Improving Exercise Adherence With App Technology for At-Risk Adults Living in Rural Kansas and Nebraska

NCT07171255 | Recruiting

• 1 other identifier: 2005493
• Study Type: interventional
• Target: 54
• Locations: 1 country
• Sites: 2

Brief Summary

Alzheimer's disease and related dementias are a public health crisis impacting individuals across the world. In the United States, adults living in rural areas face an elevated risk for cognitive impairment mainly due to disparities in care, higher sedentary behavior, and reduced education. This project proposes to assess the impact of a remotely delivered exercise program (i.e., RemoteEx+) through a smartphone application. The app is programmed by our team and provides video demonstrations of exercises, workout regimes, motivational messaging, and weekly ADRD risk reduction education. The project aims to assess with a pre/post design the following aims:

• Aim 1. Assess the RemoteEx+ intervention exercise adherence, efficacy, enjoyment, and quality of life. We hypothesize that rural adults will report high exercise adherence (80% of session adherence), efficacy (\>50% on Self Efficacy for Exercise), and enjoyment (\>5.0 on Intrinsic Motivation Inventory - Interest / Enjoyment Subscale) and that these variables will be positively correlated with quality of life scores (36-Item Short Form Health Survey \[SF-36\])
• Aim 2. Determine the impact of a technology-driven exercise program on blood pressure and functional mobility associated with dementia risk. We hypothesize that the exercise program will result in improvements in blood pressure and functional mobility (2-minute step test and 30-second chair rise test) and that participants with high exercise adherence will see the greatest improvements in biomarkers associated with reduced dementia risk.
• Aim 3. Reduce health disparities among rural-dwelling Nebraska and Kansas residents. We hypothesize that RemoteEx+ will reduce barriers to exercise (Barriers to Being Active Quiz and improve knowledge surrounding dementia and modifiable risk factors (Dementia Knowledge Assessment Tool - Version 2 \[DKAT2\]) that will result in fewer lifestyle-related health disparities for the communities involved in this study. The results from this project will inform whether RemoteEx+ has an impact on the stated outcomes above for adults living in rural areas.

Conditions

Sedentary Middle Age and Older Aged Adults

Outcome Measures

Primary Outcomes (1)

• Systolic Blood Pressure

  Baseline and Week 16

Secondary Outcomes (7)

• Cardiovascular Endurance

  Baseline and Week 16

• Lower Extremity Strength

  Baseline and Week 16

• Exercise Adherence

  Baseline and Week 16

• Exercise Efficacy

  Baseline and Week 16

• Quality of Life Improvement

  Baseline and Week 16

Study Arms (1)

RemoteEx+ Program

EXPERIMENTAL

Behavioral: RemoteEx+ Programming

Interventions

RemoteEx+ Programming BEHAVIORAL

The exercise program will include video instruction for all exercises, motivational cues, and ADRD risk education throughout the 16-week exercise program to encourage exercise adherence. RemoteEx+ is optimized to enhance exercise knowledge surrounding dementia risk factors to facilitate ADRD risk reduction and overall health improvement. The purpose of this study is to investigate the efficacy of RemoteEx+ on health outcomes associated with dementia risk in underactive rural adults.

RemoteEx+ Program

Eligibility Criteria

• Age: 40 Years - 85 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age 40-85 years
• Characterized as underactive by the Telephone Assessment of Physical Activity (TAPA)50
• Self-reported proficiency in English
• Own a smartphone and willing to download an application
• Primary care provider clearance to participate for those who do not pass the PAR-Q+51
• Live in a rural area (Rural-Urban Commuting Area \[RUCA\] Codes) 52

You may not qualify if:

• Contraindications to high-intensity exercise
• Cognitive impairment (\<19 on the Telephone Montreal Cognitive Assessment \[MoCA\])
• Neurodegenerative or acute neurological diagnoses (e.g., Parkinson's disease, stroke, traumatic brain injury)
• Orthopedic surgery or injuries in the last 6 months

Sponsors & Collaborators

• Creighton University: lead

Study Sites (2)

Emporia State University

Emporia, Kansas, 66801, United States

RECRUITING

Creighton University

Omaha, Nebraska, 68178, United States

RECRUITING

Central Study Contacts

Rashelle Hoffman, PT, DPT, PhD

CONTACT

402-546-8997; rashellehoffman@creighton.edu

Erin Blocker, PhD

CONTACT

eblocker@emporia.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 26, 2025
• First Posted: September 12, 2025
• Study Start: August 22, 2025
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): June 30, 2026
• Last Updated: September 12, 2025

Record last verified: 2025-04

Locations

US (2)