Engagement, acceptability, usability and satisfaction with Active for Life, a computer-tailored web-based physical activity intervention using Fitbits in older adults

Abstract

Background: Preliminary evidence suggests that web-based physical activity interventions with tailored advice and Fitbit integration are effective and may be well suited to older adults. Therefore, this study aimed to examine the engagement, acceptability, usability, and satisfaction with 'Active for Life,' a web-based physical activity intervention providing computer-tailored physical activity advice to older adults.

Methods: Inactive older adults (n = 243) were randomly assigned into 3 groups: 1) tailoring + Fitbit, 2) tailoring only, or 3) a wait-list control. The tailoring + Fitbit group and the tailoring-only group received 6 modules of computer-tailored physical activity advice over 12 weeks. The advice was informed by objective Fitbit data in the tailoring + Fitbit group and self-reported physical activity in the tailoring-only group. This study examined the engagement, acceptability, usability, and satisfaction of Active for Life in intervention participants (tailoring + Fitbit n = 78, tailoring only n = 96). Wait-list participants were not included. Engagement (Module completion, time on site) were objectively recorded through the intervention website. Acceptability (7-point Likert scale), usability (System Usability Scale), and satisfaction (open-ended questions) were assessed using an online survey at post intervention. ANOVA and Chi square analyses were conducted to compare outcomes between intervention groups and content analysis was used to analyse program satisfaction.

Results: At post-intervention (week 12), study attrition was 28% (22/78) in the Fitbit + tailoring group and 39% (37/96) in the tailoring-only group. Engagement and acceptability were good in both groups, however there were no group differences (module completions: tailoring + Fitbit: 4.72 ± 2.04, Tailoring-only: 4.23 ± 2.25 out of 6 modules, p = .14, time on site: tailoring + Fitbit: 103.46 ± 70.63, Tailoring-only: 96.90 ± 76.37 min in total, p = .56, and acceptability of the advice: tailoring + Fitbit: 5.62 ± 0.89, Tailoring-only: 5.75 ± 0.75 out of 7, p = .41). Intervention usability was modest but significantly higher in the tailoring + Fitbit group (tailoring + Fitbit: 64.55 ± 13.59, Tailoring-only: 57.04 ± 2.58 out of 100, p = .003). Participants reported that Active for Life helped motivate them, held them accountable, improved their awareness of how active they were and helped them to become more active. Conversely, many participants felt as though they would prefer personal contact, more detailed tailoring and more survey response options.

Conclusions: This study supports web-based physical activity interventions with computer-tailored advice and Fitbit integration as engaging and acceptable in older adults.

Trial registration: Australian and New Zealand Clinical Trials Registry: ACTRN12618000646246. Registered April 23 2018, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374901.

Keywords: Activity monitors; Activity trackers; Internet; Older adults; Online; Physical activity; Wearables.

Fig. 1

Module completions by intervention group (n = 174)

Fig. 2

Time on tailored advice by week of intervention and intervention group (n = 173). Note. Intervention modules became available in week 1, 3, 5, 7, 9 and 11

Fig. 3

Satisfaction with the Active for Life program. Note: A total of 93 participants (Fitbit + tailoring = 46, tailoring only = 47) answered at least one open ended satisfaction question and are included in Fig. 3. The numbers for each category detail the number of participants from each group whose open-ended responses fit in that category (e.g., motivation)

Fig. 4

Satisfaction with the Fitbit tracker in the Active for Life program. Note: A total of 51 Fitbit + tailoring participants answered at least one open ended Fitbit satisfaction question and are included in Fig. 3. The numbers for each category detail the number of participants from each group whose open-ended responses fit in that category (e.g., goals)