Community Exergaming and Maintenance-Related Outcomes in Older Adults: Multi-Wave Observational Evaluation

Community exergaming may help older adults remain physically active by combining movement, enjoyment, and social interaction, but less is known about whether observed changes persist after supervised delivery ends in real-world community settings.

This study evaluated immediate and maintenance-related outcomes of the International Singapore Intergenerational National Games, a community-delivered exergaming program for older adults in Singapore. We examined positive mental health, intrinsic motivation, habit strength, physical activity, and exploratory implementation determinants aligned with the capability, opportunity, and motivation-behavior (COM-B) framework.

We conducted a multi-wave observational evaluation from October 2025 to January 2026 among 280 older adults recruited from 14 senior activity centers or active aging centers in Singapore. Assessments were conducted at baseline (T0), immediately after an 8-week supervised training phase (T1), after a 4-week unsupervised free-play phase (T2), and at a later follow-up for selected measures in 6 centers (T3). Immediate within-person changes were examined using 2-tailed paired t tests. Maintenance-related trajectories were examined using adjusted linear mixed-effects models. Exploratory analyses examined whether COM-B-aligned capability, opportunity, and motivation composites were associated with physical activity trajectories.

Participants had a mean age of 72.54 (SD 6.15) years, and 77.1% (216/280) were female. From T0 to T1, mean positive mental health increased from 55.19 (SD 9.79) to 57.59 (SD 8.70; Cohen dz=0.28; P<.001), mean intrinsic motivation increased from 5.94 (SD 1.00) to 6.29 (SD 0.81; Cohen dz=0.40; P<.001), and mean habit strength increased from 3.34 (SD 1.11) to 3.81 (SD 0.84; Cohen dz=0.42; P<.001). In adjusted mixed models, habit strength remained higher at T2 than at baseline (β=0.362, 95% CI .113-.611; P=.005), and intrinsic motivation remained higher at T2 (β=0.397, 95% CI .156-.638; P=.001) and T3 (β=0.305, 95% CI .009-.601; P=.04). Positive mental health was higher immediately after supervised training (β=4.140, 95% CI 2.169-6.111; P<.001) and at T2 (β=7.390, 95% CI 5.370-9.410; P<.001) than at baseline. Among the COM-B domains, only opportunity was associated with greater immediate posttraining physical activity improvement (time × opportunity interaction β=26.464, 95% CI 3.191-49.737; P=.03), with no evidence of a sustained interaction at T2.

In this observational evaluation, positive mental health, intrinsic motivation, and habit strength were higher at T2 than at baseline among respondents with available follow-up data, and intrinsic motivation was also higher at the selected-center T3 follow-up. Because this study lacked a control group and attrition increased over time, these findings represent observed longitudinal trajectories rather than causal evidence of program effectiveness. Opportunity-related supports such as access, reminders, routines, staff facilitation, and peer participation may be useful when community exergaming transitions from supervised delivery to reduced-intensity free play, although this interpretation remains exploratory.