Skip to main content
Log in

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

  • Original Article
  • Published:
Annals of Behavioral Medicine

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. 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.

    Article  PubMed  Google Scholar 

  2. 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.

    Google Scholar 

  3. World Health Organization. Health and Development Trough Physical Activity and Sport. Geneva: World Health Organization; 2003.

    Google Scholar 

  4. 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.

    Article  PubMed  Google Scholar 

  5. Kreuter MW, Farrell D, Olevitch L, Brennan L. Tailoring Health Messages: Customizing Communication with Computer Technology. Mahwah: Erlbaum; 2000.

    Google Scholar 

  6. 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.

    Article  Google Scholar 

  7. 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.

    Article  PubMed  Google Scholar 

  8. 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.

    Article  PubMed  Google Scholar 

  9. 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.

    Article  PubMed  Google Scholar 

  10. 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.

    Article  PubMed  Google Scholar 

  11. 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  Google Scholar 

  12. 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.

    Article  PubMed  Google Scholar 

  13. 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.

    Article  Google Scholar 

  14. 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.

    Article  Google Scholar 

  15. Gebel K, Bauman A, Owen N. Correlates of non-concordance between perceived and objective measures of walkability. Annals Behav Med. 2009;37:228–238.

    Article  Google Scholar 

  16. 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.

    Article  Google Scholar 

  17. 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.

    Article  PubMed  Google Scholar 

  18. 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.

    Article  Google Scholar 

  19. 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.

    Article  PubMed  Google Scholar 

  20. 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.

    Article  PubMed  Google Scholar 

  21. 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.

    Article  PubMed  Google Scholar 

  22. King AC. Interventions to promote physical activity by older adults. J Gerontol: Series A. 2001;56A:36–46.

    Google Scholar 

  23. Bartholomew L, Parcel G, Kok G, Gottlieb N. Planning Health Promotion Programs. San Francisco: Jossey-Bass; 2006.

    Google Scholar 

  24. 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  Google Scholar 

  25. 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.

    Article  Google Scholar 

  26. 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.

    Article  CAS  PubMed  Google Scholar 

  27. Schwarzer R. Modeling Health Behavior Change: The Health Action Process Approach (HAPA). http://www.hapa-model.de. Accessed April 1, 2009

  28. Weinstein ND. The precaution adoption process. Health Psychol. 1988;7:355–386.

    Article  CAS  PubMed  Google Scholar 

  29. Baumeister R, Vohs K. Handbook of Self-Regulation; Research, Theory, and Applications. New York: The Guilford; 2004.

    Google Scholar 

  30. Hagger M, Chatzisarantis N. Intrinsic Motivation and Self-Determination in Exercise and Sport. Pudsey: Human Kinetics Europe; 2007.

    Google Scholar 

  31. 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.

    Article  PubMed  Google Scholar 

  32. Castro CM, King AC, Brassington GS. Telephone versus mail interventions for maintenance of physical activity in older adults. Health Psychol. 2001;20:438–444.

    Article  CAS  PubMed  Google Scholar 

  33. Marcus BH, Ciccolo JT, Sciamanna CN. Using electronic/computer interventions to promote physical activity. Br J Sports Med. 2009;43:102–105.

    Article  CAS  PubMed  Google Scholar 

  34. 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.

    Article  Google Scholar 

  35. 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.

    Article  PubMed  Google Scholar 

  36. 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  Google Scholar 

  37. 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.

    CAS  PubMed  Google Scholar 

  38. Resnick B, Jenkins LS. Testing the reliability and validity of the self-efficacy for exercise scale. Nurs Res. 2000;49:154–159.

    Article  CAS  PubMed  Google Scholar 

  39. 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.

    Google Scholar 

  40. Twisk J, de Vente W. Attrition in longitudinal studies. How to deal with missing data. J Clin Epidemiol. 2002;55:329–337.

    Article  PubMed  Google Scholar 

  41. 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.

    Article  PubMed  Google Scholar 

  42. Twisk J. Applied Multilevel Analysis. Cambridge: Cambridge University Press; 2006.

    Book  Google Scholar 

  43. 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.

    Article  PubMed  Google Scholar 

  44. 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  Google Scholar 

  45. 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.

    Article  PubMed  Google Scholar 

  46. 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.

    Article  PubMed  Google Scholar 

  47. 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.

    Article  Google Scholar 

  48. 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.

    Article  CAS  PubMed  Google Scholar 

  49. 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.

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

This study was funded by The Netherlands Organization for Health Research and Development (ZonMw, 6100.0003).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Maartje M. van Stralen M.Sc..

About this article

Cite this article

van Stralen, M.M., de Vries, H., Bolman, C. et al. Exploring the Efficacy and Moderators of Two Computer-Tailored Physical Activity Interventions for Older Adults: A Randomized Controlled Trial. ann. behav. med. 39, 139–150 (2010). https://doi.org/10.1007/s12160-010-9166-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12160-010-9166-8

Keywords

Navigation