{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:31:30Z","timestamp":1792053090263,"version":"4.4.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T00:00:00Z","timestamp":1706832000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T00:00:00Z","timestamp":1706832000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Geriatr"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>For older, frail adults, exercise before surgery through prehabilitation (prehab) may hasten return recovery and reduce postoperative complications. We developed a smartwatch-based prehab program (BeFitMe) for older adults that encourages and tracks at-home exercise. The objective of this study was to assess patient perceptions about facilitators and barriers to prehab generally and to using a smartwatch prehab program among older adult thoracic surgery patients to optimize future program implementation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We recruited patients, aged \u226550\u2009years who had or were having surgery and were screened for frailty (Fried\u2019s Frailty Phenotype) at a thoracic surgery clinic at a single academic institution. Semi-structured interviews were conducted by telephone after obtaining informed consent. Participants were given a description of the BeFitMe program. The interview questions were informed by The Five \u201cRights\u201d of Clinical Decision-Making framework (Information, Person, Time, Channel, and Format) and sought to identify the factors perceived to influence smartwatch prehab program participation. Interview transcripts were transcribed and independently coded to identify themes in for each of the Five \u201cRights\u201d domains.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 29 interviews were conducted. Participants were 52% men (<jats:italic>n<\/jats:italic>\u2009=\u200915), 48% Black (<jats:italic>n<\/jats:italic>\u2009=\u200914), and 59% pre-frail (<jats:italic>n<\/jats:italic>\u2009=\u200911) or frail (<jats:italic>n<\/jats:italic>\u2009=\u20096) with a mean age of 68\u2009\u00b1\u20099\u2009years. Eleven total themes emerged. Facilitator themes included the importance of providers (right person) clearly explaining the significance of prehab (right information) during the preoperative visit (right time); providing written instructions and exercise prescriptions; and providing a preprogrammed and set-up (right format) Apple Watch (right channel). Barrier themes included pre-existing conditions and disinterest in exercise and\/or technology. Participants provided suggestions to overcome the technology barrier, which included individualized training and support on usage and responsibilities.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This study reports the perceived facilitators and barriers to a smartwatch-based prehab program for pre-frail and frail thoracic surgery patients. The future BeFitMe implementation protocol must ensure surgical providers emphasize the beneficial impact of participating in prehab before surgery and provide a written prehab prescription; must include a thorough guide on smartwatch use along with the preprogrammed device to be successful. The findings are relevant to other smartwatch-based interventions for older adults.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12877-024-04743-6","type":"journal-article","created":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T10:02:38Z","timestamp":1706868158000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Barriers and facilitators to smartwatch-based prehabilitation participation among frail surgery patients: a qualitative study"],"prefix":"10.1186","volume":"24","author":[{"given":"Savanna","family":"Kerstiens","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren J.","family":"Gleason","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Huisingh-Scheetz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Justine","family":"Landi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Rubin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark K.","family":"Ferguson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael T.","family":"Quinn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane L.","family":"Holl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Lucia L.","family":"Madariaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,2]]},"reference":[{"issue":"6","key":"4743_CR1","doi-asserted-by":"publisher","first-page":"1605","DOI":"10.1016\/j.jtcvs.2021.07.030","volume":"162","author":"A Pennathur","year":"2021","unstructured":"Pennathur A, Brunelli A, Criner GJ, Keshavarz H, Mazzone P, Walsh G, et al. Definition and assessment of high risk in patients considered for lobectomy for stage I non-small cell lung cancer: the American Association for Thoracic Surgery expert panel consensus document. J Thorac Cardiovasc Surg. 2021;162(6):1605\u20131618.e6.","journal-title":"J Thorac Cardiovasc Surg."},{"issue":"1","key":"4743_CR2","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1186\/s12877-021-02686-w","volume":"22","author":"X Liu","year":"2022","unstructured":"Liu X, Le MK, Lim AYC, Koh EJ, Nguyen TN, Malik NA, et al. Perspectives on frailty screening, management and its implementation among acute care providers in Singapore: a qualitative study. BMC Geriatr. 2022;22(1):58.","journal-title":"BMC Geriatr."},{"issue":"1","key":"4743_CR3","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1186\/s12877-023-03990-3","volume":"23","author":"K Barnes","year":"2023","unstructured":"Barnes K, Hladkowicz E, Dorrance K, Bryson GL, Forster AJ, Gagn\u00e9 S, et al. Barriers and facilitators to participation in exercise prehabilitation before cancer surgery for older adults with frailty: a qualitative study. BMC Geriatr. 2023;23(1):356.","journal-title":"BMC Geriatr."},{"issue":"3","key":"4743_CR4","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1213\/ANE.0000000000004342","volume":"131","author":"Z Liu","year":"2020","unstructured":"Liu Z, Qiu T, Pei L, Zhang Y, Xu L, Cui Y, et al. Two-week multimodal Prehabilitation program improves perioperative functional capability in patients undergoing thoracoscopic lobectomy for lung Cancer: a randomized controlled trial. Anesth Analg. 2020;131(3):840\u20139.","journal-title":"Anesth Analg."},{"issue":"5","key":"4743_CR5","doi-asserted-by":"publisher","first-page":"151337","DOI":"10.1016\/j.soncn.2022.151337","volume":"38","author":"BT Jensen","year":"2022","unstructured":"Jensen BT, Baldini G. Future perspectives on Prehabilitation interventions in Cancer surgery. Semin Oncol Nurs. 2022;38(5):151337.","journal-title":"Semin Oncol Nurs."},{"issue":"377","key":"4743_CR6","doi-asserted-by":"publisher","first-page":"e068788","DOI":"10.1136\/bmj-2021-068788","volume":"11","author":"R Bernabei","year":"2022","unstructured":"Bernabei R, Landi F, Calvani R, Cesari M, Del Signore S, Anker SD, et al. Multicomponent intervention to prevent mobility disability in frail older adults: randomised controlled trial (SPRINTT project). BMJ. 2022;11(377):e068788.","journal-title":"BMJ."},{"issue":"11","key":"4743_CR7","doi-asserted-by":"publisher","first-page":"3255","DOI":"10.1053\/j.jvca.2021.02.049","volume":"35","author":"EM Minnella","year":"2021","unstructured":"Minnella EM, Baldini G, Quang ATL, Bessissow A, Spicer J, Carli F. Prehabilitation in thoracic Cancer surgery: from research to standard of care. J Cardiothorac Vasc Anesth. 2021;35(11):3255\u201364.","journal-title":"J Cardiothorac Vasc Anesth."},{"issue":"2","key":"4743_CR8","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1016\/j.bja.2021.11.014","volume":"128","author":"DI McIsaac","year":"2022","unstructured":"McIsaac DI, Gill M, Boland L, Hutton B, Branje K, Shaw J, et al. Prehabilitation in adult patients undergoing surgery: an umbrella review of systematic reviews. Br J Anaesth. 2022;128(2):244\u201357.","journal-title":"Br J Anaesth."},{"issue":"9","key":"4743_CR9","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1007\/s12603-019-1273-z","volume":"23","author":"E Dent","year":"2019","unstructured":"Dent E, Morley JE, Cruz-Jentoft AJ, Woodhouse L, Rodr\u00edguez-Ma\u00f1as L, Fried LP, et al. Physical frailty: ICFSR international clinical practice guidelines for identification and management. J Nutr Health Aging. 2019;23(9):771\u201387.","journal-title":"J Nutr Health Aging."},{"issue":"12","key":"4743_CR10","doi-asserted-by":"publisher","first-page":"6035","DOI":"10.1007\/s00520-020-05436-7","volume":"28","author":"AM Dennett","year":"2020","unstructured":"Dennett AM, Harding KE, Reed MS. The challenge of timing: a qualitative study on clinician and patient perspectives about implementing exercise-based rehabilitation in an acute cancer treatment setting. Support Care Cancer. 2020;28(12):6035\u201343.","journal-title":"Support Care Cancer."},{"key":"4743_CR11","doi-asserted-by":"crossref","unstructured":"Furyk C, Senthuran S, Nye D, Ho YH, Leicht AS. Prehabilitation for frail patients undergoing colorectal surgery: lessons learnt from a randomised feasibility study. Front Rehabil Sci. 2021;2:650835.","DOI":"10.3389\/fresc.2021.650835"},{"issue":"2","key":"4743_CR12","doi-asserted-by":"publisher","first-page":"1008","DOI":"10.1007\/s00464-021-08365-6","volume":"36","author":"E Waller","year":"2022","unstructured":"Waller E, Sutton P, Rahman S, Allen J, Saxton J, Aziz O. Prehabilitation with wearables versus standard of care before major abdominal cancer surgery: a randomised controlled pilot study (trial registration: NCT04047524). Surg Endosc. 2022;36(2):1008\u201317.","journal-title":"Surg Endosc."},{"issue":"4","key":"4743_CR13","doi-asserted-by":"publisher","first-page":"e13254","DOI":"10.1111\/ecc.13254","volume":"29","author":"DJ Finley","year":"2020","unstructured":"Finley DJ, Fay KA, Batsis JA, Stevens CJ, Sacks OA, Darabos C, et al. A feasibility study of an unsupervised, pre-operative exercise program for adults with lung cancer. Eur J Cancer Care (Engl). 2020;29(4):e13254.","journal-title":"Eur J Cancer Care (Engl)."},{"issue":"4","key":"4743_CR14","doi-asserted-by":"publisher","first-page":"630","DOI":"10.3390\/diagnostics13040630","volume":"13","author":"M Greco","year":"2023","unstructured":"Greco M, Angelucci A, Avidano G, Marelli G, Canali S, Aceto R, et al. Wearable health Technology for Preoperative Risk Assessment in elderly patients: the WELCOME study. Diagnostics. 2023;13(4):630.","journal-title":"Diagnostics."},{"issue":"10","key":"4743_CR15","doi-asserted-by":"publisher","first-page":"S314","DOI":"10.1016\/j.jtho.2019.08.631","volume":"14","author":"Y Patel","year":"2019","unstructured":"Patel Y, Hylton D, Rok M, Beauchamp M, Wald J, Mbuagbaw L, et al. MA16.05 wearable Technology for Preconditioning before Thoracic Surgery: a feasibility study. J Thorac Oncol. 2019;14(10):S314.","journal-title":"J Thorac Oncol."},{"issue":"1","key":"4743_CR16","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/1748-5908-6-42","volume":"6","author":"S Michie","year":"2011","unstructured":"Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011;6(1):42.","journal-title":"Implement Sci."},{"issue":"9","key":"4743_CR17","doi-asserted-by":"publisher","first-page":"205520762312039","DOI":"10.1177\/20552076231203957","volume":"1","author":"S Kerstiens","year":"2023","unstructured":"Kerstiens S, Bender EM, Rizzo MG, Landi A, Gleason LJ, Huisingh-Scheetz M, et al. Technology-assisted behavioral intervention to encourage prehabilitation in frail older adults undergoing surgery: development and design of the BeFitMe\u2122 apple watch app. Digit Health. 2023;1(9):20552076231203957.","journal-title":"Digit Health."},{"issue":"1","key":"4743_CR18","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1186\/s12882-021-02591-9","volume":"22","author":"MB Weber","year":"2021","unstructured":"Weber MB, Ziolkowski S, Bootwala A, Bienvenida A, Anand S, Lobelo F. Perceptions of physical activity and technology enabled exercise interventions among people with advanced chronic kidney disease: a qualitative study. BMC Nephrol. 2021;22(1):373.","journal-title":"BMC Nephrol."},{"issue":"2","key":"4743_CR19","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1007\/s00520-020-05547-1","volume":"29","author":"JL Waterland","year":"2021","unstructured":"Waterland JL, Ismail H, Amin B, Granger CL, Denehy L, Riedel B. Patient acceptance of prehabilitation for major surgery: an exploratory survey. Support Care Cancer. 2021;29(2):779\u201385.","journal-title":"Support Care Cancer."},{"issue":"4","key":"4743_CR20","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1002\/1098-240X(200008)23:4<334::AID-NUR9>3.0.CO;2-G","volume":"23","author":"M Sandelowski","year":"2000","unstructured":"Sandelowski M. Whatever happened to qualitative description? Res Nurs Health. 2000;23(4):334\u201340.","journal-title":"Res Nurs Health."},{"issue":"3","key":"4743_CR21","doi-asserted-by":"publisher","first-page":"M146","DOI":"10.1093\/gerona\/56.3.M146","volume":"56","author":"LP Fried","year":"2001","unstructured":"Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146\u201356.","journal-title":"J Gerontol A Biol Sci Med Sci."},{"issue":"10","key":"4743_CR22","doi-asserted-by":"publisher","first-page":"1229","DOI":"10.1080\/08870440903194015","volume":"25","author":"JJ Francis","year":"2010","unstructured":"Francis JJ, Johnston M, Robertson C, Glidewell L, Entwistle V, Eccles MP, et al. What is an adequate sample size? Operationalising data saturation for theory-based interview studies. Psychol Health. 2010;25(10):1229\u201345.","journal-title":"Psychol Health."},{"key":"4743_CR23","unstructured":"Murphy E. Constructivism: From Philosophy to Practice [Place of publication not identified]: Distributed by ERIC Clearinghouse; 1997."},{"key":"4743_CR24","doi-asserted-by":"crossref","unstructured":"Osheroff J. Improving Outcomes with Clinical Decision Support An Implementer's Guide, Second Edition. Chicago, IL: HIMSS; 2012.","DOI":"10.4324\/9781498757461"},{"issue":"10","key":"4743_CR25","first-page":"42","volume":"84","author":"RJ Campbell","year":"2013","unstructured":"Campbell RJ. The five rights of clinical decision support: CDS tools helpful for meeting meaningful use. J AHIMA. 2013;84(10):42\u20137.","journal-title":"J AHIMA."},{"issue":"6","key":"4743_CR26","doi-asserted-by":"publisher","first-page":"2908","DOI":"10.1002\/nop2.999","volume":"9","author":"M Peddle","year":"2022","unstructured":"Peddle M. Maintaining reflexivity in qualitative nursing research. Nurs Open. 2022;9(6):2908\u201314.","journal-title":"Nurs Open."},{"key":"4743_CR27","unstructured":"Freelon DG. ReCal: Intercoder reliability calculation as a web service. Int J Internet Sci. 2010;5(1)."},{"key":"4743_CR28","unstructured":"Freelon DG. ReCal: reliability calculation for the masses. [updated 2017 May 05]. Available from: https:\/\/dfreelon.org\/utils\/recalfront\/.\u00a0 Cited 2023 Apr 23."},{"issue":"1","key":"4743_CR29","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1186\/s43058-021-00202-0","volume":"2","author":"C Bonner","year":"2021","unstructured":"Bonner C, Tuckerman J, Kaufman J, Costa D, Durrheim DN, Trevena L, et al. Comparing inductive and deductive analysis techniques to understand health service implementation problems: a case study of childhood vaccination barriers. Implement Sci Commun. 2021;2(1):100.","journal-title":"Implement Sci Commun."},{"issue":"3","key":"4743_CR30","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1123\/japa.2019-0484","volume":"29","author":"S Pollet","year":"2020","unstructured":"Pollet S, Denison-Day J, Bradbury K, Essery R, Grey E, Western M, et al. A qualitative exploration of perceptions of a digital intervention to promote physical activity in older adults. J Aging Phys Act. 2020;29(3):442\u201354.","journal-title":"J Aging Phys Act."},{"issue":"1","key":"4743_CR31","doi-asserted-by":"publisher","first-page":"e22488","DOI":"10.2196\/22488","volume":"9","author":"W Peng","year":"2021","unstructured":"Peng W, Li L, Kononova A, Cotten S, Kamp K, Bowen M. Habit formation in wearable activity tracker use among older adults: qualitative study. JMIR MHealth UHealth. 2021;9(1):e22488.","journal-title":"JMIR MHealth UHealth."},{"issue":"3","key":"4743_CR32","doi-asserted-by":"publisher","first-page":"e6967","DOI":"10.2196\/mhealth.6967","volume":"5","author":"EJ Lyons","year":"2017","unstructured":"Lyons EJ, Swartz MC, Lewis ZH, Martinez E, Jennings K. Feasibility and acceptability of a wearable technology physical activity intervention with telephone counseling for mid-aged and older adults: a randomized controlled pilot trial. JMIR MHealth UHealth. 2017;5(3):e6967.","journal-title":"JMIR MHealth UHealth."},{"issue":"1","key":"4743_CR33","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1186\/s12877-020-01868-2","volume":"20","author":"K \u00c5hlund","year":"2020","unstructured":"\u00c5hlund K, \u00d6berg B, Ekerstad N, B\u00e4ck M. A balance between meaningfulness and risk of harm \u2013 frail elderly patients\u2019 perceptions of physical activity and exercise \u2013 an interview study. BMC Geriatr. 2020;20(1):490.","journal-title":"BMC Geriatr."},{"issue":"8","key":"4743_CR34","doi-asserted-by":"publisher","first-page":"e615","DOI":"10.1016\/S2589-7500(22)00111-X","volume":"4","author":"T Ferguson","year":"2022","unstructured":"Ferguson T, Olds T, Curtis R, Blake H, Crozier AJ, Dankiw K, et al. Effectiveness of wearable activity trackers to increase physical activity and improve health: a systematic review of systematic reviews and meta-analyses. Lancet Digit Health. 2022;4(8):e615\u201326.","journal-title":"Lancet Digit Health."}],"container-title":["BMC Geriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-024-04743-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12877-024-04743-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-024-04743-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T10:03:29Z","timestamp":1706868209000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgeriatr.biomedcentral.com\/articles\/10.1186\/s12877-024-04743-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,2]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["4743"],"URL":"https:\/\/doi.org\/10.1186\/s12877-024-04743-6","relation":{},"ISSN":["1471-2318"],"issn-type":[{"value":"1471-2318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,2]]},"assertion":[{"value":"20 September 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 January 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 February 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The University of Chicago Institutional Review Board (IRB21\u20131318 on 10\/18\/2021) approved this study. Each participant provided informed consent prior to participating in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"129"}}