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Publications

Journal Article Epublish

PubMed: 41650449 DOI: 10.2196/75791

Developing Consumer Consensus on Remote Assessment and Management of Physical Function in Older Adults (RAMP): International Modified Delphi Process.

JMIR Aging 9:e75791

Authors: Elsa Dent, Christopher Hurst, Jack Dalla Via, Jackson J Fyfe, Paul Jansons, Eleanor J Hayes, Gary Skinner, Marc Sim, Mylene Aubertin-Leheudre, Sabine Britting, Fanny Buckinx, Gavin Connolly, Ruth Dignam, Lora Giangregorio, Jennifer R A Jones, Pauline Kelly, Robert Kob, Suzanne N Morin, Girish Nandakumar, Lucas B R Orssatto, Maria Pearson, Daniel Pinto, Esmee M Reijnierse, Catherine M Said, Mohamed Salem, Vina Ps Tan, Rosanna Tran, Jesse Zanker, Robin M Daly, David Scott

Affiliations

  • Division of Health, University of Waikato, Hamilton, New Zealand.
  • AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.
  • NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Cumbria Northumberland Tyne and Wear NHS Foundation Trust and Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.
  • Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia.
  • Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.
  • School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia.
  • Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne, United Kingdom.
  • School of Medicine, The University of Western Australia, Perth, Australia.
  • Département des Sciences de l'Activité Physique, Faculté des Sciences, Groupe de Recherche en Activité Physique Adaptée (GRAPA), Université du Québec à Montréal, Montréal, QC, Canada.
  • Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC, Canada.
  • Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany.
  • Research Unit in Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.
  • Metabolism and Healthy Aging Research Center (MHARC), Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States.
  • IPAN Consumer Network, Deakin University, Geelong, Australia.
  • Schlegel-UW Research Institute for Aging, University of Waterloo, Waterloo, ON, Canada.
  • Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada.
  • Physiotherapy Department, The University of Melbourne, Parkville, Australia.
  • Physiotherapy Department, Division of Allied Health, Austin Health, Heidelberg, Australia.
  • Institute of Breathing and Sleep, Heidelberg, Australia.
  • Division of General Internal Medicine, Department of Medicine, McGill University, Montréal, QC, Canada.
  • Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.
  • Centre for Sensorimotor Performance, School of Human Movement and Nutrition Sciences, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Australia.
  • Maria Pearson Coaching, Havelock North, New Zealand.
  • Department of Physical Therapy, Marquette University, Milwaukee, WI, United States.
  • Department of Nutrition and Dietetics, Faculty of Health, Sport and Physical Activity, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.
  • Physiotherapy, Western Health, St Albans, Australia.
  • Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Australia.
  • Geriatrics, Active Ageing and Community Care, Ministry for Health and Active Ageing, Valletta, Malta.
  • Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia.
  • Rehabilitation and Aged Care Services, Northern Sydney Local Health District, Sydney, Australia.
  • Department of Medicine - Royal Melbourne Hospital, The University of Melbourne, Parkville, Australia.

Abstract

BACKGROUND

Remote health care delivery, including the use of digital health interventions, is emerging as a tool for assessing and managing physical function, but its design and implementation often overlook the needs and preferences of older adult end users.

OBJECTIVE

The primary aim of this modified Delphi process was to develop consumer consensus on preferences for remote assessment and management of physical function in older adults.

METHODS

Research and consumer experts of the Remote Assessment and Management of Physical Function in Older Adults (RAMP) Working Group co-developed the Round 1 Delphi survey, which was advertised to consumers (adults aged ≥60 years) via international clinical and research networks and social media between August and November 2023. The online survey presented 23 Delphi statements for which respondents reported their level of agreement using an 11-point Likert scale (0-10; scores ≥7 indicated agreement). Statements were classified as having "strong agreement" and achieving consensus if ≥80% of participants indicated agreement. Statements classified as having "moderate" (70%-80% of participants indicated agreement) or "low" (<70% of participants indicated agreement) agreement were revised or rejected. Revised statements were presented to participants in Round 2 (January to February 2024), and the final consensus statements were consolidated into recommendations.

RESULTS

A total of 654 consumers (75.7% female) with a mean age of 69.0 (SD 6.0) years from 15 countries (5 continents) were included in analyses in Round 1. Of 23 statements, 13 achieved consensus, with the strongest agreement observed for statements relating to the importance of physical function for quality of life and performing activities of daily living (6 statements; agreement 97.6%-99.5%). Two statements regarding privacy and security concerns when using technology (agreement 20.8%) and the inability to perform physical function assessments or exercise at home (agreement 15.5%) were rejected with low agreement. The remaining 8 statements (agreement 49.5%-79.5%) were modified into 7 new statements for the Round 2 survey, which was completed by 526 (80.4%) respondents from Round 1. Five of seven Round 2 statements were accepted with strong agreement (agreement 80%-82.7%), including the importance of addressing personal preferences for self- versus clinician-led remote interventions, group versus individual exercise, and availability of necessary resources (eg, technology and exercise equipment).

CONCLUSIONS

Eighteen statements achieved consensus and were translated into 7 recommendations highlighting that older adults recognize physical function as a health priority, would value more information about it, and are willing to participate in remote assessment and management interventions (including via digital health) to maintain or improve it. These recommendations also reinforce that interventions should be easily accessible and meet individual preferences of consumers.

MeSH

Exercise, Remote Consultation, Aged, Digital Health