intervention (β=6.5, 95% CI 3.8-9.1; P<.001) and control (β=3.8, 95% CI 0.6-7.1; P=.02) groups. Conclusions: Participants with long-term DPSA use observed increases in average daily steps and CS-30 scores before and after DPSA use, although only a limited number of older adults had long-term access to the DPSA. Identifying ways to expand long-term DPSA use among older adults is necessary. Additionally, randomized controlled trials should be conducted to determine the long-term effects of DPSAs on physical activity and function in older adults.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".