Article type
Year
Abstract
Background:
Promoting physical activity (PA) and reducing sedentary behaviour (SB) in community-dwelling older adults remains a challenge. Public health interventions targeting these lifestyle behaviours are usually developed using a top-down approach in isolation from end-users.
Objectives:
SITLESS aims to provide new evidence on how to design, implement and evaluate a complex intervention enhancing exercise-referral schemes (ERS) with self-management strategies (SMS) to decrease SB and increase PA in older adults, considering end-users' views, forming co-operative teams of stakeholders, and distributing actions and decisions.
Methods:
The SITLESS intervention used a stepwise design. We conducted a systematic review on SB interventions targeting older people to identify potentially effective behaviour change techniques (BCTs) and theories. In parallel, we convened four advisory boards in Spain, Denmark, Germany and the UK with stakeholders from older people organisations, health professionals, PA providers and policy-makers. We conducted four focus groups with older adults, one at each site, to explore cultural values and personal preferences for the BCTs identified. Finally, we designed and implemented a pilot intervention combining PA and SMS at each site to assess its feasibility and optimise its design for the main trial. We held focus groups with all participants at the end of the pilot to explore their experiences.
Results:
Studies included in the systematic review (n = 5) employed the following BCTs: goal-setting, self-monitoring, feedback, health consequences and instructions on how to perform the behaviour. Participants in the focus groups discussed the pros and cons of the BCTs and requested clear and concise information and easy to use self-monitoring tools to help facilitate behaviour change. In the pilot study, 95 participants were randomised (mean age 76). Randomisation to the control group caused disappointment and rejection. Participants experiencing the SMS were highly satisfied with self-monitoring (pedometers) and the goal-setting. Social support was perceived as an effective mechanism to increase physical activity.
Conclusions:
Involving end-users to consider their preferences, cultural values and experiences early in the process of designing an intervention might be a key factor in developing a successful trial.
Promoting physical activity (PA) and reducing sedentary behaviour (SB) in community-dwelling older adults remains a challenge. Public health interventions targeting these lifestyle behaviours are usually developed using a top-down approach in isolation from end-users.
Objectives:
SITLESS aims to provide new evidence on how to design, implement and evaluate a complex intervention enhancing exercise-referral schemes (ERS) with self-management strategies (SMS) to decrease SB and increase PA in older adults, considering end-users' views, forming co-operative teams of stakeholders, and distributing actions and decisions.
Methods:
The SITLESS intervention used a stepwise design. We conducted a systematic review on SB interventions targeting older people to identify potentially effective behaviour change techniques (BCTs) and theories. In parallel, we convened four advisory boards in Spain, Denmark, Germany and the UK with stakeholders from older people organisations, health professionals, PA providers and policy-makers. We conducted four focus groups with older adults, one at each site, to explore cultural values and personal preferences for the BCTs identified. Finally, we designed and implemented a pilot intervention combining PA and SMS at each site to assess its feasibility and optimise its design for the main trial. We held focus groups with all participants at the end of the pilot to explore their experiences.
Results:
Studies included in the systematic review (n = 5) employed the following BCTs: goal-setting, self-monitoring, feedback, health consequences and instructions on how to perform the behaviour. Participants in the focus groups discussed the pros and cons of the BCTs and requested clear and concise information and easy to use self-monitoring tools to help facilitate behaviour change. In the pilot study, 95 participants were randomised (mean age 76). Randomisation to the control group caused disappointment and rejection. Participants experiencing the SMS were highly satisfied with self-monitoring (pedometers) and the goal-setting. Social support was perceived as an effective mechanism to increase physical activity.
Conclusions:
Involving end-users to consider their preferences, cultural values and experiences early in the process of designing an intervention might be a key factor in developing a successful trial.