Abstract
The feasibility and preliminary efficacy of a mobile health self-management intervention aimed at improving sleep among older adults with osteoarthritis and disturbed sleep were evaluated. This was a one-group pre-/posttest pilot study. Feasibility was measured by the number of participants eligible, enrolled, and retained. Primary efficacy outcomes were Insomnia Severity Index (ISI) score and two sleep actigraphy variables: total sleep time (TST) and sleep efficiency (SE). Overall step count, self-efficacy (SEff), and acceptance of sleep difficulties (ASD) were mechanisms of action variables. Assessments were at baseline, Week 14 (postintervention), and Week 19 (follow up). Mixed effect models were used to measure change over time. Twenty-four participants (mean age = 71 years) were enrolled and 22 completed the study. Improvements of 1.2 (95% confidence interval [CI] [−2.43, −0.05]; p = 0.04) and 2.5 (95% CI [0.9, 4.9]; p = 0.02) points in the ISI and ASD scores, respectively, were found over the 19-week period. These findings add to a growing literature that suggests older adults might reap benefits from mobile health interventions.
Targets:
Older adults with osteoarthritis and insomnia symptoms.
Intervention Description:
Activity trackers synced to a dashboard that triggered personalized weekly step goals and motivational messages augmented by telephone motivational interviews.
Mechanism of Action:
Physical activity, SEff, and ASD.
Outcomes:
Sleep measures.
[Res Gerontol Nurs. 2019; 12(4):167–173.]
- Anderson M., Perrin A. (2017, May17). Tech adoption climbs among older adults. Retrieved from http://www.pewinternet.org/2017/05/17/tech-adoption-climbs-among-older-adults > Google Scholar
- Bastien C.H., Vallières A., Morin C.M. (2001). Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Medicine, 2, 297–307.
10.1016/S1389-9457(00)00065-4 > Crossref MedlineGoogle Scholar - Bothelius K., Jernelöv S., Fredrikson M., McCracken L.M., Kaldo V. (2015). Measuring acceptance of sleep difficulties: The development of the Sleep Problem Acceptance Questionnaire. Sleep, 38, 1815–1822.
10.5665/sleep.5170 > CrossrefGoogle Scholar - Burton E., Hill K.D., Lautenschlager N.T., Thøgersen-Ntoumani C., Lewin G., Boyle E., Howie E. (2018). Reliability and validity of two fitness tracker devices in the laboratory and home environment for older community-dwelling people. BMC Geriatrics, 18, 103.
10.1186/s12877-018-0793-4 > CrossrefGoogle Scholar - Carver C.S., Scheier M.F. (1982). Control theory: A useful conceptual framework for personality-social, clinical, and health psychology. Psychology Bulletin, 92, 111–135.
10.1037/0033-2909.92.1.111 > CrossrefGoogle Scholar - Foley S., Ancoli-Israel S., Britz P., Walsh J. (2004). Sleep disturbances and chronic disease in older adults: Results of the 2003 National Sleep Foundation Sleep in America Survey. Journal of Psychosomatic Research, 56, 495–502.
10.1016/j.jpsychores.2004.02.010 > CrossrefGoogle Scholar - Georgopoulou S., Prothero L., Lempp H., Galloway J., Sturt J. (2016). Motivational interviewing: Relevance in the treatment of rheumatoid arthritis?Rheumatology, 55, 1348–1356.
10.1093/rheumatology/kev379 > CrossrefGoogle Scholar - Kirwan J.R., Hewlett S.E., Heiberg T., Hughes R.A., Carr M., Hehir M., Wale J. (2005). Incorporating the patient perspective into outcomes assessment in rheumatoid arthritis–Progress at OMERACT 7. Journal of Rheumatology, 32, 2250–2256. > Google Scholar
- Kitsiou S., Thomas M., Marai G.E., Maglaveras N., Kondos G., Arena R., Gerber B. (2017). Development of an innovative mHealth platform for remote physical activity monitoring and health coaching of cardiac rehabilitation patients. In 2017 IEEE EMBS International Conference on Biomedical & Health Informatics (BHI) (pp. 133–136). New York, NY: IEEE.
10.1109/BHI.2017.7897223 > CrossrefGoogle Scholar - Lau W.K.W., Leung M.K., Wing Y.K., Lee T.M.C. (2018). Potential mechanisms of mindfulness in improving sleep and distress. Mindfulness, 9, 547–555.
10.1007/s12671-017-0796-9 > CrossrefGoogle Scholar - Lee J., Chang R.W., Ehrlich-Jones L., Kwoh C.K., Nevitt M., Semanik P.A., Dunlop D.D. (2015). Sedentary behavior and physical function: Objective evidence from the Osteoarthritis Initiative. Arthritis Care & Research, 67, 366–373.
10.1002/acr.22432 > CrossrefGoogle Scholar - Lipton R.B., Katz M.J., Kuslansky G., Sliwinski M.J., Stewart W.F., Verghese J., Buschke H. (2003). Screening for dementia by telephone using the memory impairment screen. Journal of the American Geriatrics Society, 51, 1382–1390.
10.1046/j.1532-5415.2003.51455.x > CrossrefGoogle Scholar - Lorig K.R., Sobel D.S., Ritter P.L., Laurent D., Hobbs M. (2001). Effect of a self-management program on patients with chronic disease. Effective Clinical Practice, 4, 256–262. > MedlineGoogle Scholar
- McCracken L. (2011). Mindfulness and acceptance in behavioral medicine: Current theory and practice. Oakland, CA: New Harbinger Publications. > Google Scholar
- Nguyen H.Q., Gill D.P., Wolpin S., Steele B.G., Benditt J.O. (2009). Pilot study of a cell phone-based exercise persistence intervention post-rehabilitation for COPD. International Journal of Chronic Obstructive Pulmonary Disease, 4, 301–313.
10.2147/COPD.S6643 > CrossrefGoogle Scholar - Parker S.J., Jessel S., Richardson J.E., Reid M.C. (2013). Older adults are mobile too! Identifying the barriers and facilitators to older adults' use of mHealth for pain management. BMC Geriatrics, 13, 43.
10.1186/1471-2318-13-43 > Crossref MedlineGoogle Scholar - Power J.D., Perruccio A.V., Badley E.M. (2005). Pain as a mediator of sleep problems in arthritis and other chronic conditions. Arthritis and Rheumatism, 53, 911–919.
10.1002/art.21584 > Crossref MedlineGoogle Scholar - Rabe-Hesketh S., Skrondal A. (2008). Multilevel and longitudinal modeling using Stata (2nd ed.). College Station, TX: Stata Press. > Google Scholar
- Regnaux J.P., Lefevre-Colau M.M., Trinquart L., Nguyen C., Boutron I., Brosseau L., Ravaud P. (2015). High-intensity versus low-intensity physical activity or exercise in people with hip or knee osteoarthritis. Cochrane Database of Systematic Reviews, 29, CD010203.
10.1002/14651858.CD010203.pub2 > CrossrefGoogle Scholar - Salaffi F., Stancati A., Grassi W. (2006). Reliability and validity of the Italian version of the Chronic Pain Grade questionnaire in patients with musculoskeletal disorders. Clinical Rheumatology, 25, 619–631.
10.1007/s10067-005-0140-y > CrossrefGoogle Scholar - Taibi D.M., Vitiello M.V. (2011). A pilot study of gentle yoga for sleep disturbance in women with osteoarthritis. Sleep Medicine, 12, 512–517.
10.1016/j.sleep.2010.09.016 > Crossref MedlineGoogle Scholar - Topolski T.D., LoGerfo J., Patrick D.L., Williams B., Walwick J., Patrick M.B. (2006). The Rapid Assessment of Physical Activity (RAPA) among older adults. Preventing Chronic Disease, 3, A118. > Google Scholar
- Vidoni E.D., Watts A.S., Burns J.M., Greer C.S., Graves R.S., Van Sciver A., Bieberle N.A. (2016). Feasibility of a memory clinic-based physical activity prescription program. Journal of Alzheimer's Disease, 53, 161–170.
10.3233/JAD-160158 > CrossrefGoogle Scholar - Vitiello M.V., Rybarczyk B., Von Korff M., Stepanski E.J. (2009). Cognitive behavioral therapy for insomnia improves sleep and decreases pain in older adults with co-morbid insomnia and osteoarthritis. Journal of Clinical Sleep Medicine, 5, 355–362. > Crossref MedlineGoogle Scholar
- Vowles K.E., McCracken L.M., O'Brien J.Z. (2011). Acceptance and values-based action in chronic pain: A three-year follow-up analysis of treatment effectiveness and process. Behaviour Research and Therapy, 49, 748–755.
10.1016/j.brat.2011.08.002 > CrossrefGoogle Scholar - Zhao J., Freeman B., Li M. (2016). Can mobile phone apps influence people's health behavior change? An evidence review. Journal of Medical Internet Research, 18(11), e287.
10.2196/jmir.5692 > CrossrefGoogle Scholar