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      Requirements for (web-based) physical activity interventions targeting adults above the age of 65 years – qualitative results regarding acceptance and needs of participants and non-participants

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          Abstract

          Background

          It remains unclear how physical activity (PA) interventions need to be designed to reach older adults and to be widely accepted in this target group. The aim of this study was to assess the acceptance of a web-based PA program, including individual intervention components as well as relevant contextual factors, and to specify requirements for future interventions.

          Methods

          Two hundred sixty-six participants of a PA intervention completed a questionnaire covering individual program components (content, structure, and context). Further, 25 episodic guided interviews focusing on reasons for (non-) participation were conducted with 8 participants and 17 non-participants. Following qualitative content analysis, different requirements were identified and organized based on the social-ecological model, resulting in a profile of requirements.

          Results

          Based on the participants’ and non-participants’ statements, six different levels of requirements affecting acceptance of and successful participation in a web-based PA intervention were identified. The individual fit was influenced by an interaction of different factors at the intrapersonal, sociocultural, content, spatial, digital and organizational levels. Several age- and gender-specific requirements were noted in the interviewed older adults. Men and women, as well as younger (< 70 years) and older (≥70 years) adults differed in terms of perceived enjoyment and benefits of socializing while exercising together, the time expenditure perceived to be acceptable, previous digital skills, as well as in perceptions that ambience and accessibility of exercise facilities in the neighborhood were important.

          Conclusions

          To motivate older adults to engage in PA and address different needs in terms of life circumstances and quality of life as well as differences in technical affinity, different requirement profiles should be included in the process of intervention development and implementation. Participatory development loops and modular offer formats are recommended for this.

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          Most cited references28

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          Lack of exercise is a major cause of chronic diseases.

          Chronic diseases are major killers in the modern era. Physical inactivity is a primary cause of most chronic diseases. The initial third of the article considers: activity and prevention definitions; historical evidence showing physical inactivity is detrimental to health and normal organ functional capacities; cause versus treatment; physical activity and inactivity mechanisms differ; gene-environment interaction (including aerobic training adaptations, personalized medicine, and co-twin physical activity); and specificity of adaptations to type of training. Next, physical activity/exercise is examined as primary prevention against 35 chronic conditions [accelerated biological aging/premature death, low cardiorespiratory fitness (VO2max), sarcopenia, metabolic syndrome, obesity, insulin resistance, prediabetes, type 2 diabetes, nonalcoholic fatty liver disease, coronary heart disease, peripheral artery disease, hypertension, stroke, congestive heart failure, endothelial dysfunction, arterial dyslipidemia, hemostasis, deep vein thrombosis, cognitive dysfunction, depression and anxiety, osteoporosis, osteoarthritis, balance, bone fracture/falls, rheumatoid arthritis, colon cancer, breast cancer, endometrial cancer, gestational diabetes, pre-eclampsia, polycystic ovary syndrome, erectile dysfunction, pain, diverticulitis, constipation, and gallbladder diseases]. The article ends with consideration of deterioration of risk factors in longer-term sedentary groups; clinical consequences of inactive childhood/adolescence; and public policy. In summary, the body rapidly maladapts to insufficient physical activity, and if continued, results in substantial decreases in both total and quality years of life. Taken together, conclusive evidence exists that physical inactivity is one important cause of most chronic diseases. In addition, physical activity primarily prevents, or delays, chronic diseases, implying that chronic disease need not be an inevitable outcome during life. © 2012 American Physiological Society. Compr Physiol 2:1143-1211, 2012.
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            Meta-analysis of internet-delivered interventions to increase physical activity levels

            Many internet-delivered physical activity behaviour change programs have been developed and evaluated. However, further evidence is required to ascertain the overall effectiveness of such interventions. The objective of the present review was to evaluate the effectiveness of internet-delivered interventions to increase physical activity, whilst also examining the effect of intervention moderators. A systematic search strategy identified relevant studies published in the English-language from Pubmed, Proquest, Scopus, PsychINFO, CINHAL, and Sport Discuss (January 1990 – June 2011). Eligible studies were required to include an internet-delivered intervention, target an adult population, measure and target physical activity as an outcome variable, and include a comparison group that did not receive internet-delivered materials. Studies were coded independently by two investigators. Overall effect sizes were combined based on the fixed effect model. Homogeneity and subsequent exploratory moderator analysis was undertaken. A total of 34 articles were identified for inclusion. The overall mean effect of internet-delivered interventions on physical activity was d = 0.14 (p = 0.00). Fixed-effect analysis revealed significant heterogeneity across studies (Q = 73.75; p = 0.00). Moderating variables such as larger sample size, screening for baseline physical activity levels and the inclusion of educational components significantly increased intervention effectiveness. Results of the meta-analysis support the delivery of internet-delivered interventions in producing positive changes in physical activity, however effect sizes were small. The ability of internet-delivered interventions to produce meaningful change in long-term physical activity remains unclear.
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              Physical activity participation among persons with disabilities: barriers and facilitators.

              The purpose of this study was to identify various barriers and facilitators associated with participation in fitness and recreation programs/facilities among persons with disabilities. Focus groups were conducted in ten regions across the United States in 2001 to 2002 with four types of participants: (1) consumers with disabilities, (2) architects, (3) fitness and recreation professionals, and (4) city planners and park district managers. Sessions were tape-recorded and content analyzed; focus group facilitators took notes of identified barriers and facilitators to access. Content analysis of tape recordings revealed 178 barriers and 130 facilitators. The following themes were identified: (1) barriers and facilitators related to the built and natural environment; (2) economic issues; (3) emotional and psychological barriers; (4) equipment barriers; (5) barriers related to the use and interpretation of guidelines, codes, regulations, and laws; (6) information-related barriers; (7) professional knowledge, education, and training issues; (8) perceptions and attitudes of persons who are not disabled, including professionals; (9) policies and procedures both at the facility and community level; and (10) availability of resources. The degree of participation in physical activity among people with disabilities is affected by a multifactorial set of barriers and facilitators that are unique to this population. Future research should utilize this information to develop intervention strategies that have a greater likelihood of success.
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                Author and article information

                Contributors
                wichmann@leibniz-bips.de
                claudiaruth.pischke@med.uni-duesseldorf.de
                do_ju@uni-bremen.de
                darmann@uni-bremen.de
                frauke.koppelin@jade-hs.de
                s.lippke@jacobs-university.de
                alexander.pauls@jade-hs.de
                mpeters@leibniz-bips.de
                claudia.voelcker-rehage@uni-muenster.de
                muellmann@leibniz-bips.de
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                11 June 2020
                11 June 2020
                2020
                : 20
                : 907
                Affiliations
                [1 ]GRID grid.7704.4, ISNI 0000 0001 2297 4381, Institute for Public Health und Nursing Sciences – IPP, , University of Bremen, ; Bremen, Germany
                [2 ]GRID grid.418465.a, ISNI 0000 0000 9750 3253, Department Prevention and Evaluation, , Leibniz Institute for Prevention Research and Epidemiology – BIPS, ; Bremen, Germany
                [3 ]GRID grid.411327.2, ISNI 0000 0001 2176 9917, Institute of Medical Sociology, Centre for Health and Society, , Medical Faculty, Heinrich-Heine-University Duesseldorf, ; Duesseldorf, Germany
                [4 ]GRID grid.449343.d, ISNI 0000 0001 0828 9468, Jade University of Applied Sciences Wilhelmshaven/Oldenburg/Elsfleth, , Section Technology and Health for Humans, ; Oldenburg, Germany
                [5 ]GRID grid.15078.3b, ISNI 0000 0000 9397 8745, Department of Psychology & Methods, , Jacobs University Bremen, ; Bremen, Germany
                [6 ]GRID grid.7704.4, ISNI 0000 0001 2297 4381, Research Focus Health Sciences Bremen, , University of Bremen, ; Bremen, Germany
                [7 ]GRID grid.6810.f, ISNI 0000 0001 2294 5505, Institute of Human Movement Science and Health, Faculty of Behavioural and Social Sciences, , Chemnitz University of Technology, ; Chemnitz, Germany
                [8 ]GRID grid.5949.1, ISNI 0000 0001 2172 9288, Neuromotor Behavior and Exercise, , Institute of Sport and Exercise Sciences, University of Muenster, ; Muenster, Germany
                Author information
                http://orcid.org/0000-0001-5848-7200
                Article
                8927
                10.1186/s12889-020-08927-8
                7291669
                32527251
                d2d063f1-89b7-40d7-8f4c-68a3b4902cad
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 11 March 2020
                : 17 May 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100002347, Bundesministerium für Bildung und Forschung;
                Award ID: 01EL1422A
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Public health
                physical activity,older adults,requirements,acceptance,implementation,web-based,prevention,social-ecological model

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