Digital, Personalized Clinical Trials Among Older Adults: Lessons Learned From the COVID-19 Pandemic and Directions for the Future (Preprint)

Abstract

Background: The COVID-19 pandemic was extremely disruptive to clinical practice and research. Given older adults’ increased likelihood of chronic health concerns, limited resources, and greater risk for adverse outcomes of COVID-19, access to research participation during this time was critical, particularly to interventions that may impact health conditions or behaviors. Fortunately, the implementation of digital research trials during the pandemic allowed for research and intervention delivery for older adults to continue remotely, resulting in feasibility findings that can benefit researchers, practitioners, and the broader older adult population. Methods/Results: This manuscript discusses three digital, remote, personalized intervention trials implemented during the pandemic to increase physical activity (two trials) or to reduce back pain (one trial). Age cohorts were split between younger (below age 55) and older adults (above age 55) for comparison purposes. Across the three trials, the majority of participants reported high satisfaction with the usability of the trials’ digital systems including text message interventions and surveys (≥62% satisfied) and the use of wearable devices such as Fitbits (≥81% satisfied). In addition, use of the Fitbit device was shown to be feasible, as older adults across all trials wore their Fitbits for the majority of the day [Mean(SD)=20.3(3.6) hours]. Furthermore, consistent Fitbit wear was common; 100% of participants over age 55 wore their Fitbit an average of 10 or more hours per day. Implications: These trials highlight that digital, remote intervention delivery may be successfully implemented among older adults by way of personalized trials. Across the three digital interventions, feasibility and acceptability were high among older adults, and comparable to younger adults. Further, given the success of the current trials amid pandemic restrictions, we argue that these trials serve as a useful framework to aid in designing digital, remote interventions in other areas of clinical care among older adults and in planning for future disruptions including new pandemics.