Activity Programs For Older Adults Research Articles

"Pushed to Their Limits": Health Care Provider Perspectives on Barriers and Facilitators to Implementing a Mind-Body and Activity Program for Older Adults With Chronic Pain in a Community Clinic for the Underserved.

Older adults from underserved backgrounds experience chronic pain at a rate of 60% to 75%. Pharmacological treatments have limited efficacy and involve considerable risks. Mind-body interventions hold promise to improve pain outcomes but are typically not implemented in community clinics in which they are needed most, thus contributing to health disparities in chronic pain treatment. We conducted qualitative focus groups and interviews with 20 providers (eg, primary care doctors, nurses, administrators). We sought their perspectives on barriers and facilitators to implementing an evidence based mind-body activity program for older adults with chronic pain at an underserved community health clinic in Massachusetts. Subthemes were identified within 2 superordinate domains (barriers and facilitators) using a hybrid inductive-deductive thematic analysis approach following the Framework Method. Providers discussed facilitators (partner with clinic staff to facilitate referrals and buy-in, integrate referrals through the electronic medical record, offer groups in different languages, post and tailor advertisements) and barriers (limited staff bandwidth, scheduling challenges, inconsistent patient participation). These results will directly inform tailoring and subsequent effectiveness testing and implementation of the pain management program for older underserved adults with chronic pain in this community health care setting.

The Psychophysiological Relaxation Effects of Essential Oil Combined with Still-Life Painting Activities on Older Adults in Taiwan During the COVID-19 Pandemic.

Although the COVID-19 pandemic affected all types of people, older adults were disproportionately affected. Therefore, we developed an indoor program inspired by art and natural elements (plant essential oils [EOs]) intended to have a relaxing effect akin to a forest atmosphere to enhance psychophysiological health during this period. Thirty Taiwanese older adults (range, 59-79 years) participated in the study. We combined an art activity (still-life painting of vegetables) with the inhalation of Pseudotsuga menziesii and Lavandula angustifolia EOs during a 100-minute experiment. The study showed that physiological measures (heart rate, normalized low-frequency heart variability, the ratio of low- to high-frequency heart variability, high-beta waves, and gamma waves) decreased during the experiment; correspondingly, increased standard deviation of normal-to-normal intervals, normalized high-frequency heart variability, and high-alpha waves were observed, indicating relaxed physiological state. Subjective psychological assessments using the State-Trait Anxiety Inventory-State showed lower posttest scores, further supporting the relaxation effects. The psychophysiological data from this study provide important scientific evidence for the physical and mental health benefits of indoor nature-based activity programs for older adults, thereby improving their quality of life.

Effectiveness of Physical Activity Programs for Older Adults during COVID-19 across Districts with Different Healthcare Resource: A Case Study of Keelung City in Taiwan.

While past research has largely supported the importance of physical activity for the health of older adults, during the COVID-19 pandemic, older individuals may have reduced their opportunities and levels of physical activity to lower the risk of infection by minimizing outings or interactions with others. Additionally, the adequacy of medical resources in a region is often closely related to factors such as infrastructure and economic resources. Therefore, it is important to consider whether there are differences in health promotion among older adults living in areas with varying levels of medical resources. This study aimed to implement a physical activity program for older adults, selecting Keelung City, Taiwan, as the implementation area, and comparing the differences in implementation effectiveness among administrative districts with different levels of medical resources in the city. The study employed a two-way analysis of variance to examine the differences in the effectiveness of the physical activity program among administrative districts, where the average service population in medical institutions was higher or lower than the city average. The results revealed significant improvements in participants' right-hand grip strength and the number of sit-to-stand repetitions in the overall sample after the program intervention. Moreover, in administrative districts where the average service population in medical institutions was higher than the city average, participants showed greater improvement in grip strength, while in districts where it was lower than the city average, participants demonstrated greater improvement in sit-to-stand repetitions. Future research could draw upon these findings to design physical activity programs tailored to different regions with distinct allocations of medical resources. Tailored program designs considering local medical resources are necessary to optimize effectiveness. Governments and organizations should focus on elderly health, especially in resource-scarce areas, by increasing investment and support for these programs to promote well-being and bridge disparities.

Characteristics of peer-led physical activity programs for older adults: a scoping review

This scoping review investigates peer-led programs as a strategy to promote physical activity (PA) among older adults, addressing a gap in the literature concerning in-depth assessment of the characteristics, components, and effectiveness of such programs. Seven databases were searched for articles published in English, Portuguese, or Spanish on peer-led initiatives aimed at encouraging PA in older adults. A total of 53 studies were included, with a notable increase in publications since 2018, primarily focusing on randomized clinical trials involving participants of both sexes. The findings highlight that peer leaders typically have an average age of 65.2 years, with a minority having prior training in PA, although over half received specific training for leading PA programs. These programs, which predominantly span 1 to 4 months, often involve resistance exercises, walking, and flexibility/stretching/mobility activities, conducted in homes and community spaces. Despite the substantial number of studies utilizing peer-led approaches, a consistent lack of detailed reporting on the specific characteristics of peer leaders was observed, underscoring a need for more comprehensive documentation to enhance the understanding and implementation of these programs for older adults.

Examining the New-Member Effect to an Established Community-Based Physical Activity Program for Older Adults in England.

Community-based group physical activity programs promote exercise opportunities for older people. The aim of this study was to examine the short-term, new participant effect after joining Vitality, a community-based group physical activity program available in the East of England for older adults. Two independent groups of participants were assessed before and after an 8 week period: a group recruited from the 'Vitality' program (VP) (n 15, age: Age = 69.4 ± 6.4 y), and; a non-intervention control (CON) group (n 14, age: 64.5 ± 5.8 y). Assessment outcomes included basic physical health measures, a fitness test battery, and three psychological scales. The VP group recorded statistically significant improvements on the following outcomes: body mass (VP: -1.39 kg/CON: -0.2 kg), body mass index (VP: -1.5 kg/CON: -0.2 kg), 6 min walk (VP: +42.81 m/CON: -0.45 m), 30 s sit-to-stand (VP: -1.7 s/CON: -0.7 s), the chair sit-and-reach (VP: +3.12 cm/CON: +1.90 cm), and the 30 s arm curl test (VP: + 2 reps/CON: +0.9 reps). No significant differences were found with the other outcomes assessed. New members to the Vitality program achieved several physical and functional benefits without regression on any aspects of physical or psychological health.

Relaxing Effects of Breathing Pseudotsuga menziesii and Lavandula angustifolia Essential Oils on Psychophysiological Status in Older Adults.

We evaluated the effects of breathing Pseudotsuga menziesii (P. menziesii) and Lavandula angustifolia (L. angustifolia) essential oils (EOs) during a horticultural activity on older adults. A total number of 92 older adult (71.2 ± 7.7 years old) participants were guided through a leaf printing procedure. In the meantime, water vapor and EOs were diffused in an orderly manner. The heart rate variability-related parameters as well as the brain waves were recorded. In addition, we also collected data for the State-Trait Anxiety Inventory-State (STAI-S) questionnaires before and after the whole indoor natural activity program. The physiological parameters including standard deviation of normal to normal intervals, normalized high frequency (nHF), and high alpha wave increased while the normalized low frequency (nLF), the ratio of LF-to-HF power, high beta wave, and gamma wave decreased following the breathing of P. menziesii and L. angustifolia EOs. These changes indicated a relaxing effect of breathing both EOs during a horticultural activity on older adults. Our results demonstrated a beneficial effect of P. menziesii EO which is as good as a well-known relaxant L. angustifolia EO. This notion was supported by the results of STAI-S. Here we developed an indoor natural activity program for older adults to promote physical and mental health.

Mixed-methods evaluation of Daily Moves, a community-based physical activity program for older adults

BackgroundAlthough the health benefits of physical activity are well documented, most older adults are not sufficiently active. There is a need to explore approaches to physical activity promotion amongst older adults that meet the personal preferences and needs of participants, and that can be implemented on a large scale in community-based settings. The current study evaluates Daily Moves, a community-based physical activity program for older adults living in Adelaide, Australia. MethodsThe Daily Moves program, which ran almost entirely during the COVID-19 pandemic, provided participants with personalized plans and information about suitable physical activity promoting activities available in their local area. This study used an explanatory sequential mixed-methods approach to evaluate associations between participation in the Daily Moves program and physical activity engagement, physical function and psychosocial wellbeing, and to explore the experiences of Daily Moves participants through qualitative interviews, with a particular focus on the impact of the COVID-19 pandemic on program participation and enjoyment.ResultsThe research evaluation included 69 older adults (mean age at baseline = 73.9 ± 5.6 years; 19 male). Following Daily Moves, participants reported an increase in self-report physical activity levels (mean increase = 1.8 days, p < 0.001), improvements on several measures of physical function (left grip strength (mean increase = 1.8 kg, p < 0.001); right grip strength (mean increase = 1.3 kg, p = 0.03); Timed Up and Go (mean decrease = 1.3 s, p < 0.001)), and no significant changes in measures of psychosocial wellbeing. Qualitative interviews revealed that participants valued the supportive and flexible nature of Daily Moves, and that they felt connected with staff and other participants despite the onset of the pandemic.ConclusionsThis evaluation demonstrates that physical activity programs embedded within the community can provide flexible and tailored recommendations to participants, and that this approach can promote positive change in important indicators of health in older adults.

IMPACT OF WHOLE-BODY ELECTROMYOSTIMULATION AND RESISTANCE TRAINING ON BONE MINERAL DENSITY IN WOMEN AT RISK OF OSTEOPOROSIS

In recent years, there has been an increasing interest in physical activity programs for older adults. Questions have been raised about the efficacy of programs regarding real effects on life. The purpose of the study is to compare the impact of ten weeks of Whole-Body Electromyostimulation (WB-EMS) and resistance training (RT) programs on one mineral density (BMD) and T-score values in women at risk of osteoporosis. The WB-EMS was carried out once per week (total: ten sessions), the RT was carried out twice per week (total: 20 sessions). Twenty-eight elderly women participated in the study, nine in a WB-EMS group (weight: 69.84±10.29kg; BMI: 25.04±4.18 kg/m2), eight in a RT group (weight: 74.16±4.19kg; BMI: 27.35±2.76 kg/m2), and ten in a control group (CG) (weight: 79.72±15.61kg kg; BMI 28.58±5.70 kg/m2). A dual-energy X-ray absorptiometry scanner (DXA) was used to assess body composition, BMD, and T-score values. To identify the statistical significance of the differences between pre-test and post-test in all groups, the parametric t-test was used. Statistical significance was set at p ≤ 0.05. Although no significant differences were found in either BMD or T-score values, the study appeared to elicit some positive behaviour that could have an impact for more than ten weeks. The present study was designed to determine the effect of RT and WB-EMS on selected parameters in groups of women at risk of osteoporosis. Even though the results were not statistically significant, we consider the impact of programs on the level of BMD and T-score beneficial. Results show that the RT method is more practical. More tested subjects of the RT reported the same or higher level of BMD in the post-test compared to the WB-EMS method (RT 50% vs WB-EMS 44.7%). It was impossible to further investigate the significant relationships between selected parameters and intervention because the sample size was too small. Therefore, a further study with more focus on the duration of intervention and an increase in sample size is suggested.

Research-Driven Guidelines for Delivering Group Exercise Programs via Videoconferencing to Older Adults

Telehealth holds much potential for supporting older adults’ physical and social health. In particular, telewellness interventions to support the physical and social wellness of older adults are needed to overcome participation barriers with in-person programs. This paper presents guidelines for delivering telewellness interventions to older adults, which were informed by a human factors approach to developing a Tele Tai Chi intervention for older adults with mobility disabilities, including reviewing user needs literature and conducting user-centered needs assessment research. From these findings, we developed a protocol and support materials for delivering a telewellness intervention and conducted a feasibility study. We also established an adaptation committee to provide recommendations on the intervention. The outcome of our human factors approach was the establishment of research-driven design guidelines for delivering group exercise programs to older adults using videoconferencing. The guidelines provide direction for designing a telewellness protocol, supporting remote participation, and promoting socialization and engagement. These guidelines can be used to deliver interventions that increase access to socially-engaging, physical activity programs for older adults, which can ultimately help support their physical health, mental health, and quality of life.

Relationship Between Meaningful Activity Engagement and Well-Being Moderated by Race

Continuing adult education and training, or lifelong learning, has become increasingly important to fully engage in rapidly changing technology and information-rich societies. However, without motivation to learn (MtL), lifelong learning participation is unlikely to occur. Although previous research has identified lifelong learning gaps by various demographic characteristics, including age, gender, and race/ethnicity, little is known about the intersectionality or differences in MtL across specific sub-groups (e.g., older Black women vs. older Black men) at the national level. The current study analyzed U.S. data from the 2012/2014/2017 Program for International Assessment of Adult Competencies (PIAAC) to examine MtL at the intersections of age (five 10-year age groups), gender (women vs. men), and race (White vs. Black). The previously established 4-item latent MtL construct was evaluated for twenty sub-groups using the alignment optimization method, which is a machine learning algorithm for latent mean estimation and simultaneous multiple group comparisons. Results showed that the latent MtL construct was validly measured across the sub-groups, and the estimated sub-group means were then used to develop a national MtL profile. Overall, older adults tended to have lower MtL than younger age groups. Notably, compared to than older Black men age 66+ years, older White men aged 55-65 and 66+ years old had lower MtL (latent mean differences of -0.29 and -0.41, respectively, p < .05). Additionally, older Black women had significantly lower MtL than older Black men (latent mean difference = -0.50, p < .05). The national MtL profiles, the intersectionality and policy implications were discussed.

Relationship Between Meaningful Activity Engagement and Well-Being Moderated by Race

Engaging in meaningful activities has benefits for health and well-being in older adults; however, racial differences in meaning from activities have been observed. The current study examined how the relationship between engagement in a variety of meaningful activities and well-being differs for Black and White older adults. Participants (130 White and 101 Black older adults), ages 53 to 90 (M=69), completed an online survey that measured the extent to which engaging in various activities provided meaning or fulfillment as well as measures of purpose in life, positive affect, negative affect, and loneliness. Overall, the most meaningful activities included “spending time with family,” “reading,” and “being outdoors/experiencing nature.” The least meaningful activities included “job/career,” “caring for pets/animals,” and “supporting a social or political cause.” Black older adults reported greater meaning from “religious faith,” “spiritual practices/meditation,” “spending time with family,” and “listening to music,” and less meaning from “caring for pets/animals,” compared to White older adults. A series of multiple regression analyses (with age, gender, education, and income as covariates) revealed that greater meaning across activities was associated with lower loneliness, regardless of race. Significant Meaning x Race interactions revealed meaning was positively associated with sense of purpose and positive affect for Black but not White older adults. These findings suggest that finding meaning in leisure activities is a psychological resource that may contribute to Black older adults’ well-being. The racial differences in sources of meaning further support the importance of considering the target population when designing activity programs for older adults.

The Support Person's Preferences and Perspectives of Physical Activity Programs for Older Adults With Cognitive Impairment.

Objectives: Physical activity (PA) is beneficial for older adults' cognition. There is limited research investigating perspectives of support persons (SPs) of next-of-kins (NOKs) with cognitive impairment. This exploratory study aimed to investigate perspectives of SPs of older adults with Alzheimer's Dementia (AD) or Mild Cognitive Impairment (MCI).Methods: A telephone survey of 213 SPs of NOKs from the Australian Imaging, Biomarkers and Lifestyle Flagship Study of Ageing (AIBL) was undertaken to quantitatively assess SPs' beliefs and knowledge about PA benefits, current PA level of their NOK, and PA program preferences. The contribution of age, gender, diagnosis and mental health symptoms was assessed using multiple logistic regression analyses.Results: Many SPs were aware of PA benefits for memory (64%) and believed it would help their NOK (72%). Older SP age was associated with less awareness of benefits (p = 0.016). SPs caring for male NOKs were more likely to believe that PA would be helpful than those caring for female NOKs (p = 0.049). NOK AD diagnosis (rather than MCI) (p = 0.014), older age (p = 0.005) and female gender (p = 0.043) were associated with lower PA levels. SPs were mixed regarding preference for their NOKs to participate in individual (45%) or group (54%) PA. Many SPs wanted to participate in PA with their NOK (63%).Conclusions: The results highlight that SPs have high levels of awareness of the cognitive benefits of PA, and describe their preferences regarding PA programs. The findings provide new information to inform targeted public health messaging, PA prescribers and providers, and future research directions.

Feasibility Randomized Controlled Trial of a Mind-Body Activity Program for Older Adults With Chronic Pain and Cognitive Decline: The Virtual "Active Brains" Study.

Chronic pain (CP) and cognitive decline (CD) are highly comorbid and debilitating among older adults. We iteratively developed Active Brains-Fitbit (AB-F), a group mind-body activity program aided by a Fitbit that is feasible and associated with improvements in physical, cognitive, and emotional functioning when delivered in-person to older adults with CP and CD. We adapted our intervention and methodology for remote delivery to bypass barriers to participation. Here we report on a feasibility randomized controlled trial of the virtual AB-F versus a Health Enhancement Program (HEP) educational control followed by qualitative exit interviews. Older adults (aged ≥60) with CP and CD (2 cohorts) completed 8 weeks of AB-F (n = 8) or HEP (n = 11). Study procedures were fully remote via live video. Quantitative analyses explored feasibility and acceptability markers and within-group improvements in outcomes. Qualitative analyses were primarily deductive using the Framework Method. AB-F met a priori set feasibility benchmarks, similar to our in-person pilot. Participation in AB-F was associated with preliminary signals of improvement in multimodal physical function, emotional function (anxiety), cognitive function, pain intensity, and coping (e.g., pain self-efficacy, catastrophizing). Participation in HEP was associated with smaller or negligible improvements. Exit interviews confirmed feasibility and satisfaction with our completely remote interventions and methodology. Results provide evidence for the feasibility of our completely remote study and for initial markers of improvement after AB-F. The results will inform a fully powered remote efficacy trial. NCT04044183.

Experiences With Social Participation in Group Physical Activity Programs for Older Adults.

Little is known about how social participation can be facilitated among older adults in group physical activity and its psychosocial benefits that contribute to successful aging. This study aimed to understand older adults' experiences with social participation in group physical activity programs. Using interpretive description methodology, 16 observations, eight focus groups, and two interviews with participants unable to attend focus groups were conducted with adults 55 years and older attending programs across four recreation facilities. Group programs were found to influence social participation through (a)a meaningful context for connecting and (b)instructors' expectations of social interaction. Social participation in these programs addressed psychosocial needs by (c)increasing social contact and interaction, (d)fostering social relationships and belonging, and (e)promoting regular engagement. Training for instructors should include balancing the physical aspects of program delivery with the social, while also considering older adults' diverse needs and preferences for social interaction.

A Toolbox for Implementing Community-Based Physical Activity Programs for Older Adults and Adults With Disabilities

The article describes the role of rehabilitation professionals in promoting physical activity for older adults and older adults with disabilities, including tools for implementing evidence-based programs. Using the plethora of resources articulated in this article, therapists will be able to enhance their wellness, fitness, and physical activity programming in their practice. Two innovative programs in which a university collaborated with a local YMCA to provide physical activity programming and 2 clinic-based programs developed by rehabilitation professionals are described. Conducting needs assessments, measuring outcomes, and being aware of facilitators and barriers to program participation are critical to program success.

Study design and methods for the using exercise to relieve joint pain and improve AI adherence in older breast cancer survivors (REJOIN) trial

BackgroundAromatase Inhibitors (AIs) are recommended for survival in post-menopausal breast cancer survivors (BCS) with hormone-sensitive disease. AI Adherence is suboptimal, especially in older BCS. Joint pain is a common AI-related symptom that is associated with low AI adherence. The Using Exercise to Relieve Joint Pain in Older Breast Cancer Survivors (REJOIN) Trial will evaluate the efficacy of a self-management intervention (exercise + education) to increase knowledge/self-efficacy for symptom management, reduce joint pain and potentially increase AI adherence in older BCS planning to take AIs. MethodsThis randomized controlled pilot trial will include sedentary BCS, 65 years and older, diagnosed with stage I-III hormone-sensitive breast cancer, who have completed primary cancer treatment and are planning to initiate AIs. We will adapt an evidence-based physical activity program for older adults that includes bi-weekly, supervised exercise sessions plus 30 min of education. The 16-week intervention program includes: 8-weeks of supervised sessions plus 8-weeks of self-guided home sessions with periodic phone coaching. We will conduct geriatric assessments plus measurements of exercise, joint pain, and AI adherence (baseline, 4, 6 and 12 months). DiscussionREJOIN is one of the first trials to exclusively target older BCS using a self-management intervention, informed by geriatric assessment and exercise physiology, to improve health outcomes in survivorship. The REJOIN trial could lay the foundation for transdisciplinary research that bridges the gap between clinical and public health perspectives in healthy aging, with the opportunity to translate clinical interventions into non-pharmacological tools for a growing, yet underserved population of older survivors.Trial registration: NCT03955627

Changes In Dual-task Gait Speed Following A 10-week Golf Program In Older Adults

PURPOSE: To examine the change in dual-tasking ability during gait in response to a golf exercise program in healthy, older adults. BACKGROUND: The ability of older adults to perform dual-tasking during gait has been studied as a predictor of fall risk. Therefore, it is important to investigate exercise programs that not only improve fitness and balance in older adults, but also enhance the ability to dual-task. METHODS: Fifteen healthy, older adults without previous golf experience were enrolled in a golf program with fitness testing before and after the intervention. One participant had to drop out of the study due to a work-related injury at week 8. Dual-task performance was measured using a fast-gait task while counting backwards by threes on a ProtokineticsTM walking mat. Cognitive cost was determined by normalizing the dual-task responses to a seated counting task. Paired t tests were run to determine significance. Results are presented as mean±SD. Cohen’s d effect sizes were calculated and reported as small=0.2, medium=0.5, and large=0.8. RESULTS: Gait speed during the dual-task was significantly increased following the golf program with a large effect size (1.75±0.19m/s to 1.91±0.22m/s; p=0.007; d=0.85). This increase in gait speed coincided with increases in both average stride length (2.3%; p=0.061; d=0.55) and average cadence (5.8%; p=0.059; d=0.55). Cognitive dual cost did not change between pre and post testing but trended towards improving (40.94%; p=0.207; d=0.35). CONCLUSION: Golf is a unique, multimodal activity that has a beneficial impact on fitness in healthy, older adults. This study demonstrated that a golf program can improve the ability to perform dual tasking. Participants were able to increase their gait speed without compromising the amount of numbers they could recite correctly. The participants trended towards an improved correct response rate following the program as shown by the improvement in cognitive dual cost. Golf should be encouraged as a physical activity program for older adults. Supported by R&A Grant GHA0012017.

Comparison of the physical fitness levels in nursing home residents and community-dwelling older adults

PurposeThis study aimed to compare the physical fitness levels of nursing home residents and community-dwelling older adults. Materials and methodsThe 118 older adults aged between 65–85 living in a nursing home or community participated in the study. The Senior Fitness Test assessed the physical fitness levels of older adults. The older adults performed the chair stand test, arm curl test, 2-min step test, chair sit and reach test, back-scratch test, 8-foot up, and go test. ResultsThe age, cognitive status, gender, body weight, height, smoking, and education status were similar between the groups (p > 0.05). Aerobic endurance, balance, and agility were higher in nursing home residents than in the community-dwelling older adults (p < 0.05). Strength, flexibility, and BMI did not differ between groups ​​(p > 0.05). ConclusionAerobic endurance, balance, and agility may vary depending on the living environment of older adults. The determination of differences in physical fitness between community-dwelling older adults and nursing home residents could provide objective information to develop a physical activity program for older adults.

Impact of Home Quarantine on Physical Activity Among Older Adults Living at Home During the COVID-19 Pandemic: Qualitative Interview Study.

BackgroundOlder adults and those with pre-existing medical conditions are at risk of death from severe acute respiratory syndrome coronavirus 2 (SARS CoV-2). In this period of quarantine, one of the reasons for going out is physical activity. This issue is important, as the impact of a sedentary lifestyle might be lower for children and young adults, but is far more severe for older adults. Although older adults need to stay at home because they have a higher risk of coronavirus disease (COVID-19), they need to avoid a sedentary lifestyle. Physical activity is important for older adults, especially to maintain their level of independence, mental health, and well-being. Maintaining mobility in old age is necessary, as it may predict loss of independence in older adults.ObjectiveOur first objective was to evaluate the impact of this quarantine period on physical activity programs and on the physical and mental health of older adults. Our second objective was to discuss alternatives to physical activity programs that could be suggested for this population to avoid a sedentary lifestyle.MethodsWe conducted a qualitative survey using semistructured interviews with professionals (managers in charge of physical activity programs for older adults and sports trainers who run these physical activity programs) from the French Federation of Physical Education and Voluntary Gymnastics (FFPEVG) and older adults participating in a physical activity program of the FFPEVG. We followed a common interview guide. For analysis, we carried out a thematic analysis of the interviews.ResultsThis study suggests that the COVID-19 epidemic has affected, before quarantine measures, the number of seniors attending group physical activity programs in the two study territories. In addition, despite the decline in their participation in group physical activities before the quarantine, older adults expressed the need to perform physical activity at home. There is a need to help older adults integrate simple and safe ways to stay physically active in a limited space. A national policy to support older adults for physical activity at home appears essential in this context.ConclusionsGiven the results of our study, it seems necessary to globally communicate how important it is for older adults to maintain physical activity at home. We are concerned about the level of independence and mental health state of older adults after the end of quarantine if there is no appropriate campaign to promote physical activity among them at home.

Social-ecological correlates of older adults’ outdoor activity patterns

IntroductionAn understanding of outdoor activity patterns of older adults may help in the development of more tailored physical activity programs for enhancing higher physical activity levels and more effective environmental interventions. This study aimed to identify patterns of outdoor activity of older adults, and to examine their relationships with physical activity levels and correlates of these patterns. MethodsBased on data collected among 363 respondents aged 60 or older in Dalian, China, a two-step cluster analysis approach was adopted to identify outdoor activity patterns; one-way analysis of variance and chi-square tests were performed to examine differences in physical activity levels across activity patterns; and a multinomial logistic regression model was estimated to examine the socio-ecological correlates of each activity pattern. ResultsThe study identified five distinct activity patterns, namely: 1) utilitarian activity pattern; 2) low frequency/short duration leisure-time physical activity pattern; 3) sedentary activity pattern; 4) long duration leisure-time physical activity pattern; and 5) high frequency leisure-time physical activity pattern. The type of activity pattern was associated with older adults' physical activity levels. Older adults’ patterns of outdoor activity participation were associated with their age, gender, education level, physical ability and household type. In addition, neighborhood characteristics such as accessibility to local shops, safety from crime, social capital and social cohesion were also significantly associated with outdoor activity patterns. ConclusionsThe findings can help health professionals to develop tailored physical activity programs for older adults with certain socio-demographic characteristics and urban planners to design suitable environmental interventions supporting the habitual activity pattern of specific subgroups of older adults.