Evaluation und Implementierung von Interventionen zur Förderung von körperlicher Aktivität bei älteren Erwachsenen unter besonderer Berücksichtigung von eHealth-Ansätzen

Abstract

Despite the known positive effects of regular physical activity on physical, psychological, and cognitive health, only about one fifth of adults aged 65 years and above living in Germany meets the physical activity recommendations of the World Health Organization. The increasing digitalization opens new opportunities for the promotion of physical activity. Interventions which are delivered via the internet or mobile devices are defined as electronic health (eHealth) interventions. The aim of this dissertation was to investigate various aspects of the evaluation and implementation of interventions promoting physical activity in older adults, particularly focusing on eHealth interventions. The objective of this dissertation was examined in three parts, using a combination of quantitative and qualitative methods: 1) A systematic review was conducted to examine the effectiveness of eHealth interventions promoting physical activity in adults aged 55 years and above compared to either a non-eHealth physical activity intervention or a no intervention control group. 2) In a randomized controlled trial, the effectiveness of two ten-week web-based interventions promoting physical activity in adults aged 65 years and above on objectively measured physical activity was evaluated in comparison to a delayed intervention control group. 3) In qualitative case studies, facilitating factors for the implementation and maintenance of interventions and policies promoting physical activity were examined. The review showed that eHealth interventions can effectively promote physical activity in older adults compared to a no intervention control group, at least in the short-term. Compared to more traditional intervention modalities (e.g., print interventions), eHealth interventions were not more effective in promoting physical activity in older adults. Participants of the two web-based physical activity interventions did not increase moderate-to-vigorous physical activity or decrease sedentary behaviour after ten weeks, compared to a delayed intervention control group. Facilitating factors for the implementation and maintenance of interventions and policies promoting physical activity were active involvement of relevant stakeholders, standardized training for staff, tailoring of intervention materials to the needs of the target group, embedding in existing or newly created organisational structures, and continuous funding. eHealth interventions have the potential to promote physical activity in older adults. However, older adults are a very heterogeneous group. Future intervention studies promoting physical activity of older adults should hence be designed as individually as possible (e.g., with regards to the use of technical components). In addition, the target group and stakeholders should be involved more in the development and implementation of future physical activity studies targeting older adults. More time, personnel, and financial resources should be invested in the development of interventions to promote physical activity, particularly to encourage physically inactive persons to participate.