The Role of Psychological Factors in Older Adults’ Readiness to Use eHealth Technology : Cross-Sectional Questionnaire Study

Background: Information and communication technology (ICT) use among older adults has been on the rise in recent years. However, the predictors and mechanisms behind older adults’ acceptance and use of ICT are not clear. Objective: This study aimed to systematically describe ICT usage among Czech older adults and to evaluate the factors influencing their ICT use and readiness to use digital technology to promote health (eHealth readiness). The primary focus was on psychological factors and the role of persons close to older adults. Methods: The research utilized cross-sectional survey data from a quota-based sample of Czech older adults (>50 years) and persons close to them further referred to as close persons (N=250 dyads). A structural equation modeling framework was used to evaluate relationships between psychological factors, ICT use, and eHealth readiness. Results: Czech older adults’ use of ICT is low with the exception of cell phone usage (cell phone usage by 173/250, 69.2%; other devices used by 50/250, 20.0% of older adults or less). Apart from age (ß=-.21; P<.001), eHealth readiness was predicted by ICT use (ß=.65; P<.001). eHealth readiness was also indirectly affected by the need for cognitive closure (NFCC): individuals with a high need for closure perceived more barriers to ICT (ß=.23; P=.01) and more reported barriers were linked to lower ICT usage (ß=-.21; P=.001). The expected positive relationships between eHealth readiness of persons close to older adults and ICT use and eHealth readiness of older adults were not significant, but the total effect of eHealth readiness of persons close to older adults on eHealth readiness of older adults was positive and significant (ß=.18; P=.01), indicating some level of influence of persons close to them on older adults’ attitudes and behaviors. Conclusions: This study provided the first systematic examination of Czech older adults’ ICT usage and eHealth readiness. Novel predictors (NFCC and close persons’ variables) were evaluated and yielded actionable results. More research is needed to clarify the role of persons close to older adults

Enhancing our understanding of physical activity and wellbeing with a lifespan perspective

Physical activity might be a viable tool for enhancing mental wellbeing because, in general, physical activity has been found to be related to more positive affect and higher satisfaction with life. The way we think, feel, and act changes with age, so it may be that physical activity, wellbeing, and the link between physical activity and wellbeing change with age too. Without consideration for developmental changes, study findings are decontextualized and difficult to translate into people’s lives. Aiming to become better equipped to use physical activity as a tool to intervene with wellbeing, we explored a lifespan perspective of physical activity and wellbeing. In this review, we (1) discuss physical activity, wellbeing, and the link between physical activity and wellbeing at different life stages, (2) highlight the need to consider interpersonal and intrapersonal differences in these constructs, and (3) identify gaps in the literature that, if filled, would further enhance our understanding of physical activity and wellbeing across the lifespan

Running-related Achilles tendon injury: a prospective biomechanical study in recreational runners

There are relatively few running studies that have attempted to prospectively identify biomechanical risk factors associated with Achilles tendon (AT) injuries. Therefore, the aim was to prospectively determine potential running biomechanical risk factors associated with the development of AT injuries in recreational, healthy runners. At study entry, 108 participants completed a set of questionnaires. They underwent an analysis of their running biomechanics at self-selected running speed. The incidence of AT running-related injuries (RRI) was assessed after 1-year using a weekly questionnaire standardized for RRI. Potential biomechanical risk factors for the development of AT RRI injury were identified using multivariable logistic regression. Of the 103 participants, 25% of the sample (15 males and 11 females) reported an AT RRI on the right lower limb during the 1-year evaluation period. A more flexed knee at initial contact (odds ratio = 1.146, P = .034) and at the midstance phase (odds ratio = 1.143, P = .037) were significant predictors for developing AT RRI. The results suggested that a 1-degree increase in knee flexion at initial contact and midstance was associated with a 15% increase in the risk of an AT RRI, thus causing a limitation of training or a stoppage of running in runners

Developing an Instrument to Measure Physical Activity Related Self-Worth in Women: Rasch Analysis of the Women\u27s Physical Activity Self-Worth Inventory (WPASWI)

Objectives: The objective of this study is to report on the development of an instrument to assess non-physical aspects of physical activity (PA) -related self-worth (SW). Methods: Three hundred thirty five women (mean age = 36.69 ± 15.94 yrs, BMI = 24.87 ± 4.56) completed the Women’s Physical Activity Self-Worth Inventory (WPASWI), General SW Scale, and a PA Questionnaire. Rasch analysis was used to evaluate the WPASWI. Results: Three PA-related SW subscales were identified: PA Knowledge (16 items), PA Emotional (13 items), and PA Social (8 items). Rasch analysis supported construct validity, and items demonstrated acceptable internal consistency (Cronbach’s alpha = .90, .87 and .72) and test re-test reliability (r = .79, .70, .81). Women who reported regular PA participation had higher PA Knowledge, PA Emotional, PA Social, and General SW than those who reported some or no PA (p \u3c .01) and correlations between Knowledge, Emotional, and Social SW subscales and General SW were .207, .130, and .220, respectively. PA Knowledge and PA Emotional SW had stronger correlations with PA (r = .344, .273, respectively) than did General SW (r = .133). Conclusions: The WPASWI demonstrated good internal consistency, reliability, construct validity and a stronger relationship with PA than a General SW instrument

Women Bound to be Active: Differences in Long-Term Physical Activity Between Completers and Noncompleters of a Book Club Intervention

Background: Ideal approaches to increasing long-term physical activity (PA) adherence in women remain unclear. This study used a longitudinal mixed-methods approach to 1) determine the effectiveness of an 8-month book club intervention for increasing PA participation and self-worth, and reducing barriers at 1-year followup; and 2) identify reasons why completers and noncompleters did or did not maintain PA. Methods: One year after the cessation of Women Bound to be Active (WBA), completers (participated in posttesting; n = 30) and noncompleters (did not participate in posttesting; n = 22) responded to questionnaires and interviews assessing their body mass index (BMI), current PA participation, barriers, and global self-worth. Results: Compared with noncompleters, completers reported decreases in BMI, higher motivation for PA, higher ratio of benefits to barriers, and more consistent PA. Both groups still reported barriers to PA, especially time; however, completers more often reported strategies for overcoming these barriers. Completers more directly discussed the impact of their improved self-worth on their PA participation. Conclusions: In the future, a greater focus on time management and self-regulation strategies should be emphasized in PA interventions, specifically those that focus on women. This may help to prevent program and long-term PA attrition

GPs’ perspectives on eHealth use in the Czech Republic : a cross-sectional mixed-design survey study

Background Digitalisation of health services is among the top priorities of the European Union (EU), yet take-up of eHealth tools is slower in some EU countries than others. Aim The aim of this study was to evaluate the use of information communication technology (ICT) and eHealth tools by Czech GPs, to elucidate their motivation and barriers to the adoption of eHealth technologies. Design & setting A cross-sectional, mixed-design survey study, administered online and conducted with GPs from seven randomly selected Czech regions. Of the invited 777 GPs, 196 participants responded (25% response rate) and 153 completed the survey. Method Quantitative (measured using, for example, the eHealth readiness scale) and qualitative (thematic analysis) methods were used. Results Hierarchical multilinear regression (controling for age, sex, and city size) showed that ICT usage in general practice was predicted by eHealth readiness. Among GPs with their own practice, age and practice size also predicted ICT use. Analysis of barriers specific to mobile health tools identified obstacles on the side of GPs (such as low perceived usefulness), patients (such as lack of interest), and contextual barriers (such as lack of time). Conclusion In addition to system-level change, educating Czech GPs about the benefits of eHealth tools for better patient–provider interaction and quality of care is necessary to facilitate eHealth adoption and usage in the Czech Republic

Feasibility of Real-time Behavior Monitoring Via Mobile Technology in Czech Adults Aged 50 Years and Above : 12-Week Study With Ecological Momentary Assessment

Background: Czech older adults have lower rates of physical activity than the average population and lag behind in the use of digital technologies, compared with their peers from other European countries. Objective: This study aims to assess the feasibility of intensive behavior monitoring through technology in Czech adults aged ≥50 years. Methods: Participants (N=30; mean age 61.2 years, SD 6.8 years, range 50-74 years; 16/30, 53% male; 7/30, 23% retired) were monitored for 12 weeks while wearing a Fitbit Charge 2 monitor and completed three 8-day bursts of intensive data collection through surveys presented on a custom-made mobile app. Web-based surveys were also completed before and at the end of the 12-week period (along with poststudy focus groups) to evaluate participants’ perceptions of their experience in the study. Results: All 30 participants completed the study. Across the three 8-day bursts, participants completed 1454 out of 1744 (83% compliance rate) surveys administered 3 times per day on a pseudorandom schedule, 451 out of 559 (81% compliance rate) end-of-day surveys, and 736 episodes of self-reported planned physical activity (with 29/736, 3.9% of the reports initiated but returned without data). The overall rating of using the mobile app and Fitbit was above average (74.5 out of 100 on the System Usability Scale). The majority reported that the Fitbit (27/30, 90%) and mobile app (25/30, 83%) were easy to use and rated their experience positively (25/30, 83%). Focus groups revealed that some surveys were missed owing to notifications not being noticed or that participants needed a longer time window for survey completion. Some found wearing the monitor in hot weather or at night uncomfortable, but overall, participants were highly motivated to complete the surveys and be compliant with the study procedures. Conclusions: The use of a mobile survey app coupled with a wearable device appears feasible for use among Czech older adults. Participants in this study tolerated the intensive assessment schedule well, but lower compliance may be expected in studies of more diverse groups of older adults. Some difficulties were noted with the pairing and synchronization of devices on some types of smartphones, posing challenges for large-scale studies

Achilles tendon structure is associated with regular running volume and biomechanics

Achilles tendinopathy was reported to have the highest incidence proportion of all running-related injuries. The purpose of this study was to analyse the association between the Achilles tendon structure and running activity status. 350 healthy participants (runners and inactive controls, 30-50 years) partici pated in this research. Each participant completed questionnaires: socioeconomic, psychological, physi cal activity habits, running status and history and VISA-A. Magnetic resonance imaging, anthropological, running biomechanics and 14 days of physical activity monitoring assessments were performed. There was a higher odd of being in the upper quartile of the Achilles tendon T2* relaxation time with higher maximal knee extension moment independent of age and sex. Compared with runners who ran 21–40 km per week, non-runners and those who ran more than 40 km per week had increased odds of having longest the Achilles tendon T2* relaxation time. Regular running of 21 to 40 km per week is related to the Achilles tendon T2* relaxation time indicating possibly better water content and collagen orientation in these runners with compare to inactive non-runners or highly active individuals. In addition, Achilles tendon T2* relaxation time as indirect indicator of the Achilles tendon structure was positively related to the maximal knee extension moment during running.Web of Science41439038

Participatory development of an mHealth intervention delivered in general practice to increase physical activity and reduce sedentary behaviour of patients with prediabetes and type 2 diabetes (ENERGISED)

Background The escalating global prevalence of type 2 diabetes and prediabetes presents a major public health challenge. Physical activity plays a critical role in managing (pre)diabetes; however, adherence to physical activity recommendations remains low. The ENERGISED trial was designed to address these challenges by integrating mHealth tools into the routine practice of general practitioners, aiming for a significant, scalable impact in (pre)diabetes patient care through increased physical activity and reduced sedentary behaviour. Methods The mHealth intervention for the ENERGISED trial was developed according to the mHealth development and evaluation framework, which includes the active participation of (pre)diabetes patients. This iterative process encompasses four sequential phases: (a) conceptualisation to identify key aspects of the intervention; (b) formative research including two focus groups with (pre)diabetes patients (n = 14) to tailor the intervention to the needs and preferences of the target population; (c) pre-testing using think-aloud patient interviews (n = 7) to optimise the intervention components; and (d) piloting (n = 10) to refine the intervention to its final form. Results The final intervention comprises six types of text messages, each embodying different behaviour change techniques. Some of the messages, such as those providing interim reviews of the patients’ weekly step goal or feedback on their weekly performance, are delivered at fixed times of the week. Others are triggered just in time by specific physical behaviour events as detected by the Fitbit activity tracker: for example, prompts to increase walking pace are triggered after 5 min of continuous walking; and prompts to interrupt sitting following 30 min of uninterrupted sitting. For patients without a smartphone or reliable internet connection, the intervention is adapted to ensure inclusivity. Patients receive on average three to six messages per week for 12 months. During the first six months, the text messaging is supplemented with monthly phone counselling to enable personalisation of the intervention, assistance with technical issues, and enhancement of adherence. Conclusions The participatory development of the ENERGISED mHealth intervention, incorporating just-in-time prompts, has the potential to significantly enhance the capacity of general practitioners for personalised behavioural counselling on physical activity in (pre)diabetes patients, with implications for broader applications in primary care

BIOMECHANICS IN THE 4HAIE STUDY: AIR POLLUTION AND MUSCULOSKELETAL HEALTH - AN UPDATE

The overall purpose of the 4HAIE study was to assess the influence of the interaction between air pollution and biomechanical, physiological and psychosocial factors on the incidence of injuries, health and well-being. A total of 1,500 active runners and inactive controls aged 18-65 will be recruited. Herein, we describe the biomechanical study design with data examples to investigate musculoskeletal and neuro-mechanics health in different air quality regions