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Fang H, Xiong Z, Li Y, Cui W, Cheng Z, Xiang J, Ye T. Physical activity and transitioning to retirement: evidence from the China health and retirement longitudinal study. BMC Public Health 2023; 23:1937. [PMID: 37803340 PMCID: PMC10557290 DOI: 10.1186/s12889-023-16870-7] [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: 03/23/2023] [Accepted: 10/01/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND The impact of retirement on physical activity among older individuals remains ambiguous. This study aims to investigate the influence of retirement on physical activity and delineate the trajectories of physical activity changes during the retirement transition among elderly Chinese residents. Additionally, we endeavor to examine the factors that contribute to each trajectory. METHODS This longitudinal cohort study used data from four surveys of the China Health and Retirement Longitudinal Study and included a sample of 428 individuals who underwent formal retirement and provided information on physical activity. We employed generalized estimating equation to explore the impact of the retirement transition on physical activity among Chinese older adults. Latent class growth analysis was used to identify distinct trajectories of physical activity, and binary logistic regression was performed to identify pre-retirement factors influencing changes in physical activity. RESULTS Our findings indicate that retirement can lead to a decline in physical activity among older Chinese residents (OR = 0.85, 95%CI 0.75 ~ 0.97). We identified three distinct trajectories of physical activity during the retirement transition: Trajectory 1 - "sustained low level of physical activity" (7.94%); Trajectory 2 - "middle level of physical activity with gradual decline" (69.16%); Trajectory 3 - "sustained high level of physical activity with significant fluctuations" (22.90%). Furthermore, we discovered that individuals in the "middle level of physical activity and gradual decline" trajectory were more likely to have an annual income exceeding 40,000 yuan (OR = 9.69, 95%CI 1.12 ~ 83.63), reside in urban areas (OR = 2.27, 95%CI 1.14 ~ 4.52), and have a fondness for playing Mahjong (OR = 2.42, 95%CI 1.18 ~ 5.00) compared to those in the "sustained high level of physical activity with significant fluctuations" trajectory. Additionally, having an annual income exceeding 40,000 yuan (OR = 19.67, 95%CI 1.30 ~ 298.61) predicted membership in the "sustained low level of physical activity" trajectory when compared to the "sustained high level of physical activity with significant fluctuations" trajectory. CONCLUSION Retirement represents a substantial milestone in the life course and is associated with notable alterations in physical activity patterns. Among older Chinese residents, the trajectories of physical activity during the retirement transition exhibit diverse paths and are influenced by pre-retirement factors, including annual income, residential location, and hobbies. The findings of this study have important implications for the formulation of policies aimed at promoting healthy aging among individuals approaching retirement age.
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Affiliation(s)
- Huiyan Fang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Education, Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial, Wuhan, China
| | - Zihui Xiong
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Education, Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial, Wuhan, China
| | - Yilin Li
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Education, Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial, Wuhan, China
| | - Wenhui Cui
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Education, Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial, Wuhan, China
| | - Ziping Cheng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Education, Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial, Wuhan, China
| | - Ji Xiang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Education, Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial, Wuhan, China
| | - Ting Ye
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
- Department of Education, Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial, Wuhan, China.
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Morris A, Bright C, Cocks M, Gibson N, Goff L, Greaves C, Griffin S, Jane B, Kinnafick F, Robb P, Roberts M, Salman D, Saxton J, Taylor A, West D, Yates T, Andrews RC, Gill JMR. Recommendations from Diabetes UK's 2022 diabetes and physical activity workshop. Diabet Med 2023; 40:e15169. [PMID: 37381170 DOI: 10.1111/dme.15169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 06/30/2023]
Abstract
AIMS To describe the process and outputs of a workshop convened to identify key priorities for future research in the area of diabetes and physical activity and provide recommendations to researchers and research funders on how best to address them. METHODS A 1-day research workshop was conducted, bringing together researchers, people living with diabetes, healthcare professionals, and members of staff from Diabetes UK to identify and prioritise recommendations for future research into physical activity and diabetes. RESULTS Workshop attendees prioritised four key themes for further research: (i) better understanding of the physiology of exercise in all groups of people: in particular, what patient metabolic characteristics influence or predict the physiological response to physical activity, and the potential role of physical activity in beta cell preservation; (ii) designing physical activity interventions for maximum impact; (iii) promoting sustained physical activity across the life course; (iv) designing physical activity studies for groups with multiple long-term conditions. CONCLUSIONS This paper outlines recommendations to address the current gaps in knowledge related to diabetes and physical activity and calls on the research community to develop applications in these areas and funders to consider how to stimulate research in these areas.
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Affiliation(s)
| | | | - Matthew Cocks
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | | | - Louise Goff
- Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
| | - Colin Greaves
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Simon Griffin
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Ben Jane
- School of Health and Wellbeing, Plymouth Marjon University, Plymouth, UK
| | - Florence Kinnafick
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Centre for Sport and Exercise Medicine, Loughborough, UK
| | | | | | - David Salman
- Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - John Saxton
- Department of Sport, Health & Exercise Science, University of Hull, Hull, UK
| | - Adrian Taylor
- Schools of Dentistry & Medicine, University of Plymouth, Plymouth, UK
| | - Daniel West
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Rob C Andrews
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Jason M R Gill
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
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3
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Ashikali EM, Ludwig C, Mastromauro L, Périvier S, Tholomier A, Ionita I, Graf C, Busnel C. Intrinsic Capacities, Functional Ability, Physiological Systems, and Caregiver Support: A Targeted Synthesis of Effective Interventions and International Recommendations for Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4382. [PMID: 36901392 PMCID: PMC10002353 DOI: 10.3390/ijerph20054382] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
The ageing population calls for interventions that can assist older people to age healthily. This study aimed to provide a targeted synthesis of high-level research and current evidence-based recommendations on effective interventions for maintaining or preventing the decline in intrinsic capacity, functional ability, and physiological systems, or for caregiver support. Nestled within the healthy ageing framework by the World Health Organization, available evidence was selected in a targeted manner, with the purpose of providing a synthesis that would allow the application of this knowledge in real life. As such, the outcome variables were examined through an Evidence and Gap Map of interventions for functional ability and through guidelines from leading institutions. Systematic reviews, meta-analyses, and guidelines on community-dwelling older adults with or without minor health limitations were considered. Thirty-eight documents were included and over fifty interventions identified. Physical activity interventions were consistently effective across several domains. Recommendations point to screening, whilst highlighting the importance of behavioural factors in the endeavour to age healthily. There is a wide range of activities which are likely to foster healthy ageing. To encourage their uptake, it is important for communities to offer suitable promotion and support, and to make these accessible to the public.
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Affiliation(s)
| | - Catherine Ludwig
- Geneva School of Health Sciences, HES-SO, University of Applied Sciences and Arts Western Switzerland, 1206 Geneva, Switzerland
| | - Laura Mastromauro
- Geneva Institution for Home Care and Assistance (imad), 1227 Carouge, Switzerland
- Geneva School of Health Sciences, HES-SO, University of Applied Sciences and Arts Western Switzerland, 1206 Geneva, Switzerland
| | - Samuel Périvier
- Geneva Institution for Home Care and Assistance (imad), 1227 Carouge, Switzerland
- Department of Rehabilitation and Geriatrics, Geneva University Hospital, 1226 Geneva, Switzerland
| | - Aude Tholomier
- Geneva Institution for Home Care and Assistance (imad), 1227 Carouge, Switzerland
| | - Irina Ionita
- PLATEFORME du Réseau Seniors Genève, 1227 Geneva, Switzerland
| | - Christophe Graf
- Department of Rehabilitation and Geriatrics, Geneva University Hospital, 1226 Geneva, Switzerland
| | - Catherine Busnel
- Geneva Institution for Home Care and Assistance (imad), 1227 Carouge, Switzerland
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Sanchez M, Vidal JS, Bichon A, Mairesse C, Flouquet C, Hanon O, Raynaud-Simon A. Impact of a public open-access community-based physical activity and fall prevention program on physical performance in older adults. Eur J Public Health 2023; 33:132-138. [PMID: 36594685 PMCID: PMC9898008 DOI: 10.1093/eurpub/ckac186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND In older adults, physical activity (PA) is important in maintaining physical performance. Data on the effectiveness of public open-access community-based programs on physical performance and fall prevention are scarce. METHODS Prospective observational controlled study in community centers providing an open-access public prevention program. Retirees aged ≥60 years who chose to participate in weekly PA workshops for 3 months were compared to those who chose the cognitive stimulation (CS) workshops. Collected data: handgrip strength, five times sit-to-stand, single-leg stance, Timed Up and Go tests, gait speed, short physical performance battery (SPPB) and frailty status at baseline (M0) and at 3 months (M3). The proportion of participants reporting a history of falls was assessed at baseline and using follow-up telephone interviews (F-Up). RESULTS Two hundred eighty-eight participants (age 73.8 years, 87% women) were included. The sit-to-stand test, single-leg stance and SPPB scores improved significantly between M0 and M3 in both groups. A greater SPPB increase was observed in the PA than in the CS group (+0.39 vs. +0.32 points, P = 0.02) after adjustment for age, sex, number of sessions attended, fall history and SPPB at baseline. During F-Up (median 22 months), the proportion of participants reporting at least one fall decreased from 55% to 31% (P = 0.01) in the PA group and from 27% to 19% (P = 0.12) in the CS group. CONCLUSION In a public open-access community-based program participants improved physical performance and reduced fall incidence when participating in the PA or the CS workshops. Older adults may benefit most from multifaceted prevention programs.
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Affiliation(s)
- Manuel Sanchez
- Department of Geriatrics, AP-HP North, Bichat, Beaujon and Bretonneau Hospitals, Paris, France.,Health Faculty, Medical School, University of Paris, Paris, France.,Gérond'if, Paris, France
| | | | - Astrid Bichon
- Department of Geriatrics, AP-HP North, Bichat, Beaujon and Bretonneau Hospitals, Paris, France
| | | | | | - Olivier Hanon
- Health Faculty, Medical School, University of Paris, Paris, France.,Gérond'if, Paris, France.,Department of Geriatrics, AP-HP Center, Broca Hospital, Paris, France
| | - Agathe Raynaud-Simon
- Department of Geriatrics, AP-HP North, Bichat, Beaujon and Bretonneau Hospitals, Paris, France.,Health Faculty, Medical School, University of Paris, Paris, France.,Gérond'if, Paris, France
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5
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A Scoping Review on Community-Based Programs to Promote Physical Activity in Older Immigrants. J Aging Phys Act 2023; 31:144-154. [PMID: 35606098 DOI: 10.1123/japa.2021-0258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 02/16/2022] [Accepted: 03/25/2022] [Indexed: 02/03/2023]
Abstract
Older immigrants are at higher risks for inactivity due to cultural, environmental, and social barriers in the postmigration context. Community-based physical activity (PA) programs increase PA in older adults, yet little is known about approaches that specifically target older immigrants. This scoping review explores the literature on community-based programs that increase PA and physical fitness in immigrant older adults and identifies barriers and facilitators to PA program participation in this population. A systematic search of electronic databases and gray literature was conducted, and a total of 11 articles met the inclusion criteria after full-text screening. A range of populations and PA program characteristics are described, yet there is a lack of studies on older immigrant men, Black older immigrants, and immigrants from Arab and African countries. There is a need for further research to develop evidence-informed PA programs for this diverse population.
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Appelhans BM, Gabriel KP, Lange-Maia BS, Karavolos K, Ylitalo KR, Karvonen-Gutierrez CA, Kravitz HM, Janssen I. Longitudinal associations of mid-life employment status with impaired physical function in the Study of Women's Health Across the Nation. Ann Epidemiol 2022; 74:15-20. [PMID: 35714876 PMCID: PMC10214385 DOI: 10.1016/j.annepidem.2022.06.001] [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: 03/18/2022] [Revised: 06/03/2022] [Accepted: 06/06/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE This study examined whether employment status during mid-life and older adulthood is associated with physical function impairment. METHODS Participants were 2700 women in the multiracial/multiethnic Study of Women's Health Across the Nation. Time-varying, lagged, and cumulative exposure analyses modeled associations between self-reported employment status and the likelihood of severe physical function impairment across 19 years of follow-up. RESULTS Independent of demographic variables, women who were not working (OR = 1.58, 95% CI = 1.22, 2.04) or employed part-time (OR = 1.29, 95% CI = 1.04, 1.61) were more likely to report severe physical function impairments than women employed full-time. This same pattern was seen in lagged analyses predicting risk of physical function impairment from employment status at the prior assessment (not working vs. full-time: OR = 1.53, 95% CI = 1.08, 2.18; part-time vs. full-time: OR = 1.53, 95% CI = 1.17, 2.00). The likelihood of severe physical function impairment increased by 20% for every additional 10% of follow-up spent not working (OR = 1.02, 95% CI: 1.01, 1.03). Associations were robust to adjustment for health-related variables, body mass index, and physical activity. CONCLUSIONS Women with lower levels of employment from mid-life to older adulthood were more likely to experience severe impairment in physical function. However, the underlying mechanisms, and the timescales over which associations unfold, require further study.
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Affiliation(s)
- Bradley M Appelhans
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.
| | - Kelley Pettee Gabriel
- Department of Epidemiology, School of Public Health, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Brittney S Lange-Maia
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA; Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Kelly Karavolos
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Kelly R Ylitalo
- Department of Public Health, Baylor University, Waco, TX, USA
| | | | - Howard M Kravitz
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Imke Janssen
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
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7
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Deidda M, Coll-Planas L, Tully MA, Giné-Garriga M, Kee F, Roqué i Figuls M, Blackburn NE, Guerra-Balic M, Rothenbacher D, Dallmeier D, Caserotti P, Skjødt M, McIntosh E. Cost-effectiveness of a programme to address sedentary behaviour in older adults: results from the SITLESS RCT. Eur J Public Health 2022; 32:415-421. [PMID: 35426903 PMCID: PMC9159313 DOI: 10.1093/eurpub/ckac017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background This study details the within-trial economic evaluation and long-term economic model of SITLESS, a multi-country, three-armed randomized controlled trial comparing a combined intervention of exercise referral schemes (ERS) enhanced by self-management strategies (SMS) against ERS alone and usual care (UC). Methods A cost-utility analysis, conducted from the base-case perspective of the National Health Service and personal and social services, estimated the incremental cost per incremental quality-adjusted life year (QALY) and years in full capability (YFC). A secondary analysis combined the costs with a broad set of outcomes within a cost-consequence framework, from a societal perspective. A Markov-type decision-analytic model was developed to project short-term changes in physical activity to long-term outcomes and costs, over a 5- and 15-year time horizon. Results The results of the within-trial analysis show that SMS+ERS is highly likely to be cost-effective compared to ERS alone (ICER €4270/QALY), but not compared to UC. Participants allocated to the SMS+ERS group also showed an improvement in YFC compared to ERS alone and UC. The long-term analysis revealed that SMS+ERS is likely to be a cost-effective option compared to ERS and UC over a 5-year, but not with a 15-year horizon, being then dominated by ERS alone. Conclusion This research provides new evidence that SMS is a cost-effective add-on to ERS strategies. This economic evaluation informs the case for further, cost-effective, refinement of lifestyle change programmes targeted to older adults, with the aim of ultimately reducing the impact of non-communicable diseases in this population.
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Affiliation(s)
- Manuela Deidda
- Health Economics and Health Technology Assessment (HEHTA), Institute of Health and Wellbeing (IHW), University of Glasgow, Glasgow, UK
| | - Laura Coll-Planas
- Fundació Salut i Envelliment—UAB, Institute of Biomedical Research (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mark A Tully
- University of Ulster, Coleraine, Londonderry, UK
| | - Maria Giné-Garriga
- Facultat de Psicologia, Ciències de l’Educació i de l’Esport Blanquerna (Universitat Ramon Llull), Barcelona, Spain
| | - Frank Kee
- UKCRC Centre of Excellence for Public Health (NI), Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Marta Roqué i Figuls
- Fundació Salut i Envelliment—UAB, Institute of Biomedical Research (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Míriam Guerra-Balic
- Facultat de Psicologia, Ciències de l’Educació i de l’Esport Blanquerna (Universitat Ramon Llull), Barcelona, Spain
| | | | - Dhayana Dallmeier
- Ulm University, Ulm, Baden-Württemberg, Germany
- Agaplesion Bethesda Hospital, Geriatric Research Unit Ulm University, Ulm, Germany
| | - Paolo Caserotti
- Department of Sports Science and Clinical Biomechanics, Syddansk Universitet, Odense M, Denmark
| | - Mathias Skjødt
- Department of Sports Science and Clinical Biomechanics, Syddansk Universitet, Odense M, Denmark
| | - Emma McIntosh
- Health Economics and Health Technology Assessment (HEHTA), Institute of Health and Wellbeing (IHW), University of Glasgow, Glasgow, UK
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Huang Y, Ng OL, Ha ASC. A Qualitative Exploration of Facilitators and Barriers to Physical Activity Participation among Chinese Retired Adults in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063495. [PMID: 35329182 PMCID: PMC8955847 DOI: 10.3390/ijerph19063495] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 02/04/2023]
Abstract
The purpose of this study was to identify facilitators and barriers associated with physical activity participation among retired Chinese adults in Hong Kong. This study adopts an interview research design in order to generate an in-depth understanding and insights into the participants' thoughts, motivators and experiences of physical activity participation. Independent, semi-structured interviews with 10 retired participants (aged 54-74) were conducted based on an interview protocol with open-ended questions prompting the participants to describe their experiences. Transcribed texts were analysed using thematic analysis, combining both deductive and inductive analysis techniques. Common physical activities reported were walking, stretching exercise and jogging/running. Participants responded that their physical activity level increased since their retirement. We report the interview results according to the themes which emerged from the analysis: (1) physical and mental health, (2) socio-emotional factors, (3) environmental context, (4) family responsibilities. We found that the themes (1), (2) and (3) act either as a facilitator or a barrier for the participants interviewed, while theme (4) family responsibilities act as a barrier. The findings suggested that future physical activity interventions for retired Chinese adults should include more physical activity knowledge, such as the benefits to physical and mental health brought by physical activity and social elements, considering the specific challenges that participants are confronted with (from the family side).
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Affiliation(s)
- Ying Huang
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Hong Kong 999077, China;
| | - Oi-Lam Ng
- Department of Curriculum and Instruction, Faculty of Education, The Chinese University of Hong Kong, Hong Kong 999077, China;
| | - Amy S. C. Ha
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Hong Kong 999077, China;
- Correspondence:
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Robinson SM, Westbury LD, Ward K, Syddall H, Cooper R, Cooper C, Sayer AA. Is lifestyle change around retirement associated with better physical performance in older age?: insights from a longitudinal cohort. Eur J Ageing 2021; 18:513-521. [PMID: 34786013 PMCID: PMC8563887 DOI: 10.1007/s10433-021-00607-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2021] [Indexed: 11/29/2022] Open
Abstract
A growing evidence base links individual lifestyle factors to physical performance in older age, but much less is known about their combined effects, or the impact of lifestyle change. In a group of 937 participants from the MRC National Survey of Health and Development, we examined their number of lifestyle risk factors at 53 and 60-64 years in relation to their physical performance at 60-64, and the change in number of risk factors between these ages in relation to change in physical performance. At both assessments, information about lifestyle (physical activity, smoking, diet) was obtained via self-reports and height and weight were measured. Each participant's number of lifestyle risk factors out of: obesity (body mass index ≥ 30 kg/m2); inactivity (no leisure time physical activity over previous month); current smoking; poor diet (diet quality score in bottom quarter of distribution) was determined at both ages. Physical performance: measured grip strength, chair rise and standing balance times at both ages and conditional change (independent of baseline) in physical performance outcomes from 53 to 60-64 were assessed. There were some changes in the pattern of lifestyle risk factors between assessments: 227 (24%) participants had fewer risk factors by age 60-64; 249 (27%) had more. Reductions in risk factors were associated with better physical performance at 60-64 and smaller declines over time (all p < 0.05); these associations were robust to adjustment. Strategies to support reduction in number of lifestyle risk factors around typical retirement age may have beneficial effects on physical performance in early older age. SUPPLEMENTARY INFORMATION The online version of this article (10.1007/s10433-021-00607-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sian M. Robinson
- AGE Research Group, Newcastle University Institute for Translational and Clinical Research, Newcastle upon Tyne, NE4 5PL UK
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle Upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Leo D. Westbury
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Kate Ward
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Holly Syddall
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Rachel Cooper
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Avan A. Sayer
- AGE Research Group, Newcastle University Institute for Translational and Clinical Research, Newcastle upon Tyne, NE4 5PL UK
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle Upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
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10
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Mullan B, Olivier C, Thøgersen‐Ntoumani C. Mind the gap: Habit and self-determined motivation predict health behaviours in middle-aged and older adults. Br J Health Psychol 2021; 26:1095-1113. [PMID: 33938096 PMCID: PMC8519144 DOI: 10.1111/bjhp.12522] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/15/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Physical activity and fruit and vegetable consumption are two key health behaviours associated with the health and well-being of middle-aged and older adults. The present research investigated how habit and self-determined motivation interact with intention to prospectively predict physical activity and fruit and vegetable consumption in middle-aged and older adults. DESIGN A prospective correlational design (two data collection points) was used. METHODS A convenience sample of 195 adults completed online questionnaires measuring intention, habit, and self-determined motivation. One week later, 177 participants (67.2% female), aged 52-87 years (M = 61.50, SD = 5.90), completed self-report measures of physical activity and fruit and vegetable consumption over the previous week. RESULTS Separate hierarchical multiple regression analyses were conducted. For physical activity, the model explained 46% of the variance in behaviour, F(8, 168) = 17.88, p < .001 and a large effect size (ƒ2 = .85). Two-way interactions contributed an additional 3.70% of unique variance in physical activity, F(3, 165) = 4.07, p = .008, ƒ2 = .04. For fruit and vegetable consumption, the model explained 19.20% of the variance in behaviour, F(5, 171) = 8.13, p < .001 and a medium effect size (ƒ2 = .24). Two-way interactions did not significantly improve the model, F(3, 168) = 1.68, p = .174. CONCLUSIONS Habit and self-determined motivation were both important in narrowing the intention-behaviour gap for two key health behaviours, and combining these processes may better inform strategies to support people's intentions to improve these health behaviours.
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Affiliation(s)
- Barbara Mullan
- Health Psychology and Behavioural Medicine Research GroupSchool of PsychologyCurtin UniversityPerthWestern AustraliaAustralia
| | - Claudia Olivier
- Health Psychology and Behavioural Medicine Research GroupSchool of PsychologyCurtin UniversityPerthWestern AustraliaAustralia
- Physical Activity and Well‐Being Research GroupSchool of PsychologyCurtin UniversityWestern Australia
| | - Cecilie Thøgersen‐Ntoumani
- Health Psychology and Behavioural Medicine Research GroupSchool of PsychologyCurtin UniversityPerthWestern AustraliaAustralia
- Physical Activity and Well‐Being Research GroupSchool of PsychologyCurtin UniversityWestern Australia
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11
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Vigezzi GP, Gaetti G, Gianfredi V, Frascella B, Gentile L, d'Errico A, Stuckler D, Ricceri F, Costa G, Odone A. Transition to retirement impact on health and lifestyle habits: analysis from a nationwide Italian cohort. BMC Public Health 2021; 21:1670. [PMID: 34521363 PMCID: PMC8439097 DOI: 10.1186/s12889-021-11670-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 08/09/2021] [Indexed: 01/01/2023] Open
Abstract
Background Retirement is a life-course transition likely to affect, through different mechanisms, behavioural risk factors’ patterns and, ultimately, health outcomes. We assessed the impact of transitioning to retirement on lifestyle habits and perceived health status in a nationwide cohort of Italian adults. Methods We analysed data from a large cohort of Italian adults aged 55–70, derived from linking six waves of the Participation, Labour, Unemployment Survey (PLUS), a national survey representative of the Italian workforce population, conducted between 2010 and 2018. We estimated relative-risk ratios (RRR) of transition to retirement and their corresponding 95% confidence intervals (CIs) for selected behavioural risk factors and health outcomes using multivariable logistic regression models. We used propensity score matching (PSM) to account for potential confounders. Results We included 5169 subjects in the study population, of which 1653 retired between 2010 and 2018 (exposed, 32%). Transition to retirement was associated with a 36% increased probability of practising sports (RRR 1.36, 95% CI 1.12–1.64). No statistically significant changes were reported for smoking habit (current smoker RRR: 1.18, 95% CI 0.94–1.46) and BMI (overweight/obese RRR: 0.96, 95% CI 0.81–1.15). Overall, retiring was associated with improved self-rated health status (RRR 1.26, 95% CI 1.02–1.58). Conclusion Individual data-linkage of multiple waves of the PLUS can offer great insight to inform healthy ageing policies in Italy and Europe. Transition to retirement has an independent effect on perceived health status, physical activity and selected behavioural risk factors. It should be identified as a target moment for preventive interventions, with particular reference to primary prevention so as to promote health and wellbeing in older ages. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11670-3.
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Affiliation(s)
| | - Giovanni Gaetti
- School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
| | | | | | | | - Angelo d'Errico
- Department of Epidemiology, ASL TO3, Piedmont Region, Grugliasco, Turin, Italy
| | - David Stuckler
- Department of Social and Political Sciences, Bocconi University, Milan, Italy
| | - Fulvio Ricceri
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Giuseppe Costa
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini, 2, Pavia, Italy.
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12
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Enhancing Planning Behavior during Retirement: Effects of a Time Perspective Based Training Intervention. SOCIAL SCIENCES 2021. [DOI: 10.3390/socsci10080306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Time perspective is a psychological construct that reflects the way people view time. Two schools of thought exist that theorize how this temporal mindset affects behavior—dominant and balanced. We applied dominant and balanced time perspective frameworks separately to two versions of an online intervention that aimed to promote goal-setting and accumulation of essential retirement resources (health, physical, social, cognitive and emotional) and compared effects with a control group. The effectiveness of the intervention was tested with 109 US retirees using a 4-wave design over a 6-month period. Linear mixed models showed an increase in health goal striving for the balanced group at posttraining and gains were maintained at the 3-month time point. Both training groups demonstrated an increase in the number and specificity of goals at posttraining and 3-months. Applying a time perspective framework to an online planning intervention for retirees shows promise in promoting planning for retirement resources. Practical implications, limitations, and suggestions for developing future interventions are discussed.
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13
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LESKINEN TUIJA, SUORSA KRISTIN, TUOMINEN MIIKA, PULAKKA ANNA, PENTTI JAANA, LÖYTTYNIEMI ELIISA, HEINONEN ILKKA, VAHTERA JUSSI, STENHOLM SARI. The Effect of Consumer-based Activity Tracker Intervention on Physical Activity among Recent Retirees-An RCT Study. Med Sci Sports Exerc 2021; 53:1756-1765. [PMID: 34261997 PMCID: PMC8284385 DOI: 10.1249/mss.0000000000002627] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The randomized controlled trial REACT (NCT03320746) examined the effect of a 12-month consumer-based activity tracker intervention on accelerometer-measured physical activity among recent retirees. METHODS Altogether 231 recently retired Finnish adults (age, 65.2 ± 1.1 yr, mean ± SD; 83% women) were randomized to intervention and control groups. Intervention participants were requested to wear a commercial wrist-worn activity tracker (Polar Loop 2; Polar, Kempele, Finland) for 12 months, to try to reach the daily activity goals shown on the tracker display, and to upload their activity data to a Web-based program every week. The control group received no intervention. Accelerometer-based outcome measurements of daily total, light physical activity (LPA), and moderate to vigorous (MVPA) physical activity were conducted at baseline and at 3-, 6-, and 12-month time points. Hierarchical linear mixed models were used to examine the differences between the groups over time. All analyses were performed by intention-to-treat principle and adjusted for wake wear time. RESULTS The use of a commercial activity tracker did not increase daily total activity, LPA, or MVPA over the 12-months period when compared with nonuser controls (group-time interaction, P = 0.39, 0.23, and 0.77, respectively). There was an increase in LPA over the first 6 months in both the intervention (26 min·d-1, 95% confidence interval [CI] = 13 to 39) and the control (14 min·d-1, 95% CI = 1 to 27) groups, but the difference between the groups was not significant (12 min·d-1, 95% CI = -6 to 30). In both groups, LPA decreased from 6 to 12 months. CONCLUSION The 12-month use of a commercial activity tracker does not appear to elicit significant changes in the daily total activity among a general population sample of recent retirees, thus highlighting the need to explore other alternatives to increase physical activity in this target group.
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Affiliation(s)
- TUIJA LESKINEN
- Department of Public Health, University of Turku and Turku University Hospital, Turku, FINLAND
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, FINLAND
| | - KRISTIN SUORSA
- Department of Public Health, University of Turku and Turku University Hospital, Turku, FINLAND
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, FINLAND
| | - MIIKA TUOMINEN
- Department of Public Health, University of Turku and Turku University Hospital, Turku, FINLAND
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, FINLAND
| | - ANNA PULAKKA
- Finnish Institute for Health and Welfare, Helsinki, FINLAND
| | - JAANA PENTTI
- Department of Public Health, University of Turku and Turku University Hospital, Turku, FINLAND
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, FINLAND
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, FINLAND
| | - ELIISA LÖYTTYNIEMI
- Department of Biostatistics, University of Turku and Turku University Hospital, Turku, FINLAND
| | - ILKKA HEINONEN
- Turku PET Centre, and Department of Clinical Physiology and Nuclear Medicine, University of Turku, Turku, FINLAND
- Rydberg Laboratory of Applied Sciences, Department of Environmental and Biosciences, University of Halmstad, Halmstad, SWEDEN
| | - JUSSI VAHTERA
- Department of Public Health, University of Turku and Turku University Hospital, Turku, FINLAND
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, FINLAND
| | - SARI STENHOLM
- Department of Public Health, University of Turku and Turku University Hospital, Turku, FINLAND
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, FINLAND
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Gil-Lacruz M, Gil-Lacruz AI, Domingo-Torrecilla P, Cañete-Lairla MA. Health-Related Quality of Life and Physical Activity in a Community Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147301. [PMID: 34299751 PMCID: PMC8304005 DOI: 10.3390/ijerph18147301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 11/16/2022]
Abstract
This article analyses how physical activity reinforces each of the dimensions (mental, physical, social, etc.) of the health-related quality of life concept. To that end, we determined whether this relationship is moderated by educational level and area of residence. The empirical part was based on data obtained from a cross-sectional survey carried out in the Casablanca neighbourhood (Zaragoza, Spain). The sample comprised 1083 participants aged between 25 and 84 years residing in the three residential areas of this neighbourhood: Viñedo Viejo, Las Nieves and Fuentes Claras. These three areas exhibit significant socio-economic differences in their population. The self-reported questionnaire included the following key information for this study: socio-economic characteristics (sex, age, educational level and area of residence) and health-related quality of life (WHOQOL-Brief: mental health, physical health, social relations and environment). The main results obtained from the descriptive statistics and regression systems were added. Playing a sport or undertaking some physical activity brings many health benefits, both physical and mental. The educational level and area of residence affect this relationship, such that the effects of physical activity are greater for those residents of Casablanca who have a higher educational level and/or live in more favoured areas of this neighbourhood. The results have also been discussed by sex and age group. Investing in innovative programmes in educational institutions and communities to acquire healthy habits and behaviour patterns that take into account socioeconomic differences in the population would be an advisable public health strategy.
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Affiliation(s)
- Marta Gil-Lacruz
- Health Science Faculty, University of Zaragoza, 50009 Zaragoza, Spain
- Correspondence:
| | - Ana Isabel Gil-Lacruz
- School of Engineering and Architecture, University of Zaragoza, 50018 Zaragoza, Spain;
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15
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Taylor J, Walsh S, Kwok W, Pinheiro MB, de Oliveira JS, Hassett L, Bauman A, Bull F, Tiedemann A, Sherrington C. A scoping review of physical activity interventions for older adults. Int J Behav Nutr Phys Act 2021; 18:82. [PMID: 34193157 PMCID: PMC8243293 DOI: 10.1186/s12966-021-01140-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/12/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND To inform implementation and future research, this scoping review investigates the volume of evidence for physical activity interventions among adults aged 60+. Our research questions are: (1) what is the evidence regarding interventions designed to increase total physical activity in adults aged 60+ years, in accordance with three of the four strategic objectives of GAPPA (active societies, active environments, active people); (2) what is the current evidence regarding the effectiveness of physical activity programmes and services designed for older adults?; and (3) What are the evidence gaps requiring further research? METHODS We searched PEDro, MEDLINE, CINAHL and Cochrane from 1 January 2010 to 1 November 2020 for systematic reviews and meta-analyses of physical activity interventions in adults aged 60+. We identified interventions designed to: (1) increase physical activity; and (2) deliver physical activity programmes and services in home, community or outpatient settings. We extracted and coded data from eligible reviews according to our proposed framework informed by TIDieR, Prevention of Falls Network Europe (PROFANE), and WHO's International Classification of Functioning, Disability and Health (ICF). We classified the overall findings as positive, negative or inconclusive. RESULTS We identified 39 reviews of interventions to increase physical activity and 342 reviews of programmes/services for older adults. Interventions were predominantly structured exercise programmes, including balance strength/resistance training, and physical recreation, such as yoga and tai chi. There were few reviews of health promotion/coaching and health professional education/referral, and none of sport, workplace, sociocultural or environmental interventions. Fewer reported outcomes of total physical activity, social participation and quality of life/well-being. We noted insufficient coverage in diverse and disadvantaged samples and low-middle income countries. CONCLUSIONS There is a modest but growing volume of evidence regarding interventions designed to increase total physical activity in older adults, although more interventional studies with long term follow-up are needed, particularly for GAPPA 1. Active Societies and GAPPA 2. Active Environments. By comparison, there is abundant evidence for GAPPA 3. specific programmes and services, but coverage of sport and workplace interventions, and diverse samples and settings is lacking. Comprehensive reviews of individual studies are now needed as well as research targeting neglected outcomes, populations and settings.
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Affiliation(s)
- Jennifer Taylor
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, NSW, 2050, Australia.
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Sarah Walsh
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, NSW, 2050, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Wing Kwok
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, NSW, 2050, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Marina B Pinheiro
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, NSW, 2050, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Juliana Souza de Oliveira
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, NSW, 2050, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Leanne Hassett
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, NSW, 2050, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Adrian Bauman
- Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- WHO Collaborating Centre for Physical Activity, Nutrition and Obesity, Sydney, Australia
| | - Fiona Bull
- Physical Activity Unit, Department of Health Promotion, Division of Universal Health Coverage and Healthier Populations, World Health Organization (WHO), Geneva, Switzerland
| | - Anne Tiedemann
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, NSW, 2050, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Catherine Sherrington
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, NSW, 2050, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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16
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Suorsa K, Leskinen T, Pulakka A, Pentti J, Löyttyniemi E, Heinonen I, Vahtera J, Stenholm S. The effect of a consumer-based activity tracker intervention on accelerometer-measured sedentary time among retirees: a randomized controlled REACT trial. J Gerontol A Biol Sci Med Sci 2021; 77:579-587. [PMID: 33839766 PMCID: PMC8893187 DOI: 10.1093/gerona/glab107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Indexed: 12/03/2022] Open
Abstract
Background Effective strategies to reverse the increasing trend of sedentary behavior after retirement are needed. The aim of this study was to examine the effect of 12-month activity tracker-based intervention on daily total and prolonged sedentary time (≥60 minutes) among recent retirees. Methods Randomization to intervention and control groups was performed to 231 retirees (mean age 65.2 [SD 1.1] years, 83% women). Intervention participants wore a consumer-based wrist-worn activity tracker (Polar Loop 2, Polar, Kempele, Finland), including daily activity goal, every day and night for 12 months. The activity tracker also gave vibrating reminders to break up uninterrupted inactivity periods after 55 minutes. A wrist-worn triaxial ActiGraph wGT3X-BT accelerometer was used to measure sedentary time at baseline and at 3-, 6-, and 12-month time points. Results The use of an activity tracker did not reduce daily total or prolonged sedentary time over 12 months (p values for time * group interaction 0.39 and 0.27, respectively). In the post hoc analysis focusing on short- and medium-term effects on prolonged sedentary time, no differences between the intervention and control groups over 3 months were found, but a tendency for a greater decrease in prolonged sedentary time in the intervention group over 6 months was seen (mean difference in changes between the groups 29 minutes, 95% CI −2 to 61). Conclusions The activity tracker with inactivity alerts did not elicit changes in sedentary time over 12 months among recent retirees. Alternative approaches may be needed to achieve long-term changes in sedentary time among retirees. Clinical Trials registration Number: NCT03320746
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Affiliation(s)
- Kristin Suorsa
- Department of Public Health, University of Turku and Turku University Hospital, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Finland
| | - Tuija Leskinen
- Department of Public Health, University of Turku and Turku University Hospital, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Finland
| | - Anna Pulakka
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jaana Pentti
- Clinicum, Faculty of Medicine, University of Helsinki, Finland
| | - Eliisa Löyttyniemi
- Department of Biostatistics, University of Turku and Turku University Hospital, Finland
| | - Ilkka Heinonen
- Turku PET Centre, and department of Clinical Physiology and Nuclear Medicine, University of Turku, Turku, Finland.,Rydberg Laboratory of Applied Sciences, department of Environmental- and Biosciences, University of Halmstad, Halmstad, Sweden
| | - Jussi Vahtera
- Department of Public Health, University of Turku and Turku University Hospital, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku and Turku University Hospital, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Finland
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17
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de Koning J, Richards SH, Wood GER, Stathi A. Profiles of Loneliness and Social Isolation in Physically Active and Inactive Older Adults in Rural England. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3971. [PMID: 33918808 PMCID: PMC8070246 DOI: 10.3390/ijerph18083971] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/30/2021] [Accepted: 04/07/2021] [Indexed: 11/16/2022]
Abstract
Objective: Loneliness and social isolation are associated with higher risk of morbidity and mortality and physical inactivity in older age. This study explored the socioecological context in which both physically active and inactive older adults experience loneliness and/or social isolation in a UK rural setting. Design: A mixed-methods design employed semi structured interviews and accelerometer-measured moderate-to-vigorous physical activity (MVPA). Interviews explored the personal, social and environmental factors influencing engagement with physical activities, guided by an adapted-socioecological model of physical activity behaviour. Findings: Twenty-four older adults (Mean Age = 73 (5.8 SD); 12 women) were interviewed. Transcripts were thematically analysed and seven profiles of physical activity, social isolation and loneliness were identified. The high-MVPA group had established PA habits, reported several sources of social contact and evaluated their physical environment as activity friendly. The low MVPA group had diverse experiences of past engagement in social activities. Similar to the high MVPA, they reported a range of sources of social contact but they did not perceive the physical environment as activity friendly. Conclusions: Loneliness and/or social isolation was reported by both physically active and inactive older adults. There is wide diversity and complexity in types and intensity of PA, loneliness and social isolation profiles and personal, social and environmental contexts.
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Affiliation(s)
| | - Suzanne H Richards
- Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9NL, UK;
| | - Grace E R Wood
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK;
| | - Afroditi Stathi
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK;
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18
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Rétsági E, Prémusz V, Makai A, Melczer C, Betlehem J, Lampek K, Ács P, Hock M. Association with subjective measured physical activity (GPAQ) and quality of life (WHOQoL-BREF) of ageing adults in Hungary, a cross-sectional study. BMC Public Health 2020; 20:1061. [PMID: 32799853 PMCID: PMC7429902 DOI: 10.1186/s12889-020-08833-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 05/01/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND It is well known that physical activity (PA) has health benefits. This study aimed to examine physical activity carried out by the senior (over 50) participants and its relation to their quality of life (QoL). METHODS Surveillance of PA and QoL was measured by using questionnaires (GPAQ, WHOQoL-BREF) in this study. Descriptive data were presented as means and standard deviations (SD) for continuous variables and as percentages for categorical variables. Multivariate linear regression analysis was conducted. The significance level was set at p ≤ 0.05. RESULTS Overall, 250 participants were recruited, the mean age of the study population (n = 243) was 70.2 (SD 7.1) years. The results clearly showed that the Hungarian participants aged over 50 years were more likely to do PA if they had university degree and lower age (p ≤ 0.001) and used more active transportation (p = 0.035) if they had low education. The results of WHOQoL-BREF showed that the Hungarian individuals have better QoL if they have university degree (p ≤ 0.001) and lower age (p ≤ 0.001). Using multivariate linear regression analysis to examine the effect of PA patterns on QoL adjusted for demographic variables (age, education, BMI, place of living), the result showed significant correlation between WHOQoL-BREF dimensions and GPAQ (p ≤ 0.001). CONCLUSION Higher amount of PA among aging population can result in better QoL in all dimensions.
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Affiliation(s)
- Erzsébet Rétsági
- Faculty of Health Sciences, Institute of Physiotherapy and Sport Sciences, University of Pécs, 4 Rét str., Pécs, H-7623 Hungary
| | - Viktória Prémusz
- Faculty of Health Sciences, Doctoral School of Health Sciences, University of Pécs, 4 Vörösmarty str., Pécs, H-7621 Hungary
| | - Alexandra Makai
- Faculty of Health Sciences, Institute of Physiotherapy and Sport Sciences, University of Pécs, 4 Rét str., Pécs, H-7623 Hungary
| | - Csaba Melczer
- Faculty of Health Sciences, Institute of Physiotherapy and Sport Sciences, University of Pécs, 4 Rét str., Pécs, H-7623 Hungary
| | - József Betlehem
- Faculty of Health Sciences, Institute of Emergency Care and Health Pedagogy, University of Pécs Pécs, 4 Vörösmarty str., Pécs, H-7621 Hungary
| | - Kinga Lampek
- Department of Public Health and Health Promotion, Faculty of Health Sciences, Institute of Health Insurance, University of Pécs, 5-7 Mária str., Pécs, H-7621 Hungary
| | - Pongrác Ács
- Faculty of Health Sciences, Institute of Physiotherapy and Sport Sciences, University of Pécs, 4 Rét str., Pécs, H-7623 Hungary
| | - Márta Hock
- Faculty of Health Sciences, Institute of Physiotherapy and Sport Sciences, University of Pécs, 4 Rét str., Pécs, H-7623 Hungary
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19
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Schönbach JK, Bolte G, Czwikla G, Manz K, Mensing M, Muellmann S, Voelcker-Rehage C, Lhachimi SK. Equity impacts of interventions to increase physical activity among older adults: a quantitative health impact assessment. Int J Behav Nutr Phys Act 2020; 17:103. [PMID: 32795299 PMCID: PMC7427912 DOI: 10.1186/s12966-020-00999-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 07/21/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Behavioural interventions may increase social inequalities in health. This study aimed to project the equity impact of physical activity interventions that have differential effectiveness across education groups on the long-term health inequalities by education and gender among older adults in Germany. METHODS We created six intervention scenarios targeting the elderly population: Scenarios #1-#4 applied realistic intervention effects that varied by education (low, medium high). Under scenario #5, all older adults adapted the physical activity pattern of those with a high education. Under scenario #6, all increased their physical activity level to the recommended 300 min weekly. The number of incident ischemic heart disease, stroke and diabetes cases as well as deaths from all causes under each of these six intervention scenarios was simulated for males and females over a 10-year projection period using the DYNAMO-HIA tool. Results were compared against a reference-scenario with unchanged physical activity. RESULTS Under scenarios #1-#4, approximately 3589-5829 incident disease cases and 6248-10,320 deaths could be avoided among males over a 10-year projection period, as well as 4381-7163 disease cases and 6914-12,605 deaths among females. The highest reduction for males would be achieved under scenario #4, under which the intervention is most effective for those with a high education level. Scenario #4 realizes 2.7 and 2.4% of the prevented disease cases and deaths observed under scenario #6, while increasing inequalities between education groups. In females, the highest reduction would be achieved under scenario #3, under which the intervention is most effective amongst those with low levels of education. This scenario realizes 2.7 and 2.9% of the prevented disease cases and deaths under scenario #6, while decreasing inequalities between education groups. Under scenario #5, approximately 31,687 incident disease cases and 59,068 deaths could be prevented among males over a 10-year projection period, as well as 59,173 incident disease cases and 121,689 deaths among females. This translates to 14.4 and 22.2% of the prevented diseases cases among males and females under scenario #6, and 13.7 and 27.7% of the prevented deaths under scenario #6. CONCLUSIONS This study shows how the overall population health impact varies depending on how the intervention-induced physical activity change differs across education groups. For decision-makers, both the assessment of health impacts overall as well as within a population is relevant as interventions with the greatest population health gain might be accompanied by an unintended increase in health inequalities.
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Affiliation(s)
- Johanna-Katharina Schönbach
- University of Bremen, Institute of Public Health and Nursing Research, Department of Social Epidemiology, Bremen, Germany.
- University of Bremen, Health Sciences Bremen, Bremen, Germany.
| | - Gabriele Bolte
- University of Bremen, Institute of Public Health and Nursing Research, Department of Social Epidemiology, Bremen, Germany
- University of Bremen, Health Sciences Bremen, Bremen, Germany
| | - Gesa Czwikla
- University of Bremen, Institute of Public Health and Nursing Research, Department of Social Epidemiology, Bremen, Germany
- University of Bremen, Health Sciences Bremen, Bremen, Germany
| | | | | | - Saskia Muellmann
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Claudia Voelcker-Rehage
- Chemnitz University of Technology, Institute of Human Movement Science and Health, Chemnitz, Germany
- University of Münster, Institute of Sport and Exercise Sciences, Münster, Germany
| | - Stefan K Lhachimi
- University of Bremen, Health Sciences Bremen, Bremen, Germany
- University of Bremen, Institute of Public Health and Nursing Research, Department of Health Services Research, Bremen, Germany
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20
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Ter Hoeve N, Ekblom M, Galanti MR, Forsell Y, Nooijen CFJ. Unfavourable sedentary and physical activity behaviour before and after retirement: a population-based cohort study. BMJ Open 2020; 10:e037659. [PMID: 32723744 PMCID: PMC7389486 DOI: 10.1136/bmjopen-2020-037659] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND During transition to retirement there is often a rearrangement of daily life which might provide a key opportunity for interventions to promote a non-sedentary and active lifestyle. To be able to design effective interventions, it is essential to know which sedentary and physical behaviour domains (eg, at home or during leisure time) have potential to facilitate healthy ageing during the retirement transition. OBJECTIVE To determine whether unfavourable sedentary and physical activity behaviour before retirement predict unfavourable sedentary and physical activity behaviour after retirement. DESIGN Population-based cohort. SETTING AND PARTICIPANTS Adults (n=3272) employed in 2010 but retired in 2014. METHODS Self-reported preretirement job activity, sedentary leisure time, physical activity at home, and walking-cycling and exercise were assessed as predictors for unfavourable sedentary and physical activity behaviours after retirement using logistic regression. Unfavourable behaviours were defined based on the respective median of the cohort distribution. Furthermore, the OR for having multiple unfavourable behaviours after retirement was determined, based on the amount of unfavourable behaviours before retirement. All models were adjusted for gender and education. RESULTS Unfavourable preretirement physical activity and sedentary behaviour at home or during leisure time were the strongest predictors of the same behaviours after retirement. Unfavourable job activity did not predict physical activity but did predict unfavourable sedentary behaviour after retirement (OR=1.66, 95% CI 1.41 to 1.96). Unfavourable exercise behaviour before retirement predicted unfavourable sedentary and physical activity after retirement in all domains. With all behaviours being unfavourable before retirement, the OR of having at least three unfavourable behaviours after retirement was 36.7 (95% CI 16.8 to 80.5). CONCLUSIONS Adults with a higher number of unfavourable preretirement physical activity and sedentary behaviours are likely to carry these unfavourable behaviours into retirement age. Interventions should target those with more unfavourable preretirement physical activity and sedentary behaviours before retirement, and those interventions focusing on exercise might have greatest potential.
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Affiliation(s)
- Nienke Ter Hoeve
- Capri Cardiac Rehabilitation, Rotterdam, The Netherlands
- Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Maria Ekblom
- The Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden
- The Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Maria R Galanti
- The Department of Global Public Health, Karolinska Institutet, and Centre for Epidemiology and Community Medicine, Stockholm, Sweden
| | - Yvonne Forsell
- The Department of Global Public Health, Karolinska Institutet, and Centre for Epidemiology and Community Medicine, Stockholm, Sweden
| | - Carla F J Nooijen
- The Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden
- The Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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21
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Rodríguez-Monforte M, Fernández-Jané C, Martin-Arribas A, Costa-Tutusaus L, Sitjà-Rabert M, Ramírez-García I, Canet Vélez O, Kopp J, Vilaró J, Carrillo-Alvarez E. Interventions across the Retirement Transition for Improving Well-Being: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4341. [PMID: 32560506 PMCID: PMC7344699 DOI: 10.3390/ijerph17124341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/10/2020] [Accepted: 06/12/2020] [Indexed: 11/16/2022]
Abstract
(1) Background: The work-to-retirement transition involves a process of psychologically and behaviorally distancing oneself from the workforce that is often accompanied by other social changes, which can influence health and well-being. However, research on interventions targeting the work-to-retirement transition to improve health status is limited. Our objective was to summarize and describe interventions aiming to improve well-being across the retirement transition; (2) Methods: We conducted a scoping review following the methodological framework described by Arksey and O'Malley; the Joanna Briggs Institute guidelines as well as the PRISMA-ScR statements; we systematically searched articles and gray literature to identify interventions and policies that aimed to improve well-being across the retirement transition. (3) Results: 15 publications were included, which comprised both experimental designs (n = 10) and systematic reviews (n = 5). (4) Conclusions: More research on how to promote overall well-being during the work-to-retirement transition is needed. The results of this scoping review show that most reported interventions address one single lifestyle behavior, and that relevant social determinants of health have been barely considered in their design. Future investigations need to consider vulnerable groups and country-specific structural conditions. Adopting a patient and public involvement approach will contribute to developing interventions that address the significant needs of those in the transition to retirement.
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Affiliation(s)
- Miriam Rodríguez-Monforte
- Global Research on Well-Being (GRoW), Blanquerna School of Health Sciences, Universitat Ramon Llull, Padilla, 326-332, 08025 Barcelona, Spain; (M.R.-M.); (L.C.-T.); (M.S.-R.); (J.K.); (J.V.); (E.C.-A.)
| | - Carles Fernández-Jané
- Global Research on Well-Being (GRoW), Blanquerna School of Health Sciences, Universitat Ramon Llull, Padilla, 326-332, 08025 Barcelona, Spain; (M.R.-M.); (L.C.-T.); (M.S.-R.); (J.K.); (J.V.); (E.C.-A.)
| | - Anna Martin-Arribas
- GHenderS Research Group, Blanquerna School of Health Sciences, Universitat Ramon Llull, Padilla, 326-332, 08025 Barcelona, Spain; (A.M.-A.); (I.R.-G.); (O.C.V.)
| | - Lluís Costa-Tutusaus
- Global Research on Well-Being (GRoW), Blanquerna School of Health Sciences, Universitat Ramon Llull, Padilla, 326-332, 08025 Barcelona, Spain; (M.R.-M.); (L.C.-T.); (M.S.-R.); (J.K.); (J.V.); (E.C.-A.)
| | - Mercè Sitjà-Rabert
- Global Research on Well-Being (GRoW), Blanquerna School of Health Sciences, Universitat Ramon Llull, Padilla, 326-332, 08025 Barcelona, Spain; (M.R.-M.); (L.C.-T.); (M.S.-R.); (J.K.); (J.V.); (E.C.-A.)
| | - Inés Ramírez-García
- GHenderS Research Group, Blanquerna School of Health Sciences, Universitat Ramon Llull, Padilla, 326-332, 08025 Barcelona, Spain; (A.M.-A.); (I.R.-G.); (O.C.V.)
| | - Olga Canet Vélez
- GHenderS Research Group, Blanquerna School of Health Sciences, Universitat Ramon Llull, Padilla, 326-332, 08025 Barcelona, Spain; (A.M.-A.); (I.R.-G.); (O.C.V.)
| | - Jenna Kopp
- Global Research on Well-Being (GRoW), Blanquerna School of Health Sciences, Universitat Ramon Llull, Padilla, 326-332, 08025 Barcelona, Spain; (M.R.-M.); (L.C.-T.); (M.S.-R.); (J.K.); (J.V.); (E.C.-A.)
| | - Jordi Vilaró
- Global Research on Well-Being (GRoW), Blanquerna School of Health Sciences, Universitat Ramon Llull, Padilla, 326-332, 08025 Barcelona, Spain; (M.R.-M.); (L.C.-T.); (M.S.-R.); (J.K.); (J.V.); (E.C.-A.)
| | - Elena Carrillo-Alvarez
- Global Research on Well-Being (GRoW), Blanquerna School of Health Sciences, Universitat Ramon Llull, Padilla, 326-332, 08025 Barcelona, Spain; (M.R.-M.); (L.C.-T.); (M.S.-R.); (J.K.); (J.V.); (E.C.-A.)
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22
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Balis LE, Strayer T, Ramalingam N, Wilson M, Harden SM. Open-Access Physical Activity Programs for Older Adults: A Pragmatic and Systematic Review. THE GERONTOLOGIST 2020; 59:e268-e278. [PMID: 29329395 DOI: 10.1093/geront/gnx195] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Open-access, community-based programs are recommended to assist older adults in meeting physical activity guidelines, but the characteristics, impact, and scalability of these programs is less understood. The Land-Grant University Cooperative Extension System, an organization providing education through county-based educators, functions as a delivery system for these programs. A systematic review was conducted to determine characteristics of effective older adult physical activity programs and the extent to which programs delivered in Extension employ these characteristics. RESEARCH DESIGN AND METHODS A systematic review of peer-reviewed and grey literature was conducted from August 2016 to February 2017. The review was limited to open-access (available to all), community-based physical activity interventions for older adults (≥65 years of age). The peer-reviewed literature search was conducted in PubMed and EBSCOhost; the grey literature search for Extension interventions was conducted through Extension websites, Land-Grant Impacts, and the Journal of Extension. RESULTS Sixteen peer-reviewed studies and 17 grey literature sources met inclusion criteria and were analyzed. Peer-reviewed and Extension programs were similar in their limited use of behavioral theories and group-based strategies. Compared to Extension programs, those in the peer-reviewed literature were more likely to use a combination of physical activity components and be delivered by trained professionals. DISCUSSION AND IMPLICATIONS The results indicate notable differences between peer-reviewed literature and Extension programs and present an opportunity for Extension programs to more effectively use evidence-based program characteristics, including behavioral theories and group dynamics, a combination of physical activity components, and educator/agent-trained delivery agents.
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Affiliation(s)
- Laura E Balis
- University of Wyoming, Extension, Laramie.,Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg
| | - Thomas Strayer
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg
| | | | - Meghan Wilson
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg
| | - Samantha M Harden
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg
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23
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Jelsma JGM, Gale J, Loyen A, van Nassau F, Bauman A, van der Ploeg HP. Time trends between 2002 and 2017 in correlates of self-reported sitting time in European adults. PLoS One 2019; 14:e0225228. [PMID: 31714933 PMCID: PMC6850696 DOI: 10.1371/journal.pone.0225228] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 10/30/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND This study explores trends in the prevalence of high sitting time and its correlates among "high sitting" and "high sitting-least active" European adults from 2002 to 2017. Both groups have merit for future public health interventions to prevent development of a range of prevalent non-communicable diseases. METHODS Data collected in the 2002 (15 countries), 2005 (30 countries), 2013 (28 countries) and 2017 (28 countries) Eurobarometer surveys were used, including around 15,000 respondents in 2002 and >26,000 respondents in the other years. Sitting time and moderate to vigorous intensity physical activity were measured with the validated International Physical Activity Questionnaire-short. High sitting was defined as >7.5 hours per day. Respondents in the lowest quartile of total reported days of physical activity (i.e. days walking, days in moderate activity, and days in vigorous activity) were defined as least active. Multivariate odds ratios of high sitting, and high sitting-least active were assessed by country and socio-demographic characteristics for each survey year using binary logistic regression analyses. RESULTS Trends in sitting time were relatively stable over a 15-year period, although this time trend was limited by a change in the sitting question between 2005 and 2013. Men, higher educated people, students, retired people, white collar workers, people living in urban areas, people with lower physical activity levels, and people living in the Czech Republic, Denmark or the Netherlands were consistently more likely to be in the high sitting group across all four survey years. Similarly, men, students, retired people, unemployed people, white collar workers, and people living in the Czech Republic or Denmark were consistently more likely to be in the high sitting-least active group across all four surveys. CONCLUSION This study identified population sub-groups that need special attention in public health interventions to lower total sitting time.
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Affiliation(s)
- Judith G. M. Jelsma
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Van der Boechorststraat, Amsterdam, The Netherlands
| | - Joanne Gale
- Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, Australia
| | - Anne Loyen
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Femke van Nassau
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Van der Boechorststraat, Amsterdam, The Netherlands
| | - Adrian Bauman
- Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, Australia
| | - Hidde P. van der Ploeg
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Van der Boechorststraat, Amsterdam, The Netherlands
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24
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Alley SJ, Samra P, Rebar AL, Schoeppe S, Parkinson L, Power D, van Uffelen JGZ, Schneiders A, Vandelanotte C. A focus group study of older adults' perceptions and preferences towards web-based physical activity interventions. Inform Health Soc Care 2019; 45:273-281. [PMID: 31690152 DOI: 10.1080/17538157.2019.1656210] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To explore older adults' perceptions and preferences for web-based physical activity interventions. PARTICIPANTS Adults 65+ years were recruited via telephoning randomly selected households in Central Queensland, Australia. METHODS Six focus groups were conducted with a total of 46 adults 65+ years. Data were analyzed by qualitative content analysis. RESULTS This group of older adults liked websites that have links to information and included instructional videos and disliked websites that were hard to navigate. Many participants did not express an initial interest in web-based physical activity programs. The most common reason was that they did not have a computer or adequate internet connection. Some participants said they would be interested if it included a structured exercise program. When asked about preferences for web-based physical activity programs, this group preferred them to be simple and not cluttered, to include personalized advice, to include reminder check-ins and the ability to review goals after illness or injury. The most common preference for personalized advice in web-based interventions was that the information needs to be tailored to their existing injuries and illnesses. CONCLUSION The findings from this study will inform the design of future web-based interventions specifically tailored to the needs of older people.
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Affiliation(s)
- Stephanie J Alley
- School of Health, Medical and Applied Sciences, Central Queensland University , Rockhampton, Australia
| | - Pamela Samra
- School of Health, Medical and Applied Sciences, Central Queensland University , Rockhampton, Australia
| | - Amanda L Rebar
- School of Health, Medical and Applied Sciences, Central Queensland University , Rockhampton, Australia
| | - Stephanie Schoeppe
- School of Health, Medical and Applied Sciences, Central Queensland University , Rockhampton, Australia
| | - Lynne Parkinson
- School of Nursing, Midwifery and Social Sciences, Central Queensland University , Rockhampton, Australia
| | - Deborah Power
- School of Health, Medical and Applied Sciences, Central Queensland University , Rockhampton, Australia
| | | | - Anthony Schneiders
- School of Health, Medical and Applied Sciences, Central Queensland University , Rockhampton, Australia
| | - Corneel Vandelanotte
- School of Health, Medical and Applied Sciences, Central Queensland University , Rockhampton, Australia
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25
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Equity-Specific Effects of Interventions to Promote Physical Activity among Middle-Aged and Older Adults: Development of a Collaborative Equity-Specific Re-Analysis Strategy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173195. [PMID: 31480561 PMCID: PMC6747170 DOI: 10.3390/ijerph16173195] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 08/23/2019] [Accepted: 08/28/2019] [Indexed: 01/01/2023]
Abstract
Reducing social inequalities in physical activity (PA) has become a priority for public health. However, evidence concerning the impact of interventions on inequalities in PA is scarce. This study aims to develop and test the application of a strategy for re-analyzing equity-specific effects of existing PA intervention studies in middle-aged and older adults, as part of an international interdisciplinary collaboration. This article aims to describe (1) the establishment and characteristics of the collaboration; and (2) the jointly developed equity-specific re-analysis strategy as a first result of the collaboration. To develop the strategy, a collaboration based on a convenience sample of eight published studies of individual-level PA interventions among the general population of adults aged ≥45 years was initiated (UK, n = 3; The Netherlands, n = 3; Belgium, n = 1; Germany, n = 1). Researchers from these studies participated in a workshop and subsequent e-mail correspondence. The developed strategy will be used to investigate social inequalities in intervention adherence, dropout, and efficacy. This will allow for a comprehensive assessment of social inequalities within intervention benefits. The application of the strategy within and beyond the collaboration will help to extend the limited evidence regarding the effects of interventions on social inequalities in PA among middle-aged and older adults.
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26
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Jonkman NH, Colpo M, Klenk J, Todd C, Hoekstra T, Del Panta V, Rapp K, van Schoor NM, Bandinelli S, Heymans MW, Mauger D, Cattelani L, Denkinger MD, Rothenbacher D, Helbostad JL, Vereijken B, Maier AB, Pijnappels M. Development of a clinical prediction model for the onset of functional decline in people aged 65-75 years: pooled analysis of four European cohort studies. BMC Geriatr 2019; 19:179. [PMID: 31248370 PMCID: PMC6595632 DOI: 10.1186/s12877-019-1192-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 06/18/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Identifying those people at increased risk of early functional decline in activities of daily living (ADL) is essential for initiating preventive interventions. The aim of this study is to develop and validate a clinical prediction model for onset of functional decline in ADL in three years of follow-up in older people of 65-75 years old. METHODS Four population-based cohort studies were pooled for the analysis: ActiFE-ULM (Germany), ELSA (United Kingdom), InCHIANTI (Italy), LASA (Netherlands). Included participants were 65-75 years old at baseline and reported no limitations in functional ability in ADL at baseline. Functional decline was assessed with two items on basic ADL and three items on instrumental ADL. Participants who reported at least some limitations at three-year follow-up on any of the five items were classified as experiencing functional decline. Multiple logistic regression analysis was used to develop a prediction model, with subsequent bootstrapping for optimism-correction. We applied internal-external cross-validation by alternating the data from the four cohort studies to assess the discrimination and calibration across the cohorts. RESULTS Two thousand five hundred sixty community-dwelling people were included in the analyses (mean age 69.7 ± 3.0 years old, 47.4% female) of whom 572 (22.3%) reported functional decline at three-year follow-up. The final prediction model included 10 out of 22 predictors: age, handgrip strength, gait speed, five-repeated chair stands time (non-linear association), body mass index, cardiovascular disease, diabetes, chronic obstructive pulmonary disease, arthritis, and depressive symptoms. The optimism-corrected model showed good discrimination with a C statistic of 0.72. The calibration intercept was 0.06 and the calibration slope was 1.05. Internal-external cross-validation showed consistent performance of the model across the four cohorts. CONCLUSIONS Based on pooled cohort data analyses we were able to show that the onset of functional decline in ADL in three years in older people aged 65-75 years can be predicted by specific physical performance measures, age, body mass index, presence of depressive symptoms, and chronic conditions. The prediction model showed good discrimination and calibration, which remained stable across the four cohorts, supporting external validity of our findings.
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Affiliation(s)
- Nini H. Jonkman
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Marco Colpo
- Laboratory of Clinical Epidemiology, InCHIANTI Study Group, LHTC Local Health Tuscany Center, Firenze, Italy
| | - Jochen Klenk
- Department of Clinical Gerontology, Robert Bosch Hospital, Stuttgart, Germany
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Chris Todd
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre and Manchester University NHS Foundation Trust, Manchester, UK
| | - Trynke Hoekstra
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Vieri Del Panta
- Laboratory of Clinical Epidemiology, InCHIANTI Study Group, LHTC Local Health Tuscany Center, Firenze, Italy
| | - Kilian Rapp
- Department of Clinical Gerontology, Robert Bosch Hospital, Stuttgart, Germany
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Natasja M. van Schoor
- Amsterdam Public Health Research Institute, Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Stefania Bandinelli
- Laboratory of Clinical Epidemiology, InCHIANTI Study Group, LHTC Local Health Tuscany Center, Firenze, Italy
| | - Martijn W. Heymans
- Amsterdam Public Health Research Institute, Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Dominique Mauger
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Luca Cattelani
- Department of Computer Science and Engineering, University of Bologna, Bologna, Italy
| | - Michael D. Denkinger
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
- Geriatric Research Unit Ulm University and Geriatric Center, Agaplesion Bethesda Hospital Ulm, Ulm, Germany
| | | | - Jorunn L. Helbostad
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Beatrix Vereijken
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Andrea B. Maier
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
- Faculty of Medicine Dentistry and Health Sciences, Medicine and Aged Care, University of Melbourne, Royal Melbourne Hospital, Melbourne, Australia
| | - Mirjam Pijnappels
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
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Lehne G, Voelcker-Rehage C, Meyer J, Bammann K, Gansefort D, Brüchert T, Bolte G. Equity Impact Assessment of Interventions to Promote Physical Activity among Older Adults: A Logic Model Framework. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E420. [PMID: 30717136 PMCID: PMC6388141 DOI: 10.3390/ijerph16030420] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 01/23/2019] [Accepted: 01/30/2019] [Indexed: 11/16/2022]
Abstract
Reducing social inequalities in health and health determinants, including physical activity (PA), is a major challenge for public health. PA-promoting interventions are increasingly implemented. Little is known, however, about the impact of these interventions on social inequalities. For prioritizing interventions most likely to be effective in reducing inequalities, studies of PA interventions need to conduct equity impact assessments. The aim of this article is to describe the development of a logic model framework for equity impact assessments of interventions to promote PA. The framework was developed within the prevention research network AEQUIPA-Physical activity and health equity: primary prevention for healthy ageing, informed by an equity-focused systematic review, expert interviews, exploratory literature searches, and joint discussions within the network. The framework comprises a general equity-focused logic model to be adapted to specific interventions. The intervention-specific equity-focused logic models illustrate the key elements relevant for assessing social inequalities in study participation, compliance with and acceptance of interventions, as well as the efficacy of interventions. Future work within AEQUIPA will reveal which key elements are most critical for the interventions' equity impacts. Equity impact assessments are beneficial for prioritizing interventions most likely to be effective in reducing health inequalities.
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Affiliation(s)
- Gesa Lehne
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany.
- Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany.
| | - Claudia Voelcker-Rehage
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, 09126 Chemnitz, Germany.
| | - Jochen Meyer
- OFFIS-Institute for Information Technology, 26121 Oldenburg, Germany.
| | - Karin Bammann
- Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany.
- Working Group Epidemiology of Demographic Change, Institute of Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany.
| | - Dirk Gansefort
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany.
| | - Tanja Brüchert
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany.
- Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany.
| | - Gabriele Bolte
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany.
- Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany.
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Takemoto M, Manini TM, Rosenberg DE, Lazar A, Zlatar ZZ, Das SK, Kerr J. Diet and Activity Assessments and Interventions Using Technology in Older Adults. Am J Prev Med 2018; 55:e105-e115. [PMID: 30241621 PMCID: PMC7176031 DOI: 10.1016/j.amepre.2018.06.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 03/27/2018] [Accepted: 06/04/2018] [Indexed: 12/31/2022]
Abstract
UNLABELLED This paper reports on the findings and recommendations specific to older adults from the "Tech Summit: Innovative Tools for Assessing Diet and Physical Activity for Health Promotion" forum organized by the North American branch of the International Life Sciences Institute. The summit aimed to investigate current and emerging challenges related to improving energy balance behavior assessment and intervention via technology. The current manuscript focuses on how novel technologies are applied in older adult populations and enumerated the barriers and facilitators to using technology within this population. Given the multiple applications for technology in this population, including the ability to monitor health events and behaviors in real time, technology presents an innovative method to aid with the changes associated with aging. Although older adults are often perceived as lacking interest in and ability to adopt technologies, recent studies show they are comfortable adopting technology and user uptake is high with proper training and guided facilitation. Finally, the conclusions suggest recommendations for future research, including the need for larger trials with clinical outcomes and more research using end-user design that includes older adults as technology partners who are part of the design process. THEME INFORMATION This article is part of a theme issue entitled Innovative Tools for Assessing Diet and Physical Activity for Health Promotion, which is sponsored by the North American branch of the International Life Sciences Institute.
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Affiliation(s)
- Michelle Takemoto
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California.
| | - Todd M Manini
- Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida
| | - Dori E Rosenberg
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Amanda Lazar
- College of Information Studies, University of Maryland, College Park, Maryland
| | - Zvinka Z Zlatar
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Sai Krupa Das
- Energy Metabolism Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
| | - Jacqueline Kerr
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California
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Hale LA, Smith CM, Mulligan HF, Adhia D, Siew B, Treharne GJ. Exploring the Blue Prescription intervention to promote physical activity in people with long-term conditions. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2018. [DOI: 10.12968/ijtr.2018.25.7.365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Leigh A Hale
- Dean, Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, Dunedin, New Zealand
| | - Catherine M Smith
- Lecturer, Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, Dunedin, New Zealand
| | - Hilda F Mulligan
- Senior lecturer, Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, Dunedin, New Zealand
| | - Divya Adhia
- Research assistant, Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, Dunedin, New Zealand
| | - Bryan Siew
- Post-graduate student, Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, Dunedin, New Zealand
| | - Gareth J Treharne
- Senior lecturer, Department of Psychology, University of Otago, Dunedin, New Zealand
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Jones SA, Li Q, Aiello AE, O'Rand AM, Evenson KR. Physical Activity, Sedentary Behavior, and Retirement: The Multi-Ethnic Study of Atherosclerosis. Am J Prev Med 2018; 54:786-794. [PMID: 29650285 PMCID: PMC5962425 DOI: 10.1016/j.amepre.2018.02.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 02/06/2018] [Accepted: 02/06/2018] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Physical activity and sedentary behavior are major risk factors for chronic disease. These behaviors may change at retirement, with implications for health in later life. The study objective was to describe longitudinal patterns of moderate to vigorous and domain-specific physical activity and TV watching by retirement status. METHODS Participants in the Multi-Ethnic Study of Atherosclerosis (n=6,814) were recruited from six U.S. communities and were aged 45-84 years at baseline. Retirement status and frequency and duration of domain-specific physical activity (recreational walking, transport walking, non-walking leisure activity, caregiving, household, occupational/volunteer) and TV watching were self-reported at four study exams (2000 to 2012). Fixed effect linear regression models were used to describe longitudinal patterns in physical activity and TV watching by retirement status overall and stratified by socioeconomic position. Analyses were conducted in 2017. RESULTS Of 4,091 Multi-Ethnic Study of Atherosclerosis participants not retired at baseline, 1,012 (25%) retired during a median of 9 years follow-up. Retirement was associated with a 10% decrease (95% CI= -15%, -5%) in moderate to vigorous physical activity and increases of 13% to 29% in recreational walking, household activity, and TV watching. Among people of low socioeconomic position, the magnitude of association was larger for moderate to vigorous physical activity. Among people of high socioeconomic position, the magnitude of association was larger for non-walking leisure and household activity. CONCLUSIONS The retirement transition was associated with changes in physical activity and TV watching. To inform intervention development, future research is needed on the determinants of behavior change after retirement, particularly among individuals of low socioeconomic position.
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Affiliation(s)
- Sydney A Jones
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.
| | - Quefeng Li
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Allison E Aiello
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina; Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina
| | - Angela M O'Rand
- Department of Sociology, Duke University, Durham, North Carolina
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
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de Almeida ML, Casemiro FG, Baba CT, Monteiro D, Fornazieri M, Cerri N, Fernandes DFM, de Oliveira Gomes GA. Studies About Physical Activity Interventions Including Follow-Up Analysis: A Systematic Review. J Phys Act Health 2018; 15:462-467. [PMID: 29542365 DOI: 10.1123/jpah.2016-0580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Some studies have used the follow-up method to analyze real behavioral changes in research involving physical activity (PA) interventions. This has great scientific value; however, it is hard to apply without satisfactory resources and research funding. Little is known about how many studies have used this method to analyze PA interventions in low-income and middle-income countries, especially Brazil. PURPOSE To describe Brazilian studies using follow-up analysis after PA interventions. METHODS A systematic review was performed including Brazilian studies with follow-up analysis after PA interventions; the analyzed papers were from the previous 10 years. The search was carried out in Portuguese, English, and Spanish in the following databases: SciELO, Latin American and Caribbean Health Science Literature, PubMed, and Scopus. The Preferred Reporting Items for Systematic Review and Meta-Analysis method was used. RESULTS In total, 6 of the 7 studies analyzed were from the southeast region, with the intervention time ranging from 2 to 12 months, carrying out follow-up every 5.3 months with 2.2 observations on average. The interventions had a behavioral approach and were generally carried out in universities, hospitals, and ambulatory care. CONCLUSION Studies on PA interventions using follow-up analysis are scarce. Considering the relevance of follow-up studies to measure behavior changes, the results suggest that more studies about this topic are essential in Brazil.
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How does a lifestyle intervention during pregnancy influence perceived barriers to leisure-time physical activity? The Norwegian fit for delivery study, a randomized controlled trial. BMC Pregnancy Childbirth 2018; 18:127. [PMID: 29724165 PMCID: PMC5934849 DOI: 10.1186/s12884-018-1771-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 04/24/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To develop effective health promotional and preventive prenatal programs, it is important to understand perceived barriers to leisure-time physical activity during pregnancy, including exercise and sport participation. The aims of the present study was 1) to assess the effect of prenatal lifestyle intervention on the perceived barrier to leisure-time physical activity during pregnancy and the first year after delivery and 2) identify the most important perceived barriers to leisure-time physical activity at multiple time points during and after pregnancy. METHODS This secondary analysis was part of the Norwegian Fit for Delivery study, a combined lifestyle intervention evaluated in a blinded, randomized controlled trial. Healthy, nulliparous women with singleton pregnancy of ≤20 gestational weeks, age ≥ 18 years and body mass index ≥19 kg/m2 were recruited via healthcare clinics in southern Norway, including urban and rural settings. Participants were randomized to either twice-weekly supervised exercise sessions and nutritional counselling (n = 303) or standard prenatal care (n = 303). The principal analysis was based on the participants who completed the standardized questionnaire assessing their perceived barriers to leisure-time physical activity at inclusion (gestational week 16, n = 589) and following intervention (gestational week 36, n = 509), as well as six months (n = 470) and 12 months (n = 424) postpartum. RESULTS Following intervention (gestation week 35.4 ± 1.0), a significant between-group difference in perceived barriers to leisure-time physical activity was found with respect to time constraints: "... I do not have the time" (intervention: 22 vs. control: 38, p = 0.030), mother-child safety concerns: "... afraid to harm the baby" (intervention: 8 vs. control: 25, p = 0.002) and self-efficacy: "... I do not believe/think that I can do it" (intervention: 3 vs. control: 10, p = 0.050). No positive effect was seen at postpartum follow-up. Intrapersonal factors (lack of time, energy and interest) were the most frequently perceived barriers, and consistent over time among all participants. CONCLUSION The intervention had effect on intrapersonal perceived barriers in pregnancy, but not in the postpartum period. Perceived barriers to leisure-time physical activity were similar from early pregnancy to 12 months postpartum. TRIAL REGISTRATION ClinicalTrials.gov: NCT01001689 , registered July 2, 2009.
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Leskinen T, Pulakka A, Heinonen OJ, Pentti J, Kivimäki M, Vahtera J, Stenholm S. Changes in non-occupational sedentary behaviours across the retirement transition: the Finnish Retirement and Aging (FIREA) study. J Epidemiol Community Health 2018; 72:695-701. [DOI: 10.1136/jech-2017-209958] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 02/26/2018] [Accepted: 03/22/2018] [Indexed: 11/04/2022]
Abstract
BackgroundRetirement is a major life transition which may influence health behaviours and time use. Little is known about how sedentary behaviour changes as a result of increased time availability after retirement. The aim of this study was to examine changes in non-occupational sedentary behaviours across the retirement transition. In addition, we examined which preretirement characteristics were associated with these changes.MethodsThe study population consisted of 2011 participants from the Finnish Retirement and Aging Study. Repeated postal survey including questions on sedentary behaviour domains (television viewing, computer use at home, sitting in a vehicle and other sitting) were conducted once a year across the retirement transition, covering on average 3.4 study waves. Linear regression with generalised estimating equations was used for the analyses.ResultsTotal sedentary time increased by 73 (95% CI 66 to 80) min/day during the retirement transition. Of the domain-specific sedentary behaviours, television viewing time increased by 28 (95% CI 25 to 32) min/day, computer use at home by 19 (95% CI 17 to 22) min/day and other sitting time by 37 (95% CI 33 to 41) min/day, while time sitting in a vehicle decreased by 6 (95% CI 4 to 9) min/day. Highest increase in total sedentary time was among women and persons who had high occupational sitting time, low physical activity level, sleep difficulties, mental disorders or poor health before retirement (all p values for interaction <0.03).ConclusionTotal and domain-specific sedentary time, except sitting in a vehicle, increased during the retirement transition.
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Changes in Sports Participation across Transition to Retirement: Modification by Migration Background and Acculturation Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111356. [PMID: 29117151 PMCID: PMC5707995 DOI: 10.3390/ijerph14111356] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 10/27/2017] [Accepted: 10/30/2017] [Indexed: 12/14/2022]
Abstract
While total physical activity decreases over the life course, sports and leisure-time physical activity (LTPA) have shown to increase after transition to retirement. This paper aimed to investigate whether this change in sports participation differs (1) between non-migrant persons (NMP) versus persons with a migrant background (PMB), and (2) by acculturation status. Data was drawn from 16 waves of the German Socio-Economic Panel Study (SOEP) including 2664 NMP and 569 PMB. PMB were grouped according to acculturation status (integrated, assimilated, marginalised, separated), assessed regarding three dimensions (language, social interaction and identification). We applied multilevel logistic regression models, adjusting for sex, retirement age, socioeconomic status, health status and body mass index. Our results show that (1) transition to retirement led to an increase in the sports participation of NMP during the first 5 years and the subsequent 5 years after retirement. Changes in sports participation were modified by migration status: In PMB sports participation increased to a lesser extent than in NMP. (2) While sports participation of integrated PMB was not significantly different from NMP in the preretirement phase, sports participation among integrated PMB increased less after retirement compared with NMP. Marginalized and assimilated PMB did not show consistent sports participation patterns before retirement, but seemingly increased their sports participation less than NMP over the retirement transition. Separated PMB had particularly low levels of sports participation. Considering that LTPA is a key factor for healthy ageing, the increasing gap in levels of sports participation after transition to retirement indicates the need for interventions targeting physical activity of the older migrant population.
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‘You started something … then I continued by myself’: a qualitative study of physical activity maintenance. Prim Health Care Res Dev 2017; 18:574-590. [DOI: 10.1017/s1463423617000433] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Background
Most mid-life and older adults are not achieving recommended physical activity (PA) targets and effective interventions are needed to increase and maintain PA long-term for health benefits. The Pedometer And Consultation Evaluation (PACE-UP) trial, a three-armed primary care pedometer-based walking intervention in those aged 45–75 years, demonstrated increased PA levels at 12 months. A three-year follow-up was conducted to evaluate long-term PA maintenance, including a qualitative component.
Aim
To examine facilitators and barriers to PA maintenance in mid-life and older adults previously involved in a PA trial.
Method
Semi-structured telephone interviews were conducted with 60 PACE-UP participants across all study arms. Interviews were audio-recorded, transcribed verbatim and coded independently by researchers, prior to thematic analysis.
Findings
Two-thirds of participants felt since the PACE-UP trial they had an awareness of PA, with the pedometer reported as ‘kick-starting’ regular activity, and then helped them to maintain regular activity. PA facilitators included: maintaining good health, self-motivation, social support and good weather. Lack of time was the most frequently cited barrier. Other barriers were often the inverse of the facilitators; for example, poor health and bad weather. Participants described the type of ‘top-up’ intervention they would find beneficial to aid PA maintenance (eg, text messages, online resources and walking groups).
Conclusion
A challenge for future PA interventions is to transform barriers into facilitators; for example, educating trial participants about the value of PA for many chronic health conditions to change this from inhibiting to promoting PA. Participants provided ideas for encouraging PA maintenance which could be incorporated into future interventions.
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Zubala A, MacGillivray S, Frost H, Kroll T, Skelton DA, Gavine A, Gray NM, Toma M, Morris J. Promotion of physical activity interventions for community dwelling older adults: A systematic review of reviews. PLoS One 2017; 12:e0180902. [PMID: 28700754 PMCID: PMC5507305 DOI: 10.1371/journal.pone.0180902] [Citation(s) in RCA: 176] [Impact Index Per Article: 25.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 06/22/2017] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES While there is strong evidence that regular participation in physical activity (PA) brings numerous health benefits to older adults, and interventions to effectively promote PA are being developed and tested, the characteristics and components of the most effective interventions remain unclear. This systematically conducted review of systematic reviews evaluated the effects and characteristics of PA promotion interventions aimed at community dwelling people over 50 years old. METHODS Major databases were searched for reviews from January 1990 to May 2015. TIDieR guidelines aided data extraction and the ROBIS tool was used to assess the risk of bias. Primary outcomes were objective and self-reported levels of PA. Indicators of psychological wellbeing and participation rates were secondary outcomes. RESULTS Of 1284 records identified, 19 reviews met inclusion criteria and eight included meta-analyses. Interventions typically incorporated behaviour change techniques (BCTs) and were delivered as face-to-face, remote, group, individual or as combined interventions. Despite their heterogeneity, interventions often resulted in sustained improvements in PA over the study period, typically at 12 months, and led to improvements in general wellbeing. However, ways to ensure effective maintenance beyond one year are unclear. Certain intervention components were more clearly associated with positive effects (e.g. tailoring promotion strategy with combination of cognitive and behavioural elements, low to moderate intensity activity recommended). We found no evidence that certain other intervention characteristics were superior in achieving positive outcomes (e.g. mode of delivery, setting, professional background of the intervention provider, type of PA recommended). CONCLUSION The evidence suggests that interventions to promote PA among older adults are generally effective but there is uncertainty around the most beneficial intervention components. There are indications that purely cognitive strategies and BCTs might be less suitable for older adults than motivators more meaningful to them, including social and environmental support, and enjoyment coming from being physically active. A whole system-oriented approach is required that is tailored to meet the needs of older adults and aligned with social, individual and environmental factors.
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Affiliation(s)
- Ania Zubala
- Scottish Improvement Science Collaborating Centre, School of Nursing and Health Sciences, University of Dundee, Dundee, Scotland, United Kingdom
| | - Stephen MacGillivray
- Evidence Synthesis Training and Research Group (STAR Group), School of Nursing and Health Sciences, University of Dundee, Dundee, Scotland, United Kingdom
| | - Helen Frost
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland, United Kingdom
| | - Thilo Kroll
- School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
| | - Dawn A. Skelton
- Institute for Applied Health Research, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom
| | - Anna Gavine
- Evidence Synthesis Training and Research Group (STAR Group), School of Nursing and Health Sciences, University of Dundee, Dundee, Scotland, United Kingdom
| | - Nicola M. Gray
- Scottish Improvement Science Collaborating Centre, School of Nursing and Health Sciences, University of Dundee, Dundee, Scotland, United Kingdom
| | - Madalina Toma
- Scottish Improvement Science Collaborating Centre, School of Nursing and Health Sciences, University of Dundee, Dundee, Scotland, United Kingdom
| | - Jacqui Morris
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom
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Giné-Garriga M, Coll-Planas L, Guerra M, Domingo À, Roqué M, Caserotti P, Denkinger M, Rothenbacher D, Tully MA, Kee F, McIntosh E, Martín-Borràs C, Oviedo GR, Jerez-Roig J, Santiago M, Sansano O, Varela G, Skjødt M, Wirth K, Dallmeier D, Klenk J, Wilson JJ, Blackburn NE, Deidda M, Lefebvre G, González D, Salvà A. The SITLESS project: exercise referral schemes enhanced by self-management strategies to battle sedentary behaviour in older adults: study protocol for a randomised controlled trial. Trials 2017; 18:221. [PMID: 28521831 PMCID: PMC5437412 DOI: 10.1186/s13063-017-1956-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 04/26/2017] [Indexed: 11/26/2022] Open
Abstract
Background Older adults are the fastest growing segment of the world‘s population. Recent evidence indicates that excessive sitting time is harmful to health, independent of meeting the recommended moderate to vigorous physical activity (PA) guidelines. The SITLESS project aims to determine whether exercise referral schemes (ERS) can be enhanced by self-management strategies (SMSs) to reduce sedentary behaviour (SB), increase PA and improve health, quality of life and function in the long term, as well as psychosocial outcomes in community-dwelling older European citizens from four countries, within a three-armed pragmatic randomised controlled trial, compared with ERS alone and also with general recommendations about PA. Methods A total of 1338 older adults will be included in this study, recruited from four European countries through different existing primary prevention pathways. Participants will be randomly allocated into an ERS of 16 weeks (32 sessions, 45–60 min per session), ERS enhanced by seven sessions of SMSs and four telephone prompts, or a control group. Outcomes will be assessed at baseline, month 4 (end of ERS intervention), month 16 (12 months post intervention) and month 22 (18 months post intervention). Primary outcomes will include measures of SB (time spent sedentary) and PA (counts per minute). Secondary outcomes will include muscle and physical function, health economics’ related outcomes, anthropometry, quality of life, social networks, anxiety and depressive symptoms, disability, fear of falling, executive function and fatigue. A process evaluation will be conducted throughout the trial. The full analysis set will follow an intention-to-treat principle and will include all randomised participants for whom a baseline assessment is conducted. The study hypothesis will be tested with mixed linear models with repeated measures, to assess changes in the main outcomes (SB and PA) over time (baseline to month 22) and between study arms. Discussion The findings of this study may help inform the design and implementation of more effective interventions to reduce SB and increase PA levels, and hence improve long-term health outcomes in the older adult population. SITLESS aims to support policy-makers in deciding how or whether ERS should be further implemented or restructured in order to increase its adherence, impact and cost-effectiveness. Trial registration ClinicalTrials.gov, NCT02629666. Registered 19 November 2015. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1956-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maria Giné-Garriga
- Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna (Universitat Ramon Llull), C/ Císter 34, 08022, Barcelona, Spain.
| | - Laura Coll-Planas
- Fundació Salut i Envelliment UAB, Casa Convalescència UAB, C/ Sant Antoni Maria Claret 171, 4a planta, 08041, Barcelona, Spain
| | - Míriam Guerra
- Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna (Universitat Ramon Llull), C/ Císter 34, 08022, Barcelona, Spain
| | - Àlex Domingo
- Fundació Salut i Envelliment UAB, Casa Convalescència UAB, C/ Sant Antoni Maria Claret 171, 4a planta, 08041, Barcelona, Spain
| | - Marta Roqué
- Fundació Salut i Envelliment UAB, Casa Convalescència UAB, C/ Sant Antoni Maria Claret 171, 4a planta, 08041, Barcelona, Spain
| | | | - Michael Denkinger
- Agaplesion Bethesda Clinic, Geriatric Research Unit Ulm University and Geriatric Center Ulm Alb-Donau, Zollernring 26, 89073, Ulm, Germany
| | | | - Mark A Tully
- UKCRC Centre of Excellence for Public Health (NI), Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Frank Kee
- UKCRC Centre of Excellence for Public Health (NI), Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Emma McIntosh
- Health Economics and Health Technology Assessment (HEHTA), Institute of Health and Wellbeing (IHW), University of Glasgow, Lilibank Gardens, Glasgow, G12 8RZ, UK
| | - Carme Martín-Borràs
- Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna (Universitat Ramon Llull), C/ Císter 34, 08022, Barcelona, Spain
| | - Guillermo R Oviedo
- Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna (Universitat Ramon Llull), C/ Císter 34, 08022, Barcelona, Spain
| | - Javier Jerez-Roig
- Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna (Universitat Ramon Llull), C/ Císter 34, 08022, Barcelona, Spain
| | - Marta Santiago
- Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna (Universitat Ramon Llull), C/ Císter 34, 08022, Barcelona, Spain
| | - Oriol Sansano
- Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna (Universitat Ramon Llull), C/ Císter 34, 08022, Barcelona, Spain
| | - Guillermo Varela
- Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna (Universitat Ramon Llull), C/ Císter 34, 08022, Barcelona, Spain
| | - Mathias Skjødt
- Syddansk Universitet, Campusvej 55, 5230, Odense M, Denmark
| | - Katharina Wirth
- Agaplesion Bethesda Clinic, Geriatric Research Unit Ulm University and Geriatric Center Ulm Alb-Donau, Zollernring 26, 89073, Ulm, Germany.,Institute of Epidemiology and Medical Biometry, Ulm University, 89081, Ulm, Germany
| | - Dhayana Dallmeier
- Agaplesion Bethesda Clinic, Geriatric Research Unit Ulm University and Geriatric Center Ulm Alb-Donau, Zollernring 26, 89073, Ulm, Germany
| | - Jochen Klenk
- Institute of Epidemiology and Medical Biometry, Ulm University, 89081, Ulm, Germany
| | - Jason J Wilson
- UKCRC Centre of Excellence for Public Health (NI), Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Nicole E Blackburn
- UKCRC Centre of Excellence for Public Health (NI), Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Manuela Deidda
- Health Economics and Health Technology Assessment (HEHTA), Institute of Health and Wellbeing (IHW), University of Glasgow, Lilibank Gardens, Glasgow, G12 8RZ, UK
| | - Guillaume Lefebvre
- Sport Initiative et Loisir Bleu Association, BP 18104, 67038, Strasbourg, Cedex, France
| | - Denise González
- Sport Initiative et Loisir Bleu Association, C/ Bailén 5 bajos, 08010, Barcelona, Spain
| | - Antoni Salvà
- Fundació Salut i Envelliment UAB, Casa Convalescència UAB, C/ Sant Antoni Maria Claret 171, 4a planta, 08041, Barcelona, Spain
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Pavey TG, Kolbe-Alexander TL, Uijtdewilligen L, Brown WJ. Which Women are Highly Active Over a 12-Year Period? A Prospective Analysis of Data from the Australian Longitudinal Study on Women's Health. Sports Med 2017; 47:2653-2666. [PMID: 28477211 DOI: 10.1007/s40279-017-0732-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Current Australian physical activity (PA) guidelines encourage adults to accumulate 150-300 min of moderate to vigorous PA each week. Some critics assert that 300 min is unachievable. OBJECTIVES The aims of this study were to identify the proportion of younger and mid-aged women who met the 300-min recommendation over a 12-year period, examine how the "highly active" women achieved this level of activity (in terms of walking, moderate activity, and vigorous activity), and to identify the sociodemographic, biological, lifestyle, and work-related determinants of being "highly active". METHODS Younger (n = 7843) and mid-aged (n = 8043) participants in the Australian Longitudinal Study on Women's Health completed triennial surveys between 2000 and 2013, when their ages were 24.6-36.3 and 52.5-64.5 years, respectively. Self-reported PA was assessed as time spent in walking, moderate activity, and vigorous activity in the previous week; an index of MET.min/week was derived and dichotomized as <1000 MET.min/week (<300 min; not highly active) or ≥1000 MET.min/week (≥300 min; highly active). Generalized estimating equations were used to examine univariable and multivariable associations between a number of sociodemographic, lifestyle, and health variables with PA status (measured at every survey). RESULTS In the younger cohort, the proportion who were highly active decreased from 40% in 2000 to 31% in 2012. High levels of activity were achieved through a combination of walking (39.1-45.1% of total activity) and vigorous PA (41.8-47.7%). In the mid-age cohort, the proportion of women who were highly active increased from 32% in 2001 to 47% in 2013; this was achieved predominantly through walking (55.8-59.7%). In multi-variable models, the highest odds for being in the high PA category (odds ratios [ORs] ≥ 1.20; p < 0.001) were for younger women who were single, those who worked long full-time hours, those who drank any quantity of alcohol, and those who sat for less than 8 h/day. In the mid-age cohort, the highest odds for being in the high PA category (ORs ≥1.20; p < 0.001) were for women with post-school education, those who were retired, those who were low-risk drinkers (compared with non-drinkers), those who sat for less than 8 h/day, and those with lower levels of stress. DISCUSSION Our findings clearly indicate that the upper limit of the Australian PA guidelines is achievable for large numbers of women. Factors associated with being highly active were different for younger and mid-age women, but healthy weight, high education, and paid work (full-time in the younger women, part-time in mid-age) were common characteristics of highly active women in both cohorts.
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Affiliation(s)
- Toby G Pavey
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Brisbane, QLD, 4059, Australia. .,Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia.
| | - Tracy L Kolbe-Alexander
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Leonie Uijtdewilligen
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore
| | - Wendy J Brown
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia
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Forberger S, Bammann K, Bauer J, Boll S, Bolte G, Brand T, Hein A, Koppelin F, Lippke S, Meyer J, Pischke CR, Voelcker-Rehage C, Zeeb H. How to Tackle Key Challenges in the Promotion of Physical Activity among Older Adults (65+): The AEQUIPA Network Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14040379. [PMID: 28375177 PMCID: PMC5409580 DOI: 10.3390/ijerph14040379] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 03/17/2017] [Accepted: 03/27/2017] [Indexed: 12/21/2022]
Abstract
The paper introduces the theoretical framework and methods/instruments used by the Physical Activity and Health Equity: Primary Prevention for Healthy Ageing (AEQUIPA) prevention research network as an interdisciplinary approach to tackle key challenges in the promotion of physical activity among older people (65+). Drawing on the social-ecological model, the AEQUIPA network developed an interdisciplinary methodological design including quantitative/qualitative studies and systematic reviews, while combining expertise from diverse fields: public health, psychology, urban planning, sports sciences, health technology and geriatrics. AEQUIPA tackles key challenges when promoting physical activity (PA) in older adults: tailoring of interventions, fostering community readiness and participation, strengthening intersectoral collaboration, using new technological devices and evaluating intervention generated inequalities. AEQUIPA aims to strengthen the evidence base for age-specific preventive PA interventions and to yield new insights into the explanatory power of individual and contextual factors. Currently, the empirical work is still underway. First experiences indicate that thenetwork has achieved a strong regional linkage with communities, local stakeholders and individuals. However, involving inactive persons and individuals from minority groups remained challenging. A review of existing PA intervention studies among the elderly revealed the potential to assess equity effects. The results will add to the theoretical and methodological discussion on evidence-based age-specific PA interventions and will contribute to the discussion about European and national health targets.
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Affiliation(s)
- Sarah Forberger
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany.
| | - Karin Bammann
- Working Group Epidemiology of Demographic Change, Institute for Public Health und Nursing Research (IPP), Faculty for Human and Health Sciences, University of Bremen, 28359 Bremen, Germany.
| | - Jürgen Bauer
- Geriatrisches Zentrum, Universität Heidelberg, Agaplesion Bethanien-Krankenhaus, 69126 Heidelberg, Germany.
| | - Susanne Boll
- Media Informatics and Multimedia Systems, Department of Computing Science, Carl von Ossietzky University of Oldenburg, 26121 Oldenburg, Germany.
| | - Gabriele Bolte
- Department of Social Epidemiology, Institute for Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany.
- Research Focus Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany.
| | - Tilman Brand
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany.
| | - Andreas Hein
- Department of Health Services Research, School of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, 26111 Oldenburg, Germany.
| | - Frauke Koppelin
- Section Technology and Health for Humans, Jade University of Applied Sciences Oldenburg, 26121 Oldenburg, Germany.
| | - Sonia Lippke
- Department of Psychology and Methods, Jacobs University Bremen, 28759 Bremen, Germany.
| | - Jochen Meyer
- OFFIS-Institute for Information Technology, 26121 Oldenburg, Germany.
| | - Claudia R Pischke
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany.
| | - Claudia Voelcker-Rehage
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, 09107 Chemnitz, Germany.
| | - Hajo Zeeb
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany.
- Research Focus Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany.
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Lehne G, Bolte G. Impact of universal interventions on social inequalities in physical activity among older adults: an equity-focused systematic review. Int J Behav Nutr Phys Act 2017; 14:20. [PMID: 28187766 PMCID: PMC5303302 DOI: 10.1186/s12966-017-0472-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 01/31/2017] [Indexed: 01/19/2023] Open
Abstract
Background Physical activity is one of the most important contributors to healthy aging. Public health strategies aiming to promote physical activity among older adults are increasingly being implemented. However, little is known about their impact on social inequalities. Purpose of the study was to analyze whether and how studies of interventions consider effects on social inequalities in physical activity among older adults. Methods Nine electronic databases were searched to identify quantitative studies evaluating the effects of interventions on self-reported or objectively measured physical activity among the general population of older adults (≥50 years). English and German language peer-reviewed journal articles published between 2005 and 2015 were included. Using the PROGRESS-Plus framework, data on whether and how social factors were considered both for describing participants’ baseline characteristics and for measuring intervention effects were systematically extracted. Studies examining differential intervention effects by at least one PROGRESS-Plus factor were quality assessed. Results were presented in narrative synthesis. Results Fifty-nine studies were included. Beside age and sex, 44 studies used at least 1 further PROGRESS-Plus factor for the description of participants’ baseline characteristics. When measuring intervention effects, 22 studies considered PROGRESS-Plus factors as control variables. Eleven studies reported having analyzed potential effects on inequalities by testing interaction effects, stratifying effect analyses, or exploring associations between PROGRESS-Plus factors and increases in physical activity following an intervention. Effects were most often analyzed by gender/sex (n = 9) and age (n = 9), followed by education (n = 3), marital status (n = 2), and race/ethnicity (n = 2). Five studies pointed to gender/sex- or age-specific intervention effects, indicating that some interventions affect males and females, and younger and older individuals differently. Conclusions Many studies evaluating the effects of interventions on physical activity among older adults have not exploited the potential for assessing effects on social inequalities so far. There is an urgent need for systematic application of appropriate methodological approaches and transparent reporting of social inequalities-related findings which can provide important indications for the design of those interventions most likely to be effective across all social groups of older adults. Trial registration PROSPERO registration number: CRD42015025066 Electronic supplementary material The online version of this article (doi:10.1186/s12966-017-0472-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gesa Lehne
- Department of Social Epidemiology, Institute for Public Health and Nursing Research, University of Bremen, Grazer Strasse 2a, Bremen, 28359, Germany. .,Health Sciences Bremen, University of Bremen, Bremen, Germany.
| | - Gabriele Bolte
- Department of Social Epidemiology, Institute for Public Health and Nursing Research, University of Bremen, Grazer Strasse 2a, Bremen, 28359, Germany.,Health Sciences Bremen, University of Bremen, Bremen, Germany
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Stenholm S, Pulakka A, Kawachi I, Oksanen T, Halonen JI, Aalto V, Kivimäki M, Vahtera J. Changes in physical activity during transition to retirement: a cohort study. Int J Behav Nutr Phys Act 2016; 13:51. [PMID: 27084334 PMCID: PMC4833915 DOI: 10.1186/s12966-016-0375-9] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 04/12/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Retirement is a major life transition which may affect lifestyle. The aim of this study is to examine within-individual changes in physical activity during the transition from full-time work to retirement. METHODS The study population consisted of 9,488 Finnish public-sector employees who retired in 2000-2011 and who reported their leisure-time and commuting physical activity before and after retirement. On average, participants provided data at 3.6 (of the four) repeat examinations during 10 years before and 10 years after the retirement. Physical activity was self-reported and was expressed as weekly metabolic equivalent task (MET) hours. Generalized estimating equations were used to examine physical activity trajectories around retirement. RESULTS Among participants entering to statutory retirement physical activity first increased by 1.81 MET-hours (95% confidence interval [CI] 1.20 to 2.42) during 4-year retirement transition, but then decreased by -1.80 MET hours (95% CI -2.83 to -0.79) during the subsequent post-retirement period. Older retirement age, higher occupational status and fewer chronic diseases were associated with greater increase in physical activity during transition to statutory retirement. CONCLUSIONS Statutory retirement appears to be associated with a temporary increase in physical activity. Future research should examine ways to maintain the increased activity level after retirement.
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Affiliation(s)
- Sari Stenholm
- Department of Public Health, University of Turku, Turku, Finland. .,School of Health Science, University of Tampere, Tampere, Finland. .,National Institute for Health and Welfare, Helsinki, Finland.
| | - Anna Pulakka
- Department of Public Health, University of Turku, Turku, Finland
| | - Ichiro Kawachi
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Tuula Oksanen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - Ville Aalto
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London Medical School, London, UK.,Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
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