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Background: Behavioral change is the key to alter individuals’ lifestyle from sedentary to active. The aim was to assess the feasibility of delivering a Lifestyle-integrated Functional Exercise programme and evaluate the delivery of the intervention by use of digital technology (eLiFE) to prevent functional decline in 61–70 year-old adults. Methods: This multicentre, feasibility randomized controlled trial was run in three countries (Norway, Germany, and the Netherlands). Out of 7,500 potential participants, 926 seniors (12%) were screened and 180 participants randomized to eLiFE (n = 61), aLiFE (n = 59), and control group (n = 60). eLiFE participants used an application on smartphones and smartwatches while aLiFE participants used traditional paper-based versions of the same lifestyle-integrated exercise intervention. Participants were followed for 12 months, with assessments at baseline, after a 6 month active trainer-supported intervention, and after a further 6 months of unsupervised continuation of the programme. Results: At 6 months, 87% of participants completed post-test, and 77% completed the final assessment at 12 months. Participants were willing to be part of the programme, with compliance and reported adherence relatively high. Despite small errors during start-up in the technological component, intervention delivery by use of technology appeared acceptable. No serious adverse events were related to the interventions. All groups improved regarding clinical outcomes over time, and complexity metrics show potential as outcome measure in young seniors. Conclusion: This feasibility RCT provides evidence that an ICT-based lifestyle-integrated exercise intervention, focusing on behavioral change, is feasible and safe for young seniors. Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT03065088. Registered on 14 February 2017. Copyright © 2020 Taraldsen, Mikolaizak, Maier, Mellone, Boulton, Aminian, Becker, Chiari, Follestad, Gannon, Paraschiv-Ionescu, Pijnappels, Saltvedt, Schwenk, Todd, Yang, Zacchi, van Ancum, Vereijken and Helbostad. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Introduction The European population is rapidly ageing. In order to handle substantial future challenges in the healthcare system, we need to shift focus from treatment towards health promotion. The PreventIT project has adapted the Lifestyle-integrated Exercise (LiFE) programme and developed an intervention for healthy young older adults at risk of accelerated functional decline. The intervention targets balance, muscle strength and physical activity, and is delivered either via a smartphone application (enhanced LiFE, eLiFE) or by use of paper manuals (adapted LiFE, aLiFE)., Methods and analysis The PreventIT study is a multicentre, three-armed feasibility randomised controlled trial, comparing eLiFE and aLiFE against a control group that receives international guidelines of physical activity. It is performed in three European cities in Norway, Germany, and The Netherlands. The primary objective is to assess the feasibility and usability of the interventions, and to assess changes in daily life function as measured by the Late-Life Function and Disability Instrument scale and a physical behaviour complexity metric. Participants are assessed at baseline, after the 6 months intervention period and at 1 year after randomisation. Men and women between 61 and 70 years of age are randomly drawn from regional registries and respondents screened for risk of functional decline to recruit and randomise 180 participants (60 participants per study arm)., Ethics and dissemination Ethical approval was received at all three trial sites. Baseline results are intended to be published by late 2018, with final study findings expected in early 2019. Subgroup and further in-depth analyses will subsequently be published.

The health and wellbeing benefits of engaging in physical activity (PA), and of improving strength and balance, are well documented. The World Health Organization's recommendations of 150 min per week of moderate intensity physical activity have been adopted across the world in policy and practice recommendations. However, the number of older adults engaging in this level of PA remains low. The European Project, PreventIT, has adapted the Lifestyle-integrated Functional Exercise (LiFE) programme, which reduced falls in people 75 years and over, for a younger cohort (aLiFE). aLiFE incorporates challenging strength and balance/agility tasks, as well as specific recommendations for increasing physical activity and reducing sedentary behaviour in young-older adults, aged 60–70 years. Personalised advice is given on how to integrate strength, balance and physical activities into daily life. aLiFE has been further developed to be delivered using smartphones and smartwatches (eLiFE), providing the opportunity to send timely motivational messages and real-time feedback to the user. Both aLiFE and eLiFE are behaviour change interventions, supporting older adults to form long-term physical activity habits. PreventIT has taken the original LiFE concept and further developed the behaviour change elements, explicitly mapping them to Social Cognitive Theory, Habit Formation Theory and 30 Behaviour Change Techniques (BCTs). Goal setting, planning, prompts and real-time feedback are used to deliver a person-centred experience. Over 1300 motivational messages have been written, mapped to psychological theory, BCTs and evidence regarding the importance of strength, balance and PA. A motivational assessment tool has been developed to enable us to investigate stated motivational drivers with actual performed behaviour within the feasibility Randomised Controlled Trial. The PreventIT mHealth intervention focusses on behaviour change from initiation to long-term maintenance, addressing the different phases of adopting a healthier lifestyle. As such, it makes a strong contribution to the developing field of evidence-based mobile health (mHealth). © 2019 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)