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Fitness & Exercise for Senior Citizens
Hand-Held Computers Prod Older Adults to Exercise
More, Stanford Study Shows
 Researchers also evaluated the usefulness of PDAs
in modifying dietary behavior
By ALISSA POH
Feb. 6, 2008 - Today’s younger generation may
reckon that “ne’er the twain shall meet” where technology and their
elders are concerned. However, ongoing research by Abby King, PhD,
professor of health research and policy and of medicine at the Stanford
Prevention Research Center, appears to be gradually dispelling that
notion.
In a study that appears in the February issue of
the American Journal of Preventive Medicine, King showed that specially
programmed PDAs, or personal digital assistants, can prod middle-aged
and older Americans - the most sedentary segment of the U.S. population
- into increasing their physical activity levels.
This first-generation study follows on the heels of
King’s research report in the December issue of Health Psychology, in
which she showed that automated computer calls were almost as effective
as live health educators in coaxing people previously less active to get
more of a spring in their step.
King and colleagues feel that developing approaches
to help people increase their exercise frequency, while taking into
account an individual’s schedule and environment, is particularly
important.
“Portable computer devices are useful because they
can be carried around throughout a person’s day,” King said. “Such
devices represent one kind of strategy for being able to provide
individuals with the help and support they need, in a convenient,
real-time context.”
The researchers invited the public to participate
in this new study through local mass-media outlets, like the Palo Alto
Daily News and the San Jose Mercury News. Out of 69 callers who were
screened for eligibility, 37 were invited to be study participants and
randomly assigned to an eight-week program in which they either received
a Dell Axim X5 PDA, or traditional handouts related to physical
activity.
“Then we let ’em roll,” King said.
The Dell Axim X5, chosen for its large-sized,
easy-to-read screen and good contrast, was fitted with a program that
asked participants approximately three minutes’ worth of questions.
● Among the questions:
● Where are you now?
● Who are you with?
● What barriers did you face in doing your physical activity routine?
The device automatically beeped once in the
afternoon and once in the evening; if participants ignored it the first
time, it beeped three additional times at 30-minute intervals. During
the second (evening) session, the device also asked participants about
their goals for the next day.
With this program, participants could set goals,
track their physical activity progress twice a day and get feedback on
how well they were meeting their goals. After eight weeks, the
researchers found that while participants assigned to the PDA group
devoted approximately five hours each week to exercise, those in the
control group spent only about two hours on physical activities—in other
words, the PDA users were more than twice as active.
One surprise was the participants’ positive
response to the program’s persistence. The PDA users liked the three
additional “reminder” beeps that went off if they failed to respond to
the first one. In fact, almost half of them wound up responding to the
PDA only after being beeped for the fourth time.
“The PDAs can really keep on you,” King observed
with wry humor. “We were surprised by that; we thought by the time they
heard the fourth beep, they might find it annoying and not respond at
all.”
The study targeted people interested in health
changes, but with little if any knowledge of portable computer devices.
During the eligibility screening, 93 percent said they had never used a
PDA before. So there could have been difficulties in grasping the
technology, or participants refusing to deal with it and giving up
entirely. This, however, did not turn out to be a problem.
“They were very curious about PDAs, and that’s why
some of them signed up,” King said. Several participants, she added,
were aware of PDAs because their children were using the device, and so
they wanted to learn more about the technology.
King and colleagues are also working with
researchers from MIT, Northeastern University, Brown University and
Boston Medical Center to evaluate the ability of other types of
computer-based, automated and interactive devices to help people change
their health behavior.
So what’s next, after PDAs?
“Cell phones, for sure,” King said. “Especially now
that we have the iPhone; its big screen would be very useful for
providing visual feedback.” She and her colleagues are also continuing
to focus on developing portable devices capable of interacting with
accelerometers (activity monitors), so that the necessary
information—for example, the amount of walking in a day—automatically
transmits to the device.
“With the PDA study, evaluations made were based
almost entirely on the participants’ self-report,” King explained. “We’d
like our devices to be able to provide real-time feedback using
objective activity as well.”
In a companion study to be published later this
year, King and colleagues have also evaluated the usefulness of PDAs in
modifying dietary behavior. Results indicate that similar “probing” and
feedback by a computer program—about a person’s eating habits rather
than activity level—can nudge participants towards increasing their
vegetable and whole-grain intake.
“Physical activity is only one piece of the puzzle;
another is dietary intake,” King noted. She would like to eventually
harness the tracking power of GPS, so that willing participants, “if
they're walking past a Fresh Choice restaurant, can be prompted to go
there instead of the fast-food outlet next door.”
Maybe that’s technical intervention, not divine—but
it could be helpful, especially when you can’t get that vision of french
fries out of your head.
King’s co-authors on the PDA study were David Ahn,
PhD, research software developer; Cynthia Castro, PhD, research
associate, and
Christopher Gardner, PhD, associate professor of medicine at the
Stanford Prevention Research Center.
Stanford University Medical Center integrates
research, medical education and patient care at its three institutions -
Stanford University School of Medicine,
Stanford Hospital & Clinics and
Lucile Packard Children's Hospital. For more information, please
visit the Office of Communication & Public Affairs site at
http://mednews.stanford.edu/.
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