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Fitness & Exercise for Senior Citizens
Computer Calls Persuade Even Skeptical Old Couch
Potatoes to Go Walking
Many of the participating adults in the study were
over age 55
By Tracie White
 Dec.
8, 2007 - Computer-generated phone calls may be an effective, low-cost
way to encourage sedentary adults to exercise, according to a recent
study by researchers at the Stanford School of Medicine.
Results of the yearlong study found that regular
telephone calls delivered from either live health educators or by an
automated computer system successfully prodded inactive adults into a
regular 150-minute per week exercise program.
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What most surprised researchers was that the
computer calls were almost as effective as the calls by a real person.
"This is the first study to directly compare the
efficacy of a physical activity program delivered by a computer versus
humans and found them to work similarly well," said lead author
Abby King, PhD, professor of health research and policy and senior
investigator at the
Stanford Prevention Research Center. "Theoretically, it could be
delivered to anybody around the country or the world, and could save
time and money.
The study was published in the current issue of the
journal Health Psychology. Many of the 218 San Francisco Bay Area adults
over age 55 who signed up for the study, the Community Health Advice by
Telephone or CHAT, insisted at the start they would need a live human
voice to be successful, King said.
"Everybody got a chance to listen to the computer
program so they knew what it sounded like before we started," King said.
"About 80 to 85 percent told us they preferred or
needed a human."
This didn't prove true. Researchers found
participants lacking confidence in their ability to increase physical
activity and who felt less comfortable interacting with people did
better overall when they didn't have to talk to a human.
"We were thrilled that at six months the results
were identical between the two groups. By 12 months, there was still
virtually no difference. The bottom line is that people tend to prefer
what they know. That doesn't necessarily mean that's the best program
for them."
The goal was to get participants out walking at a
brisk pace for 30 minutes most days of the week, or some other form of
medium-intensity physical activity, for about 150 minutes a week, as
recommended by the U.S. Surgeon General.
They were divided into three groups: a control
group that didn't get calls, a group called by trained health educators
and a group called by a computer delivering an interactive,
individualized program similar to that delivered by the health
educators. Exercise levels were measured with an accelerometer, which
provides an estimate of physical activity amount as well as intensity.
After a year, participants who received computer
calls averaged 157 minutes per week of exercise compared with 178
minutes for the group that received human voice calls and 118 minutes
for the control group, which was not called.
Both "called" groups averaged above the 150-minute
a week goal, and that's the most important thing from a public health
standpoint, King said.
The automated system allowed participants to reply
by telephone keypad. A typical computer call might go like this:
Computer voice: "Hello, Mrs. Jones. Your goal last
time we talked was to do 30 minutes per day of brisk walking five days
per week. Were you able to reach this goal? If yes, press 1; if no,
press 2. What kind of barriers got in your way? If illness, press 1; if
weather, press 2."
The computer would then provide advice about
specific barriers, allow participants to set new goals and schedule the
next telephone contact. One advantage of the computer system was the
convenience of making additional phone calls after hours when the human
health counselor would be off duty, King said.
"I think a lot of people were pleasantly surprised
that the computer voice was helpful," she said. "And it was just as
helpful for women as men. We thought originally that women might like
the human touch more."
"I thought I would hate it," said one participant,
Rita Horiguchi, 62, of San Jose.
"I wanted a real person. I didn't think a computer
calling up would work, but I met my goals of walking 30 minutes four
days a week. I did it just to satisfy the computer, but the funny thing
was it actually worked."
Future research will focus on how to combine the
human and the automated touch into the best program for optimizing
adherence and minimizing cost, King said. Researchers are also looking
at cell phone texting and other methods to encourage exercising. King
has another study on promoting physical activity through hand-held
computer devices coming out in a future issue of the American Journal of
Preventive Medicine.
Other Stanford authors who contributed to the study
were research associate and project director Cynthia Castro, PhD; data
analyst David Ahn, PhD, and Laurence Baker, PhD, professor of health
research and policy. The study was funded by the National Institute on
Aging.
>>
Source:
Stanford Prevention Research Center
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