scholarly journals Older Adults’ Experiences of a Physical Activity and Sedentary Behaviour Intervention: A Nested Qualitative Study in the SITLESS Multi-Country Randomised Clinical Trial

2021 ◽  
Vol 18 (9) ◽  
pp. 4730
Author(s):  
Nicole Blackburn ◽  
Mathias Skjodt ◽  
Mark Tully ◽  
Ilona Mc Mullan ◽  
Maria Giné-Garriga ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Interaction ◽  
Qualitative Study ◽  
Management Strategies ◽  
Randomised Clinical Trial ◽  
Control Group ◽  
Individual Interviews ◽  
Perceived Effects ◽  
Qualitative Methodologies ◽  
Exercise Referral

Background: The SITLESS programme comprises exercise referral schemes and self-management strategies and has been evaluated in a trial in Denmark, Spain, Germany and Northern Ireland. The aim of this qualitative study was to understand the implementation and contextual aspects of the intervention in relation to the mechanisms of impact and to explore the perceived effects. Methods: Qualitative methodologies were nested in the SITLESS trial including 71 individual interviews and 12 focus groups targeting intervention and control group participants from postintervention to 18-month follow-up in all intervention sites based on a semi-structured topic guide. Results: Overarching themes were identified under the framework categories of context, implementation, mechanisms of impact and perceived effects. The findings highlight the perceived barriers and facilitators to older adults’ engagement in exercise referral schemes. Social interaction and enjoyment through the group-based programmes are key components to promote adherence and encourage the maintenance of targeted behaviours through peer support and connectedness. Exit strategies and signposting to relevant classes and facilities enabled the maintenance of positive lifestyle behaviours. Conclusions: When designing and implementing interventions, key components enhancing social interaction, enjoyment and continuity should be in place in order to successfully promote sustained behaviour change.

scholarly journals I-CONECT: CHALLENGES AND OPPORTUNITIES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S224-S224
Author(s):  
Hiroko H Dodge ◽  
Jeffrey Kaye ◽  
Elena Goodrich ◽  
Jacob Lindsley ◽  
Mattie MacDonald ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Interaction ◽  
Cognitive Stimulation ◽  
Control Group ◽  
Cognitive Domains ◽  
Face To Face ◽  
Challenges And Opportunities ◽  
Socially Isolated ◽  
Intervention Trials ◽  
User Friendly

Abstract In our previous NIH-funded randomized controlled behavioral clinical trial, we developed a conversation-based social interaction cognitive stimulation protocol delivered by trained interviewers through webcams and a user-friendly interactive Internet interface. Daily 30 minute face-to-face video-chats were conducted for 6 weeks. Despite a short duration, this proof of concept study demonstrated high adherence among older adults (mean age 80 years) and showed improvement in cognitive domains which tap language-based executive functions and semantic memory among the experimental group compared to the control group who did not engage in any video-chats. Building on these results, we are now conducting two NIH-funded projects (https://www.i-conect.org), targeting socially isolated older adults who are less likely to participate in clinical trials despite their high risk of cognitive decline. In this presentation, we introduce a series of projects outlined above and share the challenges and opportunities identified in our behavioral intervention trials focused on social interaction.

scholarly journals Double-task exercise programmes to strengthen cognitive and vascular health in older adults at risk of cognitive decline: protocol for a randomised clinical trial

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e039723
Author(s):  
Rosalinda Sánchez-Arenas ◽  
Svetlana V Doubova ◽  
Mariela Bernabe-Garcia ◽  
Michel A Gregory ◽  
Laura Alejandra Mejía-Alonso ◽  
...  
Keyword(s):  
Older Adults ◽  
Clinical Trial ◽  
At Risk ◽  
Cognitive Decline ◽  
Randomised Clinical Trial ◽  
Outcome Variable ◽  
Control Group ◽  
Study Results ◽  
Registration Number ◽  
Exercise Programmes

IntroductionCognitive and physical declines are frequent causes of disability among older adults (OAs) in Mexico that imposes significant burden on the health system and OAs’ families. Programmes to prevent or delay OAs’ cognitive and physical decline are scarce.Methods and analysisA double-blind randomised clinical trial will be conducted. The study will aim to evaluate two 24-week double-task (aerobic and cognitive) square-stepping exercise programmes for OAs at risk of cognitive decline—one programme with and another without caregiver participation—and to compare these with an aerobic-balance-stretching exercise programme (control group). 300 OAs (100 per group) affiliated with the Mexican Institute of Social Security (IMSS) between 60 and 65 years of age with self-reported cognitive concerns will participate. They will be stratified by education level and randomly allocated to the groups. The intervention will last 24 weeks, and the effect of each programme will be evaluated 12, 24 and 52 weeks after the intervention. Participants’ demographic and clinical characteristics will be collected at baseline. The outcomes will include: (1) general cognitive function; (2) specific cognitive functions; (3) dual-task gait; (4) blood pressure; (5) carotid intima–media thickness; (6) OAs’ health-related quality of life; and (7) caregiver burden. The effects of the interventions on each outcome variable will be examined using a repeated-measures analysis of variance (ANOVA), with study groups as the between-subjects variable and time as the within-subject variable.Ethics and disseminationThe study was approved by the IMSS Ethics and Research Committees (registration number: 2018-785-095). All participants will sign a consent form prior to their participation. The study results will be disseminated to the IMSS authorities, healthcare providers and the research community.Trial registration numberClinicalTrials.gov (NCT04068376).

scholarly journals Facilitators and challenges in delivering a peer-support physical activity intervention for older adults: a qualitative study with multiple stakeholders

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anthony Crozier ◽  
Lorna Porcellato ◽  
Benjamin J. R. Buckley ◽  
Paula M. Watson
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Social Interaction ◽  
Qualitative Study ◽  
Peer Support ◽  
Physical Activity Intervention ◽  
Large City ◽  
North West ◽  
Intervention Delivery ◽  
Peer Volunteers

Abstract Background Involving peer volunteers in intervention delivery can provide social support and improve adherence. Whilst such interventions have the potential to reduce physical activity (PA) intervention costs, little is known about the process of delivering them in practice. This qualitative study explored the facilitators and challenges of delivering a peer-support PA intervention for older adults, with a view to making recommendations for the delivery of future interventions. Methods Data were collected via (7) semi-structured interviews and a focus group with stakeholders involved in a peer-support PA intervention for older adults in a large city in the North-West of England. Participants included local authority staff (n = 3), peer volunteers (n = 2) and service users (n = 7). Audio data were transcribed verbatim and thematically coded to identify perceived facilitators and challenges. Results Facilitators to delivery included social interaction, community referral pathways, suitable facilities, peer volunteers and high-quality instructors. Challenges surrounded inconsistent practice, staff capacity, safety and accountability, and awareness raising. Conclusions Peer volunteers can provide an additional support mechanism alongside qualified instructors for increasing social interaction within PA interventions. For optimal intervention delivery, consideration needs to be given to equipment and space, safety and accountability and consistency of practice.

scholarly journals The interplay of physical and social wellbeing in older adults: investigating the relationship between physical training and social interactions with virtual social environments

2015 ◽  
Vol 1 ◽  
pp. e30 ◽  
Author(s):  
Iman Khaghani Far ◽  
Michela Ferron ◽  
Francisco Ibarra ◽  
Marcos Baez ◽  
Stefano Tranquillini ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Interaction ◽  
Social Presence ◽  
Physical Training ◽  
Social Group ◽  
Social Facilitation ◽  
Control Group ◽  
Home Based ◽  
The Social ◽  
At Home

Background.Regular physical activity can substantially improve the physical wellbeing of older adults, preventing several chronic diseases and increasing cognitive performance and mood. However, research has shown that older adults are the most sedentary segment of society, spending much of their time seated or inactive. A variety of barriers make it difficult for older adults to maintain an active lifestyle, including logistical difficulties in going to a gym (for some adults, leaving home can be challenging), reduced functional abilities, and lack of motivation. In this paper, we report on the design and evaluation of Gymcentral. A training application running on tablet was designed to allow older adults to follow a personalized home-based exercise program while being remotely assisted by a coach. The objective of the study was to assess if a virtual gym that enables virtual presence and social interaction is more motivating for training than the same virtual gym without social interaction.Methods.A total of 37 adults aged between 65 and 87 years old (28 females and 9 males, mean age = 71, sd = 5.8) followed a personalized home-based strength and balance training plan for eight weeks. The participants performed the exercises autonomously at home using the Gymcentral application. Participants were assigned to two training groups: the Social group used an application with persuasive and social functionalities, while the Control group used a basic version of the service with no persuasive and social features. We further explored the effects of social facilitation, and in particular of virtual social presence, in user participation to training sessions. Outcome measures were adherence, persistence and co-presence rate.Results.Participants in the Social group attended significantly more exercise sessions than the Control group, providing evidence of a better engagement in the training program. Besides the focus on social persuasion measures, the study also confirms that a virtual gym service is effective for supporting individually tailored home-based physical training for older adults. The study also confirms that social facilitation tools motivate users to train together in a virtual fitness environment.Discussion.The study confirms that Gymcentral increases the participation of older adults in physical training compare to a similar version of the application without social and persuasive features. In addition, a significant increase in the co-presence of the Social group indicates that social presence motivates the participants to join training sessions at the same time with the other participants. These results are encouraging, as they motivate further research into using home-based training programs as an opportunity to stay physically and socially active, especially for those who for various reasons are bound to stay at home.

scholarly journals Exercise referral schemes enhanced by self-management strategies to reduce sedentary behaviour and increase physical activity among community-dwelling older adults from four European countries: protocol for the process evaluation of the SITLESS randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e027073 ◽  
Author(s):  
Laura Coll-Planas ◽  
Sergi Blancafort Alias ◽  
Mark Tully ◽  
Paolo Caserotti ◽  
Maria Giné-Garriga ◽  
...  
Keyword(s):  
Physical Activity ◽  
Controlled Trial ◽  
Management Strategies ◽  
Community Dwelling ◽  
Self Management ◽  
Qualitative And Quantitative ◽  
Perceived Effects ◽  
Randomised Controlled ◽  
Exercise Referral

IntroductionSITLESS is a randomised controlled trial determining whether exercise referral schemes can be enhanced by self-management strategies to reduce sedentary behaviour and increase physical activity in the long term, in community-dwelling older citizens. The intervention is complex and requires a process evaluation to understand how implementation, causal mechanisms and context shape outcomes. The specific aims are to assess fidelity and reach of the implementation, understand the contextual aspects of each intervention site, evaluate the mechanisms of impact, and explore perceived effects.Methods and analysisFollowing the Medical Research Council guidance on complex interventions, a combination of qualitative and quantitative procedures is applied, including observational checklists and attendance registries, standardised scales (ie, Marcus’s Self-Efficacy Questionnaire, Physical Activity Self-Regulation Scale and the Lubben Social Network Scale) at baseline, postintervention and follow-up assessments, semistructured questionnaires gathering contextual characteristics, and participant observations of the sessions. Semistructured interviews and focus groups with the participants and trainers are conducted at postintervention and during the follow-up to explore their experiences. Outcomes from the standardised scales are analysed as moderators within the impact evaluation. Descriptive results on context and perceived effects complement results on impact. The qualitative and quantitative findings will help to refine the logic model to finally support the interpretation of the results on the effectiveness of the intervention.Ethics and disseminationThe study design was approved by the respective Ethical Committee of Ramon Llull University, Southern Denmark, Northern Ireland and Ulm University. Participation is voluntary, and all participants are asked to sign informed consent before starting the study. A dissemination plan operationalises how to achieve a social impact by reaching academic and non-academic stakeholders. A data management plan describes the specific data sets and regulates its deposition and curation. All publications will be open access.Trial registration numberNCT02629666; Pre-results.

A Qualitative Study of Older Adults and Staff at an Adult Day Center in a Cambodian Community in the United States

2015 ◽  
Vol 36 (6) ◽  
pp. 733-750 ◽  
Author(s):  
Nicole Dubus
Keyword(s):  
United States ◽  
Older Adults ◽  
Qualitative Study ◽  
Day Care ◽  
Care Program ◽  
The United States ◽  
Adult Day Care ◽  
Subjective Experiences ◽  
Staff Members ◽  
Individual Interviews

Purpose: Adult day care programs in the United States are seeing an increase in culturally diverse patients. The purpose of this study was to better understand the subjective experiences of staff and Cambodian refugees attending an adult day center in the United States that provides services focused on the cultural needs of the older adults, such as Cambodian food, activities, and Cambodian staff. Design: This is a qualitative study using grounded theory to analyze 10 individual interviews from staff members and 80 individual interviews from participants who attend an adult day care program for Cambodians in a city in the northeast United States. Findings: Three primary themes emerged: The participants felt respected, there was a generational tension between the young staff and the participants, and the center acted as a cultural liaison between the medical providers and the participants.

scholarly journals A randomised clinical trial comparing 35 Hz versus 50 Hz frequency stimulation effects on hand motor recovery in older adults after stroke

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Trinidad Sentandreu-Mañó ◽  
José M. Tomás ◽  
J. Ricardo Salom Terrádez
Keyword(s):  
Older Adults ◽  
Clinical Trial ◽  
Neuromuscular Electrical Stimulation ◽  
Motor Impairment ◽  
Randomised Clinical Trial ◽  
Motor Recovery ◽  
Pinch Strength ◽  
Control Group ◽  
Specific Stimulation ◽  
And Function

AbstractMore solid data are needed regarding the application of neuromuscular electrical stimulation (NMES) in the paretic hand following a stroke. A randomised clinical trial was conducted to compare the effects of two NMES protocols with different stimulation frequencies on upper limb motor impairment and function in older adults with spastic hemiparesis after stroke. Sixty nine outpatients were randomly assigned to the control group or the experimental groups (NMES with 50 Hz or 35 Hz). Outcome measures included motor impairment tests and functional assessment. They were collected at baseline, after 4 and 8 weeks of treatment, and after a follow-up period. NMES groups showed significant changes (p < 0.05) with different effect sizes in range of motion, grip and pinch strength, the Modified Ashworth Scale, and the muscle electrical activity in the extensors of the wrist. The 35 Hz NMES intervention showed a significant effect on Barthel Index. Additionally, there were no significant differences between the groups in the Box and Block Test. Both NMES protocols proved evidence of improvements in measurements related to hand motor recovery in older adults following a stroke, nevertheless, these findings showed that the specific stimulation frequency had different effects depending on the clinical measures under study.

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