Middle-aged and older adults’ acceptance of mobile nutrition and fitness apps: A systematic mixed studies review

Background: To promote healthy aging, the support of digital mobile health tools such as mobile applications (apps) addressing a healthy diet or physical activity appears promising, particularly when initiated before entering old age. For such tools to be effective, middle-aged and older adults' acceptance need to be studied in depth. Objective: The aim of this systematic review was to provide an integrative synthesis of the current state of research regarding the question in how far middle-aged and older adults (people aged 50 years and above) accept mobile nutrition and fitness apps to gain a deeper understanding of the influencing factors shaping this target group's usage behaviour and needs. Methods: The review process followed the PRISMA guidelines. The databases Medline, Embase, Web of Science as well as reference lists were systematically searched. Study quality was assessed using the MMAT and AXIS appraisal tools. Data of the included studies were extracted and thereupon narratively synthesized, involving thematic analysis. Results: Of N = 8823 articles screened, n = 7 studies could be identified-five quantitative, cross-sectional ones and two qualitative studies. Overall, the synthesized findings showed a lower acceptance among middle-aged and older adults compared to younger populations, which was particularly reflected in lower usage rates and more negative attitudes towards such apps (e.g., Perceived usefulness, Ease of use). The target group's acceptance of fitness apps was greater compared to nutrition apps. Findings on contextual factors and social determinants were inconsistent (e.g., regarding gender differences). Conclusion: While cross-study comparability was limited, the synthesized evidence underscores the importance to target mobile nutrition and fitness apps to the distinctive and heterogeneous needs of middle-aged and, particularly, of older adults. The scarcity of the existing body of knowledge highlights the need of further (longitudinal) research

The retirement status passage – potential for the diet-related health promotion? Theoretical foundations, methodology & findings of a systematic review

Hintergrund & Zielsetzung: Inwiefern geht die Statuspassage von der Erwerbstätigkeit in den Ruhestand mit veränderten Ernährungspraktiken einher und welches Potenzial für eine gesundheitsfördernde Ernährung birgt diese? Die vorliegende Arbeit widmet sich diesen Fragen mittels einer systematischen Recherche und explorativen Integration bisheriger Forschungsbefunde. Ein umfassendes Wissen und vertieftes Verständnis der biografisch lebensweltlichen Umstände, die das alltägliche Ernährungsverhalten prägen, ist grundlegend für eine effektive ernährungsbezogene Förderung gesunden Alterns. Im Rahmen dieser Dissertation werden theoretisch-konzeptionelle Grundlagen aus gesundheits- und ernährungssoziologischer Perspektive eingeordnet und diskutiert. Zudem wird die Methodik Systematischer Mixed Studies Reviews anhand einer detaillierten Verfahrensbeschreibung vertieft. Methodik: Ein Systematisches Mixed Studies Review wurde durchgeführt, dessen Prozess neun teils iterative Arbeitsschritte umfasste. Insgesamt wurden N=974 Studien identifiziert, welche anhand a priori definierter Kriterien auf Eignung für einen Einschluss geprüft wurden. Je fünf qualitative und quantitative Studien entsprachen den Inklusionskriterien. Für deren Befundintegration wurde ein Qualitative Databased Synthesis Design gewählt. Die Datenauswertung erfolgte mittels Thematischer Analyse. Ergebnisse: Die eingeschlossenen Primärstudien zeichneten sich durch heterogene Studien- und Stichprobencharakteristika aus. Inwiefern sich die Ernährung im Ruhestand verändert, erwies sich als ambivalent. So wurden sowohl gesundheitsförderliche als auch ungesündere Ernährungspraktiken beobachtet. Als zentrale Einflussfaktoren waren das weibliche Geschlecht und der Partnerschaftsstatus mit einer gesünderen Ernährung assoziiert. Außerdem ließen sich strukturelle ernährungsbezogene Veränderungen – wie extensivere Mahlzeitroutinen im Ruhestand – identifizieren. Diskussion: Wenngleich die bisher dünne, teils inkonsistente Studienlage keine manifesten Schlussfolgerungen zulässt, unterstreichen die synthetisierten Ergebnisse, dass die Statuspassage Ruhestand mit diversen ernährungsbezogenen Veränderungen einhergeht und somit Potenzial für die Gesundheitsförderung bietet. In dieser Dissertation werden die Befunde u.a. mit Fokus auf die moderierende Rolle des sozialen Geschlechts sowie den Bedeutungswandel der sozialen und strukturieren Funktionen von Ernährungspraktiken im Ruhestand diskutiert. Zudem werden methodische Herausforderungen und Limitationen erörtert. Implikationen: Künftige ernährungsbezogene Maßnahmen zur Förderung gesunden Alterns sollten bereits vor dem Übergang in den Ruhestand ansetzen und dabei individuelle Bedarfe innerhalb der heterogenen Zielgruppe der (Vor-)Ruheständler*innen ebenso wie Risikofaktoren und vorhandene Barrieren berücksichtigen. Hierzu bedarf es weiterer interdisziplinärer Forschung sowie einer effektiven Translation in die Praxis.Background & Objective: To what extent is the status passage from the occupational phase to retirement accompanied by changes in dietary practices and what potential does it bear for a health-promoting diet? This thesis addresses these questions by means of a systematic search and exploratory integration of the existing body of research. Gaining comprehensive knowledge and in-depth understanding of the biographical and lifeworld circumstances that shape everyday dietary practices is fundamental for an effective diet-related health promotion targeting older adults. In the scope of this dissertation, the research subject is further contextualized and theoretically-conceptually discussed from the perspectives of the sociology of health and the sociology of food. Moreover, the methodology of Systematic Mixed Studies Reviews is elaborated by a stepwise description of the review process. Methods: A Systematic Mixed Studies Review was conducted, the process of which comprised nine consecutive, partly iterative steps. A total of N=974 studies were identified, which were screened for eligibility based on a priori defined criteria. Five qualitative and five quantitative studies met the inclusion criteria. To integrate the study findings, a Qualitative Databased Synthesis Design was chosen and data were analyzed using Thematic Analysis. Results: Overall, the included primary studies were characterized by heterogeneous study and sample characteristics. The extent to which the diet changes during the retirement status passage proved to be ambivalent, since both health-promoting and unhealthier dietary practices were observed. As central influencing factors, female gender and partnership status showed to be associated with healthier diets. In addition, structural diet-related changes – such as more extensive mealtime routines at retirement – emerged. Discussion: The scarce, partially ambivalent body of evidence does not allow definite conclusions to be drawn. However, the results underscore that the status passage retirement is accompanied by diverse diet-related changes and may thus offer potential for the promotion of healthy aging. In this dissertation, the synthesized findings are discussed, among others, with a focus on the moderating role of gender and the changing meaning of the social and structuring functions of dietary practices that are relatedwith the status passage retirement. Furthermore, methodical challenges and limitations are addressed. Implications: Future measures to promote healthy diets in older age should be initiated prior to the transition to retirement and thereby consider the diverse individual needs within the heterogeneous target group of (pre-)retirees. Moreover, existing risk factors and barriers that impede healthy diets should be taken into account. This requires further interdisciplinary research and its effective translation into practice

Middle-aged and older adults’ acceptance of mobile nutrition and fitness tools: A qualitative typology

Background The utilization of mobile health (mHealth) devices such as nutrition and fitness tools seems to be promising in facilitating healthy lifestyle behaviors in middle-aged and older adults. As user acceptance plays a decisive role in the successful implementation of mHealth tools, it is vital to examine the target groups’ acceptance, particularly their usage behavior and attitudes toward these tools. This qualitative study aimed to explore how far middle-aged as well as older adults accept mobile nutrition and fitness tools and to identify facilitators and barriers shaping their acceptance. Methods Twenty-one qualitative semi-structured interviews were conducted with German adults aged 50 years and older. Data material was analyzed using Qualitative Content Analysis (Kuckartz). Results A comprehensive acceptance typology with three acceptance types could be reconstructed: The Rejection Type , The Selective Acceptance Type , and The Comprehensive Acceptance Type . The target group's acceptance of mobile nutrition and fitness tools appeared to differ considerably across the three acceptance types and between the two different types of mHealth tools – with mobile nutrition tools having been less accepted. Among others, high levels of usability were identified as a key facilitator, while a desire for autonomy and privacy concerns showed to be prominent barriers. Conclusion The resulting typology indicates a pronounced heterogeneity among middle-aged and older adults regarding their acceptance of mobile nutrition and fitness tools. The findings highlight a need for more individualized mHealth tools along with respective promotion strategies that are specifically tailored to the needs and expectations of middle-aged and older adults

Inclusion and exclusion criteria according to the PICOS criteria¹.

Inclusion and exclusion criteria according to the PICOS criteria1.</p

Search strategies (EMBASE & medline).

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Age group-specific acceptance of nutrition and fitness apps (middle-aged/older adults vs. younger adults).

Age group-specific acceptance of nutrition and fitness apps (middle-aged/older adults vs. younger adults).</p

Fitness and nutrition app acceptance investigated by the qualitative study by Cabrita et al. [55].

Fitness and nutrition app acceptance investigated by the qualitative study by Cabrita et al. [55].</p

Fitness app acceptance investigated by the qualitative study by Wichmann et al. [53].

Fitness app acceptance investigated by the qualitative study by Wichmann et al. [53].</p

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