JMIR Publications

Background:

Successful Aging is a multidimensional concept that encompasses mental and physical health, chronic disease management and social engagement of older adults. A number of mobile health (mHealth) interventions have been designed to promote Successful Aging, but the majority focus on one aspect such as physical health via diet or exercise, etc. and specific older adults such as high literacy or high income.

Objective:

The objective of this research is to test the feasibility of a mHealth intervention in community-dwelling older adults with low-socioeconomic status to improve self-perceptions of Successful Aging.

Methods:

This is a single-arm experimental pre–post design to test the feasibility of a mHealth app called eSeniorCare. 33 older adults from two low-income independent living facilities voluntarily participated in the study. 8 participants dropped out or did not complete and hence were not included in the analysis. The remaining 25 participants consisted of 14 females with the mean age 65 years (standard deviation= 7years). On average participants had 13.86 years of education and median income of 0 − $10K. Each participant received a tablet PC pre-installed with the eSeniorCare app and chosen casual mobile games. The study lasted for 42 weeks during which participants used the eSeniorCare app (to set and track medication intake reminders and health goals) and played casual games (for mental stimulation). Self-rated measures of Successful Aging were collected using standardized Short Form (SF12v2) Health Survey and standardized Older Person Quality of Life (OPQOL) questionnaire at the beginning and the end of the study. Semi-structured interviews were also conducted at the study conclusion.

Results:

The participants’ self-ratings of mental and physical health improved according to the evaluation questionnaires. According to the paired Wilcoxon-Rank sign test, only mental health (V = 405, P = 0.03*) and health-related quality of life (V = 211.5, P = 0.002*) improvements were statistically significant. Based on Wilcoxon-Rank Sum test, statistically significant differences in HRQOL gain scores were found between frequent and infrequent users of eSeniorCare (V = 38, P = 0.03*). Participants reported that the eSeniorCare app motivated them to take their medications on time and pursue self-set health goals. They also thought that playing tablet games was mentally stimulating and it improved their overall mental health. Based on their experiences with eSeniorCare, (n= 14 out of 20) 70% of the participants indicated that they would use technology to self-manage their medications, (n= 18 out of 25) 72% said they would use a technology-based goal-setting approach to self-manage their health and wellness, and (n= 23 out of 25) 92% indicated that they would recommend eSeniorCare to a friend.

Conclusions:

The results show that the participants found the eSeniorCare app useful and acceptable for managing health and wellness, which resulted in statistically significant improvements in self-perceptions of physical and mental health. Using mHealth apps may be feasible to improve self-perceptions of Successful Aging among community-dwelling older adults with low socioeconomic status.

Clinicaltrial: