Enabling quality physical activity change in older adults – a study of barriers, facilitators and interventions

1. Seamus Nugent
Dr Niamh Murphy
Dr Mary Cowman
Department of Health, Sport and Exercise Science
Waterford Institute of Technology

2. Phase I – data collection and
analysis
 Questionnaire with community based groups –
data collection (n = 300) and analysis
 Demographics, activity levels, attitudes to PA,
(stages of change model), barriers and facilitators
to PA based on Socio-Ecological Model
 36% male (n=108); 64% female (n=192). Mean age
66 years

3. Phase II – intervention design,
implementation and interpretation
 Multiple setting intervention (5) designed and
implemented by community partners
 Evaluation using REAIM framework (Glasgow,
1999)
 Pre and Post questionnaires for participants
 Interviews with key stakeholders.

4. Results from Phase I
 81% claim to be sufficiently active but . . .
 Only 31% meeting the PA guidelines
 60% did no muscle strengthening activities in previous
7 days
 However, 93% of older adults believe PA is extremely
important
 Poor knowledge of PA guidelines
 High level of car usage / low active travel

5. Barriers
 Recent illness, operation or medical reasons
 Not having a friend to be active with / inactive spouse
or partner
 Gym apathy - 57% not interested in gym membership*
 Lack of walking facilities in rural areas
 Over 90% have access to car (barrier or facilitator??)
 Walking environment safety (rural vs urban)

6. Facilitators
From Phase I older adults rated the following as the 4
most important facilitators
1. Social Support – having a friend to walk or be active
with
2. Organised groups in the local community
3. Instructor that makes PA fun*
4. Safe walking paths and parks
5. Gym activities that takes OA needs into
consideration*

7. Interventions (5) + Mass Media
 Community Centre 1 – set up walking group to
increase walking levels; use outdoor gym
 Community Centre 2 – 8 week walking programme
(Tuesdays); Chair based activities (Wednesdays)
 Rural Setting 1 – walking group on Tuesday mornings
and chair based activities on Thursday nights
 Rural Setting 2 – deliver circuit based PA to group in
community hall
 Fitness facility – Make use of new gym setting
3/weekly at reduced rate with tea/coffee afterwards

8. Conclusion
 All settings contacted adopted the programme and
feedback was good
 Reach was low - <2%
 Adoption and Implementation were good
 Effectiveness: Interventions raised PA levels; increased
knowledge of PA guidelines; participants reported
‘health benefits’ and lowered barriers to PA but…
recruitment to new programmes was very difficult
 Maintenance: 2 programmes still running at 6mths
 4/5 settings did exit interview - very positive feedback

9. What works?
 Programmes need long term funding commitments in
order for programmes to ‘bed in’
 Use Community Halls and Community Sports Hubs
for OA programmes
 Cost: recruitment to a programme such as GALM
(Stevens, 2008) was $84 per person in 2008. The cost
of my study: €3,300 including facilitator time = €786
with 45 participants
 CPD for fitness facility management and staff
 Raise awareness of growing market for PT

10. What works?
 PA campaigns could do better in promoting the health
benefits of PA. For example debunking some of the
myths around muscle strengthening activities
 Community groups from Phase I – provided no
physical activity
 Social aspect of community group based PA with ‘fun
instructor’