This randomized controlled trial aims to evaluate the impact of a mobile-friendly, web-based hydration tracking application (named "SIVI") on hydration-related knowledge, attitudes, and behaviors in older adults. Inadequate fluid intake is a common and modifiable risk factor for dehydration in the elderly, leading to increased morbidity, hospitalizations, and functional decline. However, many older individuals forget to drink fluids or face barriers such as fear of incontinence, mobility limitations, or cognitive challenges.
This study will include 70 community-dwelling older adults aged 65-84 years, recruited from a Family Health Center. Participants will be randomly assigned to either the intervention or control group. The intervention group will use the SIVI application for two months. The app is specially designed for older adults and includes features such as personalized fluid goals, reminders, hydration education modules, feedback, and a user-friendly interface with large fonts and high contrast. Participants will log their daily fluid intake, receive motivational messages, and access videos and information about healthy hydration habits. A water bottle will be provided to standardize measurement across groups.
The control group will receive only routine care. Both groups will complete questionnaires measuring demographics, hydration knowledge, attitudes, behaviors, and fluid consumption habits at baseline, one month, and two months.
Data collection will be conducted face-to-face by the researcher, and analysis will be performed using SPSS 22.0. Statistical tests will include descriptive statistics, Shapiro-Wilk for normality, chi-square for categorical data, and t-tests and ANOVA for comparisons over time.
The results are expected to show that the SIVI application improves older adults' hydration knowledge, fosters positive attitudes, and promotes healthy fluid intake behaviors, thus supporting self-management of hydration and potentially reducing dehydration-related health risks.
Daily water and other fluid intake below the recommended levels: less than 2.0 L/day for older adult men and less than 1.6 L/day for older adult women (ESPEN Guidelines, 2024) Aged between 65 and 84 years Having at least a primary school education Having sufficient motor skills Having the cognitive capacity, willingness, and experience necessary to use technology Willing to participate in the study Owning a mobile phone compatible with the application Having prior experience using mobile applications
Diagnosed with moderate or severe cognitive impairment (MMSE < 24)
Having vision or hearing impairments that prevent participation
Diagnosed with advanced stage chronic kidney disease (Stage 4-5)
Diagnosed with congestive heart failure (NYHA class III-IV)
Parallel
Mobile-Compatible Web-Based Hydration Tracking Program
BehavioralIntervention Description: The SIVI Hydration Application is a mobile-compatible, web-based behavioral intervention designed specifically for older adults. It supports self-monitoring and self-management of daily fluid intake through features such as personalized fluid goals, visual drink-logging with icons, daily reminders, progress graphics, educational videos, and motivational digital badges. The app was developed using gerotechnology and universal design principles to accommodate cognitive and sensory changes common in aging. Its unique focus on hydration behavior, combined with usability features like large fonts, high contrast, and voice-assisted guidance, distinguishes it from general health or diet tracking apps. Participants use the app for 8 weeks as part of a structured intervention with training and weekly follow-up.
Hydration Knowledge, Attitude, and Behavior Scale Scores
Participants' hydration-related knowledge, attitude, and behavior will be assessed using the Turkish version of the Hydration Knowledge, Attitude, and Behavior Scale (HyKS). The scale includes 16 knowledge items, 18 attitude items, and 4 behavior items. Scores are calculated separately for each domain. Higher scores indicate improved knowledge, more positive attitudes, and healthier hydration behaviors.
System Usability Score of the Mobile Hydration Tracking Application
Usability and user satisfaction with the hydration tracking mobile application will be assessed using the Turkish version of the System Usability Scale (SUS). The SUS consists of 10 items rated on a 5-point Likert scale. The total score is calculated by summing item scores after reverse scoring specific items (2, 4, 6, 8, and 10), then multiplying the result by 2.5 to yield a total score ranging from 0 to 100. Higher scores indicate better usability. Scores of 65-70 and above reflect acceptable usability. The SUS is a reliable, validated tool to assess user experience in mobile health interventions
Fluid Intake Habits Based on Self-Reported Form
Fluid intake habits will be assessed using a self-developed "Fluid Intake Habits Form" created by the investigator. The form collects descriptive data on the types and amounts of fluids consumed daily, frequency and timing of fluid intake, personal fluid intake goals, and behaviors such as self-monitoring. The form also identifies factors affecting fluid consumption (e.g., medication use, chronic illness, environmental influences). Expert opinion will obtained to validate the content. Responses will be analyzed to observe qualitative and quantitative changes in fluid intake patterns over the course of the intervention.
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Ezgi Atasoy
Lead sponsor
Dokuz Eylul University
Sponsor institution
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