Enabling quality, sustainable physical activity change in older adults – a study of barriers, facilitators and interventions

Background In the recent census (2016) the 65+ age group saw the greatest increase, rising by 19.1% (Central Statistics Office, 2016). The Irish Longitudinal Study on Ageing (TILDA) found that 34% of older adults in Ireland report low levels of physical activity (Donoghue, 2016). Methodology This study sought to identify barriers and facilitators to PA for older adults (Phase I) in a convenience, sample (n=300) of community dwelling older adults. These were stratified by age, urban and rural location, gender, and physical activity (PA) level (high, medium or low / inactive). They completed a questionnaire in May 2015 which was based on social ecological theory. Following consultation with stakeholders in various settings, a series of interventions were developed and implemented in Phase II. Pre and Post questionnaires were administered (March 2016) to those who took part in the interventions (n=45). Analysis of interventions was conducted using the REAIM framework (Glasgow, 1999). Additionally, qualitative interviews were conducted with stakeholders (n=5) to further examine enablers and barriers to implementation. Results Phase I found the majority of older adults were not sufficiently active (69%) nor sufficiently aware of PA guidelines (61%). Knowing the guidelines is a facilitator to PA. The main barriers to PA were poor knowledge of PA guidelines, antipathy towards gym, perceived high cost of PA and lack of basic walking programmes. In Phase II Reach (programme uptake) was low. It varied between 0.085% to 0.2% in urban areas and from 3.9% to 8% in rural areas. In total, 65 participants took part across 5 selected settings. The interventions increased PA frequency from 3.09 days per week (SD 1.72) pre intervention to 3.36 days (SD 1.5) post intervention. Muscle strengthening activities increased significantly from 1.33 days per week pre intervention to 1.88 days per week post (p=.001). The interventions had mixed success but all stakeholders indicated a willingness to continue the programmes. Conclusion Reach could be improved by specific targeting of older adults. Important success factors for implementation of older adult programmes should include capacity building (audit of staff and facilities, appropriate instructor training, buy in from key management personnel in the settings. Sustainability of programmes can be achieved by the availability of sustainable funding which allows for long term implementation of programmes.