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Long Term Care
LONG-TERM CARE NEWS Research in action:
Ground-breaking study on mobility in older adults paves way for novel monitoring tool
By Michele Sponagle
Dr. Marla Beauchamp feels fortunate to be leading a first-of-its-kind study looking at how technology can help older adults with their mobility – a vital health indicator. Called McMaster Monitoring My Mobility – or MacM3 for short – the AGE-WELL-funded study is now underway and recruiting as many as 2,000 participants ages 65 to 80.
Before Dr. Beauchamp became an AGE-WELL researcher and associate professor, CRC (tier 2), Mobility, Aging, and Chronic Disease, at McMaster University in Hamilton, Ontario, she earned a master’s degree in physical therapy at the University of Toronto. As part of her studies, she did a placement working with older people. It marked an important step in a career devoted to supporting healthy aging. Her pursuit is personal to a degree.
“I was very close to my grandparents, so that’s part of it,” she says. “I also appreciate the wealth of experience that older people share. I think about how they’ve contributed their whole lives – and wonder how we can help people to live independently for longer. I saw how important that was to my grandparents and it’s what interested me about physiotherapy and rehabilitation. It is the lens that I bring to my research.”
For the MacM3 study, Dr. Beauchamp and her co-leads from disciplines spanning geography, social science and mathematics, have created a smartwatch app that participants wear for 10-day intervals every four months throughout the two-year study. Continued on page 36 Dr. Marla Beauchamp, School of Rehabilitation Science, McMaster University, leads the first-of-its-kind mobility study.
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Continued from page 35 Research in action
Information collected includes step count, mode of travel, distance travelled and activity intensity. Everything is encrypted for privacy. This is in conjunction with GPS and additional health measures, such as in-person assessments, quarterly phone calls and monthly diaries.
Currently, there is no wearable that comprehensively monitors mobility and that is valid for predicting important health outcomes in older adults. Problems with everyday mobility, such as walking, getting in and out of a car, and driving, are common with aging and can negatively affect health and wellbeing. During consultations with older adults and caregivers, there was a clear interest in using wearable tracking devices to self-monitor mobility.
To date, study participants are from the Hamilton area. Recruitment will soon begin in Toronto through a partnership with the McMaster Institute for Research on Aging | Dixon Hall Centre.
PREVENTING OR DELAYING MOBILITY PROBLEMS
With the data gathered in the study, machine learning and advanced statistical methods will be used to identify trajectories of change in mobility over time and how these trajectories relate to health outcomes, such as falls. With input from older adults and caregivers, the ultimate goal is to develop a mobility self-monitoring tool that can help prevent or delay mobility problems in later life through early detection and treatment.
The MacM3 study addresses a gap in mobility research. “While there have been studies looking at how fast people can get in and out of a chair and how fast someone walks, current mobility research doesn’t address how mobility is something to take charge of as a central strategy for managing your health,” says Dr. Beauchamp. “We go to a doctor who takes measurements, like blood pressure and BMI, yet there’s no measurement of mobility – something that we value so much. It’s an indicator of our overall wellbeing and a future predictor of falls and hospitalization. Examining someone’s mobility is an opportunity for early intervention and information sharing.”
Irene Schieberl is one of the study participants. The 80-year-old Hamilton resident was keen to take part. “I have participated in a few different studies conducted by McMaster,” she says. “I would like to help the senior population in any way I can to keep us healthy and in our homes as long as possible because that’s less expensive for the health-care system. This is a way for me to give back.”
Schieberl also thought it was a good chance to understand more about her own mobility. She has a life-long passion for dancing, everything from tap to Hawaiian and jazz, and performing – something she hasn’t been able to do throughout the COVID pandemic. “I needed a way to get motivated and to improve my strength and stamina,” the mother of two explains. “During my exercise pre-tests at the McMaster Innovation Park, I was able to see how good my balance, endurance and strength were and get a benchmark for my current mobility.”
For Michael Kasoian, being involved in the study and wearing a smartwatch to track his movements is a way to monitor how his mobility will change over the next 24 months. The retired elementary school principal who lives in Burlington considers himself to be a very healthy 73-year-old – one who keeps fit by playing pickleball, walking and golfing. “When you get to be my age, you know things are going to change,” he says. “I am interested in anything that can keep me as active as I can be.”
Over the course of the study, participants will send in monthly postcards to report falls, wear their smartwatches and an optional activity device on their thighs, and do a fitness test that will compare where they started physically and where they ended up two years later. They are asked to live normally throughout the study, keeping their normal level of activity and maintaining their current diets to get the most accurate assessment of their progress.
A custom smartwatch app is used to collect data on mobility.
AGE-WELL ‘A PERFECT FIT’
Before recruiting participants and equipping them with wearable devices, Dr. Beauchamp and colleagues worked with talented software developers to develop the specific technology that would gather the data and analyze it. The result was the Ivy app to collect the information through a smartwatch, and an app called Clover, which downloads and processes that data. “We had to develop the software and heavily test it – all during COVID,” she explains. “Before we actually started our study, there was a lot of preparation that went into it.”
Dr. Beauchamp credits the support received from AGE-WELL (Canada’s technology and aging network) with getting things moving by providing core research funding. “It was a perfect fit, not just for the funding, but for the opportunity to work with a partner,” she says. “It has been phenomenal. Everyone involved in MacM3 is really excited about it.”
Dr. Beauchamp also acknowledged the McMaster Institute for Research on Aging (MIRA) as co-funder of MacM3.
She adds: “I’m lucky to have found an area of research that I am really passionate about. What I do doesn’t feel like work. It just feels like something I want to do and was meant to do.”
To join the MacM3 study or learn more, visit: https://macm3.com/ n H
Michele Sponagle is an editor, writer and content manager. AGE-WELL is a federally funded Network of Centres of Excellence. The pan-Canadian network brings together researchers, older adults, caregivers, partner organizations and future leaders to accelerate the delivery of technologybased solutions for healthy aging. agewell-nce.ca
Health literacy consultants Vincent Terstappen and Shirley Chandler are on a mission to make healthcare knowledge more accessible through the use of plain language. They offer a goldmine of tips and resources for AHS staff, physicians and volunteers as well as oversee MyHealth.Alberta.ca, a trusted source of easy-to-understand information on health conditions, healthy living, medicines, tests and treatments.
Keep it simple
to build understanding and better healthcare
By Gregory Kennedy
Don’t ever doubt the value of plain language when it comes to healthcare. Consider this bit of medical bafflegab: “Ingest two capsular units of acetylsalicylic acid and implement a vocal communication my way in the ante meridiem.”
If your doctor were to utter such words, you’d tell them to get the marbles out of their mouth, and try again with something simpler like: “Take two aspirins and call me in the morning.”
A passion for clarity and a love of language keep health literacy consultants Shirley Chandler, Vincent Terstappen and Heather Ball on their grammatical toes daily for Alberta Health Services. They’re the team who oversee content for MyHealth. Alberta.ca, the website Albertans rely upon as a trusted source of easy-to-understand information on health conditions, healthy living, medicines, tests and treatments.
“I love making things understandable and easier for people to read so that they know what’s going on,” says Chandler. “I’m a Registered Nurse and I like finding ways to explain things better. It’s always been a passion of mine.
“I’ve experienced it myself, and I’ve also seen it in others, where you tell them something and they nod and say ‘yes’ or they sit there with this stone look on their face – and you know you haven’t reached them. You know they don’t get what you’re saying.”
With a background in population health and communications, Terstappen says he believes presenting health information in a more understandable way not only preserves, but has the potential to improve the well-being of all Albertans.
“At MyHealth.Alberta.ca, we get lots of content from subject-matter experts across Alberta who work in, what some might call “the nuance”. They’re so smart. They’re so deep in their areas and we get this amazing health information from them.
“Then we take a look at it to say: ‘How can we present this in a more straightforward way that makes sense to someone who’s just pulling this up to read on their smartphone in the middle of their busy day?”
According to the International Plain Language Federation: “A communication is in plain language if its wording, structure, and design are so clear that the intended audience can easily find what they need, understand what they find, and use that information.”
Plain language also advances AHS’ goal of providing Patient & Family Centred Care, which promotes the respect and dignity of the patient, the sharing of information in an affirming and useful way, collaboration, and empowers the patient to participate more in their healthcare journey.
“We want to give people some information they can take away and use,” adds Chandler. “When it comes
to healthcare, you’re not just trying to get a better deal on a car – your life is involved there.”
Keep a personal tone with an active voice to reach more readers, she suggests. Don’t tell people what they shouldn’t do, let them know what they can do, to keep healthy.
Bulleted lists with headings also allow people to skim and absorb information easier.
“By giving lots of subheadings, we’re organizing content in a flow that makes sense, and really supporting people to scan and browse,” says Terstappen, who adds that the question-and-answer format is also a triedand-true way to reach the reader.
“We structure a lot of our health content as question-and-answer. For example, the question may be: ‘What should I do if I get this test result?’ The answer will begin: ‘If you get this test result, you should…’ This kind of language allows the reader to see themselves. When we edit, one of the big changes that we often make is to make sure we’re really speaking directly to the person, like Shirley says, in an active voice.”
Acronyms, jargon, medicalese and colloquialisms are also to be avoided, wherever possible.
“Not everybody was born and raised in the same type of household or culture,” says Chandler. “Diversity and inclusion, gender and culture sensitivity are huge in what we do – and it’s becoming increasingly so.”
As the small but mighty health literacy team reaches out to others who share their passion, interest is growing in their work, and they’re winning over new converts to the joy of simplicity.
“A dream of ours is to develop a community of practice within Alberta Health Services for everybody who’s interested in plain language and health literacy. This dream is becoming a reality in that AHS has started an initiative to bring together various portfolios who support health literacy and who may be working in this area.” n H
Plain Language… • is easy to read • can be read quickly • is easy to understand the first time it’s read • allows the reader to easily find the information they need and use it • gets rid of jargon Five Things to Consider • your audience and the purpose of the content • how to organize content that best communicates your message • design – layout and adequate white space – typography (font, font size) that is easy to read
– graphics to present information in an accessible and engaging way • expression – tone, word choice • evaluation – editing and user testing Plain Language Tips • Aim for a Grade 5 to 8 reading level (use the SMOG test for readability) • Use “you”, “your child”, and “your family” • Use simple, common words and contractions • Keep sentences and paragraphs short • Use Arabic numbers (1, 2, 3), try to avoid Roman numerals and don’t spell out numbers unless at the beginning of a sentence • It’s OK to use medical or complex words, but explain them in plain language • Words with two syllables or less tend to be plainer than words with three or more syllables • Avoid jargon • Write like you’re talking to the reader • Use inclusive, people-first and gender-neutral language, and a conversational tone
For more information, visit Plain Language Association International.
Gregory Kennedy is a communications officer at Alberta Health Services.
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