Get Healthy Get Active: Prevention is better than care


Student thesis: Doctoral Thesis


Low levels of physical activity (PA) and high levels of sedentary behaviour (SB) among older adults, carry considerable burdens to physical (e.g., premature mortality, chronic diseases and all-cause dementia risk) and psychosocial (e.g., self-perceived quality of life, wellbeing and self-efficacy for exercise) health. Numerous large scale interventions designed to engage physically inactive older adults have shown the potential that interventions guided by theoretical frameworks, consider implementation at scale across levels of the socioecological model and are designed, implemented and delivered in close partnership with stakeholders can have among this population. This thesis aimed to investigate the effectiveness of Sport England’s Get Healthy Get Active (GHGA) PA intervention. GHGA was delivered by Sefton Metropolitan Borough Council (SMBC) and was designed to engage inactive older adults in PA for at least once a week for 30 minutes. The purpose of Chapter 3 was to elicit subjective views of older adults about perceived facilitators and barriers to PA participation and to inform the design, delivery and recruitment strategies of Sport England’s GHGA PA intervention. Analyses revealed time of day, cost and social support to be key predictors in promoting PA. Sessions that avoid taking place in the early morning or late afternoon, are free of charge, and promote social interaction were also significant predictors of older adults’ PA participation. Wrist- and hip-based accelerometers are now common in assessing PA in population-based studies, however no raw acceleration cutpoints for moderate-to-vigorous PA (MVPA) and SB exist for older adults. Chapter 4 was the first to test a laboratory-based protocol using activities representative of older adults’ PA behaviours, to generate behaviourally valid, population specific wrist- and hip-based raw acceleration cutpoints for SB and MVPA in older adults. These cut-points were subsequently applied within Chapter 5, along with self-reported measures of SB, PA and health indicators, to investigate time spent in MVPA and SB, and measures of quality of life (QoL), self-rated health (SRH), self-assessment of physical fitness (SAPF), and self-efficacy for exercise (SEE). Chapter 6 addressed the main objective of the thesis which was to assess the effectiveness of the GHGA PA intervention on PA levels among inactive older adults ≥ 65 years of age. The GHGA PA intervention was effective in increasing QoL, SRH, SAPF, and SEE scores over time after adjustment for covariates. However, the intervention was ineffective in both reducing time spent in SB and increasing time spent in MVPA. As a measure of intervention fidelity, Chapter 7 evaluated whether the GHGA multi-component PA intervention was implemented as intended. Results from both deliverer interviews and session observations revealed that a high degree of intervention fidelity was maintained throughout the GHGA PA sessions within five core domains including: Study Design, Provider Training, Intervention Delivery, Intervention Receipt and Enactment. This thesis contributes to the understanding of feasible and acceptable PA strategies in older adults. Future research is needed to establish whole system-oriented multi-component community-based interventions that are effective at increasing PA levels in older adults.
Date of Award18 Oct 2018
Original languageEnglish
Awarding Institution
  • Edge Hill University
SupervisorSTUART FAIRCLOUGH (Director of Studies), BRENDA ROE (Supervisor) & AXEL KAEHNE (Supervisor)

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