A smartphone lecture program integrated with app-based peer support led to modest but meaningful improvements in step counts among older Japanese adults at Week 12 of the 12-week intervention.
Key Findings
Results
The digital peer support intervention produced a significantly higher increase in daily step counts compared to the control group at Week 12.
Unadjusted mixed model for repeated measures showed a difference of 579 steps (95% CI 36-1123; P=.04) at Week 12.
Baseline daily steps averaged 3951 (SD 1686) in controls versus 4583 (SD 1973) in the intervention arm.
Valid step data were available for 117 of 156 participants.
Missing step data ranged from 5.1% to 29.1% across time points.
Results
No significant difference was found between intervention and control groups in total MET-minutes per week.
Difference in total METs was 646 MET-min per week (95% CI -12 to 1303; P=.054).
Total METs were assessed via the International Physical Activity Questionnaire (IPAQ).
The result was borderline non-significant.
Results
The intervention did not significantly increase the likelihood of walking 30 or more minutes per day.
Odds ratio for walking ≥30 minutes per day was 1.56 (95% CI 0.63-3.90; P=.33).
Walking time was assessed via self-administered paper questionnaires.
Results
The intervention arm showed a significant increase in daily smartphone use compared to the control arm.
Odds ratio for daily smartphone use was 4.10 (95% CI 1.15-14.6; P=.03).
This was a secondary outcome assessed through self-administered paper questionnaires.
Results
The intervention arm demonstrated a significant increase in the number of smartphone use purposes.
Difference in number of smartphone use purposes was 0.58 (95% CI 0.12-1.05; P=.01).
This was a secondary outcome assessed via self-administered paper questionnaires.
Methods
The cluster-randomized trial enrolled 156 community-dwelling older adults across 40 clusters in two urban regions of Japan.
Participants were randomized into 20 intervention clusters (n=80) and 20 control clusters (n=76).
The trial was conducted in Sumida Ward, Tokyo, and Chiba City, Chiba.
Eligible participants were aged ≥60 years, able to walk independently, and smartphone users.
Exclusion criteria included prior use of the peer support app or medical restrictions on walking.
Participants were recruited offline during community smartphone lectures (closed-group recruitment).
Results
Trial retention was 79.5% at 12-week follow-up.
124 of 156 participants (79.5%) completed the follow-up.
Valid step data were available for 117 participants.
Missing data ranged from 5.1% to 29.1% across assessment points.
Methods
The intervention combined face-to-face smartphone lectures with a digital peer support app (Minchalle) featuring daily step goals, peer sharing, and group encouragement.
All participants received a baseline smartphone lecture.
Intervention participants attended 2 additional sessions using the Minchalle app (A10 Lab Inc).
Control participants attended 2 standard follow-up smartphone lectures.
The primary outcome was the change in weekly average daily step count from baseline to Week 12.
Outcomes were assessed both objectively via smartphones and through self-administered paper questionnaires.
Nakagomi A, Abe N, Ueno T, Izuka G, Kawasaki Y, Kondo K. (2026). Digital Peer Support to Increase Walking Among Older Adults: Cluster Randomized Trial.. Journal of medical Internet research. https://doi.org/10.2196/75708