Effects of a Blended Face-to-Face and eHealth Lifestyle Intervention on Physical Activity, Diet, and Health Outcomes in Hong Kong Community-Dwelling Older Adults: A Randomized Controlled Trial

Background: Unhealthy lifestyle patterns, consisting of insufficient physical activity (PA) and unhealthy diets, are prevalent among older people, leading to detrimental health outcomes as the population ages. Traditional face-to-face was found to be resource-intensive and limited transfer. Exploring eHealth as a complementary approach to traditional interventions for older adults holds promise. However, whether a blended approach, integrating both face-to-face and eHealth interventions, could potentially enhance the effectiveness of interventions aimed at initiating and sustaining positive lifestyle behaviors was not tested in older individuals so far systematically. This study aims to examine the intervention effectiveness on health behaviors (i.e., PA and diet) and health outcomes among Hong Kong older adults. Methods: A three-arm, single-blind, randomized controlled trial was conducted. 132 eligible older adults were recruited and randomly assigned into three groups. The blended intervention group received 10-week weekly two 60-minute face-to-face sessions with one for PA and one for diet, and two web-based sessions with one for PA and one for diet. The face-to-face intervention group received the same content and intensity like the blended group but as face-to-face sessions. The control group underwent biweekly telephone interviews. Data were collected at baseline, 10-week post-test, and 3-month follow-up assessment. All data were analyzed using IBM SPSS 29.0. A series of generalized linear mixed models were used to evaluate the effects of the intervention. Results : The findings supported the effectiveness of blended interventions for PA and diet behaviors. Significant interaction effects were found on diet behaviors with large effect sizes. More participants in the blended group met the multiple health behavior guidelines than those in the face-to-face and control groups at T2 and T3. The results also revealed significant interaction effects on PA self-efficacy, PA planning, PA action control, fruit and vegetable intake self-efficacy, and meat, fish, egg, and alternatives intake action control. Significant intervention effects were found in agility and dynamic balance, and health-related quality of life. Conclusions : This study provides empirical evidence for the effectiveness of blended interventions designed to promote PA, diet, and overall health outcomes among Hong Kong older adults. Trial registration : ISRCTN, ISRCTN32329348. Registered 1 December 2023 - Retrospectively registered, https://doi.org/10.1186/ISRCTN32329348