What factors support older people to increase their physical activity levels? An exploratory analysis of the experiences of PACE-Lift trial participants. (November 2016) - Victor, Christina R.
Highlights: A nurse led primary care walking based physical activity (PA) intervention showed increased step counts at 3 and 12 months. We explored the factors that promoted this long-term behaviour change. We selected intervention group participants who increased PA and those who had not to explore facilitators and barriers to behaviour change. We expected the two groups to give contrasting narratives but these did not emerge. The groups differed in the identification of the same factor, eg social support, as either a facilitator or barrier. Participants who sustained increased walking participated in the trial as couple and had a companion to walk with. Those who did not improve lacked these, had higher levels of chronic illness and were more sceptical of the goal setting element of the intervention. Abstract: Background: Physical Activity (PA) has significant health benefits for older adults, but nearly all UK over 60′s are not achieving recommended levels. The PACE-Lift primary care-based walking intervention for 60–75 year-olds used a structured, theoretically grounded intervention with pedometers, accelerometers, handbooks and support from practice nurses trained in behaviour change techniques. It demonstrated an objective increase in walking at 3 and 12 months. We investigated the experiences of intervention participants who did (and did not) increase their walking, in order to explore facilitators to increased walking. Methods: Semi-structured telephone interviews used an interview schedule with a purposive sample of 30 intervention participants, 19 who had objectively increased their walking over the previous year and 11 who had not. Interviews were audio-recorded, transcribed and coded independently by researchers to generate a thematic coding framework. Results: Both groups confirmed that walking was an appropriate PA for people of 'their age'. The majority of those with increased walking participated in the trial as a couple, were positive about individualised goal-setting, developed strategies for maintaining their walking, and had someone to walk with. Non-improvers reported their attempts to increase walking were difficult because of lack of social support and were less positive about the intervention's behaviour change components. Discussion: Walking is an acceptable and appropriate PA intervention for older people. The intervention's goal-setting components were important for those who increased their walking. Mutual support between partners participating as a couple and having someone to walk with also facilitated increased walking.