An exploratory study on the impact of daily activities on the pleasure and physical activity of older adults

Examining the link between exercise motivation and preferred exercise setting in college students

Introduction: This study examined differences in self-determined motivation between those who prefer to exercise outdoors vs indoors. These differences could foster targeted applications of Self-Determination Theory to develop intrinsic exercise motivation. Participants: n = 506 students attending a mid-size four-year university in the southeastern United States participated. Methods: This was a cross-sectional study using a modified version of the Exercise Motivations Inventory (EMI-2). Results: Using exploratory and confirmatory factor analysis, three exercise motivations were identified: intrinsic, extrinsic, and social. Using structural equation modeling, we found higher extrinsic motivation was associated with indoor exercise preference, whereas higher social motivation was associated with outdoor exercise preference. Discussion: This study revealed exercise setting as a possible contributing factor for self-determined motivation. Those who prefer to exercise indoors may be at higher risk of strengthening external regulation. Interventions that support psychological needs may help foster self-determined exercise motivation among college students.

An Empowerment-Based Physical Activity Intervention for Older People with Advanced Age-Related Macular Degeneration: An Exploratory Qualitative Case Study Design

Background: Age-related macular degeneration (AMD) is the most common cause of incurable visual impairment and impacts daily life. There are benefits of physical activity for people who are affected with AMD; however, living with AMD is associated with lower levels of physical activity and social isolation. The aim of this study was to explore how older people with AMD in Sweden experienced participation in a 6-month empowerment-based physical activity intervention and how it influenced their physical abilities. Methods: The participants were nine individuals with AMD aged 70-87 years. The intervention comprised physical and social activities in a group twice a week and individual health coaching on three occasions. The study was based on an exploratory qualitative case study design. Results: The findings showed two themes: created meaningfulness in life and creative and playful ways to develop body movements. The findings also showed improved muscle strength after the intervention. Conclusions: The findings showed that participants had increased social connectedness, improved physical self-efficacy and physical ability, as well as improved muscle strength. The empowerment process of the intervention was appreciated by the participants and challenged them to participate in physical activity offered by the municipality for older individuals.

The Within-Subject Association of Physical Behavior and Affective Well-Being in Everyday Life: A Systematic Literature Review

BACKGROUND

The interplay of physical activity (PA) with affective well-being (AWB) is highly critical to both health behaviors and health outcomes. Current prominent theories presume AWB to be crucial for PA maintenance, and PA is evidenced to foster mental health. However, thus far, PA-AWB associations have mainly been researched in laboratory settings and with interventional designs, but the everyday life perspective had not been focused on, mostly due to technological limitations. In the course of digitization, the number of studies using device-based methods to research the within-subject association of physical activity and affective well-being (PA-AWB) under ecological valid conditions increased rapidly, but a recent comprehensive systematic review of evidence across populations, age groups, and distinct AWB components remained inconclusive.

OBJECTIVES

Therefore, we aimed to firstly review daily-life studies that assessed intensive longitudinal device-based (e.g., electronic smartphone diaries and accelerometry) and real-time PA-AWB data, secondly to develop and apply a quality assessment tool applicable to those studies, and thirdly to discuss findings and draw implications for research and practice.

METHODS

To this end, the literature was searched in three databases (Web of Science, PubMed, Scopus) up to November 2022. The systematic review followed the PRISMA guidelines and had been pre-registered (PROSPERO id: CRD42021277327). A modified quality assessment tool was developed to illustrate the risk of bias of included studies.

RESULTS

The review of findings showed that, in general, already short PA bouts in everyday life, which clearly differ from structured exercise sessions, are positively associated with AWB. In particular, feelings of energy relate to incidental (non-exercise and unstructured) activity, and PA-AWB associations depend on population characteristics. The quality assessment revealed overall moderate study quality; however, the methods applied were largely heterogeneous between investigations. Overall, the reviewed evidence on PA-AWB associations in everyday life is ambiguous; for example, no clear patterns of directions and strengths of PA-AWB relationships depending on PA and AWB components (such as intensity, emotions, affect, mood) emerged.

CONCLUSIONS

The reviewed evidence can fuel discussions on whether the World Health Organization's notion "every move counts" may be extended to everyday life AWB. Concurrently, the PA-AWB relationship findings endorse prominent theories highlighting the critical role of AWB in everyday PA engagement and maintenance. However, the review also clearly highlights the need to advance and harmonize methodological approaches for more fine-grained investigations on which specific PA/AWB characteristics, contextual factors, and biological determinants underly PA-AWB associations in everyday life. This will enable the field to tackle pressing challenges such as the issue of causality of PA-AWB associations, which will help to shape and refine existing theories to ultimately predict and improve health behavior, thereby feeding into precision medicine approaches.

The effect of outdoor activities on the medical expenditure of older people: multiple chain mediating effects of health benefits

BACKGROUND

With the global aging population, attention to the health and medical issues of older adults is increasing. By analyzing the relationship between older people's participation in outdoor activities and medical expenditure, this study aims to provide a scientific basis for improving their quality of life and reducing the medical burden.

METHODS

Data on outdoor activity participation, medical expenditures, and relevant variables were collected through questionnaires and databases. A multi-chain mediation effect model was established to analyze the impact of outdoor activities on the medical expenditure of older people, considering mediation effects and heterogeneity.

RESULTS

Results revealed that increased participation in outdoor activities among older adults correlated with lower medical expenditures. Outdoor activities positively influenced their health by improving mental health, cognition, eating habits, and activities of daily living, resulting in reduced medical expenditures. Robustness tests confirmed the consistent effect of outdoor activities on older people's medical expenditure.

CONCLUSION

These findings contribute to understanding the relationship between outdoor activities, health, and medical expenditure in older people, guiding policy formulation and interventions. Encouraging and supporting older adults in outdoor activities can enhance their quality of life and alleviate medical resource strain. The study's conclusions can also inform health promotion measures for other populations and serve as a basis for future research in this area.

Understanding the Impact of COVID-19 Lockdowns on Older Adults' Routines and Well-being: 3 Case Reports

The COVID-19 pandemic has significantly impacted the daily lives of older adults. Three case reports illustrate how individuals have coped with loss, maintained routines, and faced emotional challenges. Understanding these experiences can guide efforts to promote the well-being and resilience of older adults during this time. Interview questions included "What was your daily routine and any leisure activities you participated in before COVID-19? During the height of social distancing?" to explore the impact of this pandemic on older adults' daily routines and the effects on their mental and physical health.

The Effect of Passion for Outdoor Activities on Employee Well-Being Using Nature Connectedness as the Mediating Variable and Environmental Identity as the Moderating Variable

PURPOSE

Although prior research has found outdoor activities to be an important effect on employee well-being, the mechanisms of their effect are understudied. This study integrated the Broaden-and-Build Theory, Attention Restoration Theory and Cognitive Assessment Theory to examine the relation between passion for outdoor activities (two dimensions, namely, harmonious passion, obsessive passion) and employee well-being (three dimensions, namely, life well-being, workplace well-being, psychological well-being) by the mediating role of nature connectedness and the moderating role of environmental identity.

PARTICIPANTS AND METHODS

Data were collected from 403 employees of Guangxi enterprises in China. The structural equation model was constructed using AMOS and SmartPLS to test the hypotheses proposed in this study.

RESULTS

Our results confirm that harmonious passion for outdoor activities had a positive effect on employee nature connectedness, workplace well-being and psychological well-being. Obsessive passion for outdoor activities had a negative effect on employee nature connectedness, life well-being and psychological well-being. Natural connectedness has a positive effect on all three dimensions of employee well-being. Nature connectedness mediates between harmonious passion for outdoor activities and all three dimensions of employee well-being. Environmental identity positively moderated the relationship between nature connectedness and the three dimensions of employee well-being. Harmonious passion for outdoor activities has no direct effect on employee life well-being. Obsessive passion for outdoor activities had no direct effect on employee workplace well-being.

CONCLUSION

This study reveals the mechanism of passion for outdoor activities on employee well-being from a new perspective and unveils that the two dimensions of passion for outdoor activities have different effects on employees' life well-being, workplace well-being, and psychological well-being. Business managers should give attention to the benefits of outdoor activities and nature connectedness for their employees, through which they can relieve stress at work, recover attention and improve well-being.

Screen or No Screen? Lessons Learnt from a Real-World Deployment Study of Using Voice Assistants With and Without Touchscreen for Older Adults

While voice user interfaces offer increased accessibility due to hands-free and eyes-free interactions, older adults often have challenges such as constructing structured requests and perceiving how such devices operate. Voice-first user interfaces have the potential to address these challenges by enabling multimodal interactions. Standalone voice + touchscreen Voice Assistants (VAs), such as Echo Show, are specific types of devices that adopt such interfaces and are gaining popularity. However, the affordances of the additional touchscreen for older adults are unknown. Through a 40-day real-world deployment with older adults living independently, we present a within-subjects study (N = 16; age M = 82.5, SD = 7.77, min. = 70, max. = 97) to understand how a built-in touchscreen might benefit older adults during device setup, conducting self-report diary survey, and general uses. We found that while participants appreciated the visual outputs, they still preferred to respond via speech instead of touch. We identified six design implications that can inform future innovations of senior-friendly VAs for managing healthcare and improving quality of life.

What happens behind doors? Exploring everyday indoor activities when ageing in place

Engaging in social interaction and physical movement during everyday activities has a positive influence on wellbeing in later life. For older adults who age in place, the majority of activities occur indoors, yet studies typically focus on outdoors. Gender influences social and physical activities but is understudied in an ageing-in-place context. We aim to address these gaps by increasing insight into the indoor activities in later life, with a focus on gender differences in social interaction and physical movement. Through a mixed-methods approach, data were collected using global positioning system (GPS) trackers, pedometers and activity diaries. Twenty community-dwelling older adults (11 women and 9 men) who were living in Lancashire collected these data over seven days. An exploratory spatio-temporal analysis was conducted on the 820 activities they undertook. We discovered that our participants spend large amounts of time indoors. We also found that social interaction increases the duration of the activity and, conversely, decreases levels of physical movement. When zooming in to gender differences, men's activities took significantly longer than women's activities and were characterised by higher level of social interaction. Based on these results, we argue that there is a trade-off between social interaction and physical movement in everyday activities. We suggest establishing a balance between socialising and moving in everyday activities in later life, specifically because maintaining high levels of movement and social interaction at the same time seems unachievable. In conclusion, it is important to design indoor environments that facilitate choice between being active and resting, and between being social and being on one's own rather than assume they are mutually-exclusive and/or universally "good" or "bad" per se.

"I Hear the Music and My Spirits Lift!" Pleasure and Ballroom Dancing for Community-Dwelling Older Adults

Physical activity for older adults is recommended to encourage the maintenance of functional autonomy and improve mental health. Ballroom dancing involves aerobic, strength, and balance work and is an inherently a social activity. This 12-month qualitative study considered the influence of ballroom dancing on health and well-being in community-dwelling older adults. It explores an underreported aspect of physical activity, which may incentivize older people to participate, that is, pleasure. Qualitative data were managed and analyzed using the Framework Analysis approach. Semistructured interviews were conducted with 26 older adult ballroom dancers. Five typologies of pleasure were identified. In addition to "sensual pleasure," "pleasure of habitual action," and "pleasure of immersion," as suggested by Phoenix and Orr, the "pleasure of practice" and "pleasure of community" were also identified. Ballroom dancing produces a strong sense of embodied pleasure for older adults and should be promoted by health and exercise professionals for community-dwelling older adults.

A Quasi-Experimental Study on the Effect of an Outdoor Physical Activity Program on the Well-Being of Older Chinese People in Hong Kong

Active participation in physical activity by older people is effective in improving their health. This research aims to examine the positive effects of participation in vigorous outdoor physical activities by older Chinese people in Hong Kong, and whether such effects would vary with socioeconomic background. A quasi-experimental, nonequivalent group design was used. A total of 22 participants were randomly assigned to participate in an outdoor physical activity program. Another 14 participants took part as a control group. The 14-item Self-Image of Aging Scale for Chinese Elders and the four-item self-report Subjective Happiness Scale were used to measure participants’ self-image and overall happiness level. All participants completed the assessment before and after the program. Happiness level was enhanced in participants in the experimental group (p = 0.037) and their level of overall mental health also improved (p = 0.031, η²p = 0.129). Demographics did not have any significant effect on well-being outcomes. A structured outdoor physical activity program could be a viable choice for future practice to enhance the mental well-being of older Chinese people.

Digital Health Interventions among People Living with Frailty: A Scoping Review

OBJECTIVES

Digital health interventions (DHIs) are interesting resources to improve various health conditions. However, their use in the older and frail population is still sparse. We aimed to give an overview of DHI used in the frail older population.

DESIGN

Scoping review with PRISMA guidelines based on Population, Concept, and Context.

SETTING AND PARTICIPANTS

We included original studies in English with DHI (concept) on people described as frail (population) in the clinical or community setting (context) and no limitation on date of publication. We searched 3 online databases (PubMed, Scopus, and Web of Science).

MEASURES

We described DHI in terms of purpose, delivering, content and assessment. We also described frailty assessment and study design.

RESULTS

We included 105 studies that fulfilled our eligibility criteria. The most frequently reported DHIs were with the purpose of monitoring (45; 43%), with a delivery method of sensor-based technologies (59; 56%), with a content of feedback to users (34; 32%), and for assessment of feasibility (57; 54%). Efficacy was reported in 31 (30%) studies and usability/feasibility in 57 (55%) studies. The most common study design was descriptive exploratory for new methodology or technology (24; 23%). There were 14 (13%) randomized controlled trials, with only 4 of 14 studies (29%) showing a low or moderate risk of bias. Frailty assessment using validated scales was reported in only 47 (45%) studies.

CONCLUSIONS AND IMPLICATIONS

There was much heterogeneity among frailty assessments, study designs, and evaluations of DHIs. There is now a strong need for more standardized approaches to assess frailty, well-structured randomized controlled trials, and proper evaluation and report. This work will contribute to the development of better DHIs in this vulnerable population.

Contextual influences on the within-person association between physical activity and affect in adolescents: an ecological momentary assessment study

There is limited research on how the context in which moderate-to-vigorous physical activity (MVPA) occurs influences the relationship between physical activity and affect. This study aimed to investigate how the social context and physical environment enhance the relationship between MVPA and affect in daily life. Overall, 119 adolescents (mean age = 14.7 years) provided information about their core affect, physical environment and social context on multiple occasions over a 4-day period using ecological momentary assessment. Additionally, participants' level of MVPA was objectively measured using accelerometers. Level of MVPA was positively associated with energetic arousal, being outdoors was positively associated with valence and energetic arousal, and being with someone else was also positively associated with energetic arousal. Additionally, being outdoors moderated the association between MVPA and tense arousal so that MVPA was only inversely related to tense arousal when outdoors. These findings showed that young people experience more positive valence, greater levels of energetic arousal and less tense arousal when physically active outdoors compared to when indoors and highlight the importance of encouraging young people to participate in physical activity outdoors. Further research is warranted to understand how social contexts may influence the association between MVPA and affect in young people.

Exploring Feelings of Pleasure and Purpose Associated With Older People's Activities Using Ecological Momentary Analysis: An Observational Study

Momentary feelings of pleasure and purpose can be sources of intrinsic motivation, but momentary purpose is rarely studied. Activities, contexts, and feelings of retired/semiretired adults (n = 67, aged 50-78 years) were captured using ecological momentary assessment. Participants provided 2,065 valid responses to six daily smartphone surveys for 7 days. Physical activity was measured by waist-worn ActiGraph accelerometer. Pleasure (measured by affective happiness) and purpose outcomes were regressed on activities, context, and potential confounding variables. Interactions between activities and contexts were explored. Participants were highly active: 98.5% met physical activity guidelines. Sedentary activities were negatively associated with sense of purpose, especially when indoors. However, social sedentary activities were positively associated with feelings of happiness. Active, social outdoor activities were positively associated with both outcomes. Less sedentary participants experienced greater happiness and purpose during all their activities. Context matters: active, social, and outdoor activities seem to be more appealing to older adults.

Associations between individual factors, environmental factors, and outdoor independence in older adults

The degree to which individuals can accomplish outdoor activity by themselves or require support is an important facet of successful aging. While prior research focuses on participation in outdoor activity, understanding of older adults' outdoor independence is limited. We adopt an ecological approach to examine the role of individual factors and environmental factors in explaining outdoor independence. Our sample comprised older adults aged 65 + living in a medium-sized city in Germany (N = 1070). The results show that being male, younger, and healthier was positively associated with outdoor independence, while living together was not. Further, outdoor independence decreased with higher levels of perceived environmental barriers. This negative association was moderated such that it was stronger for the less healthy and older participants. Based on our empirical findings, we offer insights for policy makers, urban planners, and community groups to design age-friendly communities and consequently facilitate outdoor independence among older adults.

mHealth technology for ecological momentary assessment in physical activity research: a systematic review

OBJECTIVE

To systematically review the publications on ecological momentary assessment (EMA) relating to physical activity (PA) behavior in order to classify the methodologies, and to identify the main mHealth technology-based tools and procedures that have been applied during the first 10 years since the emergence of smartphones. As a result of this review, we want to ask if there is enough evidence to propose the use of the term "mEMA" (mobile-based EMA).

DESIGN

A systematic review according to PRISMA Statement (PROSPERO registration: CRD42018088136).

METHOD

Four databases (PsycINFO, CINALH, Medline and Web of Science Core Collection) were searched electronically from 2008 to February 2018.

RESULTS

A total of 76 studies from 297 potential articles on the use of EMA and PA were included in this review. It was found that 71% of studies specifically used "EMA" for assessing PA behaviors but the rest used other terminology that also adjusted to the inclusion criteria. Just over half (51.3%) of studies (39) used mHealth technology, mainly smartphones, for collecting EMA data. The majority (79.5%) of these studies (31 out of 39) were published during the last 4 years. On the other hand, 58.8% of studies that only used paper-and-pencil were published during the first 3 years of the 10-year period analyzed. An accelerometer was the main built-in sensor used for collecting PA behavior by means of mHealth (69%). Most of the studies were carried out on young-adult samples, with only three studies in older adults. Women were included in 60% of studies, and healthy people in 82%. The studies lasted between 1 and 7 days in 57.9%, and between three and seven assessments per day were carried out in 37%. The most popular topics evaluated together with PA were psychological state and social and environmental context.

CONCLUSIONS

We have classified the EMA methodologies used for assessing PA behaviors. A total of 71% of studies used the term "EMA" and 51.3% used mHealth technology. Accelerometers have been the main built-in sensor used for collecting PA. The change of trend in the use of tools for EMA in PA coincides with the technological advances of the last decade due to the emergence of smartphones and mHealth technology. There is enough evidence to use the term mEMA when mHealth technology is being used for monitoring real-time lifestyle behaviors in natural situations. We define mEMA as the use of mobile computing and communication technologies for the EMA of health and lifestyle behaviors. It is clear that the use of mHealth is increasing, but there is still a lot to be gained from taking advantage of all the capabilities of this technology in order to apply EMA to PA behavior. Thus, mEMA methodology can help in the monitoring of healthy lifestyles under both subjective and objective perspectives. The tendency for future research should be the automatic recognition of the PA of the user without interrupting their behavior. The ecological information could be completed with voice messages, image captures or brief text selections on the touch screen made in real time, all managed through smartphone apps. This methodology could be extended when EMA combined with mHealth are used to evaluate other lifestyle behaviors.

Purpose, Frequency, and Mode of Transport by Which Older Adults Leave Their Home-A Cross-Sectional Analysis

Time spent out-of-home can increase physical activity (PA) levels. However, the association between the purpose for leaving home and the mode of transport on time out-of-home and PA are not straightforward. In a large sample of community-dwelling older adults (≥65 years), daily walking duration was measured prospectively over 1 week using body-fixed sensors and time-out-of-home questionnaires. Data from 1,277 participants yielded 6,500 full days for analysis. The following statistically significant associations were seen: public transport use increased the time spent out-of-home by 88 min and daily walking duration by 16 min. Social contacts or the use of a car increased the time out-of-home, but decreased PA. Shopping or "going by foot" decreased the time spent out-of-home by 19 and 62 min, respectively, while both increased the daily walking duration by 5 min. The association between time out-of-home and PA (daily walking duration) is strongly dependent on the activity and mode of transport.

Persuasive technology to support active and healthy ageing: An exploration of past, present, and future

The age of the population worldwide is rapidly increasing, bringing social and economic challenges. Persuasive technology can alleviate the burden on traditional healthcare services when used to support healthy behaviors, for instance in the prevention and treatment of chronic diseases. Additionally, healthy behaviors are key factors for active and healthy ageing by delaying or even reversing functional decline. In this manuscript, we present a multi-perspective analysis of technologies that can be used in the support of active and healthy ageing in the daily life. First, we take the perspective of physical and mental health, by focusing on the promotion of physical activity and emotional wellbeing. From a temporal perspective, we look at how technology evolved from past, present and future. The overview of the literature is structured in four main sections: (1) measurement of current behavior (monitoring), (2) analysis of the data gathered to derive meaningful information (analyzing & reasoning), (3) support the individual in the adoption or maintenance of a behavior (coaching), and (4) tools or interfaces that provide the information to the individual to stimulate the desired behavior (applications). Finally, we provide recommendations for the design, development and implementation of future technological innovations to support Active and Healthy Ageing in daily life.