Abstract
BackgroundThe Lifestyle-integrated Functional Exercise (LiFE) programme is a fall prevention programme originally taught in a resource-intensive one-to-one format with limited feasibility for large-scale implementation. The aim of this paper is to present the conceptual framework and initial feasibility evaluation of a group-based LiFE (gLiFE) format developed for large-scale implementation.MethodsThe conceptual gLiFE framework (part I) is based on three pillars, LiFE Activities and Principles, Theory of Behaviour Change and Behaviour Change Techniques, and Instruction. The feasibility of gLiFE was tested (part II) within a multimodal approach including quantitative questionnaires measuring safety, acceptability (1 = best to 7 = insufficient), and adherence to the LiFE activities (range = 0–14) as well as a focus group interview. Exploratory self-reported measures on behaviour change including self-determined motivation (range = 1–5), intention, planning, action control, and habit strength (range = 1–6) were assessed pre and post intervention. Data analyses were performed using descriptive statistics and qualitative content analysis.ResultsThe development process resulted in a manualised gLiFE concept containing standardised information on gLiFE’s content and structure. Feasibility testing: Six older adults (median = 72.8 years, 5 female) completed the feasibility study and rated safety (median = 7.0, IQR = 0.3) and acceptability as high (median = 1, IQR = 1). Participants implemented 9.5 LiFE activities (IQR = 4.0) into their daily routines. No adverse events occurred during the study. In the focus group, the group format and LiFE activities were perceived as positive and important for maintaining strength and balance capacity. Self-determined motivation intention, planning, and habit strength were rated higher post intervention.ConclusionThe developed conceptual gLiFE framework represents the basis for a gLiFE format with potential for standardised large-scale implementation. Proof-of-concept could be demonstrated in a group of community-dwelling older adults at risk of falling. The public health potential of gLiFE in terms of (cost-)effectiveness is currently being evaluated in a large trial.Trial registrationClinicalTrials.gov NCT03412123. Registered on January 26, 2018
Highlights
Since falls display a major health risk factor in our ageing society [1,2,3], there is a strong need for increasing accessibility to effective fall prevention programmes
Lifestyleintegrated training was developed as an alternative approach in order to increase long-term adherence through embedding functional exercises into daily life, that is, daily routines are enriched with small low-intensity bouts of activity with the aim to create new activity habits [12,13,14]
Part II: feasibility testing A feasibility study (ClinicalTrials.gov, NCT03412123) was conducted to test the proof-of-concept of group-based Lifestyleintegrated Functional Exercise (LiFE) (gLiFE). This included an evaluation of the three pillars of the gLiFE concept, i.e., the LiFE activities, a prepost assessment of psychological components related to behaviour change and gLiFE’s instruction
Summary
Since falls display a major health risk factor in our ageing society [1,2,3], there is a strong need for increasing accessibility to effective fall prevention programmes. Lifestyleintegrated training was developed as an alternative approach in order to increase long-term adherence through embedding functional exercises into daily life, that is, daily routines are enriched with small low-intensity bouts of activity with the aim to create new activity habits [12,13,14]. The Lifestyleintegrated Functional Exercise (LiFE) fall prevention programme by Clemson et al [16] recorded greater adherence rates compared to a traditional, structured training. The Lifestyle-integrated Functional Exercise (LiFE) programme is a fall prevention programme originally taught in a resource-intensive one-to-one format with limited feasibility for large-scale implementation. The aim of this paper is to present the conceptual framework and initial feasibility evaluation of a group-based LiFE (gLiFE) format developed for large-scale implementation
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