Skip to main content
Top
Published in: Annals of Behavioral Medicine 2/2010

01-05-2010 | Original Article

Exploring the Efficacy and Moderators of Two Computer-Tailored Physical Activity Interventions for Older Adults: A Randomized Controlled Trial

Authors: Maartje M. van Stralen, M.Sc., Hein de Vries, Ph.D., Catherine Bolman, Ph.D., Aart N. Mudde, Ph.D., Lilian Lechner, Ph.D.

Published in: Annals of Behavioral Medicine | Issue 2/2010

Login to get access

Abstract

Background

Important health benefits can be derived when low-cost (e.g., computer-tailored) physical activity interventions for older adults demonstrate sustained effects.

Purpose

The purpose of the study was to conduct in-depth analysis on the long-term efficacy of two tailored physical activity interventions for older adults.

Methods

A randomized controlled trial (n = 1,971) with two computer-tailored interventions and a no-intervention control group was conducted. The two tailored interventions consisted of three tailored letters, delivered during 4 months. The basic tailored intervention targeted psychosocial determinants alone, while the environmentally tailored intervention additionally targeted environmental determinants, by providing tailored environmental information. Self-reported behaviors (i.e., total physical activity, transport walking and cycling, leisure walking and cycling, and sports) were measured at baseline and 12 months. Additionally, potential personal, health-related, and psychosocial moderators of the intervention effects were examined.

Results

The environmentally tailored intervention was effective in changing total physical activity, leisure cycling, and sports compared with the basic intervention and control group. No intervention effects were found for the basic intervention. Moderation analysis revealed that participants with a higher age, lower body mass index, and higher intention were unresponsive to the interventions.

Conclusions

Providing environmental information is an effective intervention strategy for increasing physical activity behaviors among older adults, especially among certain “at-risk” subgroups such as lower educated, overweight, or insufficiently active participants. Moderation analysis was perceived as a promising method for identifying meaningful subgroups that are unaffected by an intervention, which should receive special attention in future interventions.
Literature
1.
go back to reference Nelson ME, Rejeski WJ, Blair SN, et al. Physical activity and public health in older adults: Recommendation from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39:1435–1445.CrossRefPubMed Nelson ME, Rejeski WJ, Blair SN, et al. Physical activity and public health in older adults: Recommendation from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39:1435–1445.CrossRefPubMed
2.
go back to reference Department of Health. At Least Five a Week: Evidence on the Impact of Physical Activity and its Relationship to Health. London: Department of Health; 2004. Department of Health. At Least Five a Week: Evidence on the Impact of Physical Activity and its Relationship to Health. London: Department of Health; 2004.
3.
go back to reference World Health Organization. Health and Development Trough Physical Activity and Sport. Geneva: World Health Organization; 2003. World Health Organization. Health and Development Trough Physical Activity and Sport. Geneva: World Health Organization; 2003.
4.
go back to reference De Vries H, Brug J. Computer-tailored interventions motivating people to adopt health promoting behaviours: Introduction to a new approach. Patient Educ Couns. 1999;36:99–105.CrossRefPubMed De Vries H, Brug J. Computer-tailored interventions motivating people to adopt health promoting behaviours: Introduction to a new approach. Patient Educ Couns. 1999;36:99–105.CrossRefPubMed
5.
go back to reference Kreuter MW, Farrell D, Olevitch L, Brennan L. Tailoring Health Messages: Customizing Communication with Computer Technology. Mahwah: Erlbaum; 2000. Kreuter MW, Farrell D, Olevitch L, Brennan L. Tailoring Health Messages: Customizing Communication with Computer Technology. Mahwah: Erlbaum; 2000.
6.
go back to reference Kroeze W, Werkman A, Brug J. A systematic review of randomized trials on the effectiveness of computer-tailored education on physical activity and dietary behaviors. Annals Behav Med. 2006;31:205–223.CrossRef Kroeze W, Werkman A, Brug J. A systematic review of randomized trials on the effectiveness of computer-tailored education on physical activity and dietary behaviors. Annals Behav Med. 2006;31:205–223.CrossRef
7.
go back to reference Noar S, Benac C, Harris M. Does tailoring matter? Meta-analytic review of tailored print health behavior change interventions. Psychol Bull. 2007;133:673–693.CrossRefPubMed Noar S, Benac C, Harris M. Does tailoring matter? Meta-analytic review of tailored print health behavior change interventions. Psychol Bull. 2007;133:673–693.CrossRefPubMed
8.
go back to reference Jancey JM, Lee AH, Howat PA, Clarke A, Wang K, Shilton T. The effectiveness of a physical activity intervention for seniors. Am J Health Promot. 2008;22:318–321.PubMedCrossRef Jancey JM, Lee AH, Howat PA, Clarke A, Wang K, Shilton T. The effectiveness of a physical activity intervention for seniors. Am J Health Promot. 2008;22:318–321.PubMedCrossRef
9.
go back to reference King AC, Friedman R, Marcus B, et al. Ongoing physical activity advice by humans versus computers: The Community Health Advice by Telephone (CHAT) trial. Health Psychol. 2007;26:718–727.CrossRefPubMed King AC, Friedman R, Marcus B, et al. Ongoing physical activity advice by humans versus computers: The Community Health Advice by Telephone (CHAT) trial. Health Psychol. 2007;26:718–727.CrossRefPubMed
10.
go back to reference Walker SN, Pullen CH, Boeckner L, et al. Clinical trial of tailored activity and eating newsletters with older rural women. Nurs Res. 2009;58:74–85.CrossRefPubMed Walker SN, Pullen CH, Boeckner L, et al. Clinical trial of tailored activity and eating newsletters with older rural women. Nurs Res. 2009;58:74–85.CrossRefPubMed
11.
go back to reference Cunningham G, Michael Y. Concepts guiding the study on the impact of the built environment on physical activity for older adults: A review of the literature. Am J Health Promot. 2004;18:435–443.PubMed Cunningham G, Michael Y. Concepts guiding the study on the impact of the built environment on physical activity for older adults: A review of the literature. Am J Health Promot. 2004;18:435–443.PubMed
12.
go back to reference Humpel N, Owen N, Leslie E. Environmental factors associated with adults’ participation in physical activity: A review. Am J Prev Med. 2002;22:188–199.CrossRefPubMed Humpel N, Owen N, Leslie E. Environmental factors associated with adults’ participation in physical activity: A review. Am J Prev Med. 2002;22:188–199.CrossRefPubMed
13.
go back to reference Kremers SP, de Bruijn GJ, Visscher TL, van Mechelen W, de Vries NK, Brug J. Environmental influences on energy balance-related behaviors: A dual-process view. Int J Behav Nutrition Physical Activity. 2006;3:1–9.CrossRef Kremers SP, de Bruijn GJ, Visscher TL, van Mechelen W, de Vries NK, Brug J. Environmental influences on energy balance-related behaviors: A dual-process view. Int J Behav Nutrition Physical Activity. 2006;3:1–9.CrossRef
14.
go back to reference van Stralen MM, Lechner L, Mudde AN, Bolman C, De Vries H. Determinants of initiation and maintenance of physical activity among older adults: A literature review. Health Psychol Review. 2009;3:147–207.CrossRef van Stralen MM, Lechner L, Mudde AN, Bolman C, De Vries H. Determinants of initiation and maintenance of physical activity among older adults: A literature review. Health Psychol Review. 2009;3:147–207.CrossRef
15.
go back to reference Gebel K, Bauman A, Owen N. Correlates of non-concordance between perceived and objective measures of walkability. Annals Behav Med. 2009;37:228–238.CrossRef Gebel K, Bauman A, Owen N. Correlates of non-concordance between perceived and objective measures of walkability. Annals Behav Med. 2009;37:228–238.CrossRef
16.
go back to reference Humpel N, Marshall A, Leslie E, Bauman A, Owen N. Changes in neighborhood walking are related to changes in perceptions of environmental attributes. Annals Behav Med. 2004;27:60–67.CrossRef Humpel N, Marshall A, Leslie E, Bauman A, Owen N. Changes in neighborhood walking are related to changes in perceptions of environmental attributes. Annals Behav Med. 2004;27:60–67.CrossRef
17.
go back to reference Ball K, Jeffery RW, Crawford DA, Roberts RJ, Salmon J, Timperio AF. Mismatch between perceived and objective measures of physical activity environments. Prev Med. 2008;47:294–298.CrossRefPubMed Ball K, Jeffery RW, Crawford DA, Roberts RJ, Salmon J, Timperio AF. Mismatch between perceived and objective measures of physical activity environments. Prev Med. 2008;47:294–298.CrossRefPubMed
18.
go back to reference van Stralen MM, Kok G, De Vries H, Mudde AN, Bolman C, Lechner L. The Active plus protocol: Systematic development of two theory- and evidence-based tailored physical activity interventions for the over-fifties. BMC Public Health. 2008;8:395.CrossRef van Stralen MM, Kok G, De Vries H, Mudde AN, Bolman C, Lechner L. The Active plus protocol: Systematic development of two theory- and evidence-based tailored physical activity interventions for the over-fifties. BMC Public Health. 2008;8:395.CrossRef
19.
go back to reference van Stralen MM, De Vries H, Mudde AN, Bolman C, Lechner L. Efficacy of two tailored physical activity interventions for older adults. Am J Prev Med. 2009;37:405–417.CrossRefPubMed van Stralen MM, De Vries H, Mudde AN, Bolman C, Lechner L. Efficacy of two tailored physical activity interventions for older adults. Am J Prev Med. 2009;37:405–417.CrossRefPubMed
20.
go back to reference Bauman AE, Sallis JF, Dzewaltowski DA, Owen N. Toward a better understanding of the influences on physical activity: The role of determinants, correlates, causal variables, mediators, moderators, and confounders. Am J Prev Med. 2002;23:5–14.CrossRefPubMed Bauman AE, Sallis JF, Dzewaltowski DA, Owen N. Toward a better understanding of the influences on physical activity: The role of determinants, correlates, causal variables, mediators, moderators, and confounders. Am J Prev Med. 2002;23:5–14.CrossRefPubMed
21.
go back to reference Kremers SP, de Bruijn GJ, Droomers M, van Lenthe F, Brug J. Moderators of environmental intervention effects on diet and activity in youth. Am J Prev Med. 2007;32:163–172.CrossRefPubMed Kremers SP, de Bruijn GJ, Droomers M, van Lenthe F, Brug J. Moderators of environmental intervention effects on diet and activity in youth. Am J Prev Med. 2007;32:163–172.CrossRefPubMed
22.
go back to reference King AC. Interventions to promote physical activity by older adults. J Gerontol: Series A. 2001;56A:36–46. King AC. Interventions to promote physical activity by older adults. J Gerontol: Series A. 2001;56A:36–46.
23.
go back to reference Bartholomew L, Parcel G, Kok G, Gottlieb N. Planning Health Promotion Programs. San Francisco: Jossey-Bass; 2006. Bartholomew L, Parcel G, Kok G, Gottlieb N. Planning Health Promotion Programs. San Francisco: Jossey-Bass; 2006.
24.
go back to reference van Stralen MM, Lechner L, Mudde AN, De Vries H, Bolman C. Determinants of awareness, initiation and maintenance of physical activity among the over-fifties: A Delphi study. Health Educ Res. 2008. doi:10.1093/her/cyn045.PubMed van Stralen MM, Lechner L, Mudde AN, De Vries H, Bolman C. Determinants of awareness, initiation and maintenance of physical activity among the over-fifties: A Delphi study. Health Educ Res. 2008. doi:10.​1093/​her/​cyn045.PubMed
25.
go back to reference De Vries H, Mesters I, Van’t Riet J, Willems K, Reubsaet A. Motives of Belgian adolescents for using sunscreen: The role of action plans. Cancer Epidemiol Biomark Prev. 2006;15:1360–1366.CrossRef De Vries H, Mesters I, Van’t Riet J, Willems K, Reubsaet A. Motives of Belgian adolescents for using sunscreen: The role of action plans. Cancer Epidemiol Biomark Prev. 2006;15:1360–1366.CrossRef
26.
go back to reference Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: Toward an integrative model of change. J Consult Clin Psychol. 1983;51:390–395.CrossRefPubMed Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: Toward an integrative model of change. J Consult Clin Psychol. 1983;51:390–395.CrossRefPubMed
29.
go back to reference Baumeister R, Vohs K. Handbook of Self-Regulation; Research, Theory, and Applications. New York: The Guilford; 2004. Baumeister R, Vohs K. Handbook of Self-Regulation; Research, Theory, and Applications. New York: The Guilford; 2004.
30.
go back to reference Hagger M, Chatzisarantis N. Intrinsic Motivation and Self-Determination in Exercise and Sport. Pudsey: Human Kinetics Europe; 2007. Hagger M, Chatzisarantis N. Intrinsic Motivation and Self-Determination in Exercise and Sport. Pudsey: Human Kinetics Europe; 2007.
31.
go back to reference Marcus BH, Napolitano MA, King AC, et al. Telephone versus print delivery of an individualized motivationally tailored physical activity intervention: Project STRIDE. Health Psychol. 2007;26:401–409.CrossRefPubMed Marcus BH, Napolitano MA, King AC, et al. Telephone versus print delivery of an individualized motivationally tailored physical activity intervention: Project STRIDE. Health Psychol. 2007;26:401–409.CrossRefPubMed
32.
go back to reference Castro CM, King AC, Brassington GS. Telephone versus mail interventions for maintenance of physical activity in older adults. Health Psychol. 2001;20:438–444.CrossRefPubMed Castro CM, King AC, Brassington GS. Telephone versus mail interventions for maintenance of physical activity in older adults. Health Psychol. 2001;20:438–444.CrossRefPubMed
33.
go back to reference Marcus BH, Ciccolo JT, Sciamanna CN. Using electronic/computer interventions to promote physical activity. Br J Sports Med. 2009;43:102–105.CrossRefPubMed Marcus BH, Ciccolo JT, Sciamanna CN. Using electronic/computer interventions to promote physical activity. Br J Sports Med. 2009;43:102–105.CrossRefPubMed
34.
go back to reference Wagenmakers R, van den Akker-Scheek I, Groothoff JW, et al. Reliability and validity of the short questionnaire to assess health-enhancing physical activity (SQUASH) in patients after total hip arthroplasty. BMC Musculoskelet Disorders. 2008;9:141.CrossRef Wagenmakers R, van den Akker-Scheek I, Groothoff JW, et al. Reliability and validity of the short questionnaire to assess health-enhancing physical activity (SQUASH) in patients after total hip arthroplasty. BMC Musculoskelet Disorders. 2008;9:141.CrossRef
35.
go back to reference Wendel-Vos GC, Schuit AJ, Saris WH, Kromhout D. Reproducibility and relative validity of the short questionnaire to assess health-enhancing physical activity. J Clin Epidemiol. 2003;56:1163-1169.CrossRefPubMed Wendel-Vos GC, Schuit AJ, Saris WH, Kromhout D. Reproducibility and relative validity of the short questionnaire to assess health-enhancing physical activity. J Clin Epidemiol. 2003;56:1163-1169.CrossRefPubMed
36.
go back to reference Wilcox S, Dowda M, Dunn A, Ory MG, Rheaume C, King AC. Predictors of increased physical activity in the active for life program. Preventing Chronic Disease. 2009;6:A25.PubMed Wilcox S, Dowda M, Dunn A, Ory MG, Rheaume C, King AC. Predictors of increased physical activity in the active for life program. Preventing Chronic Disease. 2009;6:A25.PubMed
37.
go back to reference Lechner L, De VH. Participation in an employee fitness program: Determinants of high adherence, low adherence, and dropout. J Occup Environ Med. 1995;37:429–436.PubMed Lechner L, De VH. Participation in an employee fitness program: Determinants of high adherence, low adherence, and dropout. J Occup Environ Med. 1995;37:429–436.PubMed
38.
go back to reference Resnick B, Jenkins LS. Testing the reliability and validity of the self-efficacy for exercise scale. Nurs Res. 2000;49:154–159.CrossRefPubMed Resnick B, Jenkins LS. Testing the reliability and validity of the self-efficacy for exercise scale. Nurs Res. 2000;49:154–159.CrossRefPubMed
39.
go back to reference Sheeran P, Orbell S. Implementation intentions and repeated behaviour: Augmenting the predictive validity of the theory of planned behavior. Eur J Soc Psychol. 1999;37:231–250. Sheeran P, Orbell S. Implementation intentions and repeated behaviour: Augmenting the predictive validity of the theory of planned behavior. Eur J Soc Psychol. 1999;37:231–250.
40.
go back to reference Twisk J, de Vente W. Attrition in longitudinal studies. How to deal with missing data. J Clin Epidemiol. 2002;55:329–337.CrossRefPubMed Twisk J, de Vente W. Attrition in longitudinal studies. How to deal with missing data. J Clin Epidemiol. 2002;55:329–337.CrossRefPubMed
41.
go back to reference Fayers PM, King MT. How to guarantee finding a statistically significant difference: The use and abuse of subgroup analyses. Qual Life Res. 2009;18:527–530.CrossRefPubMed Fayers PM, King MT. How to guarantee finding a statistically significant difference: The use and abuse of subgroup analyses. Qual Life Res. 2009;18:527–530.CrossRefPubMed
42.
go back to reference Twisk J. Applied Multilevel Analysis. Cambridge: Cambridge University Press; 2006.CrossRef Twisk J. Applied Multilevel Analysis. Cambridge: Cambridge University Press; 2006.CrossRef
43.
go back to reference Trost SG, Owen N, Bauman AE, Sallis JF, Brown W. Correlates of adults’ participation in physical activity: Review and update. Med Sci Sports Exerc. 2002;34:1996–2001.CrossRefPubMed Trost SG, Owen N, Bauman AE, Sallis JF, Brown W. Correlates of adults’ participation in physical activity: Review and update. Med Sci Sports Exerc. 2002;34:1996–2001.CrossRefPubMed
44.
go back to reference Greaney ML, Riebe D, Ewing GC, et al. Long-term effects of a stage-based intervention for changing exercise intentions and behavior in older adults. Gerontologist. 2008;48:358–367.PubMed Greaney ML, Riebe D, Ewing GC, et al. Long-term effects of a stage-based intervention for changing exercise intentions and behavior in older adults. Gerontologist. 2008;48:358–367.PubMed
45.
go back to reference Kolt GS, Schofield GM, Kerse N, Garrett N, Oliver M. Effect of telephone counselling on physical activity for low-active older people in primary care: A randomized, controlled trial. J Am Geriatr Soc. 2007;55:986–992.CrossRefPubMed Kolt GS, Schofield GM, Kerse N, Garrett N, Oliver M. Effect of telephone counselling on physical activity for low-active older people in primary care: A randomized, controlled trial. J Am Geriatr Soc. 2007;55:986–992.CrossRefPubMed
46.
go back to reference Pinto BM, Goldstein MG, Ashba J, Sciamanna CN, Jette A. Randomized controlled trial of physical activity counseling for older primary care patients. Am J Prev Med. 2005;29:247–255.CrossRefPubMed Pinto BM, Goldstein MG, Ashba J, Sciamanna CN, Jette A. Randomized controlled trial of physical activity counseling for older primary care patients. Am J Prev Med. 2005;29:247–255.CrossRefPubMed
47.
go back to reference van Stralen MM, De Vries H, Mudde AN, Bolman C, Lechner L. The working mechanisms of an environmentally tailored physical activity intervention for older adults: A randomized controlled trial. Int J Behav Nutrition Physical Activity [serial online]. 2009;6:83.CrossRef van Stralen MM, De Vries H, Mudde AN, Bolman C, Lechner L. The working mechanisms of an environmentally tailored physical activity intervention for older adults: A randomized controlled trial. Int J Behav Nutrition Physical Activity [serial online]. 2009;6:83.CrossRef
48.
go back to reference King AC, Kiernan M, Oman RF, Kraemer HC, Hull M, Ahn D. Can we identify who will adhere to long-term physical activity? Signal detection methodology as a potential aid to clinical decision making. Health Psychol. 1997;16:380–389.CrossRefPubMed King AC, Kiernan M, Oman RF, Kraemer HC, Hull M, Ahn D. Can we identify who will adhere to long-term physical activity? Signal detection methodology as a potential aid to clinical decision making. Health Psychol. 1997;16:380–389.CrossRefPubMed
49.
go back to reference Lorentzen C, Ommundsen Y, Jenum AK, Holme I. The “Romsas in Motion” community intervention: Mediating effects of psychosocial factors on forward transition in the stages of change in physical activity. Health Educ Behav. 2009;36:348–365.CrossRefPubMed Lorentzen C, Ommundsen Y, Jenum AK, Holme I. The “Romsas in Motion” community intervention: Mediating effects of psychosocial factors on forward transition in the stages of change in physical activity. Health Educ Behav. 2009;36:348–365.CrossRefPubMed
Metadata
Title
Exploring the Efficacy and Moderators of Two Computer-Tailored Physical Activity Interventions for Older Adults: A Randomized Controlled Trial
Authors
Maartje M. van Stralen, M.Sc.
Hein de Vries, Ph.D.
Catherine Bolman, Ph.D.
Aart N. Mudde, Ph.D.
Lilian Lechner, Ph.D.
Publication date
01-05-2010
Publisher
Springer-Verlag
Published in
Annals of Behavioral Medicine / Issue 2/2010
Print ISSN: 0883-6612
Electronic ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-010-9166-8

Other articles of this Issue 2/2010

Annals of Behavioral Medicine 2/2010 Go to the issue