Opportunities to Improve a Mobile Obesity Wellness Intervention for Rural Older Adults with Obesity

A qualitative study to determine whether mHealth devices, like Amulet, could be useful in supporting rural-health interventions.

  • John Batsis, Stephen Bartels, Rachel Dokko, Alexandra Zagaria, John Naslund, Elizabeth Carpenter-Song, and David Kotz. Opportunities to Improve a Mobile Obesity Wellness Intervention for Rural Older Adults with Obesity. Journal of Community Health, September 2019. DOI 10.1007/s10900-019-00720-y.

Abstract: Older adults with obesity are at a high risk of decline, particularly in rural areas. Our study objective was to gain insights into how a potential Mobile Health Obesity Wellness Intervention (MOWI) in rural older adults with obesity, consisting of nutrition and exercise sessions, could be helpful to improve physical function. A qualitative methods study was conducted in a rural community, community-based aging center. Four community leaders, 7 clinicians and 29 patient participants underwent focus groups and semi-structured interviews. All participants had a favorable view of MOWI and saw its potential to improve health and create accountability. Participants noted that MOWI could overcome geographic barriers and provided feedback about components that could improve implementation. There was expressed enthusiasm over its potential to improve health. The use of technology in older adults with obesity in rural areas has considerable promise. There is potential that this intervention could potentially extend to distant areas in rural America that can surmount accessibility barriers. If successful, this intervention could potentially alter healthcare delivery by enhancing health promotion in a remote, geographically constrained communities. MOWI has the potential to reach older adults with obesity using novel methods in geographically isolated regions.

Usability evaluation for the Amulet wearable device in rural older adults with obesity

The following paper dates to last year, but is an important publication from the Amulet group:

  • John A. Batsis, Alexandra Zagaria, David F. Kotz, Stephen J. Bartels, George G. Boateng, Patrick O. Proctor, Ryan J. Halter, and Elizabeth A. Carpenter-Song. Usability evaluation for the Amulet wearable device in rural older adults with obesity. Gerontechnology, 17(3):151-159, 2018. DOI 10.4017/gt.2018.

Abstract: Mobile health (mHealth) interventions hold the promise of augmenting existing health promotion interventions. Older adults present unique challenges in advancing new models of health promotion using technology including sensory limitations and less experience with mHealth, underscoring the need for specialized usability testing. We use an open-source mHealth device as a case example for its integration in a newly designed health services intervention. We performed a convergent, parallel mixed-methods study including semi-structured interviews, focus groups, and questionnaires, using purposive sampling of 29 older adults, 4 community leaders, and 7 clinicians in a rural setting. We transcribed the data, developed codes informed by thematic analysis using inductive and deductive methods, and assessed the quantitative data using descriptive statistics. Our results suggest the importance of end-users in user-centered design of mHealth devices and that aesthetics are critically important. The prototype could potentially be feasibly integrated within health behavior interventions. Centralized dashboards were desired by all participants and ecological momentary assessment could be an important part of monitoring. Concerns of mHealth, including the prototype device, include the device’s accuracy, its intrusiveness in daily life and privacy. Formative evaluations are critically important prior to deploying large-scale interventions.

Use of Amulet in behavioral change for geriatric obesity management

John Batsis and the Amulet team just published a paper regarding Use of Amulet in behavioral change for geriatric obesity management.

Background: Obesity in older adults is a significant public health concern. Weight-loss interventions are known to improve physical function but risk the development of sarcopenia. Mobile health devices have the potential to augment existing interventions and, if designed accordingly, could improve one’s physical activity and strength in routine physical activity interventions. Methods and results: We present Amulet, a mobile health device that has the capability of engaging patients in physical activity. The purpose of this article is to discuss the development of applications that are tailored to older adults with obesity, with the intention to engage and improve their health. Conclusions: Using a team-science approach, Amulet has the potential, as an open-source mobile health device, to tailor activity interventions to older adults.

John A. Batsis, Alexandra B. Zagaria, Ryan J. Halter, George G. Boateng, Patrick Proctor, Stephen J. Bartels, and David Kotz. Use of Amulet in behavioral change for geriatric obesity management. Journal of Digital Health, 5, June 2019. DOI 10.1177/2055207619858564.

Technology for Behavioral Change in Rural Older Adults with Obesity

A new paper from the extended Amulet group.

John A. Batsis, John A. Naslund, Alexandra B. Zagaria, David Kotz, Rachel Dokko, Stephen J. Bartels & Elizabeth Carpenter-Song. Technology for Behavioral Change in Rural Older Adults with ObesityJournal of Nutrition in Gerontology and Geriatrics, April 2019.DOI: 10.1080/21551197.2019.1600097

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New grant to apply Amulet to study obesity in elderly people

Dr. John Batsis, DHMCThe Amulet team is collaborating with geriatrician Dr. John Batsis of Dartmouth-Hitchcock Medical Center to explore the use of the Amulet in developing intervension methods to help obese elderly people maintain function while they remain living at home.  This “grant … from the National Institute on Aging will allow Dr. John A. Batsis to focus on strategies for improving health care delivery and wellness in older adults with obesity by using video conferencing, personal monitoring devices and frequent coaching by healthcare providers.” [press release]

Check out the video interview with Dr. Batsis on WCAX television.

This research is supported by the National Institute On Aging of the National Institutes of Health under Award Number K23AG051681.