A Group-Based Walking Study Using WeChat to Enhance Physical Activity Among Older Adults

The aim for the study is to use the function WeRun in the application WeChat to encourage physical activity and social engagement among community dwelling older adults. The investigators asked participants in the social engagement group to use the WeRun function in WeChat to track their daily walking steps and to compare their performance with their group members for 4 weeks. To encourage social engagement among their group members, the daily walking steps were calculated and the participant who has the highest step count in the group will be indicated each day.Those in the control group will only use the WeRun function in WeChat to track their own walking steps.

The investigators expected that the participants in the social contact group will walk more often and report more social activities than those in the control group, who will not compete with their peers in daily walking. To test these predictions, daily walking steps and the total walking steps per week were obtained and compared across groups. The nature and the extent of change was analyzed over the four weeks. Exercise self-efficacy was measured using a measure based on Bandura's model. Social engagement was measured using the short Lubben Social Network Scale, a self report measure of social engagement on a 12-item scale, and physical activity was measured using International Physical Activity Questionnaire (IPAQ), a self-report measure of physical activity on a 12-item scale.

• Control condition (Behavioral): Participants in the control group only saw their own daily walking steps using the WeChat. They did not use WeChat to see other group members' daily steps and did not contact other group members. The participants were asked to use the app every day. A message (through WeChat) was sent to remind them to use the application if they had not done so within three days.
• Treatment condition (Behavioral): Participants in the experimental condition used WeChat for 4 weeks to see their own and other's walking steps and also were able to contact other group members. The participants were asked to use the application every day. A message (through the group chat) was sent to remind them to use the application if they have not done so within three days.

Primary outcomes

• Number of Steps Walked [[Time Frame: Baseline (pretest) Week, Week 4 (posttest) and Week 8 (one month follow up)]]: Weekly average number of steps recorded with WeRun on the phone \[ (averaged across 7 days at Baseline week and averaged across 7 days at Week 4 (Posttest) and averaged across 7 days at Week 8 (one month follow up)\].

Secondary outcomes

• Social Engagement [Pretest given 1 week before the intervention and then at the posttest after the 4 week study and one month follow up]: Short Lubben Social Network Scale-Revised, a self-report measure of social engagement on a 12-item scale. The total score is calculated by the sum of all the items. The total score ranges between 0 and 60, with a higher score indicating more social engagement.
• Exercise Self Efficacy [Pretest given 1 week before the intervention and then at the posttest after the 4 week study and one month follow up]: This scale is a self-report of exercise self-efficacy. Total score is calculated by summing the responses to each question. This scale has a range of total scores from 0-90. A higher score indicates higher self-efficacy for exercise.

Sex: All, ages: 60 Years to any, accepts healthy volunteers

Inclusion Criteria:

* Participants who are 60 or older who have a cellphone, with either android or iPhone system with data plan.
* They must be fit enough to walk for at least 20 minutes at a time.
* English speaking

Exclusion Criteria:

* Unable to walk more than 20 minutes;
* do not have smart phone with data plan.
* younger than 60

Participant flow

Outcome results

• Number of Steps Walked (Primary), Mean, steps: Control Condition 3992 +/- 2388; Treatment Condition 4125 +/- 2693 (p 0.02)
• Social Engagement (Secondary), Mean, units on a scale: Control Condition 35.1 +/- 11.5; Treatment Condition 35.9 +/- 11.3 (p 0.03)
• Exercise Self Efficacy (Secondary), Mean, units on a scale: Control Condition 57.7 +/- 22.8; Treatment Condition 60.3 +/- 22.3 (p 0.06)

Adverse events

Time frame: From enrollment through study completion, an average of 2 months

• Results publication: Liu Y, Lachman ME. A Group-Based Walking Study to Enhance Physical Activity Among Older Adults: The Role of Social Engagement. Res Aging. 2021 Oct-Dec;43(9-10):368-377. doi: 10.1177/0164027520963613. Epub 2020 Oct 6. PMID 33021146

• Study Protocol and Statistical Analysis Plan (PDF, 2019-07-22)
• Informed Consent Form (PDF, 2019-07-22)