A good fit: A new tool to get older adults moving

Regular physical activity is one of the biggest contributors to health and well-being, particularly in older adults. Previous research has shown that even small increases in activity levels can improve the health and quality of life of this population and help them manage chronic conditions like heart disease and diabetes. Experts recommend at least 150 minutes of moderate-intensity physical activity per week; however, only a fraction of older adults meet these guidelines.

Most older adults see their primary care providers regularly and trust them, but these providers have few programs to recommend to older adults to help increase their physical activity. Alicia Hong, PhD, associate professor in the Texas A&M School of Public Health, believes iCanFit 2.0 could help solve this problem. Research to date indicates this multi-level, mobile-enabled physical activity promotion program has great potential to be used effectively in primary care settings.

A recent study published in the journal JMIR Research Protocols outlines the iCanFit 2.0 protocol and details procedures to test its efficacy through a cluster randomized controlled trial (RCT).

“The protocol was developed as a result of five years of research in promoting physical activity in older adults with chronic conditions,” Hong said.

The iCanFit 1.0 was developed from formative research, went through usability testing and was pilot-tested for its initial efficacy. A pilot project tested the feasibility mobile-based health behavior assessment in a primary care clinic. The latest version, iCanFIt 2.0, was designed through results from all these research projects and many years of working with the Family Medicine Department of Baylor Scott and White Health.

The unique features of iCanFit 2.0 include multi-level interventions for the individual and health care provider with the added benefit of social support.

“Patients complete a health behavior assessment on an iPad while waiting for their doctor’s appointment, from which a report is generated and sent in advance to the doctor, serving as a conversation starter when the patient sees the physician,” Hong said. “After the appointment, the patient will meet with a health coach for further counseling and to develop a personalized exercise plan. The patient will also receive a Fitbit Flex wristband to track their physical activity and join the iCanFit online community for continuous monitoring and support.”

The next step for the research team is to test the efficacy of iCanFit 2.0 through a cluster RCT. Six pairs of primary care clinics will be randomized into an intervention or a control group. A total of 622 overweight older adult patients from 12 clinics will be recruited. The patients in the control group will also receive a Fitbit Flex wristband, but they will not complete the health behavior assessment, receive counseling from a health coach or have access to the iCanFit online community. Patients from both groups will be evaluated at three- and six-month intervals for total minutes of exercise, quality of life and progression of chronic health conditions as indicated in their medical records.

“This project is based on years of preliminary research and has a rigorous design,” Hong said. “It is our hope to secure additional funding to test the efficacy of iCanFit 2. We need more evidence-based programs to increase physical activity in older adults in primary care settings and this program holds great promise to do just that.”

For more information on the iCanFit project, see http://icanfit.org/

Additional researchers include Marcia Ory, PhD, MPH, of the School of Public Health; Samuel Forjuoh, MD, DrPH, and Mike Reis, MD, of Baylor Scott and White Health; and Huiyan San, PhD, of the Texas A&M University Department of Statistics.