Development and evaluation of two web-based interventions for the promotion of physical activity in older adults: study protocol for a community-based controlled intervention trial Efficacy of a web-based, center-based or combined physical activity intervention among older adults. Cluster randomized controlled trial of a multilevel physical activity intervention for older adults Promoting physical activity for elders with compromised function: the lifestyle Interventions and Independence for elders (LIFE) study physical activity intervention Physical activity combined with resistance training reduces symptoms of frailty in older adults: A randomized controlled trial. Web-based Intervention to Promote Physical Activity by Sedentary Older Adults: Randomized Controlled Trial Activity adherence and physical function in older adults with functional limitations. Home-based physical activity intervention for breast cancer patients. Outcomes of a multifaceted physical activity regimen as part of a diabetes self-management intervention Promoting community readiness for physical activity among older adults in Germany – protocol of the ready to change intervention trial Effect of physical activity guidelines on physical function in older adults. The Lifestyle Interventions and Independence for Elders Pilot (LIFE-P): 2-year follow-up. Randomized trial of three strategies to promote physical activity in general practice. Long-term efficacy of a printed or a Web-based tailored physical activity intervention among older adults A school-based physical activity program to improve health and fitness in children aged 6–13 years ("Kinder-Sportstudie KISS"): study design of a randomized controlled trial [ISRCTN15360785] Understanding physical activity maintenance in breast cancer survivors. Learning and Developing Individual Exercise Skills (L.A.D.I.E.S.) for a better life: a physical activity intervention for black women.
Background Regular physical activity ( PA ) is a key contributor to healthy ageing . However , despite known health benefits , only one third of older adults in Germany reach the PA levels recommended for persons aged 65 years and above by the World Health Organization . The aim of the current study is to evaluate the effectiveness of two web-based interventions for the initiation and maintenance of regular PA ( i.e. , intervention groups 1 and 2 ) compared to a delayed intervention control group of older adults aged 65 to 75 years . Methods / Design Study participants will be r and omly assigned to one of three study arms in five communities in the Bremen-Oldenburg metropolitan region : a ) Participants in the first arm will receive access to a web-based intervention for 10 weeks allowing them to track their weekly PA ( subjective self-monitoring , intervention group 1 ) ; b ) participants in the second arm will receive access to the web-based intervention for 10 weeks and , in addition , track PA using Fitbit Zips ( objective self-monitoring , intervention group 2 ) ; c ) participants in the delayed intervention control group will receive access to the intervention implemented in the first study arm after completion of the 12-week follow-up in the other two groups within each community . In addition , weekly group meetings in the communities will be offered to study participants in the intervention groups providing the opportunity to address questions related to the use of the website and to practice PA in groups ( e.g. , neighborhood walks , strength and balance exercises ) . To evaluate short-term effects of the intervention on physical and psychological health , PA , physical fitness , and cognitive and psychological variables will be assessed at baseline and 12-week follow-up . Discussion This study will provide answers regarding acceptance and effectiveness of web-based interventions promoting uptake and maintenance of regular PA in persons aged 65–75 years . Study findings will contribute to a growing body of evidence in Germany concerning the role of community-based interventions for the promotion of PA and healthy ageing in older adults . Trial registration German Clinical Trials Register DRKS00010052 ( Date of registration 07–11 - 2016 ) With more social support and environment-centered interventions being recommended in web-based interventions , this study examined the efficacy of three intervention conditions aim ed at promoting physical activity ( PA ) in older adults . The efficacy analyses included the self-reported PA level , stage of change for PA and awareness about PA among participants . Eligible participants ( N = 149 ; M = 65 years old , SD = 6 ) , recruited in a unique Belgian French-speaking municipality , were r and omized in four research arms for a 3-month intervention : ( i ) web-based ; ( ii ) center-based ; ( iii ) mixed ( combination of web- and center-based ) ; and ( iv ) control ( no intervention ) . Web-based condition included a PA website and monthly tailored emails whereas center-based condition comprised 12 sessions ( 1 per week ) of group exercising . With a significant increase in PA , the PA stage of change and the PA awareness at 12 months , the mixed intervention condition seemed to include the key social and motivating elements for sustainable behavior change . Center-based intervention was more likely to produce significant improvements of the PA level and the stage of change for PA change whereas web-based intervention was more likely to extend the awareness about PA Background Older adults are the least active population group . Interventions in residential setting s may support a multi-level approach to behavior change . Methods In a cluster r and omized control trial , 11 San Diego retirement communities were assigned to a physical activity ( PA ) intervention or a healthy aging attention control condition .  Participants were 307 adults over 65 years old . The multilevel PA intervention was delivered with the assistance of peer leaders , who were trained older adult from the retirement communities . Intervention components included individual counseling & self-monitoring with pedometers , group education sessions , group walks , community advocacy and pedestrian community change projects . Intervention condition by time interactions were tested using generalized mixed effects regressions . The primary outcomes was accelerometer measured physical activity . Secondary outcomes were blood pressure and objective ly measured physical functioning . Results Over 70 % of the sample were 80 years or older .  PA  significantly increased in the intervention condition ( 56 min of moderate-vigorous PA per week ; 119 min of light PA ) compared with the control condition and remained significantly higher across the 12 month study . Men and participants under 84 years old benefited most from the intervention . There was a significant decrease in systolic ( p < .007 ) and diastolic ( p < .02 ) blood pressure at 6 months . Physical functioning improved but the changes were not statistically significant . Conclusions Intervention fidelity was high demonstrating feasibility . Changes in PA and blood pressure achieved were comparable to other studies with much younger participants . Men , in particular , avoided a year-long decline in PA.Trial registration clincialtrials.gov Identifier : NCT01155011 The Lifestyle Interventions and Independence for Elders ( LIFE ) Study is a Phase III r and omized controlled clinical trial ( Clinical trials.gov identifier : NCT01072500 ) that will provide definitive evidence regarding the effect of physical activity ( PA ) on major  mobility disability in older adults ( 70–89 years old ) who have compromised physical function . This paper describes the methods employed in the delivery of the LIFE Study PA intervention , providing insight into how we promoted adherence and monitored the fidelity of treatment . Data are presented on participants ’ motives and self-perceptions at the onset of the trial along with accelerometry data on patterns of PA during exercise training . Prior to the onset of training , 31.4 % of participants noted slight conflict with being able to meet the dem and s of the program and 6.4 % indicated that the degree of conflict would be moderate . Accelerometry data collected during PA training revealed that the average intensity – 1,555 counts/minute for men and 1,237 counts/minute for women – was well below the cutoff point used to classify exercise as being of moderate intensity or higher for adults . Also , a sizable subgroup required one or more rest stops . These data illustrate that it is not feasible to have a single exercise prescription for older adults with compromised function . Moreover , the concept of what constitutes “ moderate ” exercise or an appropriate volume of work is dictated by the physical capacities of each individual and the level of comfort/stability in actually executing a specific prescription INTRODUCTION Increased physical activity ( PA ) is a crucial factor in the prevention of physical deterioration , and resistance training ( RT ) is also a common and effective intervention for older adults . However , the effects of PA as an adjunct to RT on frailty status remains unclear ; therefore , we clarified the effect of a PA intervention with feedback , as an adjunct to resistance strength training , on the physical and mental outcomes of frail older adults . MATERIAL S AND METHODS We employed a r and omized controlled trial . Community-dwelling frail older adults in Japan were recruited to participate . Forty-one participants ( mean age 81.5 ) were r and omly assigned to engage in a resistance training with PA ( RPA group ) or RT group for six months . Frailty status and frailty scores , which were measured according to the Cardiovascular Health Study criteria -muscle strength , mobility , instrumental activities of daily living , and health-related quality of life-were assessed . RESULTS Participants in the RPA group exhibited a significant increase in light-intensity PA , the number of steps taken daily ( p < 0.05 ) , and lower-limb muscle strength ( p < 0.05 ) and a significant decrease in frailty scores . However , pre- and postintervention frailty status , instrumental activities of daily living , and health-related quality of life did not differ significantly . CONCLUSIONS Implementation of a PA intervention as an adjunct to RT is feasible , as it reduced frailty scores and increased lower-limb muscle strength and mobility in older adults with frailty symptoms Background Physical activity ( PA ) for older adults has well-documented physical and cognitive benefits , but most seniors do not meet recommended guidelines for PA , and interventions are lacking . Objectives This study evaluated the efficacy of a 12-week Internet intervention to help sedentary older adults over 55 years of age adopt and maintain an exercise regimen . Methods A total of 368 sedentary men and women ( M=60.3 ; SD 4.9 ) were recruited , screened , and assessed online . They were r and omized into treatment and control groups and assessed at pretest , at 12 weeks , and at 6 months . After treatment group participants rated their fitness level , activity goals , and barriers to exercise , the Internet intervention program helped them select exercise activities in the areas of endurance , flexibility , strengthening , and balance enhancement . They returned to the program weekly for automated video and text support and education , with the option to change or increase their exercise plan . The program also included ongoing problem solving to overcome user-identified barriers to exercise . Results The multivariate model indicated significant treatment effects at posttest ( P=.001 ; large effect size ) and at 6 months ( P=.001 ; medium effect size ) . At posttest , intervention participation showed significant improvement on 13 of 14 outcome measures compared to the control participants . At 6 months , treatment participants maintained large gains compared to the control participants on all 14 outcome measures . Conclusions These results suggest that an online PA program has the potential to positively impact the physical activity of sedentary older adult participants . More research is needed to replicate the study results , which were based on self-report measures . Research is also needed on intervention effects with older population PURPOSE Lifestyle Interventions and Independence for Elders Pilot ( LIFE-P ) was a trial to examine the effects of a physical activity intervention ( PA ) compared with a health education control ( SA ) on measures of disability risk in sedentary older adults ( N = 424 ) . We examined adherence to the LIFE-P PA intervention for the first 12 months of the trial . METHODS The PA intervention consisted of walking , strength , flexibility , and balance training supplemented with behavioral skills training modules , and it used a phased , center-based schedule of adoption ( 3x wk(-1 ) , weeks 1 - 8 ) , transition ( 2x wk(-1 ) , weeks 9 - 24 ) , and maintenance ( 1x wk(-1 ) , weeks 25 to end of trial ) while transitioning to primarily home-based physical activity . SA consisted of weekly ( weeks 1 - 26 ) transitioning to monthly health education workshops . RESULTS Participation in moderate-intensity physical activity increased from baseline to months 6 and 12 in PA compared with SA ( P < 0.001 ) . At 12 months , PA participants who reported > or = 150 min x wk(-1 ) of moderate activity demonstrated a significantly greater improvement in their Short Physical Performance Battery score compared with participants who reported < 150 min.wk of moderate activity ( P < 0.017 ) . For the PA arm , center-based attendance was 76.3 + /- 24.5 , 65.4 + /- 28.6 , and 49.8 + /- 35.8 % in the adoption , transition , and maintenance phases , respectively . CONCLUSIONS Adherence to physical activity in LIFE-P was associated with greater improvement in SPPB score and was consistent with adherence in physical activity trials of shorter duration in this subgroup of older adults . Older individuals at risk for disability can adhere to a regular program of physical activity in a long-term r and omized trial PURPOSE The efficacy of a home-based physical activity ( PA ) intervention for early-stage breast cancer patients was evaluated in a r and omized controlled trial . PATIENTS AND METHODS Eighty-six sedentary women ( mean age , 53.14 years ; st and ard deviation , 9.70 years ) who had completed treatment for stage 0 to II breast cancer were r and omly assigned to a PA or contact control group . Participants in the PA group received 12 weeks of PA counseling ( based on the Transtheoretical Model ) delivered via telephone , as well as weekly exercise tip sheets . Assessment s were conducted at baseline , after treatment ( 12 weeks ) , and 6 and 9 month after baseline follow-ups . The post-treatment outcomes are reported here . RESULTS Analyses showed that , after treatment , the PA group reported significantly more total minutes of PA , more minutes of moderate-intensity PA , and higher energy expenditure per week than controls . The PA group also out-performed controls on a field test of fitness . Changes in PA were not reflected in objective activity monitoring . The PA group was more likely than controls to progress in motivational readiness for PA and to meet PA guidelines . No significant group differences were found in body mass index and percent body fat . Post-treatment group comparisons revealed significant improvements in vigor and a reduction in fatigue in the PA group . There was a positive trend in intervention effects on overall mood and body esteem . CONCLUSION The intervention successfully increased PA and improved fitness and specific aspects of psychological well-being among early-stage breast cancer patients . The success of a home-based PA intervention has important implication s for promoting recovery in this population Background :  Physical activity ( PA )  is important for management of diabetes , yet practical interventions that achieve sustained behavior change are rare . Purpose : The goals of this research were to evaluate the effectiveness of a multifaceted PA intervention for people with type 2 diabetes that emphasized participant choice in activity selection . Baseline activity patterns were examined to determine whether they predicted changes in PA at 2 months . Methods : Three hundred thirty-five participants were recruited from 42 primary care physicians and then r and omized to either a computer-assisted , tailored self-management intervention ( N = 174 ) or health risk appraisal with feedback control ( N = 161 ) . Primary outcome measures included the Community Healthy Activities Model Program for Seniors Question naire , diet , and psychosocial assessment s at baseline and 2 months . Results : For 301 participants who completed the 2-month follow-up , the intervention significantly improved all PA ( p < .01 ) and moderate PA ( metabolic equivalents > 3.0 , p < .01 ) relative to controls . Baseline cluster analyses grouped participant activity patterns into three categories . At 2 months , cluster assignment differentially predicted change in calories expended in moderate , rote , sport , and lifestyle PA . Conclusions : A computer-assisted , multifaceted approach to PA demonstrated improvement after 2 months . The results suggest that individuals are capable of adjusting their activity patterns to maximize their PA Background Healthy ageing is an important concern for many societies facing the challenge of an ageing population . Physical activity ( PA ) is a major contributor to healthy ageing ; however insufficient PA levels are prevalent in old age in Germany .  Community capacity building and community involvement are often recommended as key strategies to improve equitable access to prevention and health promotion . However , evidence for the effectiveness of these strategies is scarce . This study aims to assess the community readiness for PA promotion in local environments and to analyse the utility of strategies to increase community readiness for reaching vulnerable groups . Methods / Design We design ed a mixed method intervention trial comprising three study modules . The first module includes an assessment of  community readiness for PA interventions in older adults . The assessment is carried out in a sample of 24 municipalities in the Northwest of Germany using structured key informant interviews . In the second module , eight municipalities with the low community readiness are selected from the sample and r and omly assigned to one of two study groups : active enhancement of community readiness ( intervention ) versus no enhancement ( control ) . After enhancing community readiness in the active enhancement group , older adults in both study groups will be recruited for participation in a PA intervention .  Participation rates are compared between the study groups to evaluate the effects of the intervention . In addition , a cost-effectiveness analysis is carried out calculating recruitment costs per person reached in the two study groups . In the third module , qualitative interviews are conducted with participants and non- participants of the PA intervention exploring reasons for participation or non-participation . Discussion This study offers the potential to contribute to the evidence base of reaching vulnerable older adults for PA interventions and provide ideas on how to reduce participation barriers . Its findings will inform governmental authorities , professionals , academics , and NGOs with an estimate of re sources necessary to achieve equitable access to physical activity programs for vulnerable older adults . Trial registration German Clinical Trials Register DRKS00009564 ( Date of registration 03 - 11 - 2015 OBJECTIVES To determine whether elderly people who meet national guidelines have higher physical function ( PF ) scores than those who do not and the effect on functional trajectory when physical activity ( PA ) levels change from above to below this threshold , or vice versa . DESIGN Pooled data . SETTING Two 6-month r and omized controlled trials aim ed at increasing PA in adults . PARTICIPANTS Adults aged 65 to 94 ( N=357 ) . INTERVENTION PA counseling over the telephone and through mailed material s. MEASUREMENTS  Self-reported PA  dichotomized at 150 minutes/week and PF using the Medical Outcomes Study 36-item Short Form Question naire PF subscale . RESULTS At baseline , individuals reporting 150 minutes or more of moderate PA/week had mean PF scores that were 20.3 points higher than those who did not ( P<.001 ) . Change in PA minutes from above threshold to below threshold or from below threshold to above threshold from baseline to 6 months result ed in an average change in PF of -11.18 ( P<.001 ) and + 5.10 ( P=.05 ) , respectively . CONCLUSION These findings suggest that PA is an important predictor of functional status . Older sedentary adults can improve PF by meeting recommended PA levels . Conversely , dropping below recommended PA levels has a deleterious effect on PF . Given the importance of PF in maintenance of independence and quality of life in older adults , adherence to recommended PA guidelines should be endorsed BACKGROUND It is well recognized that physical activity ( PA ) is important for older adults ; yet , clinicians remain pessimistic about the ability of older adults with compromised function to adhere to long-term treatment and to maintain behavior change once treatment has been terminated . METHODS We examined the functional status of older adults at a field center ( Wake Forest University ) 2 years after completing 12 months of treatment in the Lifestyle Interventions and Independence for Elders Pilot study . At baseline , participants were r and omized to either a PA or a successful aging ( SA ) control group .  Outcome measures included an interview assessment of PA , the Short Physical Performance Battery ( SPPB ) , and performance on a 400-m self-paced walking test . RESULTS Two years after the formal intervention had ended , participants who were originally in the PA group continued to engage in more minutes of moderate PA and tended to have better SPPB and walking speed than those in the SA group ( effect sizes [ ES ] : SPPB = 0.40 , walking speed = 0.37 ) . Seven ( 12.7 % ) participants in the PA group failed the 400-m walk at the 36-month follow-up assessment , whereas this number was 11 ( 21.6 % ) in the SA group . CONCLUSION Older adults who have compromised physical function are able to sustain some of the benefits derived from participating in structured PA 2 years after supervised treatment has been terminated OBJECTIVE To evaluate three strategies for promoting physical activity ( PA ) in a primary care setting . METHOD Data were collected between 2002 and 2004 from 136 patients attending two general practice s in Brisbane , Australia . Inactive patients ( 50 - 70 years ) were r and omly allocated to one of three hierarchical intervention groups : the general practitioner ( GP ) group received ' brief ' advice ; the GP+ES group also received behavior change advice from an exercise scientist ( ES ) ; and the GP+ES+P group also received a pedometer .  Self-reported PA and its determinants were measured at baseline and weeks 12 and 24 . Cardio-respiratory variables were measured at baseline and week 12 . RESULTS Overall , mean PA time increased by 84 and 128 min/week at weeks 12 and 24 ( p<.01 ) with no significant group differences . Small improvements in blood pressure and post-exercise heart rate were observed . At week 24 , the GP+ES+P group were more likely to report meeting PA guidelines than the GP group ( OR=2.39 95 % CI : 1.01 , 5.64 ) . CONCLUSION PA levels can be increased in mid- to older-age adults , either by brief advice from motivated GPs alone , or from collaboration between GPs and ESs . The most intense intervention ( GP+ES+P ) showed the most promising results Background This study provides insight into the long-term efficacy ( i.e. 12 month results ) of the Web-based or print-delivered tailored Active Plus intervention ( with and without environmental approach ) to promote physical activity ( PA ) among the over-fifties . Differences in effect among subgroups are studied as well . Methods Intervention groups ( i.e. print-delivered basic ( PB ; N = 439 ) , print-delivered environmental ( PE ; N = 435 ) , Web-based basic ( WB ; N = 423 ) , Web-based environmental ( WE ; N = 432 ) ) and a waiting list control group ( N = 411 ) were studied in a clustered r and omized controlled trial . Intervention participants received tailored advice three times within 4 months . Long-term effects ( 12 months after the intervention has started , i.e. 8 months after the intervention was completed ) on PA ( i.e. self-reported weekly minutes and days of sufficient PA ) were tested using multilevel linear regression analyses . Participants ’ age , gender , BMI , educational level , PA intention and the presence of a chronic physical limitation were considered to be potential moderators of the effect . Results Overall , the Active Plus intervention was effective in increasing weekly days of sufficient PA ( B=0.49 ; p=.005 ) , but ineffective in increasing weekly minutes of PA ( B=84.59 ; p=.071 ) . Per intervention condition analysis showed that the PB-intervention ( Bdays=0.64 ; p=.002 ; Bmi n=111.36 ; p=.017 ) and the PE-intervention ( Bdays=0.70 ; p=.001 ; Bmi n=157.41 ; p=.001 ) were effective in increasing days and minutes of PA . Neither Web-based conditions significantly increased PA , while the control group decreased their PA . In contrast to the intervention effect on minutes of PA , the effect on weekly days of PA was significantly moderated by the participants ’ baseline intention to be sufficiently physically active . Conclusions In general , after 12 months the print-delivered interventions result ed in stronger effects than the Web-based interventions . The participants ’ baseline intention was the only significant moderator of the intervention effect . All other assessed user characteristics did not significantly moderate the effect of the intervention , which might indicate that the intervention is sufficiently tailored to the different participant characteristics . Additional efforts should be taken to increase the sustainability of Web-based interventions .Trial registration Dutch Trial Register : NTR2297 Background Childhood obesity is the result of a long lasting imbalance between energy intake and energy expenditure . A major contributing factor is physical inactivity which is closely linked to bone health , cardiovascular disease risk , fitness and psychological factors . The school seems to provide an excellent setting to enhance levels of  physical activity ( PA ) .  However , there is insufficient data from previous school-based intervention trials on how to enhance overall PA . It is also unknown whether an intervention aim ed at increasing PA is effective in improving the children 's health . The purpose of this paper is to outline the design of a school-based r and omized , controlled trial ( RCT ) aim ing to increase overall PA and to improve fitness and health in 6- to 13-year-old children . Methods / Design 15 schools were r and omized to the intervention ( n = 9 ) or the control ( n = 6 ) group , stratified by geographic region ( urban vs. rural ) and by age ( 1st and 5th grade ) . Participation was given for all children in the intervention group since in this group the intervention was part of the normal school curriculum . The intervention during one academic year consisted of : 1 . two additional physical education classes per week given by trained physical education teachers adding up to a total of five PA classes per week , 2 . short PA breaks ( 2–5 min each ) during academic lessons , 3 . PA home work , and 4 . adaptation of recreational areas around the school . All children underwent  anthropometric measurements , blood pressure assessment , fitness testing , measurement of PA  and they filled out question naires . At least 70 % of all children agreed to blood sampling and measurements of body composition and bone mineral measurements by dual energy x-ray absorptiometry . The primary endpoints of the study after one year were an increase in total PA by accelerometry , an increase in aerobic fitness measured by the 20 m shuttle run , a decrease in percent body fat derived from skinfold measurements and an increase in quality of life as assessed by the child health question naire in the intervention group compared to the control group . Secondary outcomes were overall fitness , differences in body composition including body fat distribution , cardiovascular risk factors , psychosocial health , bone mineral content and density of femur , lumbar spine and total body and food intake . Discussion Our preliminary data suggest that the children were representative of Swiss children with respect to sex , socio-demographic status , and body mass index . Short-term results can be expected by the beginning of 2007 . We hypothesized that our intervention will lead to an increase in PA , fitness and overall health . Based on our data , we aim to provide important information regarding the influence of such an intervention on these outcome measures in school-aged children and to provide nationwide guidelines to improve PA in children OBJECTIVES To examine predictors of  physical activity ( PA )  6 months after a r and omized controlled trial . METHODS Breast cancer survivors ( N=377 ) completed assessment s at baseline , postintervention , and 6 months after the intervention . Data were collected on demographic , medical , psychosocial , motivational , and behavioral variables at baseline , postintervention , and 6 months . RESULTS Survivors meeting PA guidelines at baseline ( OR = 5.54 , 95 % CI = 2.99 - 9.82 , P < 0.001 ) and postintervention ( OR = 2.92 , 95 % CI = 1.63 - 5.23 , P < 0.001 ) had a greater likelihood of meeting PA guidelines at 6 months follow-up . CONCLUSIONS Interventions promoting PA maintenance should focus on optimizing PA behavior , psychosocial functioning , and motivation Physical  activity ( PA )  is low among African American women despite awareness of its positive impact on health . Learning and Developing Individual Exercise Skills for a Better Life ( L.A.D.I.E.S. ) compares three strategies for increasing PA among African American women using a cluster r and omized , controlled trial . Underactive adult women from 30 churches ( n=15 participants /church ) were recruited . Churches were r and omized to a faith-based intervention , a non-faith based intervention , or an information only control group . Intervention groups will meet 25 times in group sessions with other women from their church over a 10-month period . Control group participants will receive st and ard educational material promoting PA . All participants will be followed for an additional 12 months to assess PA maintenance . Data will be collected at baseline , 10 , and 22 months . The primary outcome is PA ( steps/day , daily moderate-to-vigorous PA ) . We expect treatment effects indicating that assignment to either of the active interventions is associated with greater magnitude of change in PA compared to the control group . In exploratory analyses , we will test whether changes in the faith-based intervention group are greater than changes in the non-faith-based intervention group . L.A.D.I.E.S. focuses on a significant issue-increasing  PA levels-in a segment of the population most in need of successful strategies for improving health . If successful , L.A.D.I.E.S. will advance the field by providing an approach that is successful for initiating and sustaining change in physical activity , which has been shown to be a primary risk factor for a variety of health outcomes , using churches as the point of delivery
Exercise interventions have small clinical benefits on  PA  levels in community-dwelling older adults , with a decline in the observed improvement after six months of the intervention cessation
Exercise is a form of physical activity ( PA ) .
PA is an important marker of health and quality of life in older adults .
The purpose of this study was to conduct a systematic review of the literature to assess the effect of exercise-based interventions on an at least six-month follow up PA measure , and to describe the specific strategies implemented during the intervention to strengthen the sustainability of PA in community-dwelling 65 + year-old adults .