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Daniels K, Quadflieg K, Robijns J, De Vry J, Van Alphen H, Van Beers R, Sourbron B, Vanbuel A, Meekers S, Mattheeussen M, Spooren A, Hansen D, Bonnechère B. From Steps to Context: Optimizing Digital Phenotyping for Physical Activity Monitoring in Older Adults by Integrating Wearable Data and Ecological Momentary Assessment. SENSORS (BASEL, SWITZERLAND) 2025; 25:858. [PMID: 39943497 PMCID: PMC11820068 DOI: 10.3390/s25030858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2024] [Revised: 01/24/2025] [Accepted: 01/28/2025] [Indexed: 02/16/2025]
Abstract
Physical activity (PA) is essential for healthy aging, but its accurate assessment in older adults remains challenging due to the limitations and biases of traditional clinical assessment. Mobile technologies and wearable sensors offer a more ecological, less biased alternative for evaluating PA in this population. This study aimed to optimize digital phenotyping strategies for assessing PA patterns in older adults, by integrating ecological momentary assessment (EMA) and continuous wearable sensor data collection. Over two weeks, 108 community-dwelling older adults provided real-time EMA responses while their PA was continuously monitored using Garmin Vivo 5 sensors. The combined approach proved feasible, with 67.2% adherence to EMA prompts, consistent across time points (morning: 68.1%; evening: 65.4%). PA predominantly occurred at low (51.4%) and moderate (46.2%) intensities, with midday activity peaks. Motivation and self-efficacy were significantly associated with low-intensity PA (R = 0.20 and 0.14 respectively), particularly in the morning. However, discrepancies between objective step counts and self-reported PA measures, which showed no correlation (R = -0.026, p = 0.65), highlight the complementary value of subjective and objective data sources. These findings support integrating EMA, wearable sensors, and temporal frameworks to enhance PA assessment, offering precise insights for personalized, time-sensitive interventions to promote PA.
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Affiliation(s)
- Kim Daniels
- Centre of Expertise in Care Innovation, Department of PXL—Healthcare, PXL University of Applied Sciences and Arts, 3500 Hasselt, Belgium; (K.Q.); (J.R.); (H.V.A.); (A.S.); (B.B.)
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium; (R.V.B.); (B.S.); (A.V.); (S.M.); (M.M.); (D.H.)
| | - Kirsten Quadflieg
- Centre of Expertise in Care Innovation, Department of PXL—Healthcare, PXL University of Applied Sciences and Arts, 3500 Hasselt, Belgium; (K.Q.); (J.R.); (H.V.A.); (A.S.); (B.B.)
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium; (R.V.B.); (B.S.); (A.V.); (S.M.); (M.M.); (D.H.)
| | - Jolien Robijns
- Centre of Expertise in Care Innovation, Department of PXL—Healthcare, PXL University of Applied Sciences and Arts, 3500 Hasselt, Belgium; (K.Q.); (J.R.); (H.V.A.); (A.S.); (B.B.)
| | - Jochen De Vry
- PXL Research, Centre of Expertise in Smart-ICT, PXL University of Applied Sciences and Arts, 3500 Hasselt, Belgium;
| | - Hans Van Alphen
- Centre of Expertise in Care Innovation, Department of PXL—Healthcare, PXL University of Applied Sciences and Arts, 3500 Hasselt, Belgium; (K.Q.); (J.R.); (H.V.A.); (A.S.); (B.B.)
| | - Robbe Van Beers
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium; (R.V.B.); (B.S.); (A.V.); (S.M.); (M.M.); (D.H.)
| | - Britt Sourbron
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium; (R.V.B.); (B.S.); (A.V.); (S.M.); (M.M.); (D.H.)
| | - Anaïs Vanbuel
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium; (R.V.B.); (B.S.); (A.V.); (S.M.); (M.M.); (D.H.)
| | - Siebe Meekers
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium; (R.V.B.); (B.S.); (A.V.); (S.M.); (M.M.); (D.H.)
| | - Marlies Mattheeussen
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium; (R.V.B.); (B.S.); (A.V.); (S.M.); (M.M.); (D.H.)
| | - Annemie Spooren
- Centre of Expertise in Care Innovation, Department of PXL—Healthcare, PXL University of Applied Sciences and Arts, 3500 Hasselt, Belgium; (K.Q.); (J.R.); (H.V.A.); (A.S.); (B.B.)
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium; (R.V.B.); (B.S.); (A.V.); (S.M.); (M.M.); (D.H.)
| | - Dominique Hansen
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium; (R.V.B.); (B.S.); (A.V.); (S.M.); (M.M.); (D.H.)
- BIOMED Biomedical Research Instititute, Faculty of Medicine and Life Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| | - Bruno Bonnechère
- Centre of Expertise in Care Innovation, Department of PXL—Healthcare, PXL University of Applied Sciences and Arts, 3500 Hasselt, Belgium; (K.Q.); (J.R.); (H.V.A.); (A.S.); (B.B.)
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium; (R.V.B.); (B.S.); (A.V.); (S.M.); (M.M.); (D.H.)
- Technology-Supported and Data-Driven Rehabilitation, Data Sciences Institute, Hasselt University, 3590 Diepenbeek, Belgium
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Kwok I, Lattie EG, Yang D, Summers A, Cotten P, Leong CA, Moskowitz JT. Developing Social Enhancements for a Web-Based, Positive Emotion Intervention for Alzheimer Disease Caregivers: Qualitative Focus Group and Interview Study. JMIR Form Res 2024; 8:e50234. [PMID: 38662432 PMCID: PMC11082732 DOI: 10.2196/50234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 02/26/2024] [Accepted: 03/06/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Alzheimer disease is a degenerative neurological condition that requires long-term care. The cost of these responsibilities is often borne by informal caregivers, who experience an elevated risk of negative physical and psychological outcomes. Previously, we designed a positive emotion regulation intervention that was shown to improve well-being among dementia caregivers when delivered through one-on-one videoconferencing lessons with a trained facilitator. However, the format required significant resources in terms of logistics and facilitator time. To broaden the reach of the intervention, we aimed to develop the Social Augmentation of Self-Guided Electronic Delivery of the Life Enhancing Activities for Family Caregivers (SAGE LEAF) program, an iteration of the intervention in a self-guided, web-based format with enhanced opportunities for social connection. OBJECTIVE The aim of this study was to gather feedback to inform the design of social features for the SAGE LEAF intervention. In the absence of a facilitator, our goal with the self-guided SAGE LEAF intervention was to integrate various social features (eg, discussion board, automated support, and profiles) to maximize engagement among participants. METHODS Qualitative data were collected from 26 individuals through (1) interviews with participants who completed a previous version of the intervention via videoconferencing with a facilitator, (2) focus groups with dementia caregivers who had not previously experienced the intervention, and (3) focus groups with Alzheimer disease clinical care providers. We conducted a qualitative thematic analysis to identify which social features would be the most helpful and how they could be implemented in a way that would be best received by caregivers. RESULTS Interview and focus group feedback indicated that participants generally liked the potential features suggested, including the discussion boards, multimedia content, and informational support. They had valuable suggestions for optimal implementation. For example, participants liked the idea of a buddy system where they would be matched up with another caregiver for the duration of the study. However, they expressed concern about differing expectations among caregivers and the possibility of matched caregivers not getting along. Participants also expressed interest in giving caregivers access to a podcast on the skills, which would allow them to review additional content when they wished. CONCLUSIONS Taken together, the discussions with caregivers and providers offered unique insights into the types of social features that may be integrated into the SAGE LEAF intervention, as well as implementation suggestions to improve the acceptability of the features among caregivers. These insights will allow us to design social features for the intervention that are optimally engaging and helpful for caregivers.
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Affiliation(s)
- Ian Kwok
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | | | | | - Amanda Summers
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Paul Cotten
- University of California San Francisco, San Francisco, CA, United States
| | - Caroline Alina Leong
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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Goodwin MV, Hogervorst E, Maidment DW. A qualitative study assessing the barriers and facilitators to physical activity in adults with hearing loss. Br J Health Psychol 2024; 29:95-111. [PMID: 37658583 DOI: 10.1111/bjhp.12689] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 08/22/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVES Growing epidemiological evidence has shown hearing loss is associated with physical inactivity. Currently, there is a dearth in evidence investigating why this occurs. This study aimed to investigate the barriers and facilitators to physical activity in middle-aged and older adults with hearing loss. DESIGN Individual semi-structured qualitative interviews. METHODS A phenomenological approach was taken. Ten adults (≥40 years) were interviewed via videoconferencing. The interview schedule was underpinned by the capability, opportunity, motivation and behaviour (COM-B) model. Reflexive thematic analysis was used to generate themes, which were subsequently mapped onto the COM-B model and behaviour change wheel. RESULTS Nine hearing loss specific themes were generated, which included the following barriers to physical activity: mental fatigue, interaction with the environment (acoustically challenging environments, difficulties with hearing aids when physically active) and social interactions (perceived stigma). Environmental modifications (digital capabilities of hearing aids), social support (hearing loss-only groups) and hearing loss self-efficacy were reported to facilitate physical activity. CONCLUSIONS Middle-aged and older adults with hearing loss experience hearing-specific barriers to physical activity, which has a deleterious impact on their overall health and well-being. Interventions and public health programmes need to be tailored to account for these additional barriers. Further research is necessary to test potential behaviour change techniques.
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Affiliation(s)
- Maria V Goodwin
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Eef Hogervorst
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - David W Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Takeda H, Takatori K. The effect of a buddy-style intervention on physical activity in community-dwelling older adults with disabilities: A 24-week follow-up of a randomized controlled trial. Clin Rehabil 2022; 36:1590-1600. [PMID: 35775120 DOI: 10.1177/02692155221111924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess the sustained effects of a buddy-style intervention aiming to improve physical activity. DESIGN A parallel-group, open-label, randomized controlled trial. SETTING Three adult day-care centers. PARTICIPANTS Sixty-five community-dwelling older adults with disabilities. INTERVENTION All participants received a 12-week home-based exercise program. An intervention group (n = 33) received a 5-10 min buddy-style intervention once a week at an adult day-care center for older adults. MAIN MEASURES The primary outcome was the average daily time spent performing "walking outside home" and "muscle strength exercises" at 24 weeks follow-up post-intervention. RESULTS Of the 65 participants, one participant in each group dropped out before the program began, 4 and 5 in the intervention and control groups by the 12-week assessment, and 4 and 3 by the 24-week assessment, respectively. Analysis of covariance of the 47 participants who were able to be assessed after 24 weeks revealed that outdoor walking time (min/day) was significantly longer in the intervention group (n = 24) than in the control group (n = 23) at 24 weeks (intervention group, 73.5 [66.1]; control group, 42.7 [45.5]; P = 0.030, f = 0.38). There was no significant difference in the duration of muscle strength exercises (min/day) between the two groups at 24 weeks (intervention group, 8.2 [9.7]; control group, 6.5 [9.3]; P = 0.593, f = 0.08). CONCLUSIONS The buddy-style intervention increased the duration of outdoor walking, with a sustained effect up to 12 weeks after the end of the intervention.
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Affiliation(s)
- Hiromichi Takeda
- Rehastage Co., Ltd, Osaka-city, Osaka, Japan.,Graduate School of Health Science, Kio University, Koryo, Japan
| | - Katsuhiko Takatori
- Graduate School of Health Science, Kio University, Koryo, Japan.,Health Promotion Center, Kio University, Koryo, Japan
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