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Salma J, Au A, Ali S, Chamberlain S, Spence JC, Jones A, Kennedy M, Tong H, Meherali S, Mngomezulu P, Flynn R. Community Group-Based Physical Activity Programs for Immigrant Older Adults: A Systematic Realist Review. J Aging Phys Act 2024:1-15. [PMID: 38936806 DOI: 10.1123/japa.2023-0244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 03/15/2024] [Accepted: 04/25/2024] [Indexed: 06/29/2024]
Abstract
Physical activity program interventions often lack sensitivity to the needs of older immigrant adults. The objective of this systematic realist review is to explain how, why, for whom, and under which circumstances community group-based physical activity programs work for immigrant older adults. The initial program theory was developed using prior research, team expertise, social cognitive theory, and knowledge user consultations. The program theory was tested and refined via a systematic review of the literature. Database searches were conducted in MEDLINE, EMBASE, CINAHL, Scopus, Cochrane Library, Sports Medicine and Education Index, and SPORTDiscus. A total of 22 sources of evidence met inclusion criteria and included intervention studies, systematic reviews, and a discussion paper. Intervention studies were appraised using the Mixed Methods Appraisal Tool. The final program theory constituted eight context-mechanism-outcome configurations that highlight the importance of facilitator characteristics, access to safe spaces, group dynamics, and social support. A limitation was the small number and variable quality of included evidence. Physical activity programs that target immigrant older adults must strengthen physical and psychological safety and maximize opportunities for role modeling and socialization. This research was supported by the Alberta Health Services Seniors Health Strategic Clinical Network and is registered in PROSPERO (ID#258179).
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Affiliation(s)
- Jordana Salma
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Alesia Au
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Sonam Ali
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Stephanie Chamberlain
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - John C Spence
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Allyson Jones
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Megan Kennedy
- Geoffrey and Robyn Sperber Health Sciences Library, University of Alberta, Edmonton,AB, Canada
| | - Hongmei Tong
- Department of Social Work, Robbins Health Learning Centre, MacEwan University, Edmonton, AB, Canada
| | - Salima Meherali
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Philile Mngomezulu
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Rachel Flynn
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
- School of Nursing and Midwifery, University College Cork, Ireland
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Lesser I, Thomson C, Lem M. Green Exercise as an Opportunity to Promote Equity in Physical Activity Engagement Across Diverse Populations. J Phys Act Health 2024; 21:533-535. [PMID: 38531352 DOI: 10.1123/jpah.2024-0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 03/28/2024]
Affiliation(s)
- Iris Lesser
- School of Kinesiology, University of the Fraser Valley, Chilliwack, BC, Canada
| | - Cynthia Thomson
- School of Kinesiology, University of the Fraser Valley, Chilliwack, BC, Canada
| | - Melissa Lem
- Department of Family Practice, The University of British Columbia, Vancouver, BC, Canada
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Xu Q, Lin Y, He Y, Zhou X, Liu J, Shen D, Wu F, Lin X, Zhang Y, Li T, Yan T. Predictive models for perceived convenience of accessing outdoor activities among elderly with physical disabilities in rural China. BMC Public Health 2024; 24:776. [PMID: 38475781 DOI: 10.1186/s12889-024-18311-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 03/08/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND The elderly, especially those with physical disabilities, often encounter barriers that prevent them from accessing outdoor activities. Their perceptions of the convenience of accessing outdoor activities may be influenced by various factors including their health, the social context, and/or planned behavior. This study aimed to develop predictive models that identify the principal determinants of perceived convenience among this demographic, and it also examined the disparities observed between genders. METHODS This was a cross-sectional survey of 1216 community-dwelling older people with physical disabilities in rural China. Grounded on the rehabilitation concepts and the theory of planned behavior, structural equation models integrated health and social behavior factors were constructed to predict perceived convenience of accessing outdoor activities. The standardized coefficients explained the contributions of various factors to the variance. RESULTS The final structural models demonstrated good fit for both female and male participants. Perceptions of the convenience of accessing outdoor activities among both women and men were directly impacted by their physical functioning and their intention to participate, and indirectly by medical expenditure, subjective norms, pain, and role limitation in emotional interactions. Positive mental health was more influential for women, while men were more influenced by subjective norms. CONCLUSIONS Structural equation models have effectively predicted the self-reported convenience of accessing outdoor activities, underscoring the importance of functional and behavioral rehabilitation. Furthermore, gender-sensitive rehabilitation programs are advised to promote engagement in outdoor activities among elderly individuals with physical disabilities.
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Affiliation(s)
- Qi Xu
- The Fifth Hospital of Xiamen, 361101, Xiamen, China
| | - Youyi Lin
- The Fifth Hospital of Xiamen, 361101, Xiamen, China
| | - Yiqi He
- The Fifth Hospital of Xiamen, 361101, Xiamen, China
| | | | - Jinhai Liu
- The Fifth Hospital of Xiamen, 361101, Xiamen, China
| | - Dewang Shen
- The Fifth Hospital of Xiamen, 361101, Xiamen, China
| | - Fan Wu
- The Fifth Hospital of Xiamen, 361101, Xiamen, China
| | - Xin Lin
- The Fifth Hospital of Xiamen, 361101, Xiamen, China
- Macau University of Science and Technology, Macao, China
| | - Yun Zhang
- The Fifth Hospital of Xiamen, 361101, Xiamen, China
| | - Taibiao Li
- The Fifth Hospital of Xiamen, 361101, Xiamen, China.
| | - Tiebin Yan
- Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 510120, Guangzhou, China.
- The Engineering Technology Research Center of Rehabilitation and Elderly Care of Guangdong Province, 510120, Guangzhou, China.
- Renowned Physician Tiebin Yan Office, XiaMen, China.
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Allan I, Innocenti P. Library based walking groups in Scotland: Exploring benefits, challenges and opportunities. JOURNAL OF LIBRARIANSHIP AND INFORMATION SCIENCE 2023. [DOI: 10.1177/09610006221149204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Public libraries support a range of health and wellbeing activities, however little research has been done into the provision of library adult walking groups. This paper reports on a unique study exploring how widely adult walking groups are provided through Scottish public libraries, as well as library staff perceptions of the benefits, challenges and opportunities of these services. A rich qualitative research approach was used, involving Freedom of Information requests to the 32 Scottish local authority regions, an online questionnaire with 106 complete responses, and 8 follow-up interviews with Scottish public library staff, with and without walking group experience. Thematic analysis was used to identify key themes from collected data. Results show that adult walking groups are not widely provided through Scottish public libraries. However, respondents identified benefits for user groups, including but not limited to: improvements to participants’ health and social wellbeing; and increased engagement with library services. A range of opportunities for public libraries were highlighted, including staff interest, partnership working and a current focus on health and wellbeing. Challenges encompass resource restrictions, variations in partnership working and lack of effective networking. This original study provides valuable insights into the provision of public library walking groups in Scotland. It suggests that many factors can potentially influence the success of this library health and wellbeing service, with a range of different possible approaches. Results indicate that successful provision of a public library walking group may require close partnership working; adequate networking and information-sharing between public library staff; as well as sufficient resources; and staff interest. This exploratory study provides transferable insights and a basis for future research.
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Taguchi H, Tadaka E, Iwata Y, Arimoto A. Factors associated with community commitment among older adults: a stratified analysis of community group leaders and members. BMC Geriatr 2022; 22:674. [PMID: 35971059 PMCID: PMC9380303 DOI: 10.1186/s12877-022-03361-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 08/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background Community commitment through group activities in the community is associated with improved health outcomes in older adults and has a ripple effect on community development. However, factors associated with community commitment through group activities in the community have not been examined. The purpose of this study was to examine individual factors and group-related factors in association with community commitment among older adult leaders and members of community groups in Japan. Methods We mailed self-administered questionnaires to all older adults participating in a community group (N = 1,898) in a ward of Yokohama city, the largest designated city in Japan. Variables included demographic characteristics, community commitment (Community Commitment Scale), individual factors, and group-related factors. We used logistic regression analysis to assess the association among study variables. Results A total of 1,154 people completed the questionnaire. The valid response rate was 48.8%. Respondents’ mean age was 78.3 years (standard deviation [SD] = 6.1, range 65–100 years), 79.6% were women, 55.9% were married, and 10.0% were employed. Factors associated with community commitment among group leaders were scores for self-efficacy in the health promotion scale (SF-15; mean ± SD: 48.5 ± 7.1), 5-item World Health Organization Well-Being Index (mean ± SD: 17.9 ± 4.3), and Lubben Social Network Scale, Japanese version (mean ± SD: 19.5 ± 6.9), as well as a perception of deriving pleasure from group participation (mean ± SD: 91.2 ± 9.4). Factors associated with community commitment among group members were economic status (Sufficient; n [%]: 749 [85.9]), frequency of going out (mean ± SD: 5.1 ± 1.8), years of group participation (mean ± SD: 6.2 ± 5.0), and perceptions of their role in the group (Yes; n [%]: 254 [30.4]) as well as the above factors for leaders. A supplementary qualitative analysis of participants’ free-text responses extracted seven categories: community support, resource mobilization, partnership action, asset management, participatory decision-making, linkages and networking, and community dissemination, related to perception of a role in the group. Conclusion Our results emphasize the importance of considering the different associations of community commitment through group activities in the community between group leaders and members, including the role of older adults in community groups, and suggest different approaches for group leaders and members.
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Affiliation(s)
- Hina Taguchi
- The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Etsuko Tadaka
- Department of Community and Public Health Nursing, Graduate School of Health Sciences and Faculty of Medicine, Hokkaido University, N12-W5, Kita-Ku, Sapporo, Hokkaido, 060-0812, Japan.
| | - Yuka Iwata
- Department of Community Health Nursing, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Azusa Arimoto
- Department of Community Health Nursing, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
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Crist K, Full KM, Linke S, Tuz-Zahra F, Bolling K, Lewars B, Liu C, Shi Y, Rosenberg D, Jankowska M, Benmarhnia T, Natarajan L. Health effects and cost-effectiveness of a multilevel physical activity intervention in low-income older adults; results from the PEP4PA cluster randomized controlled trial. Int J Behav Nutr Phys Act 2022; 19:75. [PMID: 35761363 PMCID: PMC9235144 DOI: 10.1186/s12966-022-01309-w] [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: 12/22/2021] [Accepted: 05/31/2022] [Indexed: 11/18/2022] Open
Abstract
Background Older adults are the least active population in the U.S. Low-income communities have fewer physical activity (PA) resources, contributing to less PA and increased chronic disease risk. This study assessed the effect of the multilevel, peer-led, Peer Empowerment Program 4 Physical Activity (PEP4PA) on moderate-to-vigorous PA (MVPA) and health outcomes, over 2 years of follow up. Methods In a cluster-randomized controlled trial, 12 senior or community centers serving low-income older adults were assigned to a PA intervention (n = 6) or usual programming (n = 6) condition. PEP4PA included self-monitoring, health coaching, group walks, social support, and community advocacy to improve walking conditions. The primary outcome was daily minutes of MVPA (7-day accelerometer). Secondary outcomes included Perceived Quality of Life (PQoL), 6-Minute Walk Test (6-MWT), blood pressure (BP), and depressive symptoms at baseline, 6, 12, 18 and 24 months. Mixed effects regression models estimated the effects on outcomes between groups over time and included random effects for repeated measures and center clustering. Effect modification by sex and income status was assessed. We calculated the incremental cost per daily minute of MVPA gained in the intervention group relative to the control group to assess cost effectiveness. Results We enrolled 476 older adults (50 + years). Participants were on average 71 years old, 76% female, 60% low income, and 38% identified as racial or ethnic minorities. Compared to the control group, intervention participants sustained roughly a 10 min/day increase in MVPA from baseline at all time points and increased mean PQoL scores from unsatisfied at baseline to satisfied at 12, 18 and 24 months. Males and higher-income groups had greater improvements in MVPA. No significant effects were observed for 6-MWT or depressive symptoms, and BP results were mixed. The incremental cost per minute MVPA gained per person was $0.25, $0.09, $0.06, and $0.05 at 6, 12, 18 and 24 months, respectively. Conclusions PEP4PA achieved increases in MVPA and PQoL in low-income older adults, over 2 years of follow up. The peer-led, community-based intervention provides a sustainable and cost-effective model to improve health behaviors in underserved, aging populations. Trial registration ClinicalTrials.gov (NCT02405325) March 20, 2015. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01309-w.
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Affiliation(s)
- Katie Crist
- Department of Urban Studies & Planning, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
| | - Kelsie M Full
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S 2nd Street, Minneapolis, MN, 55415, USA
| | - Sarah Linke
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Fatima Tuz-Zahra
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Khalisa Bolling
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Brittany Lewars
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Chenyu Liu
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Yuyan Shi
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Dori Rosenberg
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, Seattle, WA, 98101, USA
| | - Marta Jankowska
- Population Sciences, Beckman Research Institute, City of Hope, 1500 E Duarte Rd, Duarte, CA, 91010, USA
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Loki Natarajan
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
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Fransen K, Cruwys T, Haslam C, Iserbyt P, Seghers J, Vanderlinden J, van Uffelen J, Verbaanderd E, Boen F. Leading the way together: a cluster randomised controlled trial of the 5R Shared Leadership Program in older adult walking groups. Int J Behav Nutr Phys Act 2022; 19:63. [PMID: 35658869 PMCID: PMC9166317 DOI: 10.1186/s12966-022-01297-x] [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: 09/15/2021] [Accepted: 05/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With a rapidly ageing society, healthy ageing has become a key challenge. Engagement in physical activity, and particularly walking, is a key strategy that contributes to healthy ageing amongst older adults. The purpose of the present study was to evaluate the efficacy of a group walking program for older adults that incorporates the 5R Shared Leadership Program (5RS). By implementing a structure of shared leadership and strengthening peer leaders' identity leadership, 5RS aims to cultivate a shared social identity amongst participants, which has in other contexts been associated with greater performance and well-being. METHODS A cluster randomised controlled trial was conducted to test the efficacy of the 5RS group walking program on group identification, group cohesion, walking activity, and well-being, compared to a regular group walking program for older adults. Nineteen older adult walking groups (i.e., the clusters; N = 503; Mage = 69.23 years, SD = 6.68) all participated in a 12-week structured group walking program. Nine walking groups (n = 304) were randomly assigned to the intervention in which participants received the 5RS program in addition to regular group walking. RESULTS 5RS was successful in strengthening the identity leadership qualities of the appointed peer leaders. Multilevel regressions showed that 5RS succeeded in increasing group cohesion and walking activity to a greater extent than a regular group walking program, while participants' group identification and well-being increased to a similar extent in both conditions. Furthermore, structural equation modelling revealed that group identification mediated the impact of peer leaders' identity leadership on group cohesion and well-being (but not walking activity). CONCLUSION By harnessing the capacity of the group and its peer leaders, the 5RS program offers a promising intervention to engage older adults in physical activity. TRIAL REGISTRATION The study was retrospectively registered as clinical trial on 9 September 2021 ( NCT05038423 ).
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Affiliation(s)
- Katrien Fransen
- Department of Movement Sciences, KU Leuven, Tervuursevest 101, box 1500, 3001, Leuven, Belgium.
| | - Tegan Cruwys
- Research School of Psychology, The Australian National University, Canberra, Australia
| | - Catherine Haslam
- School of Psychology, The University of Queensland, St. Lucia, Australia
| | - Peter Iserbyt
- Department of Movement Sciences, KU Leuven, Tervuursevest 101, box 1500, 3001, Leuven, Belgium
| | - Jan Seghers
- Department of Movement Sciences, KU Leuven, Tervuursevest 101, box 1500, 3001, Leuven, Belgium
| | - Julie Vanderlinden
- Department of Movement Sciences, KU Leuven, Tervuursevest 101, box 1500, 3001, Leuven, Belgium
| | - Jannique van Uffelen
- Department of Movement Sciences, KU Leuven, Tervuursevest 101, box 1500, 3001, Leuven, Belgium
| | - Elvire Verbaanderd
- Department of Movement Sciences, KU Leuven, Tervuursevest 101, box 1500, 3001, Leuven, Belgium
| | - Filip Boen
- Department of Movement Sciences, KU Leuven, Tervuursevest 101, box 1500, 3001, Leuven, Belgium
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Social Isolation in Older Adults: A Qualitative Study on the Social Dimensions of Group Outdoor Health Walks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095353. [PMID: 35564752 PMCID: PMC9103571 DOI: 10.3390/ijerph19095353] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/19/2022] [Accepted: 04/23/2022] [Indexed: 12/05/2022]
Abstract
Physical distancing practices during the COVID-19 global pandemic contributed to a high degree of social isolation among older adults. To reduce loneliness and other ill effects of social isolation, public health experts recommended outdoor social gathering, with physical distancing. Adopting a case study approach, we explored how social aspects of group outdoor health walks (GOHWs) mitigate social isolation for older adults and improve individual social wellbeing. We used semi-structured interviews to understand the experiences of social isolation and social relationships in nine older (50–80 s) adults participating in a GOHW in Scotland, United Kingdom (UK). Verbatim transcripts were analysed through an iterative process of thematic analysis carried out by an interdisciplinary team of qualitative researchers from environmental psychology, medicine, and geography. Themes provide insight into the social dimensions of GOHWs, the mediating effects of social experiences, and the contribution these make to individual social wellbeing. GOHWs provide opportunities to be part of a group and attend to the needs of inexperienced or physically challenged individuals. Being part of the group walk fosters casual interpersonal interactions through spontaneous mixing during and after the walk. This programmatic structure counters loneliness, engenders pleasurable anticipation of regular contact with others, supports physical activity, and fosters group cohesion. These in turn contribute to individual social wellbeing, including expanding social networks, meaningful relationships, a sense of belonging, and acting on empathy for others. GOWHs may be beneficial for mitigation of social isolation as we emerge from the COVID-19 pandemic. Findings were used to propose a conceptual model to parse social constructs and inform selection or development of quantitative social measures for future studies of nature-based interventions such as GOHWs.
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Lee RE, Joseph RP, Blackman Carr LT, Strayhorn SM, Faro JM, Lane H, Monroe C, Pekmezi D, Szeszulski J. Still striding toward social justice? Redirecting physical activity research in a post-COVID-19 world. Transl Behav Med 2021; 11:1205-1215. [PMID: 33822205 PMCID: PMC8083595 DOI: 10.1093/tbm/ibab026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 crisis and parallel Black Lives Matter movement have amplified longstanding systemic injustices among people of color (POC). POC have been differentially affected by COVID-19, reflecting the disproportionate burden of ongoing chronic health challenges associated with socioeconomic inequalities and unhealthy behaviors, including a lack of physical activity. Clear and well-established benefits link daily physical activity to health and well-being—physical, mental, and existential. Despite these benefits, POC face additional barriers to participation. Thus, increasing physical activity among POC requires additional considerations so that POC can receive the same opportunities to safely participate in physical activity as Americans who are White. Framed within the Ecologic Model of Physical Activity, this commentary briefly describes health disparities in COVID-19, physical activity, and chronic disease experienced by POC; outlines underlying putative mechanisms that connect these disparities; and offers potential solutions to reduce these disparities. As behavioral medicine leaders, we advocate that solutions must redirect the focus of behavioral research toward community-informed and systems solutions.
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Affiliation(s)
- Rebecca E Lee
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Rodney P Joseph
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Loneke T Blackman Carr
- Department of Nutritional Sciences, College of Agriculture, Health, and Natural Resources, University of Connecticut, Storrs, CT, USA
| | - Shaila Marie Strayhorn
- Institute of Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Jamie M Faro
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Hannah Lane
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Courtney Monroe
- Department of Health Promotion, Education, and Behavior, Technology Center to Promote Healthy Lifestyles, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Dorothy Pekmezi
- School of Public Health, Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jacob Szeszulski
- The University of Texas Health Science Center at Houston School of Public Health, Center for Health Promotion and Prevention Research, Michael & Susan Dell Center for Healthy Living, Houston, TX, USA
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P Rigby B, van der Graaf P, B Azevedo L, Hayes L, Gardner B, J Dodd-Reynolds C. Challenges, opportunities and solutions for local physical activity stakeholders: an implementation case study from a cross-sectoral physical activity network in Northeast England. BMC Public Health 2020; 20:1760. [PMID: 33228613 PMCID: PMC7686773 DOI: 10.1186/s12889-020-09847-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 11/05/2020] [Indexed: 11/17/2022] Open
Abstract
Background Increasingly, national policy initiatives and programmes have been developed to increase physical activity (PA). However, challenges in implementing and translating these policies into effective local-level programmes have persisted, and change in population PA levels has been small. This may be due to insufficient attention given to the implementation context, and the limited interactions between local policy-makers, practitioners and researchers. In this paper we use a case study of a cross-sectoral network in Northeast England, to identify the local-level challenges and opportunities for implementing PA policies and programmes, particularly the updated 2019 UK PA guidelines. Methods Five focus groups (n = 59) were conducted with practice partners, local policy-makers and researchers during an initial workshop in April 2018. Through facilitated discussion, participants considered regional priorities for research and practice, along with barriers to implementing this agenda and how these may be overcome. During a second workshop in December 2018, overarching findings from workshop one were fedback to a similar group of stakeholders, along with national policy-makers, to stimulate feedback from delegates on experiences that may support the implementation of the UK PA guidelines locally, focusing on specific considerations for research, evidence and knowledge exchange. Results In workshop one, three overarching themes were developed to capture local challenges and needs: (i) understanding complexity and context; (ii) addressing the knowledge and skills gap; and (iii) mismatched timescales and practices. In workshop two, participants’ implementation plans encompassed: (i) exploring a systems approach to implementation; (ii) adapting policy to context; and (iii) local prioritising. Conclusions Our findings suggest that academics, practitioners and policy-makers understand the complexities of implementing PA strategies, and the challenges of knowledge exchange. The updated UK PA guidelines policy presented an opportunity for multiple agencies to consider context-specific implementation and address enduring tensions between stakeholders. An organically derived implementation plan that prioritises PA, maps links to relevant local policies and supports a context-appropriate communication strategy, within local policy, practice and research networks, will help address these. We present 10 guiding principles to support transferable knowledge exchange activities within networks to facilitate implementation of national PA policy in local contexts. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-09847-3.
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Affiliation(s)
- Benjamin P Rigby
- Department of Sociology, Faculty of Social Sciences and Health, Durham University, 32 Old Elvet, Durham, DH1 3HN, UK. .,NINE Doctoral Training Partnership, C/O Faculty of Social Sciences and Health, Durham University, Arthur Holmes Building, Durham, DH1 3LE, UK. .,Wolfson Research Institute for Health and Wellbeing Physical Activity Special Interest Group, Durham University Queen's Campus, University Boulevard, Thornaby, Stockton-on-Tees, TS17 6BH, UK. .,Fuse: The Centre for Translational Research in Public Health, Newcastle University, Newcastle-upon Tyne, NE1 7RY, UK.
| | - Peter van der Graaf
- Fuse: The Centre for Translational Research in Public Health, Newcastle University, Newcastle-upon Tyne, NE1 7RY, UK.,Centre for Public Health Research, School of Health and Life Sciences, Teesside University, Southfield Road, Middlesbrough, TS1 3BX, UK
| | - Liane B Azevedo
- Department of Allied Health Professions, Sport and Exercise, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK
| | - Louise Hayes
- Fuse: The Centre for Translational Research in Public Health, Newcastle University, Newcastle-upon Tyne, NE1 7RY, UK.,Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson, Newcastle, NE2 4AX, UK
| | - Benjamin Gardner
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, London, SE5 8AF, UK
| | - Caroline J Dodd-Reynolds
- Wolfson Research Institute for Health and Wellbeing Physical Activity Special Interest Group, Durham University Queen's Campus, University Boulevard, Thornaby, Stockton-on-Tees, TS17 6BH, UK.,Fuse: The Centre for Translational Research in Public Health, Newcastle University, Newcastle-upon Tyne, NE1 7RY, UK.,Department of Sport and Exercise Sciences, Durham University, 42 Old Elvet, Durham, DH1 3HN, UK
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