Using a Proactive Telecare System to Support Independence, Health, and Well-Being in Older Adults - Feasibility Randomized Controlled Trial

Sep 28, 2026

Proactive telecare provides outbound calls, follow-ups, and tailored information to reduce emergencies and support older adults’ autonomy through regular engagement and early detection of changing needs. This feasibility study evaluated acceptability and delivery of a proactive telecare intervention for community-dwelling older adults, reviewed eligibility criteria, and estimated impact effect size to inform sample size for a future trial. An 8-week randomized pre-post mixed-methods design used surveys and semi-structured interviews, with outcomes covering independence, health-related quality of life, mental health, and loneliness.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages16

Reading Time40 min

AccessFree to download

Abstract

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Objective

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Introduction

Background

JMIR FORMATIVE RESEARCH Fothergill et al Original Paper Using a Proactive Telecare System to Support Independence, Health, and Well-Being in Older Adults: Feasibility Randomized Controlled Trial | Lauren Fothergill 1 , PhD; Yvonne Latham2 , PhD; Niall Hayes3 , PhD; Carol Holland 1 , PhD | | --- | | 1Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom 2Management School, Organisation Work and Technology, Lancaster University, Lancaster, United Kingdom 3Leeds University Business School, Faculty of Business, University of Leeds, Leeds, United Kingdom
Corresponding Author:
Lauren Fothergill, PhD
Division of Health Research, Faculty of Health and Medicine Lancaster University
Health Innovation One Lancaster LA14AT United Kingdom
Phone: 44 (0) 1524 65201
Email: [ljfothergill@outlook.com](ljfothergill@outlook.com)
Abstract | Background: Proactive telecare offers services designed to reduce the occurrence of emergency situations by delivering proactive outbound calls and follow-ups and providing information and advice. By engaging regularly with users, proactive telecare may foster social connections with older adults and enable the detection of changes in needs. Telecare systems that promote active participation among older adults may also foster feelings of autonomy and self-management. Objective: This study aimed to (1) explore the acceptability and feasibility of delivering and evaluating a proactive telecare intervention to community-dwelling older adults prior to a potential effectiveness trial and (2) evaluate the proposed eligibility criteria and estimate the potential effect size of the impact of the intervention on health and well-being outcomes to inform sample size calculations for a future trial. Methods: An 8-week randomized pre-post feasibility study was conducted. Using a mixed methods approach, questionnairesand semistructured interviews were used to explore the feasibility and acceptability of the study. The proactive telecare system encouraged users to press an OK button once a day to confirm their well-being. If they did not respond, participants received a well-being check, and emergency contacts were notified if required. Outcomes associated with independence, health, and well-being were measured using standardized questionnaires, including health-related quality of life, mental health, and loneliness. Results: Thirty older adults were recruited, with 13 randomized into the intervention group and 17 into the control group. The mean (SD) age of the participants was 75.4 (5.2) years; 66.7%(20/30) of the participants recruited had more than one health condition. This study achieved high retention rates (30/33, 90.9%); however, the expression of interest rate was low (52/295, 17.6%), indicating that changes to recruitment strategies are required. Effect sizes for all quantitative outcomes were small (approximately 0.2) . Participants demonstrated high acceptance of the intervention, with the primary benefit cited as providing reassurance and promoting autonomy. Proactive engagement encouraged self-regulation and allowed users to control the level of support received. Those who were socially isolated reported feeling less lonely because of having additional social contact. Most participants felt the intervention would be particularly beneficial if they were experiencing poor health that significantly affected their daily activities, suggesting it may be more suited to those with limited independence. Some participants expressed anxiety about using the technology, primarily due to a lack of understanding and uncertainty in their perceived need for the device. Conclusions: This proactive telecare system is feasible to deliver within a cohort of older adults living in the community. However, changes to recruitment approaches and implementation are needed to ensure acceptability and target numbers are achieved in a future effecti

FAQs

What is the main purpose of the proactive telecare system in this study?

The system aims to reduce emergency situations through proactive outbound calls and follow-ups, while also supporting social connection, autonomy, and self-management by engaging older adults regularly.

How was the feasibility and acceptability of the intervention evaluated?

An 8-week randomized pre-post feasibility study used a mixed-methods approach with questionnaires and semi-structured interviews, alongside a daily OK-button confirmation and follow-up well-being checks when needed.

What did the results show about recruitment, retention, and participant acceptance?

Retention was high (90.9%), but the expression of interest rate was low (17.6%), indicating recruitment strategy changes are needed. Participants generally accepted the intervention, citing reassurance and autonomy as key benefits.

Sep 28, 2026

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