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Luna E, Springer A, Herrera D, Garcia ME, Brown L, Kelder SH. Identifying Factors That Influence Physical Activity and Healthy Aging Among Older Latino Adults. HEALTH EDUCATION & BEHAVIOR 2024:10901981241228221. [PMID: 38328931 DOI: 10.1177/10901981241228221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
BACKGROUND For older Latinos, some benefits of leisure-time physical activity (LTPA) include enhanced cognitive functioning, decreased loneliness, and reduced premature mortality. Despite LTPA benefits, adults ≥50 years are one of the most inactive age groups in the United States. METHODS This qualitative study aimed to add to the limited evidence of LTPA in older Latino adults by exploring the barriers and facilitators for fitness class uptake and park use. Guided by a Social-Ecological Model of Health and Social Determinants of Health theoretical and a phenomenological research design, qualitative research data were collected via 27 personal interviews with Latino adults using a semistructured interview guide. Participants were recruited using purposive sampling strategies in collaboration with community partners. Bicultural data collectors conducted the semistructured interviews over Zoom. Thematic analysis was performed using Dedoose, following an inductive and deductive approach. RESULTS The main barriers to fitness class attendance and park use were family and/or work commitments, perceived safety, and perceived discrimination. Conversely, the critical facilitators for participation were socialization into a group, social connectedness with group members, fitness instructor characteristics, and exercise history. CONCLUSIONS Findings from this study hold important implications for the design of fitness programming and park-based recreation, including the need to increase the cultural diversity of recreation staff and culturally relevant programming. Future research is needed on time poverty related to family/work commitments and whether discriminatory practices at fitness centers, like ageism and race/ethnicity, influence physical activity behavior.
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Affiliation(s)
- Elena Luna
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA
| | - Andrew Springer
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA
- Michael & Susan Dell Center for Healthy Living, Austin, TX, USA
| | - Denise Herrera
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA
| | - Maria Elena Garcia
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA
| | - Louis Brown
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), El Paso, TX, USA
| | - Steven H Kelder
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA
- Michael & Susan Dell Center for Healthy Living, Austin, TX, USA
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Jabardo-Camprubí G, Puig-Ribera A, Donat-Roca R, Farrés-Godayol P, Nazar-Gonzalez S, Sitjà-Rabert M, Espelt A, Bort-Roig J. Assessing the Feasibility and Acceptability of a Primary Care Socio-Ecological Approach to Improve Physical Activity Adherence among People with Type 2 Diabetes: The SENWI Project. Healthcare (Basel) 2023; 11:1815. [PMID: 37444649 DOI: 10.3390/healthcare11131815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/13/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
Maintaining an active lifestyle is a key health behavior in people with type 2 diabetes (T2D). This study assessed the feasibility and acceptability of a socio-ecological Nordic walking intervention (SENWI) to enhance healthy behaviors in primary healthcare settings. Participants included individuals with T2D (n = 33; age 70 (95% CI 69-74)) and healthcare professionals (HCPs, n = 3). T2D participants were randomly assigned to a SENWI, active comparator, or control group for twelve weeks. Feasibility and acceptability were evaluated based on a mixed methodology. Quantitative data reported adherence information, differences between follow-up and dropout participants and pre- and post-intervention on physical activity, sedentary behavior, and health outcomes. Qualitative data acquisition was performed using focus groups and semi-structured interviews and analyzed using thematic analysis. Thirty-three T2D invited participants were recruited, and twenty-two (66.7%) provided post-intervention data. The SENWI was deemed acceptable and feasible, but participants highlighted the need to improve options, group schedules, gender inequities, and the intervention's expiration date. Healthcare professionals expressed a lack of institutional support and resources. Nevertheless, no significant difference between the SENWI follow-up and dropout participants or pre- and post- intervention was found (only between the active comparator and control group in the physical quality of life domain). Implementing the SENWI in primary healthcare settings is feasible and acceptable in real-world conditions. However, a larger sample is needed to assess the program's effectiveness in improving healthy behaviors and its impact on health-related outcomes in the long term.
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Affiliation(s)
- Guillem Jabardo-Camprubí
- Faculty of Health Science at Manresa, University of Vic-Central University of Catalonia, Av. Universitaria 4-6, 08242 Manresa, Spain
- Sports and Physical Activity Research Group, Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (Iris-CC), Ctra. De Roda Núm. 70, 08500 Vic, Spain
| | - Anna Puig-Ribera
- Sports and Physical Activity Research Group, Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (Iris-CC), Ctra. De Roda Núm. 70, 08500 Vic, Spain
| | - Rafel Donat-Roca
- Sport Exercise and Human Movement (SEaMH), Faculty of Health Science at Manresa, University of Vic-Central University of Catalonia, Av. Universitaria 4-6, 08242 Manresa, Spain
| | - Pau Farrés-Godayol
- Research Group on Methodology, Methods, Models and Outcome of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, University of Vic-Central University of Catalonia, Sagrada Familia 7, 08500 Vic, Spain
| | - Sebastian Nazar-Gonzalez
- Department of Physical Therapy, Faculty of Health Science Blanquerna, Ramon Llul University, Padilla, 326-332, 08022 Barcelona, Spain
| | - Mercè Sitjà-Rabert
- Faculty of Health Science Blanquerna, Global Research on Wellbeing (GRoW) Research Group, Ramon Llull University, Padilla, 326-332, 08022 Barcelona, Spain
| | - Albert Espelt
- Faculty of Health Science at Manresa, University of Vic-Central University of Catalonia, Av. Universitaria 4-6, 08242 Manresa, Spain
- Departament de Psicologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, CIBER de Epidemiologia i Salud Pública, 08193 Barcelona, Spain
| | - Judit Bort-Roig
- Sports and Physical Activity Research Group, Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (Iris-CC), Ctra. De Roda Núm. 70, 08500 Vic, Spain
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Jabardo-Camprubí G, Bort-Roig J, Donat-Roca R, Milà-Villarroel R, Sitjà-Rabert M, McKenna J, Puig-Ribera A. A socio-ecological approach to reduce the physical activity drop-out ratio in primary care-based patients with type 2 diabetes: the SENWI study protocol for a randomized control trial. Trials 2022; 23:842. [PMID: 36192800 PMCID: PMC9531392 DOI: 10.1186/s13063-022-06742-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 09/13/2022] [Indexed: 12/02/2022] Open
Abstract
Background Physical activity (PA) is a key behaviour for patients with type 2 diabetes (T2DM). However, healthcare professionals’ (HCP) recommendations (walking advice), which are short-term and individually focused, did not reduce the PA drop-out ratio in the long run. Using a socio-ecological model approach may contribute to reducing patient dropout and improving adherence to PA. The aim of this study is threefold: first, to evaluate the effectiveness of a theory-driven Nordic walking intervention using a socio-ecological approach with T2DM patients in Spain; second, to explore the feasibility on the PA adherence process in T2DM patients while participating in the SENWI programme; and third, to understand the HCPs’ opinion regarding its applicability within the Spanish healthcare system. Methods A three-arm randomized control trial (n = 48 each group) will assess the efficacy of two primary care-based PA interventions (Nordic walking vs. Nordic walking plus socio-ecological approach; two sessions per week for twelve weeks) compared to a control group (usual HCPs’ walking advice on PA). Inclusion criteria will include physically inactive patients with T2DM, older than 40 years and without health contraindications to do PA. PA levels and drop-out ratio, quality of life and metabolic and health outcomes will be assessed at baseline, post-intervention and at 9- and 21-month follow-ups. The effect of the different interventions will be assessed by a two-factor analysis of variance: treatment group vs time. Also, a two-factor ANOVA test will be performed with linear mixed models for repeated measures. A qualitative analysis using focus groups will explore the reasons for the (in)effectiveness of the new PA interventions. Qualitative outcomes will be assessed at post-intervention using thematic analysis. Discussion Compared with the general PA walking advice and Nordic walking prescriptions, integrating a socio-ecological approach into Spanish primary care visits could be an effective way to reduce the PA drop-out ratio and increase PA levels in patients with T2DM. Such interventions are necessary to understand the role that multiple socio-complex process in day-to-day PA behaviour has in patients with T2DM in the Spanish context. Trial registration ClinicalTrials.gov NCT05159089. Physical Activity Drop-out Ratio in Patients’ Living with Type 2 Diabetes. Prospectively registered on 15 December 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06742-7.
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Affiliation(s)
- Guillem Jabardo-Camprubí
- Sports and Physical Activity Research Group, Centre for Health and Social Research, University of Vic-Central University of Catalonia, Sagrada Familia 7, Barcelona, VIC, Spain.
| | - Judit Bort-Roig
- Sports and Physical Activity Research Group, Centre for Health and Social Research, University of Vic-Central University of Catalonia, Sagrada Familia 7, Barcelona, VIC, Spain
| | - Rafel Donat-Roca
- School of Health Science UManresa, Sport Exercise and Human Movement (SEaMH), University of Vic-Central University of Catalonia, Av. Universitaria 4-6, Manresa, Spain
| | - Raimon Milà-Villarroel
- School of Health Science Blanquerna, Ramon Llull University, Padilla, 326-332, Barcelona, Spain
| | - Mercè Sitjà-Rabert
- School of Health Science Blanquerna, Global Research on Wellbeing (GRoW) Research Group, Ramon Llull University, Padilla, 326-332, Barcelona, Spain
| | - Jim McKenna
- School of Sport, Leeds Becket University, Leeds, LS1 3HE, Leeds, England
| | - Anna Puig-Ribera
- Sports and Physical Activity Research Group, Centre for Health and Social Research, University of Vic-Central University of Catalonia, Sagrada Familia 7, Barcelona, VIC, Spain
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Piedra LM, Howe MJK, Ridings J, Gutwein M. Do Latino Older Adults and Service Providers Agree on Positive Aging? Using Concept Mapping to Compare Perspectives. THE GERONTOLOGIST 2022; 63:169-181. [PMID: 35639984 PMCID: PMC9872760 DOI: 10.1093/geront/gnac074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND AND OBJECTIVES In the United States, Latino adults are a growing segment of the aging population who will need research-informed interventions to help them age successfully. Arguably, how Latino older adults and service providers understand "positive aging" serves as an important precursor for the cultivation of such interventions. This investigation explored whether Latino older adults' conceptualizations of positive aging aligned with those of service providers. RESEARCH DESIGN AND METHODS We compared how Latino older adults (n = 93) and service providers (n = 45) rated 85 positive aging statements produced by Latino older adults. These 85 items were used to generate a concept map, which displays those items thematically by clusters and overarching regions of meaning. RESULTS We found divergences at each level of the map-statements, clusters, and regions-which illuminate differences between how service providers and Latino older adults think about Latino positive aging. For example, whereas Latino older adults prioritized the cluster containing items related to internal well-being, service providers rated it seventh of 11 clusters. The region comprising clusters related to relationships garnered the highest agreement between groups, but also a notable departure; compared to Latino older adults, service providers rated community and social involvement as less important. DISCUSSION AND IMPLICATIONS Understanding such differences can help providers tailor services consistent with the interests of Latino older adults. Future studies should examine the extent to which stakeholders believe various aspects of positive aging are modifiable.
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Affiliation(s)
- Lissette M Piedra
- Address correspondence to: Lissette M. Piedra, PhD, MSW, School of Social Work, University of Illinois at Urbana-Champaign, 1010 West Nevada St., Urbana, IL 61801, USA. E-mail:
| | | | - John Ridings
- Institute for Clinical Social Work, Chicago, Illinois, USA
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Thiamwong L. Future Nursing Research of Older Adults: Preserving Independence and Reducing Health Disparities. PACIFIC RIM INTERNATIONAL JOURNAL OF NURSING RESEARCH 2022; 26:1-5. [PMID: 35935604 PMCID: PMC9355488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Nursing professionals are at the forefront of primary care and the largest segment of the health workforce, and nurse researchers can bring vital perspectives to aging research and clinical practice. Although healthcare systems are experiencing more work from the aging of populations, unfortunately there are limited nurse researchers trained in gerontological nursing. Future research in older adults needs to be based on the current needs of and for older adults. In this article, I identify potential future research of aspects for older adults by highlighting opportunities and examples to conduct culturally appropriate interventions that aim to reduce health disparities and preserve independence. Because there is a complexity of health issues in older adults, nurse researchers need to pursue the best ways to address their needs, investigate and disseminate technology-based assessments, provide culturally appropriate interventions to promote independence, prevent chronic conditions, and enhance health equality. Nurses and nurse researchers also need to monitor the changes in functional status and health of older adults, especially as the global burden and costs of diseases and disability of this population grows, and to save unnecessary health care expenditure. To create new knowledge and discover best practices in aging care, nurse researchers lead multidisciplinary teams, develop innovative ideas with the potential for significant clinical impact, and use appropriate research approaches that steer to successful grant applications to national funding agencies. It is essential to establish a program for training or mentoring nurse researchers dedicated to caring for older adults, advocating, and disseminating innovative care to maximize the independence of older adults.
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Affiliation(s)
- Ladda Thiamwong
- College of Nursing, University of Central Florida, Orlando, FL, USA
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