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Online-delivered group and personal exercise programs to support low active older adults' mental health during the COVID-19 pandemic: a randomized controlled trial |
Beauchamp MR, Hulteen RM, Ruissen GR, Liu Y, Rhodes RE, Wierts CM, Waldhauser KJ, Harden SH, Puterman E |
Journal of Medical Internet Research 2021 Jul;23(7):e30709 |
clinical trial |
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
BACKGROUND: In response to the COVID-19 pandemic, experts in mental health science emphasized the importance of developing and evaluating approaches to support and maintain the mental health of older adults. OBJECTIVE: To assess whether a group-based exercise program relative to a personal exercise program (both delivered online) and wait-list control (WLC) can improve the psychological health of previously low active older adults during the early stages of the COVID-19 pandemic. METHODS: The Seniors COvid-19 Pandemic and Exercise (SCOPE) trial was a 3-arm, parallel randomized controlled trial conducted between May and September 2020 in which low active older adults (aged >= 65 years) were recruited via media outlets and social media. After baseline assessments, consented participants were randomized to one of two 12-week exercise programs (delivered online by older adult instructors) or a waitlist control condition. 241 older adults (n = 187 women) provided baseline measures (via online questionnaires), were randomized (N-group = 80, N-personal = 82, N-control = 79), and completed measures every two weeks for the duration of the trial. The trial's primary outcome was psychological flourishing. Secondary outcomes included global measures of mental and physical health, life satisfaction and depression symptoms. RESULTS: The results of latent growth modeling revealed no intervention effects for flourishing, life satisfaction, or depression symptoms (ps > 0.05). Participants in the group condition displayed improved mental health relative to WLC participants over the first 10 weeks (ES 0.288 to 0.601), and although the week 12 effect (ES 0.375) was in the same direction the difference was not statistically significant (p > 0.05). Participants in the personal condition displayed improved mental health, when compared to WLC participants, in the same medium effect size range (ES 0.293 to 0.565) over the first 8 weeks, and while the effects were of a similar magnitude at weeks 10 (ES 0.455) and 12 (ES 0.258) they were not statistically significant (p > 0.05). In addition, participants in the group condition displayed improvements in physical health when compared to the WLC (ES 0.079 to 0.496) across all 12 weeks of the study following baseline. No differences were observed between the personal exercise condition and WLC for physical health (p > 0.05). CONCLUSIONS: There were no intervention effects for the trial's primary outcome, psychological flourishing. It is possible that the high levels of psychological flourishing at baseline may have limited the extent to which those indicators could continue to improve further through intervention (ie, potential ceiling effects). However, the intervention effects for mental and physical health point to the potential capacity of low-cost and scalable at-home programs to support the mental and physical health of previously inactive adults in the COVID-19 pandemic. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT04412343, https://ClinicalTrials.gov/ct2/show/NCT04412343.
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