Development and Feasibility of Musculoskeletal Health Program Using a Social Media App for Older Women Workers

Abstract

Korea has the longest effective age of labor market exit at 72.3 years among the member countries of the Organization for Economic Co-operation and Development. As the workforce ages and continues to engage in physically demanding work, workers aged 60 and older are particularly vulnerable to occupational accidents, including falls, ergonomic hazards, and musculoskeletal disorders. Conserving musculoskeletal health is essential to ensure occupational safety and promote healthy aging among older workers. Applying Levine’s Conservation Model, which reflects the multidimensional health of older adults, this study aimed to develop a social media app-based musculoskeletal health program for older women workers and evaluate its feasibility and effects on physical and psychosocial health. This study followed a step-by-step process of analysis, design, development, and implementation to develop a musculoskeletal health program and conducted a single-group experimental study to evaluate its feasibility and effectiveness. A secondary analysis of the 2017-2021 Korean Working Conditions Survey was performed to ensure the program's relevance, and a literature review on muscle-strengthening interventions followed, providing a foundation for designing the program components. Focus group interviews with 11 women cleaning workers were carried out to determine their needs for an app-based program. The initial program underwent validity evaluation by seven experts and a preliminary usability test by two older workers, resulting in the development of the 8-week program under the slogan “Daily Companionship; Work, Exercise, and Be Happy Every Day”. The program evaluation included 18 women cleaning workers in their 60s. Musculoskeletal health-related outcomes were measured at three time points—before the intervention (pre-test), mid-intervention (4 weeks), and post-intervention (8 weeks)—and analyzed using Generalized Estimating Equations for repeated measures. Usability was assessed by accumulating in-app usage data and qualitatively analyzing participants' experiences through interviews. The program, utilizing a social media app, was developed as an integrated face-to-face and remote intervention to support musculoskeletal health in women cleaning workers in their 60s. It was designed according to Levine’s four principles: energy conservation through physical fitness assessments and counseling; structural integrity by practicing a 15-minute daily exercise; personal integrity through educational content promoting self-efficacy for exercise; and social integrity fostering social support through the building of a health community via a social media app. Retention rates of the daily exercise program was remarkably high at 97.7%. The use of social media app was perceived to be easy and useful for maintaining and recording daily exercise, while interactions among participants fostered a sense of achievement and enjoyment, motivating continued exercise participation. The 8-week program significantly improved musculoskeletal health indicators of handgrip strength (B=2.46, p<.001) and physical performance including arm curls (B=11.94, p<.001), 30-second sit-to-stands (B=8.50, p<.001), 2-minute steps (B=23.06, p<.001), and 8-foot up-and-go time (B=-0.52, p<.001), in women cleaning workers with a mean age of 62.7 years who worked 46.8 hours per week. However, muscle mass was not significantly changed, suggesting a need for greater exercise volume including duration and intensity and nutritional interventions. Specified outcomes related to musculoskeletal health revealed significant increases in physical activity levels, work ability index, self-efficacy for exercise, and social support for exercise. The social media app-based health program, developed with a focus on musculoskeletal health goals for older workers, demonstrated high usability, acceptability, and feasibility in their 60s. Mobile health (mHealth) interventions tailored to older adults can enhance self-confidence in managing their health, support the sustained practice of healthy behaviors, and contribute to improvements in physical and psychosocial health outcomes. The findings suggest that the mHealth program can be effectively applied to support musculoskeletal health management in older workers performing physically demanding work, particularly in small-scale workplaces, where occupational health management resources are limited.