A social media game to increase physical activity among older adult women: Protocol of a randomized controlled trial to evaluate CHALLENGE

Authors: ROBERTSON, MICHAEL - University Of Texas Medical Branch; SWARTZ, MARIA - Md Anderson Cancer Center; BASEN-ENGQUIST, KAREN - Md Anderson Cancer Center; LI, YISHENG - Md Anderson Cancer Center; JENNINGS, KRISTOFER - Md Anderson Cancer Center; Thompson, Deborah - Debbe; BARANOWSKI, TOM - Children'S Nutrition Research Center (CNRC); VOLPI, ELENA - University Of Texas At San Antonio; LYONS, ELIZABETH - University Of Texas Medical Branch

Submitted to: BioMed Central(BMC) Public Health
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/31/2024
Publication Date: 8/12/2024
Citation: Robertson, M.C., Swartz, M.C., Basen-Engquist, K., Li, Y., Jennings, K., Thompson, D.J., Baranowski, T., Volpi, E., Lyons, E.J. 2024. A social media game to increase physical activity among older adult women: Protocol of a randomized controlled trial to evaluate CHALLENGE. BioMed Central(BMC) Public Health. 24(1). Article 2172. https://doi.org/10.1186/s12889-024-19662-9.
DOI: https://doi.org/10.1186/s12889-024-19662-9

Interpretive Summary: Older adult women do not often engage in sufficient physical activity (PA) and may encounter biological changes that have negative effects from inadequate activity. Wearable activity monitors can facilitate PA initiation, but evidence of sustained behavior change is lacking. Adding activities that promote enjoyment, interest, meaning, and personal values associated with PA may support long term increased PA. This paper presents the protocol of a study designed to evaluate the efficacy of CHALLENGE (Challenges for Healthy Aging: Leveraging Limits for Engaging Networked Game-based Exercise) for increasing step count and motivation for PA in insufficiently active older women. We will recruit healthy, community dwelling older adult women on a rolling basis and randomize them to receive either the CHALLENGE intervention (experimental arm) or an activity monitor-only intervention (comparison arm). Experimental group participants will also be added to a private Facebook group, where they will face weekly challenges designed to elicit playful experiences while walking. Taking part in a year-long intervention that enhances walking behaviors with playful and celebratory experiences may help older adult women internalize PA changes to their identity and thereby facilitate sustained behavior change.

Technical Abstract: Older adult women often do not engage in sufficient physical activity (PA) and can encounter biological changes that exacerbate the negative effects of inadequate activity. Wearable activity monitors can facilitate PA initiation, but evidence of sustained behavior change is lacking. Supplementing wearable technologies with intervention content that evokes enjoyment, interest, meaning, and personal values associated with PA may support long term adherence. In this paper, we present the protocol of an NIA-funded study designed to evaluate the efficacy of CHALLENGE for increasing step count and motivation for PA in insufficiently active older women (Challenges for Healthy Aging: Leveraging Limits for Engaging Networked Game-based Exercise). CHALLENGE uses social media to supplement wearable activity monitors with the autonomy-supportive frame of a game. We hypothesize that CHALLENGE will engender playful experiences that will improve motivation for exercise and lead to sustained increases in step count. We will recruit 300 healthy, community dwelling older adult women on a rolling basis and randomize them to receive either the CHALLENGE intervention (experimental arm) or an activity monitor-only intervention (comparison arm). Participants in both groups will receive a wearable activity monitor and personalized weekly feedback emails. In the experimental group, participants will also be added to a private Facebook group, where study staff will post weekly challenges that are designed to elicit playful experiences while walking. Assessments at baseline and 6, 12, and 18 months will measure PA and motivation-related constructs. We will fit linear mixed-effects models to evaluate differences in step count and motivational constructs, and longitudinal mediation models to evaluate if interventional effects are mediated by changes in motivation. We will also conduct thematic content analysis of text and photos posted to Facebook and transcripts from individual interviews. By taking part in a year-long intervention centered on imbuing walking behaviors with playful and celebratory experiences, participating older adult women may internalize changes to their identity and relationship with PA that facilitate sustained behavior change. Study results will have implications for how we can harness powerful and increasingly ubiquitous technologies for health promotion to the vast and growing population of older adults in the U.S. and abroad.