Center Users Research Articles

The relative importance of servicescape in fitness center for facility improvement

The purpose of study was to examine the relative importance of servicescape, identify the optimal combination, and predict the market share in fitness centers. We conducted a conjoint analysis on users of fitness centers located in Seoul. As a primary result, it was found that the spatial layout, particularly ‘sufficient exercise space’, was considered most important. Secondly, cleanliness, specifically ‘well-maintained fitness equipment’, was deemed important following spatial layout. Next, users emphasized the importance of ambient conditions, especially ‘well-managed heating, ventilation, and air-conditioning’. However, aesthetics, specifically ‘Attractive interior design’, was not considered as significant compared to other attributes. The optimal combination of servicescape was identified to be ‘sufficient exercise space, well-maintained fitness equipment, and an attractive interior design within a well-managed heating, ventilation, and air conditioning’. Finally, the combination of ‘sufficient exercise space, attractive interior design, well-managed heating, ventilation and air-conditioning, and well-maintained fitness equipment’ was associated with the highest market share. From an academic perspective, this study holds significance in reaffirming the meaning and impact of servicescape on consumers. Additionally, it provides practical implications that assist in determining the direction for sustainable facility improvement and management of the fitness center.

어린이집 급식 서비스품질이 학부모의 급식만족도, 보육만족도 및 구전의도에 미치는 영향

This study investigates the impact of food service quality in childcare centers on food service satisfaction, childcare satisfaction, and word-of-mouth intentions in South Korea's low birth rate issue, thereby emphasizing the importance of meal services in childcare centers. The meal service quality scale developed through this research comprises food quality, service quality, hygiene quality, and meal education quality, demonstrating significance in content validity, construct validity, and reliability. The main findings indicate that all aspects of meal service quality positively affect meal satisfaction, with meal education quality having the most significant impact. However, only service and hygiene quality significantly influence childcare satisfaction, while meal education quality, excluding other factors, does not significantly affect word-of-mouth intentions. This study provides academic and practical contributions to improving meal service quality in childcare centers, offering significant insights for developing strategies to enhance meal services. Furthermore, it represents a meaningful attempt to systematically analyze how meal service quality affects childcare center users' satisfaction and word-of-mouth intentions, highlighting its importance in the field.

Head Protection Device for Individuals at Risk for Head Injury due to Ground-Level Falls: Single Trauma Center User Experience Investigation.

Falls represent a large percentage of hospitalized patients with trauma as they may result in head injuries. Brain injury from ground-level falls (GLFs) in patients is common and has substantial mortality. As fall prevention initiatives have been inconclusive, we changed our strategy to injury prevention. We identified a head protection device (HPD) with impact-resistant technology, which meets head impact criteria sustained in a GLF. HPDs such as helmets are ubiquitous in preventing head injuries in sports and industrial activities; yet, they have not been studied for daily activities. We investigated the usability of a novel HPD on patients with head injury in acute care and home contexts to predict future compliance. A total of 26 individuals who sustained head injuries, wore an HPD in the hospital, while ambulatory and were evaluated at baseline and 2 months post discharge. Clinical and demographic data were collected; a usability survey captured HPD domains. This user experience design revealed patient perceptions, satisfaction, and compliance. Nonparametric tests were used for intragroup comparisons (Wilcoxon signed rank test). Differences between categorical variables including sex, race, and age (age group 1: 55-77 years; age group 2: 78+ years) and compliance were tested using the chi-square test. Of the 26 patients enrolled, 12 (46%) were female, 18 (69%) were on anticoagulants, and 25 (96%) were admitted with a head injury due to a GLF. The median age was 77 (IQR 55-92) years. After 2 months, 22 (85%) wore the device with 0 falls and no GLF hospital readmissions. Usability assessment with 26 patients revealed positive scores for the HPD post discharge regarding satisfaction (mean 4.8, SD 0.89), usability (mean 4.23, SD 0.86), effectiveness (mean 4.69, SD 0.54), and relevance (mean 4.12, SD 1.10). Nonparametric tests showed positive results with no significant differences between 2 observations. One issue emerged in the domain of aesthetics; post discharge, 8 (30%) patients had a concern about device weight. Analysis showed differences in patient compliance regarding age (χ12=4.27; P=.04) but not sex (χ12=1.58; P=.23) or race (χ12=0.75; P=.60). Age group 1 was more likely to wear the device for normal daily activities. Patients most often wore the device ambulating, and protection was identified as the primary benefit. The HPD intervention is likely to have reasonably high compliance in a population at risk for GLFs as it was considered usable, protective, and relevant. The feasibility and wearability of the device in patients who are at risk for GLFs will inform future directions, which includes a multicenter study to evaluate device compliance and effectiveness. Our work will guide other institutions in pursuing technologies and interventions that are effective in mitigating injury in the event of a fall in this high-risk population.

Trends and types of dietary supplement usage amongst people visiting fitness centers in the Northern Border Region of Saudi Arabia

Purpose: To determine the trends in dietary supplement (DS) usage and its socio-demographic determinants amongst fitness centre users in Arar, Saudi Arabia. 
 Methods: This cross-sectional survey was conducted among people visiting different fitness centers in Arar, Saudi Arabia, between December 2022 and March 2023. The sample comprised 150 people (male and female) aged ≥ 18 years, who completed a self-administered questionnaire. 
 Results: More than half (63.3 %) of the gym users regularly used DS, while the rest used DS occasionally. Young age (p < 0.001), female gender (p = 0.04), higher educational level (p = 0.006), single status (p = 0.001) and schooling (p < 0.001) had significant positive correlations with regular DS use, relative to occasional use. The most important reason for using DS was recommendation by physician (30.7 %), while the most common supplements used were multivitamins (alone or in combination with other drugs; 39.3 %). The participants were well-versed in the supportive role of DS, as well as the risks and adverse effects related to DS overuse. 
 Conclusion: The prevalence of DS usage is high among Saudi fitness center attendees, and it was significantly associated with socio-demographic and lifestyle variables. Furthermore, there are high levels of awareness among participants regarding the benefits and negative effects of DS.

Development of a multidisciplinary medication management program in nursing homes: protocol for a randomized controlled trial

BackgroundPolypharmacy and the use of potentially inappropriate medications are common among nursing home residents and are associated with negative outcomes. Although deprescribing has been proposed as a way to curtail these problems, the best way to implement multidisciplinary comprehensive medication review and deprescribing and its real impact in specific high-risk populations, such as nursing home residents, is still unclear. This multicenter randomized controlled clinical trial aims to assess the effects of a multidisciplinary mediation management program on medication use and health problems.MethodsA total of 1,672 residents aged ≥ 65 years from 22 nursing homes in South Korea who meet the targeted criteria, such as the use of ≥ 10 medications, are eligible to participate. The experimental group will receive a comprehensive medication review, deprescription, and multidisciplinary case conference with the help of platform. Outcomes will be measured at baseline, at the end of the intervention, as well as at 3, 6, 9, and 12 months after the end of the intervention. The primary endpoints will be the rate of adverse drug events, number of potentially inappropriate medications/potentially inappropriate medication users/two or more central nervous system drug/ central nervous system drug users, delirium, emergency department visits, hospitalization, and falls. The secondary endpoint will be the number of medications taken and polypharmacy users.DiscussionOur trial design is unique in that it aims to introduce a structured operationalized clinical program focused on reducing polypharmacy and potentially inappropriate medications in a nursing home setting with large samples.Trial registrationEthical approval was granted by the public institutional review board of the Ministry of Health and Welfare (2022-1092-009). The study is also registered with the Clinical Research Information Service (Identifier: KCT0008157, Development and evaluation of a multidisciplinary medication management program in long-term care facility residents Status: Approved First Submitted Date: 2023/01/18 Registered Date: 2023/02/03 Last Updated Date: 2023/01/18 (nih.go.kr) https://cris.nih.go.kr/), which includes all items from the World Health Organization Trial Registration Dataset.

A real-time field bus architecture for multi-smart-motor servo system

The multi-motor servo system (MMSS) is an electro-mechanical system widely used in various fields, including electric vehicles, robotics, and industrial machinery. Depending on the application, the number of motors in the system can range from several dozens to tens of thousands, which imposes additional communication demands. Thus, ensuring synchronization and control precision of the system requires addressing the challenge of guaranteeing the performance and reliability of communication among motors in the MMSS. In this paper, we design a smart servo motor (SSM) to upgrade the system to the multi-smart-motor servo system (MSMSS) based on a distributed real-time field bus architecture, namely, Multi-Motor Bus (MMB) architecture. The proposed MMB architecture is lightweight and stable, providing real-time support for Control Area Network connections to a central user computer and inter-integrated circuit connections to SSM units. This MMB architecture facilitates the synchronization of command transmission across SSMs and ensures the consistency of motors in the MSMSS. Additionally, a serial experiments to examine 3 key system performance and reliability characteristics are conducted, including command transmission time, transmission jitters, and rotation consistency. The analysis of these characteristics demonstrates the system’s potential and feasibility to be applicable in industry.

Perceived experts are prevalent and influential within an antivaccine community on Twitter.

Perceived experts (i.e. medical professionals and biomedical scientists) are trusted sources of medical information who are especially effective at encouraging vaccine uptake. The role of perceived experts acting as potential antivaccine influencers has not been characterized systematically. We describe the prevalence and importance of antivaccine perceived experts by constructing a coengagement network of 7,720 accounts based on a Twitter data set containing over 4.2 million posts from April 2021. The coengagement network primarily broke into two large communities that differed in their stance toward COVID-19 vaccines, and misinformation was predominantly shared by the antivaccine community. Perceived experts had a sizable presence across the coengagement network, including within the antivaccine community where they were 9.8% of individual, English-language users. Perceived experts within the antivaccine community shared low-quality (misinformation) sources at similar rates and academic sources at higher rates compared to perceived nonexperts in that community. Perceived experts occupied important network positions as central antivaccine users and bridges between the antivaccine and provaccine communities. Using propensity score matching, we found that perceived expertise brought an influence boost, as perceived experts were significantly more likely to receive likes and retweets in both the antivaccine and provaccine communities. There was no significant difference in the magnitude of the influence boost for perceived experts between the two communities. Social media platforms, scientific communications, and biomedical organizations may focus on more systemic interventions to reduce the impact of perceived experts in spreading antivaccine misinformation.

Best sum-throughput evaluation of cooperative downlink transmission nonorthogonal multiple access system

In cooperative simultaneous wireless information and power transfer (SWIPT) nonorthogonal multiple access (NOMA) downlink situations, the current research investigates the total throughput of users in center and edge of cell. We focus on creating ways to solve these problems because the fair transmission rate of users located in cell edge and outage performance are significant hurdles at NOMA schemes. To enhance the functionality of cell-edge users, we examine a two-user NOMA scheme whereby the cell-center user functions as a SWIPT relay using power splitting (PS) with a multiple-input single-output. We calculated the probability of an outage for both center and edge cell users, using closed-form approximation formulas and evaluate the system efficacy. The usability of cell edge users is maximized by downlink transmission NOMA (CDT-NOMA) employing a SWIPT relay that employs PS. The suggested approach calculates the ideal value of the PS coefficient to optimize the sum throughput. Compared to the noncooperative and single-input single-output NOMA systems, the best SWIPT-NOMA system provides the cell-edge user with a significant throughput gain. Applying SWIPT-based relaying transmission has no impact on the framework’s overall throughput.

Cloud technology and capsule endoscopy: A single-center users' experience of remote online video analysis and reporting.

Background and study aims Telemedicine has progressed significantly in recent years, with newer, more integrated information technology systems improving healthcare delivery. The development of the world's first cloud-based capsule platform could allow safe and timely virtual analysis of videos from a network of linked hospital centers. We aimed to assess the efficacy of Medtronic's PillCam Remote Reader System. Methods PillCam remote reader technical data were collected from the capsule endoscopy (CE) database over 8 months. User-reported performance was collect using an online survey. Outcomes included overall procedure success, video-upload/report-download rates and speeds, encryption/decryption rates, and user/reader satisfaction. Results Data from 377 studies encompassing seven different readers was collected (318 small bowel capsules, 59 colon capsules). Overall procedure success was 100% (all videos reported). Two upload delays occurred (< 24 hours). There were no encryption/decryption errors. Seven of seven respondents felt it easy to access and use vs one of seve for the old system. Six of seven respondents felt department efficiency increased. Benefits included off-site reading and multisite-conferences. Issues included offsite difficulty accessing other hospital systems. Conclusions PillCam remote reader is a reliable, secure, and effective capsule analysis platform and should be incorporated into any CE service development plan.

Priority populations’ experiences of the accessibility and inclusion of recreation centres: a qualitative study

BackgroundAlthough the health benefits of physical activity are well documented, certain priority populations are often disproportionately insufficiently active and at higher risk of poor health. Recreation centres have the potential to provide accessible and supportive environments for physical activity for all. However, little is known about priority populations’ experiences of these venues and their views of how accessibility and inclusion can be optimised. This study aimed to gain in-depth insights of recreation centre experiences and potential strategies for improving inclusion and accessibility amongst priority populations (women, older adults, ethnic minorities, persons living with disabilities/additional needs, individuals identifying as LGBTQIA+, low socio-economic position).MethodsThis qualitative study (2021–2022) involved 18 semi-structured individual interviews with adult priority population users of recreation centres (50% 65 + years, 61.2% female) in one Melbourne municipality. Participants were asked to discuss their positive and negative experiences at the centres and to identify strategies for enhancing accessibility and inclusion. Interviews were audio-recorded and transcribed verbatim. Content analysis was performed for data analysis.ResultsWhile many participants had positive views of the facilities and programs at the centres, as they met their needs, they also had suggestions for improving accessibility and inclusion. Similarly, most participants were happy with the communications, felt included, and perceived the culture positively. Those who did not feel included at the centres offered many potential strategies for changing the culture, modifying communications (e.g., signage), and establishing partnerships for better access and inclusion.ConclusionsThe present study adds to essential knowledge concerning priority populations’ experiences of recreation centres. For recreation facilities that were generally perceived as having positive inclusion and accessibility, the findings nonetheless highlighted suggestions for further enhancement. These strategies may be useful more broadly for improving accessibility and inclusion, thereby promoting physical activity and ultimately health for all.

Wireless Patient Monitoring System Based on Smart Wristbands and Central user Interface Software.

In this article, a patient monitoring system is proposed that is able to obtain heart rate and oxygen saturation (SpO2) levels of patients, identify abnormal conditions, and inform emergency status to the nurses. The proposed monitoring system consists of smart patient wristbands, smart nurse wristbands, central monitoring user interface (UI) software, and a wireless communication network. In the proposed monitoring system, a unique smart wristband is dedicated to each of the patients and nurses. To measure heart rate and SpO2 level, a pulse oximeter sensor is used in the patient wristbands. The output of this sensor is transferred to the wristband's microcontroller where heart rate and SpO2 are calculated through advanced signal processing algorithms. Then, the calculated values are transmitted to central UI software through a wireless network. In the UI software, received values are compared with their normal values and a predefined message is sent to the nurses' wristband if an abnormal condition is identified. Whenever this message is received by a nurse's wristband, an acoustic alarm with vibration is generated to inform an emergency status to the nurse. By doing so, health services are delivered to the patients more quickly and as a result, the probability of the patient recovery is increased effectively.

Right-Wing Twitter Users in France Exhibit Growing Homophily Compared With Left and Center Users

The purpose of this research is to enhance our understanding of homophilic behaviors—where individuals prefer to associate with others like themselves—on Twitter, particularly focusing on how these behaviors vary across different political affiliations. While a general increase in homophily is a well-documented phenomenon in social networks, its expression within the diverse political contexts on Twitter remains underexplored. This study seeks to understand how political alignment influences homophily and its possible role in reinforcing extreme viewpoints. In particular, the research examines the patterns of interaction within political communities on French Twitter, delineating between right-wing, left-wing, and centrist groups. The findings reveal a significant pattern: right-wing groups demonstrate a marked increase in homophily over time, suggesting a stronger predilection for in-group interaction when compared with their centrist and left-wing counterparts. In addition, the study monitors the evolution of follower networks among these political clusters, providing insights into the shifting popularity of political parties within each group. By analyzing the social connections within these clusters, the study offers a detailed perspective on the dynamics of political homophily on Twitter and how it evolves, informing our understanding of political communication and group behavior in the digital age.

Lawyer-client relationship in divorce proceedings: development and validation of a new instrument.

This study is based on the paradigm of collaborative law and the current absence of instruments that evaluate the lawyer-client relationship as a function of the needs of the family system. The objective was to construct and validate an instrument, conceptualizing the lawyer-client relationship as a helping relationship. Two groups of experts and 239 parents (58% mothers and 42% fathers), users of Family Visitation Centers, participated in the study. The content, construct, and criterion validity of the instrument, as well as its invariance for both parents, were analyzed. The resulting 12-item instrument has been shown to have a two-dimensional structure, invariant for both parents, with high psychometric solidity. The LCR scale seems to be a valuable and effective measure for use in a legal context, with important correlations with the parents' psychological well-being, leading to a promising and relevant instrument for the holistic approach to the divorce process.

Desarrollo validación y evaluación de la prueba de conocimientos sobre reanimación cardiopulmonar y uso correcto del desfibrilador externo automático en Asunción 2023

Introduction: in out-of-hospital cardiac arrest, early and efficient intervention through cardiopulmonary resuscitation (CPR) maneuvers and the use of the automated external defibrillator (AED) are the cornerstone for survival. Instruments that improve education would increase the responsiveness of lay personnel. Objectives: to develop, validate and evaluate a knowledge test on cardiopulmonary resuscitation and correct use of the automated external defibrillator in Asunción during 2023. Methodology: observational cross-sectional study, non-probabilistic sample for convenience of lay personnel users of mass attendance centers in Asunción. An exclusive questionnaire was developed on knowledge in cardiopulmonary resuscitation and the use of the automated external defibrillator (KOR-AED) based on the chain of survival in out-of-hospital cardiac arrest. Content, construct, and internal consistency were validated using expert opinion, factor analysis and Cronbach's alpha. Results: a total of 200 lay people participated, mostly shopping mall customers, with a predominance of men (63.5 %) (127), between 25-29 years old 28.5% (57). 61.5 % (123) had a university education, 75.5 % (151) had not related to health, 52 % (104) had prior knowledge of CPR, but 81.5 % (163) did not. The test showed reliability and suitability for factor analysis (Cronbach's alpha 0.75, Kaiser-Meyers-Olkin; 0.78, Bartlett p&lt;0.05). The questions covered the first three links in the chain of survival, with items of medium to high difficulty. Women performed significantly better (p=0.04). Conclusion: the KOR-AED test is a valid and reliable instrument to improve the education of the layperson in CPR and use of the AED based on the chain of survival.

Transdisciplinary integration of knowledge in the environment of a virtual stem center

The subject of the article is the role of ontological systems in improving the processes of structuring and analyzing scientific content, especially in the context of STEM education.&#x0D; The goal of the work is to research and analyze the application of ontological systems in the context of managing educational materials in STEM education. The use of such approaches is focused on developing effective methods for structuring and presenting educational knowledge in the STEM education system, emphasizing the importance of integrating different scientific disciplines to optimize the educational process. In accordance with the purpose, the following tasks were set: to develop a methodology for creating and implementing ontological systems in STEM education and to develop the architecture of a virtual STEM center that would provide the implementation of the proposed principles.&#x0D; The research is based on the following methods: For the development of the architecture of the virtual STEM center, we used UML diagrams. We developed UML diagrams of roles and activities that illustrate the interaction of different users and systems, as well as demonstrate work processes and interactions in multi-agent systems. Special attention is paid to activity diagrams, which reflect the processing of user requests and the interaction of the stemua.science agent with other components of the STEM center.&#x0D; The following results were obtained: A modular system architecture of the virtual STEM center was developed and described using UML diagrams, which includes roles such as the STEM center administrator, editor, author, and user, as well as the administrator of the CIT "Polyhedron". The interaction of these roles with the virtual STEM center is described in detail, revealing the mechanisms of their interaction and joint work aimed at creating, filling, and editing content in the transdisciplinary STEM center.&#x0D; The process of optimizing work processes in the modular system of the virtual STEM center is also considered. Ways to fill and use the T-STEM center in an ontological form have been identified. The interaction of software entities of the T-STEM center in an ontological form has been analyzed.&#x0D; Conclusions: Based on the conducted research, it is concluded that the use of ontological systems in the context of managing educational materials in STEM education is an effective method for structuring and presenting scientific content, promoting the integration of various scientific disciplines, and optimizing the learning process. It is determined that ontological systems are an effective method for structuring and presenting scientific content, facilitating the integration of various scientific disciplines, and optimizing the learning process. The modular architecture of the system is found to facilitate efficient interaction among different roles and automate workflow processes. Integration with a multi-agent system allows for the use of external data sources and ensures interoperability with other systems. For the further development of the system, research is needed to enhance the efficiency of role interactions and workflow automation. Additionally, research on integrating the system with other STEM education systems is necessary.

Assessment of public education expenditure efficiency across Lithuanian municipalities

Abstract Efficiency of education expenditure is the ability to maximize the educational achievement given the resources invested. Although public education expenditure tends to increase, yet this does not necessarily guarantee high quality of education services. This study aims to assess public education expenditure efficiency of Lithuanian municipalities and to identify the factors explaining its variations. The study used data for 2013-2019 from 60 Lithuanian municipalities. Corrected Ordinary Least Squares method was employed for public education expenditure efficiency assessment and regression analysis was used to determine its influencing factors. Inputs included financial (public expenditure for education and maintenance) and nonfinancial (composition of teachers, occupied area, etc.) variables. Passing ratio of Lithuanian (national) language and math exams were used as efficiency outputs. The context variables represented environmental factors of educational achievements, such as number of business entities, users of social housing, libraries, and culture centres as well as municipalities’ overall financial autonomy. Results of the research are ambiguous. When assessed by the overall passing of the exams, the efficiency was high, scoring 86-90%. But when evaluated by passing exams with the highest scores, it did not even reach 40%. Two types of public expenditure were identified as the most influential factors - public expenditure for education with the negative trend, and municipality own financing with the positive influence on the public education expenditure efficiency. Such results support the decentralization of public education expenditure management and call for alternative output measures in the Lithuanian public education system.

National and State-Level Trends in Mental Health and Substance Use Disorder Services at Federally Qualified Health Centers, 2012-2019.

A disproportionate share of Federally Qualified Health Center (FQHC) users have a behavioral health condition, but there exists limited research examining changes in behavioral health provision in FQHCs. The objectives of this study were to describe how the provision of behavioral health services by FQHCs to the population of people with behavioral health conditions has changed over time in the US, how these trends varied across states, and whether the proportion of total delivered services that are behavioral health services has changed within FQHCs over time. Descriptive analysis using the Uniform Data System and Global Burden of Disease Datasets from years 2012 to 2019. From 2012 to 2019, FQHC behavioral health visits per 1,000 population with any behavioral health condition grew 103%, with a 26-fold difference in average rates across states during the study period. Annual behavioral health visits per patient increased from 3.2 to 2012 to 3.4 in 2019. From 2012 to 2019, the number of behavioral health visits per 1,000 FQHC patients grew by 51%, whereas the rate of asthma visits declined by 14%, heart disease visits declined by 4%, and hypertension and diabetes related visits remained stable (changing < 1% for both). Behavioral health visit growth at FQHCs outpaced national prevalence of behavioral health conditions. This growth was driven by FQHCs serving an increasing number of patients with behavioral health conditions, without sacrificing the frequency of visits for individual patients with behavioral health conditions.

Narrating Digital Access, Trauma, and Disability Through Comics and Image Description in Denmark

ABSTRACT Anthropologists explore sequential art, particularly comics, as an accessible medium to co-produce knowledge about trauma and disability with research collaborators. However, practices of image description developed by blind scholars and artists need to be integrated into these projects to ensure visual studies are accessible. Collaborating with sighted service users of drop-in centers in Denmark, we reflect on the process of creating comics and image descriptions about their experiences with digital access, trauma, and disability. By analyzing insights from both drawing and describing images, we propose this method in medical anthropology as one way to build research collaborations that embrace disability expertise.

Motivational regulations of users in unisex fitness centres

ABSTRACT Motivational regulation is a determining factor for adherence to physical activity. Therefore, this study investigated the influence of sociodemographic variables, such as sex, age and educational level, as well as the duration and frequency of weekly physical activity, on the motivational regulations of fitness centre users. A total of 500 users (58.70% women and 41.30% men) from public and private fitness centres participated in the study. Motivational regulations were measured using the Behavioural Regulation in Exercise Questionnaire. This instrument obtained an adequate model fit and reliability after the calculation of the Confirmatory Factor Analysis and Cronbach’s Alpha coefficient, respectively. The Kruskal–Wallis H test was calculated to determinate the differences between groups, using the Bonferroni correction. The highest scores were recorded for identified (M = 3.50; SD = 0.64), intrinsic (M = 3.33; SD = 0.83) and integrated (M = 2.95; SD = 1.06) regulations. There were no significant differences in motivational regulations according to sex. However, there were significant differences according to age, educational level, seniority in physical activity practice and weekly practice time. Therefore, users who had been in the fitness centres longer scored higher in intrinsic, integrated and identified regulations. Moreover, integrated and identified regulations were greater when the frequency of weekly fitness increased. Fitness centres and trainers should be aware of users’ physical activity motives and guide them toward more self-determined regulation that promotes sport adherence and health, especially for newer users.

Challenges Related to Recruitment and Involvement of Frail Older People in Service Development

Abstract Background Involving relevant stakeholders in development or improvement of community health services is rapidly increasing and found to be of pivotal importance for the success of the service. Involvement can help identify priorities, understand the problem, and find solutions. However, frail older people are often hard to reach, and can be an underrepresented group in terms of involvement in community health services. If community health services targeted frail older people, are expected to benefit their health and well-being, the voices of this group need to be heard and taken into consideration. The objective was to involve frail older people in the development of a health service offered in municipal senior centers, aiming to improve frail older peoples’ possibilities of accessing the social communities of senior center and thereby improve their health and well-being. Methods The involvement was carried out as continuous panel meetings throughout the development process with a panel consisting of five senior center users, recruited through a senior center staff member functioning as gatekeeper. One researcher facilitated the panel meetings. Results The involvement brought forth important knowledge about the need of frail older people, when wanting to become part of a social community. Nevertheless, two main challenges emerged during the involvement period: 1) Recruiting frail older people proved difficult albeit a gatekeeper being used and 2) Facilitation of, and the methods used for, the panel meetings should be appropriate for involvement of the specific target group, in this case frail older people, to allow for all participants to be heard. Conclusions Considerations about the involvement concepts, methods and facilitation are crucial in order for challenges linked to involvement to be minimized, making it possible for the needs of frail older people to be heard and met in the development or improvement of community health services.