Community Physical Activity Programs Research Articles

Living with COPD and its psychological effects on participating in community-based physical activity in Brazil: a qualitative study. Findings from the Breathe Well group

Physical activity (PA) improves dyspnoea, psychological wellbeing and quality of life (QoL) for people with COPD reducing their risk of exacerbation. However, engagement in PA is low especially amongst those with anxiety and depression, and PA programmes are limited in countries with limited resources such as Brazil. We explored perceptions of 21 people with COPD about the impact of their disease on taking part in community-based PA programmes in Sao Paulo, Brazil through semi-structured telephone interviews from October 2020 to April 2021. Discussions were audio-recorded, transcribed, and analysed using the Framework method. Five themes were identified: Knowledge about COPD and its management; Self-perception of life with COPD; Knowledge and experiences of depression and anxiety; Opinions on PA and repercussions of COVID-19. PA was considered to be important in bringing physical and mental health benefits but there were barriers in accessibility of formal PR programmes and therefore local community PA programmes were considered to be important. People with mental health conditions tended to view PA more negatively. COVID-19 had reduced PA opportunities, access to COPD treatment and social interaction, and was associated with more exacerbations and emotional suffering. In general, this study showed an urgent need to improve knowledge about COPD and its risk factors and management among both patients, the public and primary healthcare professionals. We provide important content for the formulation of public policies for the implementation of specific activity programmes for people with COPD in community spaces using local resources and intersectoral partnerships.

Move for Life an intervention for inactive adults aged 50 years and older: a cluster randomised feasibility trial.

Move for Life (MFL) is a theory-informed intervention that was developed to augment established physical activity (PA) programmes and enable inactive adults aged 50 years and older to be more active. This study examined the feasibility of MFL and sought to provide evidence of its potential for improving PA and associated health outcomes. A 3-arm cluster randomised feasibility trial compared MFL intervention, usual provision (UP) and control (CON) groups at baseline (T0), post-intervention (T1, at 8, 10 or 12- weeks) and 6-month follow up (T2). We used purposive sampling strategies to recruit participants according to characteristics of interest. Feasibility outcomes assessed recruitment, fidelity, adherence, retention and data completion rates based on pre-set criteria. Primary outcomes were accelerometer-based moderate-to-vigorous intensity PA (MVPA) and self-reported compliance with physical activity guidelines (PAGL). Secondary outcomes included light intensity PA (LiPA), standing time, sedentary time, body composition (adiposity), physical function and psychological well-being. We used linear mixed models (continuous outcomes) or generalized estimated equations (categorical outcomes) to estimate group differences over time in the study outcomes. Progression criteria for feasibility outcomes were met, and 733 individuals were recruited. Considering a 6-month period (T0-T2), while self-reported compliance with PAGL increased in MFL relative to UP and CON and in UP relative to CON, standing time decreased in MFL relative to CON and sedentary time increased in the latter compared to UP. Waist circumference decreased in MFL relative to UP and CON. MFL outperformed UP in the Timed Up and Go Test while MFL and UP increased the distance covered in the Six-Minute Walk Test compared to CON. Psychological well-being increased in MFL relative to CON (all p < 0.05). Findings show that MFL is feasible, while data are promising with regards to the potential of improving community PA programmes for adults aged 50 or more years. https://www.isrctn.com/Registration#ISRCTN11235176.

“We’re all in the same boat”: The role of group physical activity in community (re) development following a natural disaster

ABSTRACT After the 2018 Camp Fire decimated the town of Paradise, California, a group physical activity (PA) program was developed to support the community. The PARADISEU program (Physical Activity Reduces Anxiety and Depression Increases the Stress Response and Energizes You) was based on evidence that participating in PA has the potential to positively impact mental health. The current study explored the potential of PA programs to assist in individual and community growth and (re)development efforts following a natural disaster using a qualitative case-study method. Fourteen participants in the community PA program were interviewed. From their experiences, four themes emerged: benefits of physical exercise, a sense of place, social connection, and importance of leadership in the group PA classes for creating community. A composite vignette shares participants’ experiences surrounding these themes. This study provides valuable information for future community development in post-disaster recovery scenarios.

Sustained Effectiveness of the Walk Across Texas Program: A Follow-up Study

Objectives: In this study, we used a follow-up assessment to determine the sustained effectiveness of Walk Across Texas, a web-based community physical activity program. Methods: We recruited a sample of adult participants (N=291) who completed program assessments across 3 time periods (pre-, post-, follow-up) in 2018. We assessed changes in self-reported physical activity (days/week). Statistical analysis incorporated paired-samples t-tests, repeated measures ANOVA, and an assessment of participants' overall physical activity changes during the program and follow-up. Results: Overall, there were statistically significant differences (p &lt; .05) between self-reported physical activity pre-program (4.12 ± 2.10), post-program (5.06 ± 2.04), and at follow-up (4.40 ± 1.98). Notably, a defined Low Active pre-program activity group significantly increased from pre- (1.21 ± 0.87) to post-program (4.29 ± 2.06). Despite a decrease from post-program to follow-up (3.06 ± 1.86; δ = -1.24 days), the difference remained higher and statistically significant from pre-program. Further analysis explored limitations associated with estimating one's physical activity change in behavior. Conclusions: The results support the sustained effectiveness of the Walk Across Texas program. Overall, participants showed increased and maintained physical activity for up to 150 days from pre-program.

Willingness-to-pay in physical activity: how much older adults value the community-wide initiatives programs?

Previous studies have shown insufficient physical activity (PA) as a significant global health concern and a major risk factor for non-communicable diseases (NCDs). Community-wide initiatives in physical activity (CWIPA) is considered as a best-buy for Community-wide initiatives in physical activity (CWIPA) is considered as a best-buy for NCDs prevention. However, assessment regarding resource allocation and cost-effectiveness of existing programs is lacking. This study investigated local residents' willingness-to-pay (WTP) for community PA programs in Southern Thailand. The contingent valuation method (CVM) using the payment card approach was employed to elicit the WTP of 472 residents aged 45 years and over in selected provinces in which community PA programs had been implemented. Respondents were asked to indicate their WTP for the continuous offering of free CWIPA by choosing how much they were willing to pay from eight bid-value options, payable through their monthly electricity bill. The mean WTP of Thai older adults was found to be 72 baht/month ($2/month) or 868 baht/year ($25/year). This indicated the maximum amount an older person was willing to pay for any community-based PA program. More than half the sample (54.2%) chose zero as their answer, while there was a fairly large variation in other levels of WTP. The WTP was lower among older respondents and those who resided in rural areas but was higher among those with a history of participation in an organized PA program. The level of WTP can be interpreted as an indicator of community satisfaction with CWIPA. That finding can be used as evidence for the government and policy makers in allocating resources and designing future CWIPA. A variety of organized PA programs should be offered to all community members to ensure inclusivity and also to provide equal access for senior citizens.

Participation and Youth Sport Coaching Good Practice - An Overview and Reflection of the Active Sussex Coach Support Officers Scheme

Summary In order to meet a wide variety of social policy objectives (such as health, educational attainment, community cohesion etc.), ensuring wide access to community and youth sport programmes remains an objective of many governments. In the UK, the post 2012 Olympic Legacy Strategy, overseen by Active Partnerships under the auspices of Sport England, promoted Sportivate and Satellite Clubs programmes (aimed at increasing participation levels) through most of the rest of the decade. In order to ensure minimum standards of operation and to develop the skills of the local coaching workforce, Active Sussex (one of the Active Partnerships) commenced a Coach Support Officer (CSO) scheme with the support of the University of Chichester from 2013 to (through various iterations) time of writing. Through a longitudinal reflection/summary of the various interventions and data collection points over the last nine years, we present an overview of this scheme. Further, we outline a clear philosophy, guidelines, and accompanying set of values that extol what can be considered good (best) practice for sustainable community sport and physical activity programmes.

Meta-evaluation of studies on community physical activity programs in Brazil.

The use of the meta-evaluation, especially in health promotion programs, is still scarce. To verify if the evaluation studies conducted about the Academia da Cidade Programme and the Academia da Saúde Programme comply with the principles and standards of the meta-evaluation. This meta-evaluation study was conducted using articles from scientific databases. The parameters of utility, propriety, and accuracy, as defined by the Joint Committee on Standards for Educational Evaluation, and specificity, were applied. The classification of the studies was based on the Stufflebeam's checklist. Of the 18 selected articles, the principle of utility was fully met in 50%, given that 27.8% were classified as very good, 5.6% as good, and 16.7% as fair. The principle of propriety mostly received the result of very good (44.4%), followed by excellent (38.9%), good (11.15), and weak (5.6%). The principle of accuracy was classified as excellent in 44.4% of the studies, considering that in 33.3% it was considered very good; 11.1% good, and 11.1% fair. Specificity was classified as very good in 94.4% of the studies. The physical activity community programs evaluations were carried out in accordance to the principles and standards of meta-evaluation tenets. Most studies were classified as excellent regarding the principle of utility and accuracy, or very good as for the principle of propriety and specificity.

Motivation for Brazilian Older Adult Women to Join a Community Physical Activity Program Before COVID-19 Pandemic

Background: Intrinsic and extrinsic motivational factors can affect the levels of adherence of physical activity (PA) during the aging process. Objectives: Investigate the intrinsic and extrinsic aspects and motivation that led older women to enroll in and adhere to a community PA program before the COVID-19 pandemic. Methods: Data were collected via transversal survey before the COVID-19 pandemic. The sample consisted of 21 women, participants of a PA workshop, aged between 60 to 86 years [&lt; 1-year (n = 8) and ≥ 1-year (n = 13) groups]. Motivation was assessed by the Motivation Inventory for Regular Physical Activity Practice (IMPRAF-54), using the 60th percentile to categorize high and low motivation, and two open questions. For qualitative assessment, content analysis was used and the answers were framed into subcategories regarding the motivation factors for adherence and permanence. Results: That adherence to the program was motivated by sociability purposes [total score: 36.0 (6.0), median (interquartile range)] and pleasure [34.0; (6.0)], while the main motivation for permanence was health [40.0 (11.0)]. Differences were noticed between the groups for sociability [38.0 (3.0) P = 0.030] and competitiveness [9.50 (12.0); P = 0.037] highest medians for the &lt; 1 year group. Furthermore, the factors that least motivated older women were competitiveness and aesthetics. Conclusions: Health and sociability were the main motivators for the practice of physical activity among older adult women. Motivation played a fundamental role in the permanence of older adult women in the physical activity program.

Factors That Influence Walking Intervention Adherence for Older Adults Living in Retirement Communities.

Walking interventions improve health outcomes among older adults. However, few clinical trials evaluate long-term behavior change adherence. The authors explored factors that influence walking adherence in older adults following their participation in a clinical trial. They conducted n = 7 focus groups with n = 23 participants enrolled in the parent study (ClinicalTrials.gov number: NCT03654807). The authors used content analysis to code data according to the social-ecological model. They found that supportive services (exercise classes) in retirement communities have multilevel impacts on adherence to walking activity. Residents from communities offering services continued walking because of increased confidence gained in the parent trial, while residents in communities without services were motivated by their functional improvements. Residents voiced frustration with retirement community physical activity programs that did not address the full spectrum of physical functioning. Findings support the need for retirement communities to account for various motivational factors in tailoring programs to promote increased physical activity for older adults.

Motivation for Brazilian Older Adult Women to Join a Community Physical Activity Program Before COVID-19 Pandemic

Background: Intrinsic and extrinsic motivational factors can affect the levels of adherence of physical activity (PA) during the aging process. Objectives: Investigate the intrinsic and extrinsic aspects and motivation that led older women to enroll in and adhere to a community PA program before the COVID-19 pandemic. Methods: Data were collected via transversal survey before the COVID-19 pandemic. The sample consisted of 21 women, participants of a PA workshop, aged between 60 to 86 years [&lt; 1-year (n = 8) and ≥ 1-year (n = 13) groups]. Motivation was assessed by the Motivation Inventory for Regular Physical Activity Practice (IMPRAF-54), using the 60th percentile to categorize high and low motivation, and two open questions. For qualitative assessment, content analysis was used and the answers were framed into subcategories regarding the motivation factors for adherence and permanence. Results: That adherence to the program was motivated by sociability purposes [total score: 36.0 (6.0), median (interquartile range)] and pleasure [34.0; (6.0)], while the main motivation for permanence was health [40.0 (11.0)]. Differences were noticed between the groups for sociability [38.0 (3.0) P = 0.030] and competitiveness [9.50 (12.0); P = 0.037] highest medians for the &lt; 1 year group. Furthermore, the factors that least motivated older women were competitiveness and aesthetics. Conclusions: Health and sociability were the main motivators for the practice of physical activity among older adult women. Motivation played a fundamental role in the permanence of older adult women in the physical activity program.

An Evolving Model of Best Practice in a Community Physical Activity Program: A Case Study of "Active Herts".

Community-based physical activity programs typically evolve to respond to local conditions and feedback from stakeholders. Process evaluations are essential for capturing how programs are implemented, yet often fail to capture delivery evolution over time, meaning missed opportunities for capturing lessons learned. This research paper reports on a staged approach to a process evaluation undertaken within a community-based UK 12-month physical activity program that aimed to capture change and adaptation to program implementation. Twenty-five one-to-one interviews and 12 focus groups took place over the 3years of program delivery. Participants included program participants, management, and service deliverers. Program adaptations that were captured through the ongoing process evaluation included changes to the design of promotional material, program delivery content, ongoing training in behavior change, and the addition of regular participant community events. The authors address how these strands evolved over program delivery, and how the process evaluation was able to capture them. The pragmatic evaluation approach enabled changes in response to the local context, as well as improvements in the program to be captured in a timely manner, allowing the delivery to be responsive and the evaluation flexible.

Exercise Is Medicine On Campus At Michigan Tech: Promoting Physical Activity During The Covid-19 Pandemic

During the COVID-19 pandemic, physical activity levels have decreased by ~30% and sitting time has increased by ~30%. Recent call to actions by the ACSM and Physiological Society have urged widespread promotion and implementation of physical activity to keep communities healthy. PURPOSE: To leverage Exercise is Medicine on Campus (EIM-OC) and promote healthy living behaviors in our rural community during the pandemic. Specifically, we aimed to: 1) assess current levels of physical activity in the community, 2) increase public awareness about staying physically active during the pandemic and 3) offer a community physical activity program. METHODS: A team of kinesiology and biology students (n = 10) led our EIM-OC initiative. Levels of physical activity in the community were assessed through an online survey. Public awareness about physical activity was promoted through an infographic, virtual town hall, and discussion with health care providers. A 10-wk physical activity program was delivered through ZOOM and social media and included live workouts (3x/wk) consisting of home-based activities (e.g., aerobic exercise, resistance exercise using common household items, yoga). RESULTS: Twenty-nine adults (51 ± 17 yrs, 28 ± 6BMI) completed the survey. Majority of adults (72%) reported they were less physically active during the pandemic and 45% indicated that they had been encouraged by a health professional to remain active. Our message of staying physically active during the pandemic was communicated through website, email, radio, newspaper, social media, and state health department. More than 35 guided workouts (30-60 min) were delivered to healthy adults and those with reduced mobility. The physical activity program was also expanded to create a University-wide physical education course (50 students, 1 credit). CONCLUSIONS: Adults in our rural community reported they were moving less and not well informed about the importance of physically activity during the pandemic. As local health departments are currently overburdened with managing COVID-19, it is imperative for exercise specialists to help facilitate and communicate the importance of physical activity. EIM-OC provided a robust platform for us to deliver critical physical activity resources and keep our community active during the COVID-19 pandemic.

Longer-term effects of supervised physical activity on obstructive sleep apnea and subsequent health consequences.

Although recent trials have shown promising benefits of exercise on obstructive sleep apnea (OSA) severity, the long-term effect of these interventions remains unknown. The aim of this study was to assess the effect of a 9-month community physical activity program on OSA severity one year later in free-living conditions. OSA patients, previously included in a 9-month randomized controlled trial (EXESAS study) evaluating the effects of supervised community physical activity on OSA severity, were invited to participate in an extra one-year observational study. Twenty-eight patients completed the study. Although OSA severity did not significantly worsen over the real-life period (9 to 21months of follow-up), reductions in apnea-hypopnea index (AHI) and oxygen desaturation index were no longer significant after 21months of follow-up compared to baseline (baseline AHI: 22.2±6.3 /h; 9months: 16.3±6.4 /h; 21months: 18.7±8.9 /h). Benefits observed at 9months on daytime sleepiness and mental health were preserved at 21months, whereas cardiorespiratory fitness slightly decreased. Per-protocol analysis revealed that patients who stopped exercise at 9months had worsened OSA severity compared to those who continued exercise during the real-life period (AHI: +9.0±8.8 vs. -1.3±5.3 /h; p<.01). In conclusion, our study suggested that improvements in OSA severity remain transient and is dependent on long-term adherence to regular physical activity practice.

A Qualitative Exploration of Factors Influencing Physical Activity Behaviour for Individuals with Parkinson's Disease Using the Social Ecological Model

Physical activity (PA) can benefit individuals with Parkinson’s disease (PD), however, many individuals tend to be sedentary. This qualitative study explored factors influencing PA behaviour for individuals with PD using the social ecological model. Twelve individuals with PD took part in semi-structured interviews. Data were thematically analysed. Results suggest that individuals with PD experience several constraining and facilitating factors to PA behaviour. Intrapersonal constraints revolved around uncertainties that PA is beneficial for individuals with PD, a lack of interest in available PA programs, and disease-specific issues whereas intrapersonal facilitators included prior experiences of enjoyment in PA, seeing improvements, and wanting to maintain independence. Interpersonal constraints related to lacking social support and perceived stigma whereas interpersonal facilitators were, passionate PA program staff, and being active with similar others. Environmental constraints pertained to PA programs failing to adapt program activities, lack of time, and transportation accommodations, whereas environmental facilitators were exposure to non-traditional PA programs, access to resources on PA, and accessibility to community PA programs. Findings highlight the need to address factors influencing PA behaviour for individuals with PD.

Evaluation of community physical activity programs in Brazil: a scoping review.

Community physical activity programs were created to encourage and increase the practice of physical activity in the Brazilian population and promote healthy life habits. The Brazilian Ministry of Health invested in the evaluation of these programs and consolidated partnerships that favor the development of relevant evidence on the topic. The current study aimed to identify and summarize the scientific highlights on the approaches and results of evaluations performed in the Health Academy Program and City Academy Program. This is a scoping review based on the methodology of the Joanna Briggs Institute. We used the MEDLINE via PubMed, LILACS, Scopus, and Cochrane databases, the website of the Health Academy Program, the Catalogue of Theses and Dissertations of the Brazilian Graduate Studies Coordinating Board, and the Brazilian Digital Library of Theses and Dissertations. The sample included quantitative or qualitative primary studies with no limit on year of publication. Twenty-four studies published from 2009 to 2020 were selected and subdivided according to the approaches to evaluation: evaluability, sustainability, process (supply and structure), outcome (impact and satisfaction), and degree of inference (adequacy, plausibility, and probability). The results of the evaluations showed that the programs offer various activities, positively impact users' health indicators, and contribute to the increase in leisure-time physical activity. The evaluation of these programs is essential for the administration, health services, and healthcare workers, since it allows verifying the implementation of the proposed activities, coverage, access, impact, and interference by the political context in their continuity.

Do Paediatric Physiotherapists Promote Community-Based Physical Activity for Children and Youth with Disabilities? A Mixed-Methods Study.

Purpose: Although the importance of increased physical activity for children with disabilities is widely acknowledged, formal links between rehabilitation practitioners and community physical activity programmes are often lacking. The role of physiotherapists in the promotion of community physical activity is also often unclear. This study set out to describe the beliefs, knowledge, and practices of Canadian physiotherapists related to promoting community-based physical activity for children with disabilities. Method: We used a mixed-methods design: a survey of Canadian physiotherapists and qualitative focus group interviews with physiotherapists. Results: A total of 116 therapists participated in the survey. Of these, 80 (69.0%) considered the promotion of community-based physical activity programmes to be a physiotherapy role, and 89 (76.7%) recommended programmes to families. Therapists with less than 6 years of paediatric experience were less likely to recommend programmes to families (χ2 4 = 40.46, p < 0.001). Qualitative analysis resulted in three themes: (1) lack of clarity regarding the physiotherapy role, (2) "it's not easy" - challenges related to community-based physical activity promotion, and (3) one size does not fit all. Conclusions: Various factors shaped physiotherapists' ability to promote community physical activity, specifically their knowledge, practice setting expectations, and beliefs about their role. Concerted efforts to promote community-based physical activity may increase community capacity to support all children in physical activities.

Literature on peer-based community physical activity programmes for mental health service users: a scoping review

ABSTRACT Physical activity is a key determinant of mental health; community programmes aim to increase health and well-being on a community wide scale with emphasis on social interaction. Regular physical activity participation in community settings yields additional social benefits, such as peer support. This scoping review aimed to explore existing literature that has included peer support as a component of community-based physical activity programmes for MHSU. Published literature was examined using electronic databases (SportDiscus, Web of Science, MEDLINE, and PsycINFO), reference lists, and hand searching of journals. Thirteen eligible articles included; adults aged 18 and over, a peer support component, physical activity and/or sport, participants with mental health diagnoses and were community-based. Research published between 2007 and 2019, peer-reviewed and written in English was included. Nine studies found a significant increase in perceived social support, seven studies reported increased mental wellbeing and five studies reported increased physical activity levels. Effectiveness of reviewed programmes were categorised as; overall improvements in physical activity levels, improvements to mental health, exercise related psychosocial benefits, knowledge relating to self-care, and improved social connections. Community-based physical activity programmes produced psychosocial benefits and positive behaviour change for MHSU, warranting greater focus towards implementing effective peer support into community programmes.

Evaluation of Walk Across Texas! \u2013 a web-based community physical activity program

BackgroundIn response to the chronic disease burden, web- and community-based programs have the potential to address targeted behaviors, such as physical activity (PA), using a novel approach with large audiences. The purpose of this study was to preliminarily evaluate an established team centered, web-based community PA program in Texas.MethodsWalk Across Texas! (WAT!) is an eight-week community program delivered through a web-based platform to help people of various ages and abilities establish the habit of regular PA. Teams are challenged to walk a minimum of 832 miles. Changes in self-reported PA (miles/week; days/week) and leisure-time sitting (hours/day) were examined from 11,116 adult participants who participated in the program in 2016. Further analysis determined changes in physical activity (miles/week) between groups of pre-program assessment self-reported physical activity levels (0, 1–2, 3–4, or 5–7 days/week). Statistical analysis included paired-sample t-tests, repeated measures ANOVA and participant descriptors for PA change.ResultsOverall, mean changes in PA in all variables were statistically significant (p < .001), with the largest, clinically significant changes in submitted miles/week (mean increase of 4.89 ± 20.92). Self-reported PA increased 0.63 ± 2.89 days/week, while leisure-time sitting decreased less than 1 h per day (0.87 ± 1.86 h/day). All sub-groups (inactive, low active, active, high active at pre-program assessment) increased in self-reported miles per week, on average. Both the inactive and low-active groups experienced a statistically significant increase in mileage from week 1 to week 8 (5.48 miles/week or 12,330 steps /week, and 3.91 miles/week or 8797 steps /week, respectively).ConclusionsThe results provide initial support for the effectiveness of WAT! to initially increase and maintain moderate levels of PA of participants over 8-weeks, even in inactive or low-active participants. Descriptor variables were unable to differentiate between those who increased PA and those who did not. However; the results provide a canvas for future research questions regarding PA enhancement within a team-centered, web-based approach.

Older women’s patterns of home and community care use and transition to residential aged care: An Australian cohort study

ObjectiveTo examine whether patterns of home and community care (HACC) use and person-based characteristics were associated with time to enter permanent residential aged care (RAC). Study designA prospective cohort study. The sample consisted of 8062 participants of the Australian Longitudinal Study on Women’s Health who used HACC services between 2001 and 2014. Main outcome measuresTime from first HACC use to enter permanent RAC. The median follow-up time was 63 months. Factors associated with time to enter RAC were identified using competing risk regression models. ResultsOf the 8062 participants, 60% belonged to the ‘basic HACC’ group, who used few services minimally; 16% belonged to the ‘moderate HACC’ group, who predominantly used domestic assistance with moderate use of other services; and 24% belonged to the ‘complex HACC’ group, who used many services frequently. Being a member of the complex HACC group was associated with a lower cumulative incidence of RAC than basic or moderate HACC (chances 15% versus 30% by the median observation period, p < 0.01). Living in a remote/outer region (sub-distributional hazard ratio (sdHR) = 0.83, 95%CI: 0.74 – 0.93) was associated with delayed admission to RAC. Meanwhile, earlier admission was associated with living in an apartment (sdHR = 1.29, 95%CI: 1.20–1.40) or a retirement village (sdHR = 1.54, 95%CI = 1.38–1.72), having a physical functioning score <40 (sdHR = 1.16, 95%CI = 1.05–1.25), and falls with injury (sdHR = 1.15, 95%CI = 1.05–1.25). ConclusionsOur findings highlight the importance of providing more community care services, age-friendly housing, falls prevention and physical activity programs to reduce inappropriate admission to RAC.

A mixed-methods evaluation of a community physical activity program for breast cancer survivors

BackgroundGiven the benefits of physical activity for health and survival, clinicians are seeking opportunities for cancer patients to become more active independent of rehabilitation programs that are small, time-limited, and location specific. This proof-of-concept study evaluated a community-based physical activity program (Curves™) for increasing physical activity among women diagnosed and treated for breast cancer.MethodsWomen were recruited from a breast cancer clinic through physician chart review. In study 1, women (n = 14) received the community physical activity memberships (Curves™), guidelines, and a pedometer. This group was compared to women (n = 16) who received physical activity guidelines and a pedometer on changes in physical activity. In study 2, women (n = 66) completed self-report questionnaires after Curves™ memberships expired to evaluate the program. Study 3 was a qualitative study exploring the benefits and barriers of the physical activity program among women (n = 6) who attended Curves™ regularly.ResultsProvision of memberships to a community-based physical activity program did not improve physical activity levels beyond educational and information resources. However, there are a number of advantages to community-based physical activity programs, and the women offer a number of suggestions for improvements for community physical activity opportunities aimed at breast cancer survivors.ConclusionsWomen-only community-based physical activity programs may be a viable option to help introduce women to get active after treatment.Trial registration ISRCTN, ISRCTN14747810. Registered on 18 October 2017—Retrospectively registered, https://doi.org/10.1186/ISRCTN14747810