Best-practice physical activity programs for older adults: findings from the national impact study. Assessing the Effects of Interpersonal and Intrapersonal Behavior Change Strategies on Physical Activity in Older Adults: a Factorial Experiment Physical activity in prefrail older adults: confidence and satisfaction related to physical function. Pathways from Physical Activity to Quality of Life in Older Women Efficacy of a web-based, center-based or combined physical activity intervention among older adults. The Newcastle exercise project: a randomised controlled trial of methods to promote physical activity in primary care Reaching Out to Promote Physical Activity in Australia: A Statewide Randomized Controlled Trial of a Stage-Targeted Intervention 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 Effect of a tailored physical activity intervention delivered in general practice settings: results of a randomized controlled trial. Promoting physical activity in older adults by education of home visitors Physical activity enhances long-term quality of life in older adults: Efficacy, esteem, and affective influences Impact of a physical activity intervention program on cognitive predictors of behaviour among adults at risk of Type 2 diabetes (ProActive randomised controlled trial) Social cognitive influences on physical activity behavior in middle-aged and older adults. Harnessing motivational forces in the promotion of physical activity: the Community Health Advice by Telephone (CHAT) project. Promoting physical activity in older people in general practice: ProAct65+ cluster randomised controlled trial. Improving health-enhancing physical activity in girls' physical education. Project LIFE: a partnership to increase physical activity in elders with multiple chronic illnesses.
OBJECTIVES We assessed the impact of existing best- practice physical activity programs for older adults on physical activity participation and health-related outcomes . METHODS We used a multisite , r and omized trial with 544 older adults ( mean age 66 years ) and measures at baseline , 5 , and 10 months to test the impact of a multiple-component physical activity program compared with results for a control group that did not participate in such a program . RESULTS For adults who participated in a multiple-component physical activity program , we found statistically significant benefits at 5 and 10 months with regard to self-efficacy for exercise adherence over time ( P < .001 ) , adherence in the face of barriers ( P = .01 ) , increased upper- and lower-body strength ( P = .02 , P = .01 ) , and exercise participation ( P = .01 ) . CONCLUSIONS Best- practice community-based physical activity programs can measurably improve aspects of functioning that are risk factors for disability among older adults . US public policy should encourage these inexpensive health promotion programs Abstract Background Little is known about which behavior change strategies motivate older adults to increase their physical activity . Purpose The purpose of this study was to assess the relative effects of two sets of behavior change strategies to motivate increased physical activity among older adults :  interpersonal and intrapersonal . Methods Community-dwelling older adults ( N = 102 , mean age = 79 ) were r and omized in a 2 × 2 factorial experiment to receive interpersonal ( e.g. , social support , friendly social comparison ; no , yes ) and /or intrapersonal ( e.g. , goal setting , barriers management ; no , yes ) behavior change strategies , combined with an evidence -based , physical activity protocol ( Otago exercise program ) and a physical activity monitor ( Fitbit One ™ ) . Results Based on monitor data , participants who received interpersonal strategies , compared to those who did not , increased their average minutes of total physical activity ( light , moderate , vigorous ) per week , immediately ( p = .006 ) and 6 months ( p = .048 ) post-intervention . Similar , increases were observed on measures of functional strength and balance , immediately ( p = .012 ) and 6 months ( p = .003 ) post-intervention . The intrapersonal strategies did not elicit a significant increase in physical activity or functional strength and balance . Conclusions Findings suggest a set of interpersonally oriented behavior change strategies combined with an evidence -based physical activity protocol can elicit modest , but statistically and clinical ly significant , increases in older adults ’ physical activity and functional strength and balance . Future research should replicate these findings and investigate the sustained quantity of physical activity elicited by these strategies and their impact on older adults ’ quality of life and falls . Trial Registration The Clinical Trials.gov registration identifier is NCT02433249 We examined the hypothesis that physical activity will have favorable effects on measures of self-efficacy for a 400-m walk and satisfaction with physical functioning in older adults 70 + years of age who have deficits in mobility . We r and omized a total of 412 adults aged 70 - 89 years at elevated risk for mobility disability to either a physical activity or a successful aging educational control intervention for 12 months . Participants in the physical activity intervention had more favorable changes in both outcomes as a result of treatment than those in the successful aging intervention . Gender , age , and scores on a short physical performance battery did not moderate these effects . Physical activity is an effective means of intervening on self-efficacy and satisfaction with physical function in older adults with impaired lower extremity functioning . This is an important finding in light of the importance of these process variables in behavior change and quality of life Background In spite of consistent evidence to suggest that being more physically active is associated with enhanced quality of life ( QOL ) , there have been remarkably few attempts to determine the possible underlying mechanisms in this relationship . Purpose To prospect ively examine the roles played by self-efficacy and physical and mental health status in the physical activity and QOL relationship in older women . Method Older women ( M age = 68.12 years ) completed measures of physical activity , self-efficacy relative to balance , mental and physical health status , and global QOL at baseline  ( N = 249 ) and 24-month follow-up ( N = 217 ) . Demographics and general health information were assessed at baseline . A panel analysis within a covariance modeling framework was used to analyze the data . Results Analyses indicated that changes in physical activity over time were associated with residual changes in self-efficacy . Changes in self-efficacy were significantly associated with residual changes in physical and mental health status . Only changes in mental health status were significantly related to residual changes in global QOL . Conclusion Results from this study support the role of self-efficacy in the relationship between physical activity and QOL . Future physical activity promotion programs should include strategies to enhance self-efficacy for physical activity to be most effective for this population 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 Abstract Objective : To evaluate the effectiveness of combinations of three methods to promote physical activity . Design : R and omised controlled trial . Baseline assessment with post-intervention follow up at 12 weeks and 1 year . Setting : One urban general practice , 1995 - 7 . Participants : 523 adults aged 40 to 64 years , r and omised to four intervention groups and a control group . Interventions : Brief ( one interview ) or intensive ( six interviews over 12 weeks ) motivational interviewing based on the stages of change model of behaviour change , with or without financial incentive ( 30 vouchers entitling free access to leisure facilities ) . Main outcome measures : Physical activity score ; sessions of moderate and vigorous activity in the preceding four weeks . Results : Response rate was 81 % at 12 weeks and 85 % at one year . More participants in the intervention group reported increased physical activity scores at 12 weeks than controls ( 38 % v 16 % , difference 22 % , 95 % confidence interval for difference 13 % to 32 % ) , with a 55 % increase observed in those offered six interviews plus vouchers . Vigorous activity increased in 29 % of intervention participants and 11 % of controls ( difference 18 % , 10 % to 26 % ) , but differences between the intervention groups were not significant . Short term increases in activity were not sustained , regardless of intensity of intervention . Conclusions : The most effective intervention for promoting adoption of exercise was the most intensive . Even this did not promote long term adherence to exercise . Brief interventions promoting physical activity that are used by many schemes in the United Kingdom are of question able effectiveness . Key messages Schemes promoting physical activity are currently popular in general practice in Britain , but few have been rigorously evaluated and their effectiveness is unknown . In this study , the most effective intervention for promoting adoption of physical activity was the most intensive , involving six motivational interviews and a financial incentive A comparatively brief intervention ( one interview ) was only effective in the short term in around a third of participants Short term increases in physical activity were not maintained at one year follow up and even the most intensive intervention was ineffective in promoting long term adherence to increased physical activity . National and local government , health authorities , and primary healthcare teams should be cautious about current and future expenditure on , and implementation of , exercise prescription or referral Purpose . This study examined the broader use of a print-media intervention , which was previously shown to be effective at promoting physical activity to participants recruited from a regional Australian community , as a strategy suitable for a more diverse statewide population sample . Methods . Participants were r and omly selected adults who responded to a telephone interview conducted by the New South Wales Health Department and consented to participate in a r and omized controlled trial . Consenters were allocated to either  intervention ( n = 361 ) or control ( n = 358 ) conditions . The intervention , a personalized letter plus stage-targeted booklets , was sent 1 week postbaseline . Data were collected via telephone interview at baseline and 2 and 8 months and were analyzed using repeated measures analysis of variance ( ANOVA ) and χ2 statistics . Results . The groups were similar at baseline ( mean age 43 ± 3 years ; 64 % women ) . Process evaluation showed high intervention recall ( 76 % at 2 months ) and high follow-up response rates ( > 85 % at 8 months ) were achieved . Nonsignificant increases in physical activity were observed ( F 1,719 = 2.18 , p = .14 ) . Discussion . A single mailing of stage-targeted print material s was not effective in promoting increases in physical activity among participants selected from the statewide population . Future research could examine how the effectiveness of print media might be enhanced , possibly by using supplementary media , community-based prompts , or other incentives 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 ) OBJECTIVES We evaluated the effectiveness of a minimal intervention physical activity strategy ( physician-based assessment and counseling for exercise [ PACE ] ) applied in general practice setting s in the Netherl and s. METHODS R and omization took place at the general practice level . Participants were patients aged 18 - 70 years of age who had been diagnosed with hypertension , hypercholesterolemia , or non-insulin-dependent diabetes and had not been regularly physically active in the past 6 months . Outcome measures were assessed at baseline and at 8-week , 6-month , and 1-year follow-ups . RESULTS No significant intervention effect over time was observed on physical activity level or stage of change for regular physical activity , and an inverse intervention effect was observed for waist circumference . However , the study population as a whole exhibited a significant increase in physical activity and a borderline significant decrease in body weight at the 1-year follow-up . CONCLUSIONS Positive effects on physical activity level and body weight were observed , but the PACE intervention was not more effective than the st and ard physical activity advice The objectives were to investigate in older adults ( 1 ) whether regular preventive home visits are associated with change or stability in physical activity and ( 2 ) whether education of home visitors influences stability and change in physical activity . The design was a prospect i ve controlled r and omised follow-up study with r and omization at municipality level ( 17 intervention and 17 control municipalities ) and outcomes measured at individual level . Visitors in the intervention-municipalities received regular education during 3 years . The effect of the intervention was measured by a question naire survey among 1,913 old persons living in the 34 municipalities at baseline and 4½-year follow-up  . Changes in physical activity were measured through self-reported frequencies of vigorous physical activity . All logistic regression analyses were stratified by sex and age group ( 75 and 80 years old ) . There was no effect of receiving preventive home visits on change in physical activity among the men and among the 75-year-old women . Among the physically active 80-year-old women those who accepted and received more than four preventive home visits were more likely to go on being physically active compared to women who did not receive preventive home visits . Among the sedentary 80-year-old women those living in the intervention municipalities tended to increase their physical activity compared to the control women . These results were not seen in the old men . Preventive home visits as part of daily routine in primary care and education of home visitors and general practitioners may promote physical activity in older women Background : Physical activity has been effective in enhancing quality of life ( QOL ) of older adults over relatively short periods of time . However , little is known about the longterm effects of physical activity and even less about the possible mediators of this relationship . Purpose : We examined the mediating effects of psychological variables on the relationship between  physical activity  and global QOL ( satisfaction with life ) in older adults over a 4-year period . Methods : Participants ( N = 174 , M age = 66.7 years ) completed a battery of psychosocial measures at 1 and 5 years following enrollment in a 6-month r and omized controlled exercise trial .  Results : Panel analysis conducted within a covariance modeling framework indicated that physical activity was related to self-efficacy , physical self-esteem , and positive affect at 1 year , and in turn , greater levels of self-efficacy and positive affect were associated with higher levels of QOL . Analyses indicated that changes in physical activity over the 4-year period were related to increases in physical self-esteem and positive affect , but only positive affect directly influenced improvements in QOL . Conclusions : The findings lend support to the position that physical activity effects on QOL are in part mediated by intermediate psychological outcomes and that physical activity can have long-term effects on well-being Background In the ProActive Trial an intensive theory-based intervention program was no more effective than theory-based brief advice in increasing objective ly measured physical activity among adults at risk of Type 2 diabetes . We aim ed to illuminate these findings by assessing whether the intervention program changed cognitions about increasing activity , defined by the Theory of Planned Behaviour , in ways consistent with the theory . Methods N = 365 sedentary participants aged 30–50 years with a parental history of Type 2 diabetes were r and omised to brief advice alone or to brief advice plus the intervention program delivered face-to-face or by telephone . Question naires at baseline , 6 and 12 months assessed cognitions about becoming more physically active . Analysis of covariance was used to test intervention impact . Bootstrapping was used to test multiple mediation of intervention impact . Results At 6 months , combined intervention groups ( face-to-face and telephone ) reported that they found increasing activity more enjoyable ( affective attitude , d = .25 ) , and they perceived more instrumental benefits ( e.g. , improving health ) ( d = .23 ) and more control ( d = .32 ) over increasing activity than participants receiving brief advice alone . Stronger intentions ( d = .50 ) in the intervention groups than the brief advice group at 6 months were partially explained by affective attitude and perceived control . At 12 months , intervention groups perceived more positive instrumental ( d = .21 ) and affective benefits ( d = .29 ) than brief advice participants . The intervention did not change perceived social pressure to increase activity . Conclusion Lack of effect of the intervention program on physical activity over and above brief advice was consistent with limited and mostly small short-term effects on cognitions . Targeting affective benefits ( e.g. , enjoyment , social interaction ) and addressing barriers to physical activity may strengthen intentions , but stronger intentions did not result in more behaviour change . More powerful interventions which induce large changes in TPB cognitions may be needed . Other interventions deserving further evaluation include theory-based brief advice , intensive measurement of physical and psychological factors , and monitoring of physical activity . Future research should consider a wider range of mediators of physical activity change , assess participants ' use of self-regulatory strategies taught in the intervention , and conduct experimental studies or statistical modelling prior to trial evaluation . IS RCT N61323766 OBJECTIVES The purpose of the current study was to prospect ively test the utility of a social cognitive theory ( SCT ) model of physical activity behavior over an 18-month period in middle-aged and older adults ( N = 321 ; M age = 63.8 years ) . METHODS Participants completed measures of self-efficacy , disability limitations , goals , outcome expectations , and physical activity at baseline and follow-up . Self-efficacy was hypothesized to influence physical activity both directly and indirectly through goals and outcome expectations . Relationships were examined using panel analysis within a covariance modeling framework . RESULTS The model provided an excellent fit to the data ( χ(2 ) = 36.16 , df = 30 , p = .20 ; comparative fit index = 1.00 ; root mean square error of approximation = .03 ) . At baseline , self-efficacy was directly related to outcome expectations , disability limitations , goals , and physical activity and indirectly related to physical activity through physical outcome expectations . Changes in self-efficacy were significantly related to residual changes in outcome expectations , disability limitations , goals , and physical activity and indirectly related to residual changes in physical activity through changes in physical and social outcome expectations . DISCUSSION These results provide further support for the use of SCT to physical activity behavior in middle-aged and older adults  . Self-efficacy influenced physical activity both directly and indirectly via outcome expectations , suggesting that these variables should be targeted in physical activity interventions for middle-aged and older adults Physical inactivity among middle- and older-aged adults is pervasive , and is linked with numerous chronic conditions that diminish health and functioning . Counselor-directed physical activity programs may enhance extrinsic motivation ( reflected in social influence theories , such as self-presentation theory ) and , in turn , physical activity adherence , while the counselor is in charge of program delivery . However , external influences can undermine intrinsic motivation , making it more difficult to maintain physical activity once counselor-initiated contact ends . In contrast , programs that diminish the socially evaluative and controlling aspects of the counseling interchange may promote intrinsic motivation ( described in cognitive evaluation theory ) , and , thus , physical activity maintenance , even when counselor-initiated contact ceases . The objective of the Community Health Advice by Telephone ( CHAT ) project is to compare these two theories by conducting a r and omized controlled trial evaluating the effects of a telephone-administered counseling program delivered by a person ( social influence enhancement ) or computer ( cognitive evaluation enhancement ) on physical activity adoption and maintenance over 18 months . Healthy , sedentary adults ( n = 225 ) aged 55 years and older are r and omized to one of these programs or to a control arm . This study will contribute to advancing motivational theory as well as provide information on the sustained effectiveness of interventions with substantial public health applicability BACKGROUND Regular physical activity reduces falls , hip fractures , and all-cause mortality , but physical activity levels are low in older age groups . AIM To evaluate two exercise programmes promoting physical activity among older people . DESIGN AND SETTING Pragmatic three-arm , parallel- design cluster r and omised controlled trial involving 1256 people aged ≥65 years ( of 20 507 invited ) recruited from 43 general practice s in London , Nottingham , and Derby . METHOD Practice s were r and omised to the class-based Falls Management Exercise programme ( FaME ) , the home-based Otago Exercise Program ( OEP ) , or usual care . The primary outcome was the proportion reaching the recommended physical activity target 12 months post-intervention . Secondary outcomes included falls , quality of life , balance confidence , and costs . RESULTS In total , 49 % of FaME participants reached the physical activity target compared with 38 % for usual care ( adjusted odds ratio 1.78 , 95 % confidence interval [ CI ] = 1.11 to 2.87 , P = 0.02 ) . Differences between FaME and usual care persisted 24 months after intervention . There was no significant difference comparing those in the OEP ( 43 % reaching target at 12 months ) and usual-care arms . Participants in the FaME arm added around 15 minutes of moderate-to-vigorous physical activity per day to their baseline level ; this group also had a significantly lower rate of falls ( incident rate ratio 0.74 , 95 % CI = 0.55 to 0.99 , P = 0.042 ) . Balance confidence was significantly improved in both intervention arms . The mean cost per extra person achieving the physical activity target was £ 1740 . Attrition and rates of adverse reactions were similar . CONCLUSION The FaME programme increases self-reported physical activity for at least 12 months post-intervention and reduces falls in people aged ≥65 years , but uptake is low . There was no statistically significant difference in reaching the target , or in falls , between the OEP and usual-care arms This study examined the effectiveness of an intervention to increase  levels of moderate-to-vigorous intensity physical activity ( MVPA )  during girls ' physical education lessons . Two Year 7 classes ( age 11 - 12 years ) were r and omly appointed to control and experimental groups . Both followed the same six-lesson unit of gymnastics with identical lesson objectives . The experimental class teacher included the additional objective of increasing MVPA during each lesson . MVPA  was assessed in all six lessons using heart rate ( HR ) monitoring and systematic observation . After each lesson , students ' intrinsic motivation and perceived competence were assessed , and the teachers evaluated whether they had met planned objectives . The experimental group engaged in more  MVPA  [ F(1 , 21 ) = 8.49 , P = 0.008 ( HR ) , t8 = -2.35 , P = 0.048 ( observation ) ] than the control group and also had most opportunities for skill practice ( t8 = -2.81 , P = 0.023 ) . Intrinsic motivation and perceived competence levels were similar between the groups for each lesson , and teachers reported that lesson objectives were satisfactorily achieved . This intervention succeeded in increasing MVPA without compromising intrinsic motivation , perceived competence or planned lesson objectives The authors describe a medical center-based r and omized trial aim ed at determining the feasibility and effectiveness of partnering patients and primary -care providers  with an exercise health counselor .  Study participants included 165 veterans age 70 years and older . The primary end point was change in physical activity at 3 and 6 months comparing patients receiving  high-intensity physical activity counseling , attention control counseling , and usual care after receiving st and ardized clinic-based counseling . We noted a significant Group x Time interaction ( p = .041 ) for physical activity frequency and a similar effect for caloric expenditure ( p = .054 ) . Participants receiving high-intensity counseling and usual care  increased physical activity over the short term , but those with usual care returned to baseline by the end of the study . The intervention was well received by practitioners and patients . We conclude that partnering primary -care providers with specialized exercise counselors for age- and health-appropriate physical activity counseling is effective
The heterogeneity in reported effects was reduced in higher quality studies , when physical activity was self-directed with some professional guidance and when there was on-going professional support .
Our review suggests that physical activity interventions have a moderate effect on self reported physical activity and cardio-respiratory fitness , but not on achieving a predetermined level of physical activity .
Due to the clinical and statistical heterogeneity of the studies , only limited conclusions can be drawn about the effectiveness of individual components of the interventions .
BACKGROUND Little is known about the effectiveness of strategies to enable people to achieve an increase in their physical activity .
OBJECTIVES To assess the effects of interventions for promoting physical activity in adults aged 16 years and older , not living in an institution .