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Panaite A, Desroches O, Warren É, Rouly G, Castonguay G, Boivin A. Engaging with peers to integrate community care: Knowledge synthesis and conceptual map. Health Expect 2024; 27:e14034. [PMID: 38567865 PMCID: PMC10989131 DOI: 10.1111/hex.14034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/07/2024] [Accepted: 03/18/2024] [Indexed: 04/05/2024] Open
Abstract
CONTEXT Engaging with peers is gaining increasing interest from healthcare systems in numerous countries. Peers are people who offer support by drawing on lived experiences of significant challenges or 'insider' knowledge of communities. Growing evidence suggests that peers can serve as a bridge between underserved communities and care providers across sectors, through their ability to build trust and relationships. Peer support is thus seen as an innovative way to address core issues of formal healthcare, particularly fragmentation of care and health inequalities. The wide body of approaches, goals and models of peer support speaks volumes of such interest. Navigating the various labels used to name peers, however, can be daunting. Similar terms often hide critical differences. OBJECTIVES/BACKGROUND This article seeks to disentangle the conceptual multiplicity of peer support, presenting a conceptual map based on a 3-year knowledge synthesis project involving peers and programme stakeholders in Canada, and international scientific and grey literature. SYNTHESIS/MAIN RESULTS The map introduces six key questions to navigate and situate peer support approaches according to peers' roles, pathways and settings of practice, regardless of the terms used to label them. As a tool, it offers a broad overview of the different ways peers contribute to integrating health and community care. DISCUSSION We conclude by discussing the map's potential and limitations to establish a common language and bridge models, in support of knowledge exchange among practitioners, policymakers and researchers. PATIENT OR PUBLIC CONTRIBUTION Our team includes one experienced peer support worker. She contributed to the design of the conceptual map and the production of the manuscript. More than 10 peers working across Canada were also involved during research meetings to validate and refine the conceptual map.
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Affiliation(s)
- Andreea‐Cătălina Panaite
- Canada Research Chair in Partnership with Patients and CommunitiesCHUM Research CenterMontréalQuébecCanada
| | - Odile‐Anne Desroches
- Canada Research Chair in Partnership with Patients and CommunitiesCHUM Research CenterMontréalQuébecCanada
- School of Public HealthUniversité de MontréalMontréalQuébecCanada
| | - Émilie Warren
- Canada Research Chair in Partnership with Patients and CommunitiesCHUM Research CenterMontréalQuébecCanada
| | - Ghislaine Rouly
- Canada Research Chair in Partnership with Patients and CommunitiesCHUM Research CenterMontréalQuébecCanada
| | - Geneviève Castonguay
- Canada Research Chair in Partnership with Patients and CommunitiesCHUM Research CenterMontréalQuébecCanada
| | - Antoine Boivin
- Canada Research Chair in Partnership with Patients and CommunitiesCHUM Research CenterMontréalQuébecCanada
- School of Public HealthUniversité de MontréalMontréalQuébecCanada
- Department of Family MedicineUniversité de MontréalMontréalQuébecCanada
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Thiamwong L, Xie R, Park JH, Lighthall N, Loerzel V, Stout J. Optimizing a Technology-Based Body and Mind Intervention to Prevent Falls and Reduce Health Disparities in Low-Income Populations: Protocol for a Clustered Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e51899. [PMID: 37788049 PMCID: PMC10582821 DOI: 10.2196/51899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 08/19/2023] [Accepted: 08/20/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND The lack of health care coverage, low education, low motivation, and inconvenience remain barriers to participating in fall prevention programs, especially among low-income older adults. Low-income status also contributes to negative aging self-perceptions and is associated with a high perceived barrier to care. Existing fall prevention intervention technologies do not enable participants and practitioners to interact and collaborate, even with technologies that bring viable strategies to maintain independence, prevent disability, and increase access to quality care. Research is also limited on the use of technology to enhance motivation and help individuals align their perception with physiological fall risk. We developed a novel, 8-week Physio-Feedback Exercise Program (PEER), which includes (1) technology-based physio-feedback using a real-time portable innovative technology-the BTrackS Balance Tracking System, which is reliable and affordable, allows for home testing, and provides feedback and tracks balance progression; (2) cognitive reframing using the fall risk appraisal matrix; and (3) peer-led exercises focusing on balance, strength training, and incorporating exercises into daily activities. OBJECTIVE This study consists of 3 aims. Aim 1 is to examine the effects of the technology-based PEER intervention on fall risk, dynamic balance, and accelerometer-based physical activity (PA). Aim 2 is to examine the effects of the PEER intervention on fall risk appraisal shifting and negative self-perceptions of aging. Aim 3 is to explore participants' experiences with the PEER intervention and potential barriers to accessing and adopting the technology-based PEER intervention to inform future research. METHODS This is an intention-to-treat, single-blinded, parallel, 2-arm clustered randomized controlled trial study. We will collect data from 340 low-income older adults at baseline (T1) and measure outcomes after program completion (T2) and follow-up at 3 months (T3) and 6 months (T4). Participants will be enrolled if they meet all the following inclusion criteria: aged ≥60 years, cognitively intact, and able to stand without assistance. Exclusion criteria were as follows: a medical condition precluding exercise or PA, currently receiving treatment from a rehabilitation facility, plan to move within 1 year, hospitalized >3 times in the past 12 months, and does not speak English or Spanish. RESULTS As of August 2023, the enrollment of participants is ongoing. CONCLUSIONS This study addresses the public health problem by optimizing a customized, technology-driven approach that can operate in low-resource environments with unlimited users to prevent falls and reduce health disparities in low-income older adults. The PEER is a novel intervention that combines concepts of physio-feedback, cognitive reframing, and peer-led exercise by motivating a shift in self-estimation of fall risk to align with physiological fall risk to improve balance, PA, and negative aging self-perception. TRIAL REGISTRATION ClinicalTrials.gov NCT05778604; https://www.clinicaltrials.gov/ct2/show/study/NCT05778604. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51899.
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Affiliation(s)
- Ladda Thiamwong
- Nursing Systems Department, College of Nursing, University of Central Florida, Orlando, FL, United States
| | - Rui Xie
- Nursing Systems Department, College of Nursing, University of Central Florida, Orlando, FL, United States
| | - Joon-Hyuk Park
- Nursing Systems Department, College of Nursing, University of Central Florida, Orlando, FL, United States
| | - Nichole Lighthall
- Nursing Systems Department, College of Nursing, University of Central Florida, Orlando, FL, United States
| | - Victoria Loerzel
- Nursing Systems Department, College of Nursing, University of Central Florida, Orlando, FL, United States
| | - Jeffrey Stout
- Nursing Systems Department, College of Nursing, University of Central Florida, Orlando, FL, United States
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Smith GSE, Moyle W, Burton NW. Frequency of Physical Activity Done with a Companion: Changes Over Seven Years in Adults Aged 60+ Living in an Australian Capital City. J Aging Health 2023; 35:736-748. [PMID: 36852746 PMCID: PMC10478325 DOI: 10.1177/08982643231158424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Objectives:This study examined how often adults 60+ years were physically active with a partner, close family, friends, and neighbors, over 7 years. Methods: Data from 2062 adults living in an Australian capital city were collected using a mail survey at four time points and analyzed using multinomial logistic regression. Results: A partner was the most frequent companion at all time points. From baseline to 7 years, the greatest decline was activity with family 1-4x/month (.79 [.64-.98]) and ≥5x/month (.54 [.36-.80]). There were also decreases in activity 1-4x/month with a partner (OR = .75, [.62-.92]), friends (.55 [.44-.68]), and neighbors (.79 [.64-.98]). Physical activity with friends or neighbors ≥5x/month did not decline. Discussion: Findings extend understanding of physical activity and activity companions among older adults. More research is needed to understand factors contributing to changes in activity done with companions.
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Affiliation(s)
- Genevieve S. E. Smith
- School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
- Centre for Mental Health, Griffith University, Brisbane, QLD, Australia, Brisbane, QLD, Australia
| | - Wendy Moyle
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
- School of Nursing and Midwifery, Griffith University, Brisbane, QLD, Australia
| | - Nicola W. Burton
- School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
- Centre for Mental Health, Griffith University, Brisbane, QLD, Australia, Brisbane, QLD, Australia
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Smith GSE, Moyle W, Burton NW. The Relationship between Social Support for Physical Activity and Physical Activity across Nine Years in Adults Aged 60-65 Years at Baseline. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4531. [PMID: 36901538 PMCID: PMC10002128 DOI: 10.3390/ijerph20054531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/02/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
Physical activity is consistently recognized as a key component of healthy aging. The current study aimed to investigate the prospective association between social support specific for physical activity (SSPA) and physical activity across nine years among adults aged 60-65 years at baseline (n = 1984). An observational longitudinal design was used, with mail surveys administered to a population-based sample across four waves. SSPA was measured using a score ranging from 5-25, and physical activity was assessed as time spent in walking, or engaging in moderate and vigorous activity, during the previous week. Data were analyzed using linear mixed-effects models. The results demonstrated a positive significant relationship between SSPA and physical activity, accounting for sociodemographic and health variables. Each unit of increase in SSPA was associated with 11 extra minutes of physical activity per week (p < 0.001). There was a significant interaction between SSPA and wave at the final timepoint, such that the relationship was weaker (p = 0.017). The results highlight the value of even small increases in SSPA. SSPA could be targeted to promote physical activity among older adults, but may be more impactful in young-old adults. More research is needed to understand impactful sources of SSPA, underlying mechanisms between SSPA and physical activity, and potential moderation by age.
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Affiliation(s)
- Genevieve S. E. Smith
- School of Applied Psychology, Griffith University, Mt. Gravatt, QLD 4122, Australia
- Menzies Health Institute Queensland, Griffith University, Southport, QLD 4215, Australia
- Centre for Mental Health, Griffith University, Mt. Gravatt, QLD 4122, Australia
| | - Wendy Moyle
- Menzies Health Institute Queensland, Griffith University, Southport, QLD 4215, Australia
- School of Nursing and Midwifery, Griffith University, Nathan, QLD 4111, Australia
| | - Nicola W. Burton
- School of Applied Psychology, Griffith University, Mt. Gravatt, QLD 4122, Australia
- Menzies Health Institute Queensland, Griffith University, Southport, QLD 4215, Australia
- Centre for Mental Health, Griffith University, Mt. Gravatt, QLD 4122, Australia
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Leung T, Fang Y, Chan PSF, Yu FY, Sun F. The Changes in Levels and Barriers of Physical Activity Among Community-Dwelling Older Adults During and After the Fifth Wave of COVID-19 Outbreak in Hong Kong: Repeated Random Telephone Surveys. JMIR Aging 2023; 6:e42223. [PMID: 36599172 PMCID: PMC9947816 DOI: 10.2196/42223] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 12/19/2022] [Accepted: 12/27/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND COVID-19 has had an impact on physical activity (PA) among older adults; however, it is unclear whether this effect would be long-lasting, and there is a dearth of studies assessing the changes in barriers to performing PA among older adults before and after entering the "postpandemic era." OBJECTIVE The aim of this study was to compare the levels and barriers of PA among a random sample of community-dwelling older adults recruited during (February to April 2022) and after the fifth wave of the COVID-19 outbreak (May to July 2022) in Hong Kong. In addition, we investigated factors associated with a low PA level among participants recruited at different time points. METHODS This study involved two rounds of random telephone surveys. Participants were community-dwelling Chinese-speaking individuals aged 65 years or above and having a Hong Kong ID card. Household telephone numbers were randomly selected from the most updated telephone directories. Experienced interviewers carried out telephone interviews between 6 PM and 10 PM on weekdays and between 2 PM and 9 PM on Saturdays to avoid undersampling of working individuals. We called 3900 and 3840 households in the first and second round, respectively; for each round, 640 and 625 households had an eligible older adult and 395 and 370 completed the telephone survey, respectively. RESULTS As compared to participants in the first round, fewer participants indicated a low level of PA in the second round (28.6% vs 45.9%, P<.001). Participants in the second round had higher metabolic equivalent of tasks-minutes/week (median 1707.5 vs 840, P<.001) and minutes of moderate-to-vigorous PA per week (median 240 vs 105, P<.001) than those in the first round. After adjustment for significant background characteristics, participants who perceived a lack of physical capacity to perform PA (first round: adjusted odds ratio [AOR] 3.34, P=.001; second round: 2.92, P=.002) and believed that PA would cause pain and discomfort (first round: AOR 2.04, P=.02; second round: 2.82, P=.001) were more likely to have a low level of PA in both rounds. Lack of time (AOR 4.19, P=.01) and concern about COVID-19 infection during PA (AOR 1.73, P=.02) were associated with a low level of PA among participants in the first round, but not in the second round. A perceived lack of space and facility to perform PA at home (AOR 2.03, P=.02) and unable to find people to do PA with (AOR 1.80, P=.04) were associated with a low PA level in the second round, but not in the first round. CONCLUSIONS The level of PA increased significantly among older adults after Hong Kong entered the "postpandemic era." Different factors influenced older adults' PA level during and after the fifth wave of the COVID-19 outbreak. Regular monitoring of the PA level and its associated factors should be conducted to guide health promotion and policy-making.
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Affiliation(s)
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, Hong Kong
| | - Paul Shing-Fong Chan
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Fuk Yuen Yu
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Fenghua Sun
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, Hong Kong
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Bourke A, Niranjan V, O’Connor R, Woods C. Barriers to and motives for engagement in an exercise-based cardiac rehabilitation programme in Ireland: a qualitative study. BMC PRIMARY CARE 2022; 23:28. [PMID: 35148675 PMCID: PMC8832858 DOI: 10.1186/s12875-022-01637-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 09/27/2021] [Indexed: 12/04/2022]
Abstract
Background Insufficient physical activity (PA) is a leading risk factor for premature death worldwide. Ireland’s public healthcare system, the Health Service Executive (HSE), has supported the development of the National Exercise Referral Framework (NERF) to tackle low levels of PA amongst those with non-communicable diseases (NCDs). ‘NERF centres’ are medically supervised PA programmes across Ireland that have established referral pathways with local hospitals and general practitioners. ULMedX is one such NERF centre offering exercise-based cardiac rehabilitation (EBCR) with the aim of intervention development to reduce early drop-out and maximise adherence for optimal health benefits. Aim The purpose of this research was to identify the major factors influencing participants’ adherence and early drop-out at ULMedX. Exploring areas for future development were also prioritised. Design & setting Qualitative interviews were conducted with long-term attenders and people who have dropped out (PWDO) from ULMedX. Methods Guided by the Theory of Planned Behaviour the 1–1 semi-structured interviews were performed, transcribed, and evaluated through thematic analysis. Results Analysis was performed on 14 participants (50% female; mean age 67.3 years), comprising long-term attenders (n = 7; 13-month duration, 64% of classes) and PWDO (n = 7; 2.8-month duration, 22% of classes). Three major factors affecting adherence and drop-out were identified: social support, perceived outcomes from participation and practical barriers to attendance. Areas for future development included the provision of evening and advanced classes, psychological support, more exercise variety, more educational seminars and new members start as their own group. Conclusion The findings suggest participants at ULMedX are more likely to have had a better experience and commit to the programme if they believed involvement would benefit their physical and mental health, increase their exercise motivation by engendering a positive attitude to exercise, and that the ability to attend was within their control. Future interventions at ULMedX should have their structures centred around these motives for engagement. ULMedX should also test the participant recommendations to overcome the common barriers to adherence.
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Robbins RN, Serra MC, Kilpela LS, Parker EA, Jiwani R, Addison O. Intervention in Older Urban-Dwelling Veterans With Dysmobility: Protocol for a Pilot Feasibility Clinical Trial. JMIR Res Protoc 2022; 11:e39192. [PMID: 35830251 PMCID: PMC9330205 DOI: 10.2196/39192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/24/2022] [Accepted: 05/24/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The majority of older veterans do not meet the minimum healthy diet or physical activity recommendations despite known benefits. Identifying ways to increase adherence to programs that improve dietary quality and physical activity may reduce the risk of disability in older veterans. Peer-based interventions may be one method for facilitating lasting behavior change because peers often share a common culture and knowledge regarding problems their community experiences. OBJECTIVE This study aims to develop, pilot, and evaluate a theory-driven, 12-week, peer-led nutrition and exercise intervention that targets older veterans with dysmobility and assess its feasibility in 2 diverse urban areas with underrepresented populations. METHODS Community-dwelling veterans aged >65 years with self-reported dysmobility (defined as difficulty in at least 1 of the following: walking quickly across a street, walking a mile, ascending a flight of stairs, rising from a chair without the use of arms, or a fear of falling) from 2 Department of Veterans Affairs Geriatric Research, Education, and Clinic Centers (Baltimore, Maryland, and San Antonio, Texas) will be eligible to participate. First, this study will use validated mixed methods via web-based surveys (n=50 per site) to assess potential physical, social or environmental, and behavioral or lifestyle barriers that affect physical activity and dietary quality (phase 1). Next, we will use knowledge gained from these assessments and feedback from a focus group (n=10 per site) to adapt established Department of Veterans Affairs diet and exercise program materials to develop peer-led intervention materials and train peer leaders (n=3 per site). Finally, we will determine the feasibility and acceptability of the intervention to assess reach (recruitment and retention), adoption (satisfaction, perceived utility, attendance, and engagement), and implementation (fidelity of intervention), as well as the estimated magnitude and potential impact on selected outcomes (ie, diet quality and mobility) in 20 older veterans with dysmobility (n=10 per site). RESULTS The study was funded on January 1, 2022, with a projected data collection period of June 1, 2022, to December 31, 2023. CONCLUSIONS This study offers an innovative approach to identifying strategies that increase long-term adherence to lifestyle modification programs that improve dietary quality and physical activity in older veterans with dysmobility. TRIAL REGISTRATION ClinicalTrials.gov NCT04994938; https://clinicaltrials.gov/ct2/show/NCT04994938. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/39192.
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Affiliation(s)
- Ronna N Robbins
- San Antonio Geriatric, Research, Education, and Clinic Center, South Texas Veterans Health Care System, San Antonio, TX, United States
| | - Monica C Serra
- San Antonio Geriatric, Research, Education, and Clinic Center, South Texas Veterans Health Care System, San Antonio, TX, United States
- Division of Geriatrics, Gerontology and Palliative Medicine and Barshop Institute for Longevity & Aging Studies, Department of Medicine, University of Texas Health Science Center, San Antonio, TX, United States
| | - Lisa S Kilpela
- Department of Psychiatry & Behavioral Sciences and Barshop Institute for Longevity & Aging Studies, University of Texas Health Science Center, San Antonio, TX, United States
| | - Elizabeth A Parker
- Baltimore Geriatric Research, Education, and Clinical Center, VA Maryland Health Care System, Baltimore, MD, United States
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Rozmin Jiwani
- San Antonio Geriatric, Research, Education, and Clinic Center, South Texas Veterans Health Care System, San Antonio, TX, United States
- School of Nursing, University of Texas Health Science Center, San Antonio, TX, United States
| | - Odessa Addison
- Baltimore Geriatric Research, Education, and Clinical Center, VA Maryland Health Care System, Baltimore, MD, United States
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD, United States
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Lenstra N, Oguz F, D’Arpa C, Wilson LS. Exercising at the Library: Small and Rural Public Libraries in the Lives of Older Adults. LIBRARY QUARTERLY 2022. [DOI: 10.1086/717232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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García Bengoechea E, Clifford AM, Gallagher S, O' Regan A, O'Sullivan N, Casey M, Glynn L, Macken P, Sweeney J, Donnelly A, Murphy A, Woods CB. Juggling with theory, evidence, practice, and real-world circumstances: Development of a complex community intervention to increase physical activity in inactive adults aged 50 years and older - The Move for Life Study. EVALUATION AND PROGRAM PLANNING 2021; 89:101983. [PMID: 34404011 DOI: 10.1016/j.evalprogplan.2021.101983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 06/03/2021] [Accepted: 06/06/2021] [Indexed: 06/13/2023]
Abstract
Despite well-known benefits of physical activity, in Ireland only 38 % of older adults are sufficiently active. Behavioural interventions are rarely developed systematically and, when reported, inadequate description often becomes a barrier for subsequent replication and scalability. In this article, we describe the development and characteristics of Move for Life, an intervention to reach and help inactive adults aged 50 years and older increase their physical activity. It was designed to fit within existing group-based structured physical activity programmes run by Local Sports Partnerships, thus maximising the likelihood of translation into policy and practice. Constructs from social cognitive theory, self-determination theory, and the conceptual model of group cohesion in exercise informed the conceptual model and the development of behavioural skills, social support, and group cohesion intervention strategies. Physical activity instructors supported by peer mentors, who also contributed to sustaining the intervention, implemented these strategies. Moving away from accounts of intervention development as a relatively simple linear process, we illustrate the complex interplay of theory, evidence, practice, and real-world contextual circumstances that shaped the development of Move for Life. Against this backdrop, we discuss issues relevant to the planning and reporting of behavioural and physical activity interventions in public health.
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Affiliation(s)
- Enrique García Bengoechea
- University of Limerick Physical Activity for Health Research Cluster, Health Research Institute, Department of Physical Education and Sport Sciences, Ireland
| | | | | | - Andrew O' Regan
- University of Limerick School of Medicine and Health Research Institute, Ireland
| | - Nollaig O'Sullivan
- University of Limerick Physical Activity for Health Research Cluster, Health Research Institute, Department of Physical Education and Sport Sciences, Ireland
| | - Monica Casey
- University of Limerick School of Medicine and Health Research Institute, Ireland
| | - Liam Glynn
- University of Limerick School of Medicine and Health Research Institute, Ireland; HRB Primary Care Clinical Trial Network Ireland, Ireland
| | | | | | - Alan Donnelly
- University of Limerick Physical Activity for Health Research Cluster, Health Research Institute, Department of Physical Education and Sport Sciences, Ireland
| | - Andrew Murphy
- HRB Primary Care Clinical Trial Network Ireland, Ireland; NUI Galway Department of General Practice, Ireland
| | - Catherine B Woods
- University of Limerick Physical Activity for Health Research Cluster, Health Research Institute, Department of Physical Education and Sport Sciences, Ireland.
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McHale F, Ng K, Taylor S, Bengoechea E, Norton C, O'Shea D, Woods C. A Systematic Literature Review of Peer-led Strategies for Promoting Physical Activity Levels of Adolescents. HEALTH EDUCATION & BEHAVIOR 2021; 49:41-53. [PMID: 34628981 PMCID: PMC8892039 DOI: 10.1177/10901981211044988] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background. Low levels of physical activity (PA) in adolescents highlight the necessity for effective intervention. During adolescence, peer relationships can be a fundamental aspect of adopting and maintaining positive health behaviors. Aim. This review aims to determine peer-led strategies that showed promise to improve PA levels of adolescents. It will also identify patterns across these interventions, including training provided and the behavior change techniques (BCTs) employed. Method. Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, PubMed, PsychINFO, and Scopus were searched using key concepts of peer, PA and adolescent for articles that examined interventions that had a peer-led component and reported on at least one PA outcome in 12- to 19-year-olds. Following title and abstract screening of 1,509 studies, and full text review stage, 18 progressed to data synthesis. Methodological quality was assessed using an adapted scale. Results. Quality assessment identified 11 studies as high quality. Half of the included studies (n = 9) reported improved PA outcomes in the school setting. The most prominent behavioral change techniques were social support, information about health consequences, and demonstration of the behavior. Older adolescents leading younger peers and younger adolescents leading those of the same age showed potential. Seldom have older adolescents been targeted. Gender-specific interventions showed the most promise. Conclusion. Peer leadership requires careful planning and in the school setting can be a resourceful way of promoting adolescent PA.
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Affiliation(s)
| | - Kwok Ng
- University of Limerick, Limerick, Ireland.,University of Eastern Finland, Joensuu, Finland
| | | | | | | | - Donal O'Shea
- St. Vincent's University Hospital, Dublin, Ireland
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Carr S, Burke A, Chater AM, Howlett N, Jones A. An Evolving Model of Best Practice in a Community Physical Activity Program: A Case Study of "Active Herts". J Phys Act Health 2021; 18:1555-1562. [PMID: 34615740 DOI: 10.1123/jpah.2021-0078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 07/21/2021] [Accepted: 08/02/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Community-based physical activity programs typically evolve to respond to local conditions and feedback from stakeholders. Process evaluations are essential for capturing how programs are implemented, yet often fail to capture delivery evolution over time, meaning missed opportunities for capturing lessons learned. METHODS This research paper reports on a staged approach to a process evaluation undertaken within a community-based UK 12-month physical activity program that aimed to capture change and adaptation to program implementation. Twenty-five one-to-one interviews and 12 focus groups took place over the 3 years of program delivery. Participants included program participants, management, and service deliverers. RESULTS Program adaptations that were captured through the ongoing process evaluation included changes to the design of promotional material, program delivery content, ongoing training in behavior change, and the addition of regular participant community events. The authors address how these strands evolved over program delivery, and how the process evaluation was able to capture them. CONCLUSION The pragmatic evaluation approach enabled changes in response to the local context, as well as improvements in the program to be captured in a timely manner, allowing the delivery to be responsive and the evaluation flexible.
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Fernández-Alvira JM, Fernández-Jiménez R, de Miguel M, Santos-Beneit G, Bodega P, Hill CA, Carral V, Rodríguez C, Carvajal I, Orrit X, de Cos-Gandoy A, Dal Re M, Robledo T, Fuster V. The challenge of sustainability: Long-term results from the Fifty-Fifty peer group-based intervention in cardiovascular risk factors. Am Heart J 2021; 240:81-88. [PMID: 34147462 DOI: 10.1016/j.ahj.2021.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 06/13/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND The Fifty-Fifty trial demonstrated that a peer-group-based intervention was able to improve healthy behaviors in individuals with cardiovascular (CV) risk factors immediately post-intervention. OBJECTIVES To determine the long-term sustainability of a one-year peer-group-based intervention focused on CV health and behavior. METHODS A total of 543 adults aged 25 to 50 years with at least 1 CV risk factor were screened and recruited, received initial training through workshops, and were then randomized 1:1 to a peer-group-based intervention group (IG) or a self-management control group (CG) for 12 months. At a median of 52 months from baseline, 321 participants were re-assessed (~60% retention). The primary outcome was the mean change in a composite health score related to blood pressure, exercise, weight, alimentation, and tobacco use (Fuster-BEWAT score [FBS], range 0-15). Intervention effects were assessed using linear-mixed effects models. RESULTS The mean age of retained participants was 48.0 years (SD: 5.4), and 73% were female. Consistent with previous results, the change of overall FBS was significantly greater in the IG than in the CG at 12-month follow-up (between-group difference, 0.60 points; 95% CI, 0.08-1.12; P = .025). Assessment of long-term sustainability (52-month follow-up) showed that there were no between-group differences in the mean overall FBS (IG mean score, 8.52; 95% CI, 7.97-9.07 vs CG mean score, 8.51; 95% CI, 7.93-9.10; P = .972) or in the change of overall FBS from screening (IG mean change, 0.64; 95% CI, 0.00-1.28; CG mean change, 0.46; 95% CI, -0.20-1.12; P = .497). CONCLUSIONS A one-year peer-group-based intervention showed favorable results at immediate post-intervention but did not demonstrate significant differences between the IG and CG at 52 months. Combination of an initial training period (workshops) with the maintenance of peer-support groups or other re-intervention strategies may be required to achieve sustained effects on healthy behaviors. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT02367963. Registered (https://clinicaltrials.gov/show/NCT02367963).
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Affiliation(s)
| | - Rodrigo Fernández-Jiménez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain.
| | - Mercedes de Miguel
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Gloria Santos-Beneit
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Foundation for Science, Health and Education (SHE), Barcelona, Spain; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Patricia Bodega
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Christopher A Hill
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Vanesa Carral
- Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Carla Rodríguez
- Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Isabel Carvajal
- Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Xavier Orrit
- Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Amaya de Cos-Gandoy
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Marian Dal Re
- Spanish Agency for Food Safety and Nutrition (AESAN), Madrid, Spain
| | - Teresa Robledo
- Spanish Agency for Food Safety and Nutrition (AESAN), Madrid, Spain
| | - Valentín Fuster
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Foundation for Science, Health and Education (SHE), Barcelona, Spain; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY.
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13
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Multi-Stakeholder Retrospective Acceptability of a Peer Support Intervention for Exercise Referral. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041720. [PMID: 33578966 PMCID: PMC7916654 DOI: 10.3390/ijerph18041720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/01/2021] [Accepted: 02/05/2021] [Indexed: 11/17/2022]
Abstract
Perceived social support opportunities are central to successful exercise referral scheme (ERS) client experiences. However, there remains a lack of guidance on how ERSs can embed social support opportunities within their provision. This study presents retrospective acceptability findings from a 12-week social-identity-informed peer support intervention to enhance perceived social support among clients of an English ERS. Five peer volunteers were recruited, trained, and deployed in supervised ERS sessions across two sites. Peers assisted exercise referral officers (EROs) by providing supplementary practical, informational, motivational, and emotional support to ERS clients. Individual semi-structured interviews were conducted with peers (n = 4), EROs (n = 2), and clients (n = 5) and analysed thematically. The analysis identified three primary themes. The first theme detailed how EROs utilised peer volunteers to supplement the ERS client experience. This theme delineated peer roles within the ERS context and identified salient individual peer characteristics that contributed to their success. The second theme described peer acceptability among the various stakeholders. Peers were valued for their ability to reduce burden on EROs and to enhance perceptions of comfort among ERS clients. The final theme presented participant feedback regarding how the intervention may be further refined and enhanced. Peers represented a cost-effective and acceptable means of providing auxiliary social support to ERS clients. Moving forward, the structured integration of peers can improve the accessibility of social support among ERS participants, thus facilitating better rates of ERS completion.
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14
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Crozier A, Porcellato L, Buckley BJR, Watson PM. Facilitators and challenges in delivering a peer-support physical activity intervention for older adults: a qualitative study with multiple stakeholders. BMC Public Health 2020; 20:1904. [PMID: 33308176 PMCID: PMC7733256 DOI: 10.1186/s12889-020-09990-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 11/30/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Involving peer volunteers in intervention delivery can provide social support and improve adherence. Whilst such interventions have the potential to reduce physical activity (PA) intervention costs, little is known about the process of delivering them in practice. This qualitative study explored the facilitators and challenges of delivering a peer-support PA intervention for older adults, with a view to making recommendations for the delivery of future interventions. METHODS Data were collected via (7) semi-structured interviews and a focus group with stakeholders involved in a peer-support PA intervention for older adults in a large city in the North-West of England. Participants included local authority staff (n = 3), peer volunteers (n = 2) and service users (n = 7). Audio data were transcribed verbatim and thematically coded to identify perceived facilitators and challenges. RESULTS Facilitators to delivery included social interaction, community referral pathways, suitable facilities, peer volunteers and high-quality instructors. Challenges surrounded inconsistent practice, staff capacity, safety and accountability, and awareness raising. CONCLUSIONS Peer volunteers can provide an additional support mechanism alongside qualified instructors for increasing social interaction within PA interventions. For optimal intervention delivery, consideration needs to be given to equipment and space, safety and accountability and consistency of practice.
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Affiliation(s)
- Anthony Crozier
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Lorna Porcellato
- Faculty of health, Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Benjamin J. R. Buckley
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Paula M. Watson
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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15
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van de Vijver P, Schalkwijk F, Numans ME, Slaets JPJ, van Bodegom D. Self-organizing peer coach groups to increase daily physical activity in community dwelling older adults. Prev Med Rep 2020; 20:101181. [PMID: 33088676 PMCID: PMC7567038 DOI: 10.1016/j.pmedr.2020.101181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 07/22/2020] [Accepted: 08/14/2020] [Indexed: 11/16/2022] Open
Abstract
Many older adults do not reach the recommended level of physical activity, despite many professional-delivered physical activity interventions. Here we study the implementation of a novel physical activity intervention for older adults that is self-sustainable (no financial support) and self-organizing (participants act as organizers) due to peer coaching. We implemented three groups and evaluated process and effect using participatory observations, questionnaires, six-minute walk tests and body composition measures from October 2016 to September 2018. The intervention was implemented by staff without experience in physical activity interventions. Facilitators were a motivated initiator and a non-professional atmosphere for participants to take ownership. Barriers were the absence of motivated participants to take ownership and insufficient participants to ensure the presence of participants at every exercise session. The groups exercised outside five days a week and were self-organizing after 114, 216 and 263 days. The initial investments were 170€ for sport equipment and 81–187 h. The groups reached 118 members and a retention of 86.4% in two years. The groups continue to exist at the time of writing and are self-sustainable. Quality of life increased 0.4 on a ten-point scale (95%CI 0.1–0.7; p = 0.02) and six-minute walk test results improved with 33 m (95%CI 18–48; p < 0.01) annually. Self-organizing peer coach groups for physical activity are feasible, have positive effects on health and require only a small investment at the start. It is a sustainable and potentially scalable intervention that could be a promising method to help many older adults age healthier.
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Affiliation(s)
- Paul van de Vijver
- Leyden Academy on Vitality and Ageing, Rijnsburgerweg 10, 2333AA Leiden, The Netherlands.,Public Health and Primary Care, Leiden University Medical Center, Albinusdreef 2, 2300RC Leiden, The Netherlands
| | - Frank Schalkwijk
- Leyden Academy on Vitality and Ageing, Rijnsburgerweg 10, 2333AA Leiden, The Netherlands.,Public Health and Primary Care, Leiden University Medical Center, Albinusdreef 2, 2300RC Leiden, The Netherlands
| | - Mattijs E Numans
- Public Health and Primary Care, Leiden University Medical Center, Albinusdreef 2, 2300RC Leiden, The Netherlands
| | - Joris P J Slaets
- Leyden Academy on Vitality and Ageing, Rijnsburgerweg 10, 2333AA Leiden, The Netherlands.,University Center for Geriatric Medicine, University Medical Center Groningen, Hanzeplein 1, 9713GZ Groningen, The Netherlands
| | - David van Bodegom
- Leyden Academy on Vitality and Ageing, Rijnsburgerweg 10, 2333AA Leiden, The Netherlands.,Public Health and Primary Care, Leiden University Medical Center, Albinusdreef 2, 2300RC Leiden, The Netherlands
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16
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Eckert T, Bongartz M, Ullrich P, Abel B, Christian W, Kiss R, Hauer K. Promoting physical activity in geriatric patients with cognitive impairment after discharge from ward-rehabilitation: a feasibility study. Eur J Ageing 2020; 17:309-320. [PMID: 32904844 PMCID: PMC7458987 DOI: 10.1007/s10433-020-00555-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The aim of the present study was to examine adherence and acceptance of a home-based program to promote physical activity (PA) in older persons with cognitive impairment (CI) following inpatient rehabilitation. Sixty-three older persons (≥ 65 years) with mild to moderate CI (Mini-Mental State Examination score 17-26), allocated to the intervention group of a randomized, controlled intervention trial underwent a 12-week home-based PA intervention including (1) physical training and outdoor walking to improve functional fitness and (2) motivational strategies (goal-setting, pedometer-based self-monitoring, social support delivered by home visits, phone calls) to promote PA. Training logs were used to assess adherence to physical training, outdoor walking and to motivational strategies (goal-setting, pedometer-based self-monitoring). Acceptance (subjective feasibility and effectiveness) of the program components was assessed by a standardized questionnaire. Mean adherence rates over the intervention period were 63.6% for physical training, 57.9% for outdoor walking, and between 40.1% (achievement of walking goals), and 60.1% (pedometer-based self-monitoring) for motivational strategies. Adherence rates significantly declined from baseline to the end of intervention (T1: 43.4-76.8%, T2: 36.1-51.5%, p values<.019). Most participants rated physical training, outdoor walking, goal-setting, and pedometer self-monitoring as feasible (68.2-83.0%) and effective (63.5-78.3%). Highest ratings of self-perceived effectiveness were found for home visits (90.6%) and phone calls (79.2%). The moderate to high adherence to self-performed physical training and motivational strategies proved the feasibility of the home-based PA program in older persons with CI following inpatient rehabilitation.
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Affiliation(s)
- Tobias Eckert
- AGAPLESION Bethanien Hospital Heidelberg, Geriatric Centre at the University of Heidelberg, Rohrbacher Str. 149, 69126 Heidelberg, Germany
| | - Martin Bongartz
- AGAPLESION Bethanien Hospital Heidelberg, Geriatric Centre at the University of Heidelberg, Rohrbacher Str. 149, 69126 Heidelberg, Germany
| | - Phoebe Ullrich
- AGAPLESION Bethanien Hospital Heidelberg, Geriatric Centre at the University of Heidelberg, Rohrbacher Str. 149, 69126 Heidelberg, Germany
| | - Bastian Abel
- AGAPLESION Bethanien Hospital Heidelberg, Geriatric Centre at the University of Heidelberg, Rohrbacher Str. 149, 69126 Heidelberg, Germany
| | - Werner Christian
- AGAPLESION Bethanien Hospital Heidelberg, Geriatric Centre at the University of Heidelberg, Rohrbacher Str. 149, 69126 Heidelberg, Germany
- Centre of Geriatric Medicine, University of Heidelberg, 69117 Heidelberg, Germany
| | - Rainer Kiss
- Department of Health and Social Affairs FHM Bielefeld, University of Applied Sciences, Ravensberger Str. 10G, 33602 Bielefeld, Germany
| | - Klaus Hauer
- AGAPLESION Bethanien Hospital Heidelberg, Geriatric Centre at the University of Heidelberg, Rohrbacher Str. 149, 69126 Heidelberg, Germany
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17
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Thiamwong L, Huang HJ, Ng BP, Yan X, Sole ML, Stout JR, Talbert S. Shifting Maladaptive Fall Risk Appraisal in Older Adults through an in-Home Physio-fEedback and Exercise pRogram (PEER): A Pilot Study. Clin Gerontol 2020; 43:378-390. [PMID: 31713464 DOI: 10.1080/07317115.2019.1692120] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES 1) examine the preliminary effectiveness of the Physio-feEdback and Exercise pRogram (PEER) for shifting maladaptive to adaptive fall risk appraisal and reducing fall risk, 2) determine the participants' feedback and acceptability of the program. METHODS Forty-one older adults were assigned to either PEER intervention or attention control group. The 8-week PEER intervention consists of a visual physio-feedback, cognitive reframing, and combined group and home-based exercise led by a trained peer coach. The attention control group read fall prevention brochures and continued their normal activities. BTrackS Balance Test (BBT), short version of Fall Efficacy Scale International (short FES-I) and CDC fall risk checklist were measured from pre- to post-intervention. The feedback and acceptability were conducted at the program conclusion. RESULTS About 11% of participants in the PEER group had positive shifting but none in the attention control group. Up to 32% of the participants in attention control had negative shifting compared to 5.3% in the PEER group. PEER group reported significant decreases in fall risk and high acceptability of the program. CONCLUSIONS PEER intervention facilitates a shift from maladaptive to adaptive fall risk appraisal and reduces fall risk. CLINICAL IMPLICATIONS Preventive interventions promoting alignment between perceive and physiological fall risk may contribute to reducing falls and increasing exercise adherence.
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Affiliation(s)
- Ladda Thiamwong
- College of Nursing, University of Central Florida , Orlando, Florida, USA.,Disability, Aging, and Technology Cluster, University of Central Florida , Orlando, Florida, USA
| | - Helen J Huang
- Disability, Aging, and Technology Cluster, University of Central Florida , Orlando, Florida, USA.,Mechanical and Aerospace Engineering Department, University of Central Florida , Orlando, Florida, USA.,Biionix (Bionic Materials, Implants & Interfaces) Cluster, University of Central Florida , Orlando, Florida, USA
| | - Boon Peng Ng
- College of Nursing, University of Central Florida , Orlando, Florida, USA.,Disability, Aging, and Technology Cluster, University of Central Florida , Orlando, Florida, USA
| | - Xin Yan
- Department of Statistics and Data Science, College of Science, University of Central Florida , Orlando, Florida, USA
| | - Mary Lou Sole
- College of Nursing, University of Central Florida , Orlando, Florida, USA
| | - Jeffrey R Stout
- School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, University of Central Florida , Orlando, Florida, USA
| | - Steven Talbert
- College of Nursing, University of Central Florida , Orlando, Florida, USA
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18
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Thiamwong L, Stout JR, Sole ML, Ng BP, Yan X, Talbert S. Physio-Feedback and Exercise Program (PEER) Improves Balance, Muscle Strength, and Fall Risk in Older Adults. Res Gerontol Nurs 2020; 13:289-296. [PMID: 32286669 DOI: 10.3928/19404921-20200324-01] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 11/21/2019] [Indexed: 11/20/2022]
Abstract
A one-group pre/posttest study was conducted to examine the feasibility and effect size of an 8-week physio-feedback and exercise program (PEER) on improving balance, muscle strength, and fall risk. Nineteen participants (mean age = 76 years) received the intervention, which included visual physio-feedback by the BTrackS™ Assess Balance System, cognitive reframing, and a combined group- and home-based exercise program by a trained peer coach. Pre- and post-measurement outcomes were evaluated for balance, handgrip strength, and fall risk. Feasibility was assessed by dropout rate, safety, and adherence to exercise. Significant improvements were noted in dynamic balance (Sit-to-Stand, Timed Up & Go tests), handgrip strength, and fall risk. Participants' attendance was 87.5%, with no fall incidence. The physio-feedback, cognitive reframing, and peer coaching facilitate older adults to align their perceived fall risk with physiological fall risk and motivate them to stay active. PEER intervention is feasible; safe; improves balance, muscle strength, and fall risk; and may enhance activity engagement. TARGETS Community-dwelling older adults. INTERVENTION DESCRIPTION Provide visual physio-feedback and cognitive reframing based on the fall risk appraisal matrix and participate in combined group- and home-based exercises by a trained peer coach. MECHANISM OF ACTION Align perceived and physiological fall risk, peer coaching to exercise. OUTCOMES Balance, handgrip strength, fall risk, and activity engagement. [Research in Gerontological Nursing, 13(6), 289-296.].
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19
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Hughes SL, Tussing-Humphreys L, Schiffer L, Smith-Ray R, Marquez DX, DeMott AD, Berbaum ML, Fitzgibbon ML. Fit & Strong! Plus Trial Outcomes for Obese Older Adults with Osteoarthritis. THE GERONTOLOGIST 2020; 60:558-570. [PMID: 30476065 PMCID: PMC7350412 DOI: 10.1093/geront/gny146] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVES We compared the effectiveness of standard Fit & Strong! (F&S!; targets physical activity [PA]) to Fit & Strong! Plus (F&S! Plus; targets PA and dietary weight loss) on weight, diet quality, and PA outcomes. RESEARCH DESIGN AND METHODS We randomly assigned 413 overweight older adults with OA to the F&S! or F&S! Plus programs and assessed outcomes at 2 and 6 months. RESULTS The F&S! Plus group lost -2.0 ± 0.2 kg (mean ± SE, 2% of starting weight) at 2 months that was maintained at 6 months. Two- and 6-month BMI and waist circumference improved significantly in the F&S! Plus group (p < .001). Diet quality at 2 months showed greater improvement in the F&S! Plus group: 4.6 ± 0.7 versus 2.0 ± 0.7, p = .006, with no significant difference between groups at 6 months. The F&S! Plus group differentially improved on PA engagement at 2 months and at 2 and 6 months in joint pain (6-month mean ± SE: -1.5 ± 0.3 vs -0.6 ± 0.3, p = .02), function (-4.7 ± 0.9 vs -1.5 ± 0.9, p = .01), and 6-min walk test (29.5 ± 5.1 m vs 14.1 ± 5.2 m, p = .04). DISCUSSION AND IMPLICATIONS Adding a dietary weight loss component to F&S! achieved weight and waist circumference benefits that were maintained at 6 months. Importantly, the weight loss was accompanied by clinically meaningful improvements in OA symptoms and mobility. Future work should investigate minimum thresholds for weight reduction that improve long-term function in this population.
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Affiliation(s)
- Susan L Hughes
- Institute for Health Research and Policy, School of Public Health
- Center for Research on Health and Aging
- Division of Community Health Sciences, University of Illinois at Chicago
| | - Lisa Tussing-Humphreys
- Institute for Health Research and Policy, School of Public Health
- University of Illinois Cancer Center, Chicago
- Department of Medicine, University of Illinois at Chicago
| | - Linda Schiffer
- Institute for Health Research and Policy, School of Public Health
| | - Renae Smith-Ray
- Institute for Health Research and Policy, School of Public Health
- Health Analytics, Research and Reporting, Walgreen Co., Deerfield, Illinois
| | - David X Marquez
- Institute for Health Research and Policy, School of Public Health
- Center for Research on Health and Aging
- Department of Kinesiology and Nutrition
| | - Andrew D DeMott
- Institute for Health Research and Policy, School of Public Health
- Center for Research on Health and Aging
| | - Michael L Berbaum
- Institute for Health Research and Policy, School of Public Health
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago
| | - Marian L Fitzgibbon
- Institute for Health Research and Policy, School of Public Health
- University of Illinois Cancer Center, Chicago
- Department of Pediatrics, University of Illinois at Chicago
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20
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Thøgersen-Ntoumani C, Quested E, Biddle SJH, Kritz M, Olson J, Burton E, Cerin E, Hill KD, McVeigh J, Ntoumanis N. Trial feasibility and process evaluation of a motivationally-embellished group peer led walking intervention in retirement villages using the RE-AIM framework: the residents in action trial (RiAT). Health Psychol Behav Med 2019; 7:202-233. [PMID: 34040848 PMCID: PMC8114369 DOI: 10.1080/21642850.2019.1629934] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective: The Residents in Action Trial (RiAT; ACTRN12616001177448) was a 16-week motivationally-embellished peer-led walking intervention designed to increase walking, reduce sitting, and improve mental health and well-being in insufficiently active residents in retirement villages. In this paper we report on 1) trial feasibility and acceptability, and 2) evaluate the processes involved in the implementation of the intervention using the RE-AIM framework. Method: A mixed methods design was employed, consisting of data from accelerometers, surveys, (individual, pair-based and focus group) interviews, and participant logbooks. Participants included 116 walkers (M(SD) age = 78.37(8.30); 92% female), 8 peer leaders (i.e. ambassadors) and 3 retirement village managers from 14 retirement villages. Descriptives and linear mixed modelling were used to analyse the quantitative data and inductive thematic analyses were employed to analyse the interview data. Results: The intended cluster randomised controlled design became quasi-experimental due to insufficient numbers of recruited ambassadors. The perceived burden of the number and frequency of research assessments was a frequently mentioned reason for a poor recruitment. Facilitators to walking maintenance were the use of self-monitoring, goal setting, social support, and having a routine. Reach was modest (about 14% of eligible participants were recruited from each village), but retention was excellent (92%). The motivational strategies taught appeared to have been implemented, at least in part, by the ambassadors. The walkers in the main experimental condition increased marginally their step counts, but there were no group differences on mental health and well-being outcomes, partly because of low statistical power. Conclusions: Walkers and ambassadors who did take part in the study suggested that they enjoyed the programme and found it useful in terms of becoming more active and making social connections. However, the group format was not appealing to some participants, hence, other delivery options should be explored in the future.
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Affiliation(s)
| | - Eleanor Quested
- Physical Activity and Well-Being Lab, School of Psychology, Curtin University, Perth, Australia
| | - Stuart J H Biddle
- Physically Active Lifestyles Research Group, University of Southern Queensland, Springfield, Australia
| | - Marlene Kritz
- Physical Activity and Well-Being Lab, School of Psychology, Curtin University, Perth, Australia
| | - Jenny Olson
- Physical Activity and Well-Being Lab, School of Psychology, Curtin University, Perth, Australia.,Physically Active Lifestyles Research Group, University of Southern Queensland, Springfield, Australia
| | - Elissa Burton
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.,School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
| | - Keith D Hill
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Joanne McVeigh
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia.,Movement Physiology Laboratory, School of Physiology, University of Witwatersrand, Witwatersrand, South Africa
| | - Nikos Ntoumanis
- Physical Activity and Well-Being Lab, School of Psychology, Curtin University, Perth, Australia
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