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NCT Number: NCT07171255

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

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.

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Key information

Conditions

Sedentary Middle Age and Older Aged Adults

Age range

40 year–85 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Emporia State University, Emporia, Kansas, United States

Loading trial locations.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 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

Exclusion criteria

  • 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

Treatment and study plan

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.

Primary outcomes

  1. Systolic Blood Pressure

    Time frame: Baseline and Week 16

Secondary outcomes

  1. Cardiovascular Endurance

    Time frame: Baseline and Week 16

    2-Minute Step Test

  2. Lower Extremity Strength

    Time frame: Baseline and Week 16

    30-second chair rise test

  3. Exercise Adherence

    Time frame: Baseline and Week 16

    % of sessions completed over the 16-week program

  4. Exercise Efficacy

    Time frame: Baseline and Week 16

    Self Efficacy for Exercise (SEE) Scale (points)

  5. Quality of Life Improvement

    Time frame: Baseline and Week 16

    36-Item Short Form Health Survey

  6. Barriers to Being Active

    Time frame: Baseline and Week 16

    Barriers to Being Active Quiz

  7. Knowledge of dementia

    Time frame: Baseline and Week 16

    Dementia Knowledge Assessment Tool

Study contacts

Contact information is provided by the study sponsor or research team.

Erin Blocker, PhD

CONTACT

[email protected]

Rashelle Hoffman, PT, DPT, PhD

CONTACT

[email protected]

402-546-8997

Sponsors and collaborators

Lead sponsor

Creighton University

Other

Registry information

Acronym: RemoteEx+

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Sep 12, 2025
Registry last updated
Sep 12, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

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This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.