Re-thinking Physical Activity Programs for Older Brazilians and the Role of Public Health Centers: A Randomized Controlled Trial Using the RE-AIM Model

Barriers and Facilitators to Participation in Vigorous Lifestyle Physical Activity in Adults Aged 55-75 Years: A Scoping Review

Despite the well-known benefits of physical activity, less than half of adults aged 55-75 years participate in sufficient physical activity. Short bouts of vigorous intermittent lifestyle physical activity (VILPA) accumulated throughout the day can contribute toward the recommended volume of physical activity. A rich characterization of the barriers and facilitators to participation in VILPA is needed to develop targeted interventions. This scoping review aimed to identify barriers and facilitators to participation in different components of VILPA in adults aged 55-75 years, and to map barriers and facilitators to the Theoretical Domains Framework. Within the 18 eligible studies, the most prevalent barriers were related to a person's skills, environmental context, and social influences. Most facilitators were related to a person's goals, social influences, and environmental context. Interventions to promote VILPA should test the effectiveness of behavioral change measures related to the unique barriers and facilitators in this age group.

Implementing regular physical activity for older individuals in the family strategy program using the RE-AIM framework to ensure feasibility and sustainability: EISI study protocol

The EISI study protocol aims to address the low participation rate in physical exercise programs among older individuals, emphasizing its significance as a non-pharmacological therapeutic approach for overall health and increased physical activity. The objectives include implementing physical activity (PA) and educational health programs in Jequié, Bahia, Brazil, targeting the Family Health Strategy population to enhance local physical activity levels among older individuals. The study also seeks to evaluate the program's feasibility, safety, and sustainability for large-scale implementation, along with assessing its impact on immune and inflammatory response biomarkers to the SARS-CoV virus, as well as physical-functional and brain health. Participants, aged 60 or above, will be divided into two groups: multicomponent exercise (MCE) and behavioral change interventions (BCI). The study employs a mixed-method approach, utilizing a non-randomized controlled short-term pathway model for a 4-8 weeks of pilot study and 16-week intervention impact assessment. Data collection encompasses various aspects such as sociodemographic information, mental health, physical fitness, fall risk, functional capacity, anthropometric measurements, hemodynamic assessment, habitual physical activity, and health-related quality of life. Blood and saliva samples are collected for cytokine and antibody biomarker analysis related to SARS-CoV immunity. Pre- and post-intervention evaluations for both groups will be conducted, with the hypothesis that MCE will yield more favorable responses compared to BCI. The study's holistic approach, including the assessment of feasibility, safety, and sustainability, aims to contribute to achieving Sustainable Development Goals (SDG) 3 and SDG 9 b y promoting accessible and sustainable healthcare initiatives for older individuals. This research aligns with global efforts to enhance health and well-being, emphasizing the importance of regular exercise in the aging population.

Multicomponent Physical Program: Effects on Physical Fitness of Older Women of Different Age Groups

Purpose: Experimental studies investigating the outcomes of physical exercise among age-stratified groups of older women are still incipient. This study aimed to investigate the effects of a ten-month multicomponent physical program on the physical fitness of older women in three age-stratified groups (60-69 years, 70-79 years, and ≥80 years). Method: Participants (n = 141) were divided into three age groups: GR1 60-69 years (n = 45; 65.2 ± 2.3 years); GR2 70-79 years (n = 67; 72.9 ± 2.9 years), GR3 ≥80 years (n = 29; 83.5 ± 4.5 years). The participants performed the multicomponent physical program and were evaluated before and after the intervention with Senior Fitness Test. Data were analyzed using generalized estimating equations, Bonferroni test (p ≤.05) and effect size (Cohen's d). Results: For the group factor, there were significant differences in lower limb strength (p = .003), upper limb strength (p < .001), upper limb flexibility (p < .001), balance/agility (p < .001), and cardiorespiratory fitness (p < .001). For the time factor, significant differences were observed in lower limb strength (GR2, p = .014, small effect size), upper limb strength (GR1, p = .003; GR2, p < .001; GR3, p = .017; small effect sizes), lower limb flexibility (GR1, p = .025, non-significant effect size), cardiorespiratory fitness (GR1, p < .001, medium effect size; GR2, p = .002; small effect size). Conclusion: Physical fitness improved with training, but effects differed between age groups. Positive effects were observed for GR1 and GR2, whereas GR3 showed maintenance of physical fitness. Aging interferes more strongly in women aged 80 years and older and it is necessary for specific training programs for this age group.                                                      .

Systematic review of process evaluations of interventions in trials investigating sedentary behaviour in adults

OBJECTIVES

To systematically review and synthesise findings from process evaluations of interventions in trials which measured sedentary behaviour as an outcome in adults to explore: (1) how intervention content, implementation, mechanisms of impact and context influence outcomes and (2) how these interventions are experienced from different perspectives (participants, carers, staff).

DESIGN

Systematic review and narrative synthesis underpinned by the Medical Research Council process evaluation framework.

DATA SOURCES

Databases searches were conducted in March 2019 then updated in May 2020 and October 2021 in: CINAHL, SPORTDiscus, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, AMED; EMBASE, PsycINFO, MEDLINE, Web of Science and ProQuest Dissertations & Theses.

ELIGIBILITY CRITERIA

We included: Process evaluations of trials including interventions where sedentary behaviour was measured as an outcome in adults aged 16 or over from clinical or non-clinical populations. We excluded studies if interventions were delivered in educational or workplace settings, or if they were laboratory studies focused on immediate effects of breaking sitting.

DATA EXTRACTION AND SYNTHESIS

Two independent reviewers extracted and coded data into a framework and assessed the quality of studies using the Mixed Methods Appraisal Tool. We synthesised findings using a narrative approach.

RESULTS

17 process evaluations were included. Five interventions focused on reducing sedentary behaviour or sitting time, 12 aimed to increase physical activity or promote healthier lifestyles. Process evaluations indicated changes in sedentary behaviour outcomes were shaped by numerous factors including: barriers (eg, staffing difficulties and scheduling problems) and facilitators (eg, allowing for flexibility) to intervention delivery; contextual factors (eg, usual lifestyle and religious events) and individual factors (eg, pain, tiredness, illness, age and individual preferences).

DISCUSSION

Intervention requires careful consideration of different factors that could influence changes in sedentary behaviour outcomes to ensure that interventions can be tailored to suit different individuals and groups.

PROSPERO REGISTRATION NUMBER

CRD42018087403.

Balance, physical conditioning, and health perception in elderly women submitted to a 32-week physical exercise program

Study aim: To assess the effects of a long-term physical exercise program on balance, physical conditioning, and health perception in elderly women.

Material and methods: The sample, 143 elderly women, were randomly assigned to an experimental group (EG; n = 71; age: 71.62 ± 4.96 years) and control group (CG; n = 72; age: 72.89 ± 5.40 years). The EG was submitted to a 32-week physical exercise program (3×/week, 60 min/session). Balance and physical conditioning were assessed through the 10-step in a straight-line test, the unipedal balance test (UBT), the timed up and go (TUG) test, and the 30-second chair stand test (30s CST). Health perception was evaluated by a questionnaire.

Results: Repeated measures ANOVA (2×3) revealed significant improvements (p < 0.05) in TUG and 30s CST in the EG from the pre- to the post-test and when compared to the CG in the post-test. There were significant increases (p < 0.05) in health perception, 10-step test, and UBT in the EG, and significant improvements (p < 0.05) in these EG variables when compared to the CG in the post-test.

Conclusions: Participating in the exercise program resulted in improvements in balance, muscle strength, agility, and health perception in the elderly of the present study.

Perceived Neighborhood and Walking Among Older Brazilian Adults Living in Urban Areas: A National Study (ELSI-Brazil)

The study goal was to examine the association between perceived neighborhood characteristics and walking in urban older adults in Brazil. A cross-sectional study including 4,027 older adults from the baseline of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) was performed. Walking was measured using the International Physical Activity Questionnaire. Neighborhood characteristics were questions about physical disorder, noise pollution, safety, violence, social cohesion, services, concerns with community mobility, and pleasantness. Multinomial logistic regression was used. Concern about taking the bus, subway, or train was inversely associated with walking for men. Violence (victim of theft, robbery, or had home broken into) and social cohesion (trust in neighbors) were positively and inversely associated with walking for women, respectively. A significant interaction term between social cohesion and number of chronic diseases was observed for women. These findings demonstrate the need for sex-specific interventions and policies to increase the walking levels among older Brazilian adults.