A randomized controlled trial of an automated exercise coach for older adults.

Abstract:

OBJECTIVES:To compare the efficacy of a computer-based physical activity program (Embodied Conversational Agent-ECA) with that of a pedometer control condition in sedentary older adults. DESIGN:Single-blind block-randomized controlled trial stratified according to clinic site and health literacy status. SETTING:Three urban ambulatory care practices at Boston Medical Center between April 2009 and September 2011. PARTICIPANTS:Older adults (N = 263; mean age 71.3; 61% female; 63% African American; 51% high school diploma or less). INTERVENTION:ECA participants were provided with portable tablet computers with touch screens to use for 2 months and were directed to connect their pedometers to the computer using a data cable and interact with a computer-animated virtual exercise coach daily to discuss walking and to set walking goals. Intervention participants were then given the opportunity to interact with the ECA in a kiosk in their clinic waiting room for the following 10 months. Control participants were given a control pedometer intervention that only tracked step counts for an equivalent period of time. Intervention participants were also provided with pedometers. MEASUREMENTS:The primary outcome was average daily step count for the 30 days before the 12-month interview. Secondary outcomes were average daily step count for the 30 days before the 2-month interview. Outcomes were also stratified according to health literacy level. RESULTS:ECA participants walked significantly more steps than control participants at 2 months (adjusted mean 4,041 vs 3,499 steps/day, P = .01), but this effect waned by 12 months (3,861 vs 3,383, P = .09). For participants with adequate health literacy, those in the ECA group walked significantly more than controls at both 2 months (P = .03) and 12 months (P = .02), while those with inadequate health literacy failed to show significant differences between treatment groups at either time point. Intervention participants were highly satisfied with the program. CONCLUSION:An automated exercise promotion system deployed from outpatient clinics increased walking among older adults over the short-term. Effective methods for long-term maintenance of behavior change are needed.

journal_name

J Am Geriatr Soc

authors

Bickmore TW,Silliman RA,Nelson K,Cheng DM,Winter M,Henault L,Paasche-Orlow MK

doi

10.1111/jgs.12449

subject

Has Abstract

pub_date

2013-10-01 00:00:00

pages

1676-83

issue

10

eissn

0002-8614

issn

1532-5415

journal_volume

61

pub_type

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