@Article{info:doi/10.2196/36515,
author="Lippke, Sonia
and Ratz, Tiara
and Keller, Franziska Maria
and Juljugin, Dennis
and Peters, Manuela
and Pischke, Claudia
and Voelcker-Rehage, Claudia",
title="Mitigating Feelings of Loneliness and Depression by Means of Web-Based or Print-Based Physical Activity Interventions: Pooled Analysis of 2 Community-Based Intervention Trials",
journal="JMIR Aging",
year="2022",
month="Aug",
day="9",
volume="5",
number="3",
pages="e36515",
keywords="physical activity; older adults; intervention; loneliness; depression; eHealth; mobile health; mHealth",
abstract="Background: Physical activity (PA) is associated with benefits, such as fewer depressive symptoms and loneliness. Web- and print-based PA interventions can help older individuals accordingly. Objective: We aimed to test the following research questions: Do PA interventions delivered in a web- or print-based mode improve self-reported PA stage of change, social-cognitive determinants of PA, loneliness, and symptoms of depression? Is subjective age a mediator and stage of change a moderator of this effect? Methods: Overall, 831 adults aged ≥60 years were recruited and either allocated to a print-based or web-based intervention group or assigned to a wait-list control group (WLCG) in 2 community-based PA intervention trials over 10 weeks. Missing value imputation using an expectation-maximization algorithm was applied. Frequency analyses, multivariate analyses of variance, and moderated mediation analyses were conducted. Results: The web-based intervention outperformed (47/59, 80{\%} of initially inactive individuals being adopters, and 396/411, 96.4{\%} of initially active individuals being maintainers of the recommended PA behavior) the print-based intervention (20/25, 80{\%} of adopters, and 63/69, 91{\%} of maintainers) and the WLCG (5/7, 71{\%} of adopters; 141/150, 94{\%} of maintainers). The pattern regarding adopters was statistically significant (web vs print Z=--1.94; P=.02; WLCG vs web Z=3.8367; P=.01). The pattern was replicated with stages ($\chi$24=79.1; P<.001; contingency coefficient 0.314; P<.001); in the WLCG, 40.1{\%} (63/157) of the study participants moved to or remained in action stage. This number was higher in the groups receiving web-based (357/470, 76{\%}) or print-based interventions (64/94, 68.1{\%}). A significant difference was observed favoring the 2 intervention groups over and above the WLCG (F19, 701=4.778; P<.001; $\eta$2=0.098) and a significant interaction of time and group (F19, 701=2.778; P<.001; $\eta$2=0.070) for predictors of behavior. The effects of the interventions on subjective age, loneliness, and depression revealed that both between-group effects (F3, 717=8.668; P<.001; $\eta$2=0.018) and the interaction between group and time were significant (F3, 717=6.101; P<.001; $\eta$2=0.025). In a moderated mediation model, both interventions had a significant direct effect on depression in comparison with the WLCG (web-based: c{\textasciiacutex} path −0.86, 95{\%} CI −1.58 to −0.13, SE 0.38; print-based: c{\textasciiacutex} path −1.96, 95{\%} CI −2.99 to −0.92, SE 0.53). Furthermore, subjective age was positively related to depression (b path 0.14, 95{\%} CI 0.05-0.23; SE 0.05). An indirect effect of the intervention on depression via subjective age was only present for participants who were in actor stage and received the web-based intervention (ab path −0.14, 95{\%} CI −0.34 to −0.01; SE 0.09). Conclusions: Web-based interventions appear to be as effective as print-based interventions. Both modes might help older individuals remain or become active and experience fewer depression symptoms, especially if they feel younger. Trial Registration: German Registry of Clinical Trials DRKS00010052 (PROMOTE 1); https://tinyurl.com/nnzarpsu and DRKS00016073 (PROMOTE 2); https://tinyurl.com/4fhcvkwy International Registered Report Identifier (IRRID): RR2-10.2196/15168 ",
issn="2561-7605",
doi="10.2196/36515",
url="https://aging.jmir.org/2022/3/e36515",
url="https://doi.org/10.2196/36515",
url="http://www.ncbi.nlm.nih.gov/pubmed/35943790"
}