UKCRC Centre of Excellence for Public Health (Northern Ireland), School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Clinical Sciences Block B, Royal Victoria Hospital, Belfast, BT12 6BA, Northern Ireland, UK.
Department of General Practice and Primary Care, Queen's University Belfast, 1 Dunluce Avenue, Belfast, BT9 7HR, Northern Ireland, UK.
Trials. 2019 Apr 25;20(1):234. doi: 10.1186/s13063-019-3312-9.
Insufficient physical activity (PA) is a major public health issue. Whilst PA is an important contributor to disease prevention, engagement in PA decreases with age, particularly among women in socio-economically disadvantaged areas. Research using existing support networks to engage 'hard to reach' populations in PA interventions is sparse. We developed and tested the feasibility of a PA-promoting intervention for older women within existing community groups in socio-economically disadvantaged areas.
The Medical Research Council guidelines for complex interventions were used to guide the intervention's development. We recruited participants (n = 40) from older (aged ≥50 years) women's groups from four different community centres. A 12-week programme was delivered during existing sessions, informed by Social Practice Theory. The sessions provided education about PA, social support in the form of a PA 'buddy', group discussion and follow-up telephone calls, as well as printed information about local opportunities to participate in PA. The main uncertainties tested were rates of participant recruitment, retention, and completion of assessments of PA by accelerometry and of mental health using the Hospital Anxiety and Depression Scale (HADS). Intervention acceptability was assessed by questionnaire, and focus group interviews elicited participants' views about the intervention. Qualitative data were subjected to framework analysis.
The recruitment rate was high; 87% (n = 40/46) of women consented to participate, and 78% (n = 31) attended all education sessions. Uptake of follow-up telephone calls and PA 'buddies' was low. Few participants provided valid accelerometer data, but 63% (n=25) completed the HADS questionnaire at all time points. The printed materials and education sessions were viewed positively; telephone calls and 'buddy' support were not valued. Participants believed that organised group activities would lead to increased PA engagement, and whilst participants disliked wearing a waist accelerometer, they thought that regular PA feedback would facilitate necessary goal-setting.
High recruitment and retention rates suggest that use of existing social support groups is an acceptable and attractive method of delivering a PA intervention to this population. A randomised controlled trial of the intervention appears feasible, but its design requires refinement of the social support component, facilitation of goal-setting and reconsideration of the assessment of PA.
ClinicalTrials.gov, NCT02880449 . Registered on 26 August 2016.
体力活动不足是一个主要的公共卫生问题。虽然体力活动是预防疾病的重要因素，但随着年龄的增长，人们参与体力活动的意愿会降低，尤其是在社会经济处于不利地位的地区的女性。利用现有的支持网络来吸引“难以接触”的人群参与体力活动干预的研究很少。我们开发并测试了一种针对社会经济处于不利地位地区老年女性的体力活动促进干预措施的可行性，该措施是在现有的社区团体中进行的。
采用医学研究委员会复杂干预措施指南来指导干预措施的制定。我们从四个不同社区中心的老年（年龄≥50 岁）女性团体中招募参与者（n=40）。在现有的课程中提供为期 12 周的课程，该课程以社会实践理论为基础。课程提供有关体力活动的教育、以体力活动“伙伴”形式提供社会支持、小组讨论和后续电话，以及有关参加体力活动的当地机会的印刷信息。主要测试的不确定性是参与者招募、保留和通过加速度计评估体力活动以及使用医院焦虑和抑郁量表（HADS）评估心理健康的评估完成率。通过问卷评估干预措施的可接受性，并通过焦点小组访谈了解参与者对干预措施的看法。定性数据采用框架分析。
招募率很高；87%（n=40/46）的女性同意参与，78%（n=31）参加了所有的教育课程。后续电话和体力活动“伙伴”的参与率很低。很少有参与者提供有效的加速度计数据，但 63%（n=25）在所有时间点都完成了 HADS 问卷。印刷材料和教育课程受到了积极评价；电话和“伙伴”支持不受欢迎。参与者认为有组织的团体活动会增加体力活动的参与度，虽然参与者不喜欢佩戴腰部加速度计，但他们认为定期的体力活动反馈将有助于设定必要的目标。
高招募和保留率表明，利用现有的社会支持团体是向该人群提供体力活动干预的一种可接受且有吸引力的方法。该干预措施的随机对照试验似乎可行，但需要改进社会支持部分、促进目标设定并重新考虑体力活动评估。
ClinicalTrials.gov，NCT02880449。于 2016 年 8 月 26 日注册。
