Design and Evaluation of a Digital Health App (SingaporeWALK) for Active Aging: Pre-Post Intervention Study

Abstract

Background: The global trend toward population aging poses significant challenges for maintaining older adults’ health and well-being, particularly in multicultural urban environments like Singapore. Despite the potential of digital health interventions, older adults face substantial barriers to technology adoption, including complex interfaces and culturally inappropriate content. Existing mobile health apps often fail to integrate physical, nutritional, and mental health components or accommodate the needs of multicultural older adult populations. Objective: To address gaps in mobile app design for older adults and bridge the digital divide, this research aimed to create and evaluate the SingaporeWALK (SGWALK) app, a culturally inclusive digital health solution promoting active aging through community-based interventions among Singapore’s older adults. Methods: The SGWALK app was developed using participatory design methodology involving iterative testing with older adults to ensure appropriateness and usability. The app integrates 3 core components: exergames (Fruit Ninja, Piano Step, and Arctic Punch) aligned with Singapore’s exercise guidelines for older adults, nutrition tracking based on local dietary recommendations, and mental well-being assessment using the Mental Health Continuum–Short Form. Following development, a 4-week pre-post intervention study was conducted with 48 participants (aged 60‐85 y) randomly allocated to 4 conditions: conventional exercise, exergames only, exergames with health coach support, or exergames with peer support. In total, 5 wearable inertial measurement unit sensors captured movement data during weekly 30-minute supervised sessions at community centers. Primary outcomes included changes in physical activity metrics, technology acceptance, and mental well-being measured through pre- and postintervention assessments. Results: The 4-week intervention demonstrated significant improvements across multiple health domains. Physical activity measures showed a 6.5% increase in maximum acceleration (t47=3.82, P