A Municipality Implemented Behavioural Intervention to Improve Quality of Life Among Older Adults
ConditionQuality of Life
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age70+
SponsorLund University
About this trial
Ageing is associated with circadian rhythm sleep disorders, poor sleep at night, less physical activity and more time spent indoors, affecting the wellbeing of older adults. Their sleep and mood could benefit from daytime outdoor physical activity, exposure to daylight, better indoor lighting and sleep routines. However, maintaining or increasing one's physical activity can be challenging depending on individual behavioural conditions, e.g., having the physical and cognitive capacity (capability), finding the activity enjoyable and relevant to one's needs (motivation), and having a supportive social and physical environment (opportunity), such as a walk-friendly environment. To address these challenges, a complex behavioural intervention was developed. The intervention is delivered as a web-based course ('Light, activity and sleep in my daily life', LAS) that targets light-related behaviour, outdoor walking and sleep behaviour among community-dwelling older adults. This protocol describes a pilot case study aiming to evaluate the usability and usefulness of the LAS intervention, the intervention outcomes and whether changes to routines are sustained.
Eligible intervention participants (target N=40) are Swedish-speaking adults (≥ 70 years), living in one-person households in apartments in four municipalities. Participants complete questionnaires assessing intervention outcome measures (e.g., quality of life), are interviewed about their daily routines, and wear an accelerometer which tracks activity and rest at the baseline. Participants then enrol in a 9-week course, including self-studies at home and four physical meetings at the senior citizen meeting point. Baseline measures are repeated after the course, at 3, 6 and 10 months after baseline. In addition, participants evaluate the intervention's usability and usefulness after the course at 3 months and are interviewed at 6 months after baseline about perceived enablers and inhibitors to daytime outdoor walking.
Results will inform a subsequent larger case study focused on optimising the LAS intervention's content and delivery procedures to enable an intervention better integrated into municipal health promotion services/strategies. An anticipated long-term outcome is continued active ageing and independence.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
aged 70 and over, ambulatory and sighted,
Swedish speaking,
living independently in one-person households in ordinary apartments and
receiving no or limited home care services.
Disqualifiers
None
Trial design
Design model
Single group
Treatments tested in this trial
'Light, activity and sleep in my daily life' intervention
BehavioralThe intervention is complex in that it considers multiple factors (e.g., light-related behaviour, physical activity and sleep behaviour) and multiple components (e.g., cognitive goal setting and implementation). The intervention is delivered as a web-based course on a digital learning platform. Course material is placed in nine modules covering electric lighting, daylight, physical activity outdoors and sleep. Besides online material, the course includes a test kit containing light bulbs, a sleep mask, a checklist for the room inventory, a cap, a notebook, and a sleep diary. The purpose of the test kit is to encourage experimentation and provide handouts and printed copies to facilitate the completion of assignments.
Treatment groups
40 Participants
are divided into 1 treatment groupGroup A: InterventionExperimental treatment 1 intervention
Trial outcomes
Primary outcomes
1
Usability
System Usability Scale score. The usability of the intervention, that is, if the online content is easy for the intervention participants to use, will be evaluated through a usability testing questionnaire (perceptions of complexity, integration of functions, consistency). Following published instructions on scoring of the 10-item System Usability Scale (SUS), a total usability score will be calculated ranging from 0 to 100. Higher SUS scores indicate greater usability. Based on empirical evaluations of the SUS, a SUS score below 50 indicates usability difficulties, while scores in the 70s and 80s are considered promising.
Time frame
At one timepoint: 3 months after baselineSecondary outcomes
1
Mood
Short Swedish Core Affect Scales. Two scales measuring two dimensions, 'valence' (including three adjective pairs) and 'activation' (including three adjective pairs). Scores for each dimension can range from 1 to 9, with higher scores indicating better mood.
Time frame
At four timepoints: baseline, 3, 6 and 13 months after baseline2
Sleep quality
Sleep Disturbance instrument, Patient-Reported Outcomes Measurement Information System (PROMIS) Bank v1.0. Assessing sleep disturbance, including four items. The total raw score can range from 32 to 73.3, with higher scores indicating worse sleep quality.
Time frame
At four timepoints: baseline, 3, 6 and 13 months after baseline3
Behavioural skill
A New General Self-efficacy Scale. Assessing general self-efficacy, including eight items (goal achievement, task accomplishment, obtaining important outcomes, succeeding at most any endeavour, overcoming challenges, effective performance, doing tasks well, performing well even when things are tough). The global score can range from 1 to 5, with higher scores indicating higher self-efficacy.
Time frame
At four timepoints: baseline, 3, 6 and 13 months after baseline4
Quality of life
World Health Organization Quality of Life (BREF) questionnaire. Assessing quality of life over four domains (physical health, psychological, social relationships, environment). Scores for each domain can range from zero to 100, with higher scores indicating better quality of life.
Time frame
At four timepoints: baseline, 3, 6 and 13 months after baselineOther outcomes
1
Computer anxiety
Short Computer Anxiety Scale. Assessing computer anxiety, including six items. The global score can range from 6 to 36, with higher scores indicating higher computer anxiety.
Time frame
At two timepoints: baseline and 3 months after baseline2
Lighting quality
Perceived Indoor Lighting Quality. Five bipolar adjective scales measuring the dimension 'Strength' and five measuring the dimension 'Hedonic tone'. Scores for each dimension can range from 1 to 7, with higher scores indicating higher 'Strength' (perceived strength quality) and higher 'Hedonic tone' (perceived comfort quality).
Time frame
At two timepoints: baseline and 3 months after baselineSponsors and contacts
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Source ClinicalTrials.gov