Protocol for a randomised, double-blind trial of a chronotherapeutic mobile health (mHealth) behaviour change intervention to optimise light exposure among older adults aged ≥60 years in Singapore (LightSPAN)
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Background
Suboptimal light exposure among older adults can exacerbate circadian disruption, sleep disturbances, mood disorders, cognitive decline, and frailty. In urbanised environments like Singapore, older adults are particularly vulnerable due to lifestyle and built environment constraints. The LightSPAN study evaluates a chronotherapeutic mobile health (mHealth) behaviour change intervention, delivered via the LightUP app, designed to optimise light exposure patterns and support healthy ageing.
Methods
The main trial is a community-based, double-blind, parallel-group randomised controlled trial involving approximately 90 community-dwelling older adults (≥60 years) recruited through Active Ageing Centres in Singapore. Participants will be randomised using a secure web-based system with stratification by age, sex and recruitment site to receive either the active LightUP app with behaviour change features (goal setting, self-monitoring, personalised feedback) or a placebo version without these features. The primary outcome is daily time above 250 lx melanopic equivalent daylight illuminance (melanopic EDI) during daytime, measured with the ActLumus light logger across baseline, intervention and follow-up periods. Secondary outcomes include sleep parameters and circadian rest-activity rhythms, sleep quality, mood, cognition, frailty status, physical activity, body composition and vitamin D levels. The usability and acceptability of the LightUP app and wearable devices will also be assessed. Analyses will follow the intention-to-treat principle, supplemented by per-protocol analyses. Generalized linear mixed models will be used for repeated measures, with multiple imputation for missing data and exploratory Bayesian analyses. All analyses will be pre-registered on the Open Science Framework and de-identified datasets and code will be openly shared under a CC-BY license.
Discussion
Despite its central role in circadian regulation, light exposure has rarely been targeted in behavioural preventive interventions for older adults. This study evaluates a novel mHealth-enabled approach that empowers older adults to optimise their light exposure, extending the scope of non-pharmacological strategies for preventive medicine and health promotion.
Trial Registration
This study was retrospectively registered at the ISRCTN – The UK’s Clinical Study Registry on 05 September 2025 (ID: ISRCTN123919320 , https://doi.org/10.1186/ISRCTN12391932 ).
