German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany.
Department of General Practice, University Medical Center Goettingen, Goettingen, Germany.
PLoS One. 2023 Aug 9;18(8):e0289737. doi: 10.1371/journal.pone.0289737. eCollection 2023.
Despite physical activity (PA) health benefits, people with dementia (PwD) continue to report low levels of PA engagement compared with healthy older adults. Evidencing that PA initiatives still not reflect effective practice and outcomes. Previous studies have shown that several factors can mediate PA initiatives implementation in this population. However, most prior research have not use implementation science frameworks to outline in-depth barriers and facilitators that enables improved PA strategies in PwD. Therefore, a more holistic understanding of mediating factors is still needed.
To identify multilevel barriers and facilitator factors, applying the Consolidated Framework for Implementation Research (CFIR) to orient a systematic evaluation of one PA project in PwD and provide evidence-based evaluation results to enhance PA implementation efforts for PwD.
A qualitative study implemented in 4 German sports associations that applied a PA project for PwD. A total of 13 semi-structured interviews were conducted with 21 participants, project leaders (PLs) and sports trainers (STs). The Consolidated Framework for Implementation Research (CFIR) was used as an evaluation framework to orient both the data collection and analysis.
A total of 13 interviews were conducted with 21 participants. The CFIR guided the identification of barriers and facilitating factors that need to be targeted at different levels for successful implementation. Barriers were identified, especially in the external level, as more solid networks and funding for sustainable proposals are still needed. Other barriers were low participation rates, stigma around the disease and the COVID 19 pandemic. On an individual and structural level facilitators were found like motivated appointed leaders, established planning process, and external organizations supporting sports associations in the implementation.
Sports projects for PwD can benefit from structuring their interventions based on the CFIR framework as it helps identify multilevel factors that may influence their success and promote PA among PwD. Future efforts should continue working on implementing frameworks that facilitate and reduce the complexity of implementing sustainable PA projects for PwD.
尽管身体活动（PA）对健康有益，但与健康老年人相比，痴呆症患者（PwD）继续报告其身体活动参与度较低。这表明 PA 计划仍然没有反映出有效的实践和结果。以前的研究表明，有几个因素可以调解这一人群中 PA 计划的实施。然而，大多数先前的研究并没有使用实施科学框架来详细说明能够改善 PwD 中 PA 策略的障碍和促进因素。因此，仍然需要更全面地了解调解因素。
应用实施研究综合框架（CFIR）确定多层次障碍和促进因素，对 PwD 的一项 PA 计划进行系统评估，并提供基于证据的评估结果，以增强 PwD 的 PA 实施工作。
在 4 个德国体育协会实施了一项定性研究，该研究为 PwD 实施了一项 PA 计划。共对 21 名参与者、项目负责人（PLs）和体育教练（STs）进行了 13 次半结构化访谈。采用实施研究综合框架（CFIR）作为评估框架，指导数据收集和分析。
共对 21 名参与者进行了 13 次访谈。CFIR 指导确定了需要在不同层面上针对的障碍和促进因素，以实现成功实施。在外部层面上确定了障碍，特别是更需要建立更稳固的网络和获得可持续性提案的资金。其他障碍还包括参与率低、对疾病的污名化和 COVID-19 大流行。在个人和结构层面上，发现了促进因素，如有动力的指定领导者、既定的规划过程以及外部组织支持体育协会的实施。
针对 PwD 的体育项目可以从基于 CFIR 框架构建干预措施中受益，因为它有助于确定可能影响其成功的多层次因素，并促进 PwD 进行 PA。未来的努力应继续致力于实施促进和简化为 PwD 实施可持续 PA 项目的框架。
