Exploring the potential of technology to promote exercise snacking for older adults who are prefrail in the home setting: user-centered design study.

Older adults have an increased risk of falls, injury, and hospitalization. Maintaining/increasing participation in physical activity (PA) into older age can prevent some of the age-related declines in physical functioning that may contribute to loss of independence and lower reported quality of life. 'Exercise snacking' has been created to overcome some commonly cited barriers to exercise and encourage older adults to engage in muscle strength and balance activity, but the best way to deliver and support this novel format remains unknown. Our aim was to explore: a) how the novel 'exercise snacking' approach, i.e. incorporating short bouts of strength and balance activities into everyday routines, could be supported by technology within a home setting; and b) what types of technologies would be acceptable for pre-frail older adults. Two design workshops (Study 1) were conducted, to understand older adults' (n=11, aged 69-89 years old) attitudes towards technology aimed at supporting exercise snacking at home and to inform the design of interactive prototypes. Based on the findings of Study 1, a feasibility home evaluation (Study 2) was conducted over one day for two prototypes (n=5 participants, aged 69-80). Participants were interviewed over the telephone afterwards about their experience. Transcripts were analyzed using Framework analysis. Results showed participants were positive towards using technology at home to support exercise snacking, but both the exercises and technology would need to be simple and match participants' everyday routines. Workshop discussions (Study 1) led to the design of two prototypes using a pressure mat to support resistance and balance exercises. The home evaluation (Study 2) identified that participants reported potential in using smart devices to support exercise snacking, but the low fidelity of the prototypes influenced participants' attitudes towards them. It also hampered the acceptability of these initial versions and highlighted challenges in fitting exercise snacking into everyday life. The study concluded that older adults were positive about using technology in their homes to support strength and balance exercise snacking. We have identified key points around the suitability of the home environment for facilitating exercise snacking. While promising, the initial prototypes' further refinement and optimization prior to feasibility, acceptability and efficacy testing is required. Developers and researchers can use these findings to inform the development and evaluation of more sophisticated technologies for integration in the home environment to support PA