PreventIT brought together a strong consortium with partners from five European research institutions (Norwegian University of Science and Technology in Trondheim, Norway; University of Bologna, Italy; Free University of Amsterdam, the Netherlands; University of Manchester, England; École Polytechnique Fédérale de Lausanne, Switzerland), two hospitals (Robert Bosch Gesellschaft für Medizinische Forschung in Stuttgart, Germany; Local Health Unit Tuscany Centre in Florence, Italy), and two companies (D.o.x.e.e. Spa, Italy; Health Leads BV, the Netherlands).
In PreventIT, we developed iPAS, a proof of concept smartphone and smartwatch mobile health application for assessment and screening of functional fitness and for the delivery of a life style integrated behavioural change intervention focusing on balance, strength and physical activity. Our target group was people between 61 and 70 years of age. We developed and decided on the content of the intervention and motivational aspects to increase uptake over time, and we developed methods to measure complexity in behavior and investigated whether our intervention can prevent loss of complexity. Data from the smartphones were processed and stored on a cloud-based server designed for the project and sent back to the phones in real time for feedback. We applied a user centered design process to develop the technology, and tested it in two pilot studies and a feasibility randomized controlled trial. The feasibility trial aimed at assessing feasibility and usability of the iPAS system compared with the same intervention delivered in a paper-pen format and with a control group. The intervention lasted for six months, and participants were encouraged to continue on their own for another six months. We included in total 180 participants; 60 in each of the two intervention groups and in the control group. Results indicated that the interventions were feasible and safe, with good intervention uptake and acceptable adherence. Participants were aware that the technology was not fully developed, but they liked the concept of lifestyle-integrated activities, managed to change their daily routines towards increased activity, and were positive about the proof-of-concept technologies integrated in the app-based eLiFE. All groups showed small improvements in physical function and complexity throughout the intervention period, without significant differences between the intervention groups and the control group. However, the participants were relatively fit and well-functioning at baseline, indicating that finding those who would benefit the most from an early intervention and behaviour change programme, that is, the group with medium risk for future functional decline, remains an important challenge. A market analysis demonstrated that the proof of concept mHealth system focusing on primary prevention of functional decline needs further development before companies will invest money in the system.
