Both online and on-site delivery modes for PA interventions appeared feasible for many older adults, with feasibility depending more on supporting capability, opportunity, and motivation than on delivery mode.
The overall attrition rate was 37% across both delivery modes, with no statistically significant difference between online and on-site groups.
Mean adherence appeared higher in the online delivery mode than in the on-site delivery mode, but this difference was not statistically significant.
Qualitative analysis identified that attrition was primarily driven by physical health issues and a perceived lack of fit with the intervention.
Qualitative analysis identified multiple factors that supported adherence across both delivery modes.
No intervention-related adverse events were reported across either delivery mode during the 26-week trial.
Exploratory quantitative outcomes including PA level, lower-body strength, depressive symptoms, and health-related quality of life were assessed but the study was not powered to detect effectiveness differences.
The study used a cluster-randomized embedded convergent mixed methods design, with participants randomized by residential site rather than individually.
This research suggests that exercise programs for older adults can be delivered either online (via prerecorded videos) or in-person (in group settings) with broadly similar feasibility. In a 26-week pilot study involving 35 Swedish adults aged 60 and older, about one-third of participants dropped out, and most of these dropouts happened within the first two weeks. While participants in the online group appeared to attend slightly more sessions on average than those in the on-site group, this difference was not statistically significant, and the study was not large enough to draw firm conclusions about which format works better. Interviews with both completers and dropouts revealed that people were more likely to drop out due to physical health problems or feeling that the program was not a good fit for them — rather than because of the delivery format itself. People who stuck with the program cited things like enjoying the exercises, building a routine, having flexibility in when they could exercise, receiving feedback on their progress, and having some form of social connection as important motivators. These findings were understood through the COM-B framework, which looks at how Capability, Opportunity, and Motivation together shape behavior. This research suggests that neither online nor in-person delivery is clearly superior for older adults, and that what matters more is whether a program supports people's ability, access, and motivation to keep exercising. The early dropout pattern points to the importance of strategies to keep people engaged in the first weeks of a program. Larger studies are needed to confirm these findings and identify which formats work best for different groups of older adults.
Upload your bloodwork. We'll cross-reference your results against this study and 4,700 others.
Upload Your LabsNilstomt A, Gustavsson J, Bäccman C, Beckman L, Nilson F, Wästlund E. (2026). Feasibility of Online and On-Site Physical Activity Delivery Among Older Adults: Mixed Methods Pilot Randomized Controlled Trial.. JMIR formative research. https://doi.org/10.2196/97824