Perceptions of participants and staff of implementing a physical activity program in rural primary care

Addressing the lack of physical activity (PA) in rural adults is vital because of the role it plays in the risk for many chronic diseases. The purpose of the study was to explore the feasibility of conducting a 12-week intervention utilizing a Fitbit to increase PA behavior in inactive rural adults recruited from a primary care clinic. Semi-structured interviews were conducted with study participants (n=10) and a focus group was held with nurses (n=7) from the primary care clinic. Data were analyzed using the process of immersion/crystallization. Participants and nurses both felt the program had a positive impact on PA and that the program was needed in the community. Study participants most often reported their favorite part of the study was being able to track their activity as well as the goal setting. However, study participants reported barriers to continued participation in PA related to a lack of time and ability to be active in cold weather. Further, nursing staff reported barriers in regard to a lack of resources (staffing and money) These barriers need to be examined further and addressed in order to implement a sustainable PA program that can be maintained through a primary care clinic.     

Older Adults’ Experiences of Sexual Difficulties: Qualitative Findings From the English Longitudinal Study on Ageing (ELSA)

There is a growing body of evidence demonstrating that sexual activity is important to the quality of life of older adults, and that it can be influenced by physical, psychological, and social factors. However, older adults’ experiences of sexual difficulties remain relatively unexplored. This article draws on qualitative data collected as part of the English Longitudinal Study of Ageing (ELSA). Participants answered a Sexual Relationships and Activities Questionnaire (SRA-Q), which included an open comment box for further details, 1,084 (1/7) of which were completed. These data were analyzed using Template Analysis, and findings on the experiences of sexual difficulties are presented in this article. Sexual difficulties were contextualized within the couple relationship and could be detrimental to the relationship, particularly if the partner would not seek professional help. Participants reported that sexual difficulties could also have a negative impact on psychological well-being, described mainly as frustration, depression, and sadness. For some participants the supportive nature of their relationship buffered these impacts. Few had sought professional help; those who had reported helpful and unhelpful experiences. These findings add to the limited evidence base and have implications for health care in the context of global aging and a growing recognition of older adults’ sexual rights.     

Leadership in physical activity groups for older adults: a qualitative analysis

The purpose of this study was to determine whether a theory-based framework could be used to deductively identify and understand the characteristics of motivational leaders of physical activity groups for older adults. Participants were 23 older adults (mean age = 78.5 +/- 8.0 years, 65% women). An interview-guide approach was employed to elicit older adults' thoughts on important characteristics of physical activity group leaders. The data suggested that effective leaders are those whom the participants feel are properly qualified, are able to develop a personal bond with participants, and can use their knowledge and the group to demonstrate collective accomplishments. It was concluded that the findings could be used to extend the leadership activities beyond the traditional technical performance and individual feedback to include activities of social integration. Furthermore, the conceptual framework identified can serve as a valuable tool in guiding future researchers in their examination of leadership in physical activity groups for older adults.     

A case study on the perception of aging and participation in physical activities of older Chinese immigrants in Australia

This qualitative study explores how older Hong Kong ChineseAustralians perceive aging and to what extent this perception affects their participation in physical activities. The main methods used were in-depth interviews with 22 participants ranging in age from 60 to 91 years. Interviews were translated from Chinese (Cantonese) and transcribed into English. Content analysis was used to find recurring themes from the interview data. The main findings indicate that the perception of aging is to some extent influenced by culture. Some participants defined aging as being measured in years, and others defined it by the state of one's physical health, appearance, and capacity to continue fulfilling one's social roles. These perceptions strongly influenced their preferences for and participation in physical activities. Acknowledging the fact that Chinese-speaking people are not culturally homogeneous, this article makes some recommendations to health service providers with regard to the development of appropriate physical activity programs.     

Environmental changes to increase physical activity: perceptions of older urban ethnic-minority women

Despite the numerous benefits of physical activity, older adults continue to be more sedentary than their younger counterparts, and sedentary behavior is more prevalent among older racial and ethnic minorities than among Whites. This study used the nominal group technique (NGT) to examine participants' perceptions of what neighborhood environmental changes would encourage greater physical activity for older African American and Hispanic women. Participants age 50-75 years were recruited from 2 urban community health clinics. Nine NGT sessions (45 participants) were conducted. The women were asked what changes in their neighborhood environment would encourage them to become more physically active. Responses to the research question were tabulated, and qualitative analysis was used to identify themes and categories. Major categories were physical environment changes, safety, and activities/social support. Although the physical environment received the greatest number of points, concerns for personal safety cut across categories. Participants indicated the need for more facilities in which to be active.     

Better self-perceived health is associated with lower odds of physical inactivity in older adults with chronic disease

Poor self-perceived health (SPH) is associated with lower levels of physical activity (PA) and the presence of chronic disease in older adults. The purpose of this study was to determine whether SPH is associated with PA levels in older adults with existing chronic disease and whether this differs by disease. Using logistic regressions on data from the Canadian Community Health Survey (N = 33,168) it was found that adjusted logistic regressions revealed that odds of physical inactivity were similar in those with good SPH who reported having respiratory, musculoskeletal, or other chronic disease compared with those with good SPH without these diseases. Those with good SPH who reported having cardiometabolic disease were at significantly greater risk of physical inactivity than those with good SPH without cardiometabolic disease. It is apparent from the current analysis that SPH plays an important role in PA levels of older adults with chronic disease and should be targeted in future interventions.     

Older adults' perceptions of work

Traditional definitions of work may not reflect the activities of older adults. A broader definition that incorporates non-economic as well as economic measures may better describe their participation in the labor force and the meanings they ascribe to these activities. Because productive activity has been linked to successful aging, it is important to understand how elders perceive work. Twenty-six community-residing older adults were interviewed over a two-year period. Participants were mostly female and represented diverse cultural, religious and educational backgrounds. All these individuals participated in some activities they perceived as work. Three themes emerged as describing their attributions of meaning or importance to productive activities: contribution to self-concept, giving back to community, and staying engaged. Findings suggest that the productive activities of older adults contribute to quality of life for them and have implications for society as well.     

Gay Men

Summary

This report presents the findings from four ethnographic studies of older gay men (Brown, 1997; Brown, Sarosy, Cook & Quarto, 1997; Cook, 1991; Quarto, 1996; Sarosy, 1996). There were 69 total participants who ranged in age from 36 to 79 years; most were from 50 to 65 years of age. The purpose of these studies was to examine how older gay men have adjusted, psychologically and socially, to their sexual orientation and aging process. Participants reported that they spend 50% time or more with gay friends within their own age cohorts. Many reported being involved with the gay community in some capacity, while about 15% had no involvement with the gay community. Most participants were in regular contact with their families. Most stated that their families were aware of their sexual orientation. Most of the participants reported experiencing discrimination due to sexual orientation, and one third had experienced discrimination within the gay community based on age or ethnicity. With regard to sex life, the studies found an overall lowered frequency of sexual activity. Participants felt that HIV/AIDS has had a devastating impact on older gay men, interrupting the normal aging process for those who have contracted it and prematurely aging those who care for them. The studies' findings identified the qualities of healthy adaptation to aging for older gay males: having satisfying relationship, self-acceptance as one ages, good health, an active life with a variety of interests, and financial security.     

Physical activity in the post-hip-fracture period

The purpose of this study was to characterize physical activity (PA) based on survey and ActiGraphy data from older adults at 2 mo post-hip fracture and consider the factors that influence PA among these individuals. The sample included participants from a current Baltimore hip study, the BHS-7. Measurement of PA was based on the Yale PA Survey (YPAS) and 48 hr of ActiGraphy. The sample included the first 200 individuals enrolled in the study, with analyses including 117 individuals (59%) who completed the YPAS and wore the ActiGraph for 48 hr. Half the participants were male, with an overall mean age of 81.3 yr (SD = 7.9). Findings indicate that at 2 mo post-hip fracture participants were engaged in very limited levels of PA. Age and comorbidities were the only variables to be significantly associated with PA outcomes.     

Testing the efficacy of the theory of planned behavior to explain strength training in older adults

The purpose of this study was to use the constructs of the theory of planned behavior (TPB) to gain a better understanding of the factors influencing older adults' participation in strength training. Two hundred men and women age 55 years and older were purposely sampled from seniors' centers in Ontario Canada. Participants completed a TPB questionnaire and reported their current physical activity participation. It was hypothesized that perceived behavioral control followed by attitude would be the strongest determinants of strength-training intentions and that intention would be the strongest determinant of strength-training behavior. Regression analyses revealed that subjective norm and perceived behavioral control explained 42% of the variance in intention and intention explained 40% of the variance in behavior. Gender and current strength-training participation did not significantly moderate the relationship between the TPB variables. The results suggest that interventions targeting subjective norm and perceived control might be helpful in promoting strength-training behavior among older adults.     

A case study of physical activity among older adults in rural Newfoundland, Canada

The purpose of this study was to assess rural older adults' perceptions of leisure-time physical activity and examine these perceptions from a historical perspective. Semistructured interviews were conducted with 10 inhabitants (mean age 82 years) of Fogo Island, Newfoundland and Labrador, Canada. Interviews were transcribed verbatim and subjected to inductive analysis. Member-checking interviews were conducted with 5 participants. Findings indicated that beginning in childhood, participants were socialized into a subculture of work activity. As a result of these historical and social forces, leisure-time physical activity did not form part of the participants' lives after retirement. Strategies for successful aging involved keeping busy, but this "busyness" did not include leisure-time physical activity. Results demonstrated the importance of developing a broader understanding of how past and present-day contexts can influence participation in leisure-time physical activity.     

Hong Kong Chinese aging adults voice financial care expectations in changing family and sociocultural contexts: implications for policy and services

Despite being one of the world’s wealthiest cities, approximately one-third of Hong Kong older adults live below the poverty line. Innovatively using the Photovoice research method, this study invited 36 Hong Kong Chinese aging adults to photograph images and voice their concerns and expectations regarding financial care. Insufficient government support, diminishing family support, insecurity and fear regarding future finances, and strong desire for self-sufficiency through early preparation and bridge employment were recurring themes observed in the participants’ photographs and narratives. The shifting of the participants’ financial care expectations from informal to formal sources in changing family and sociocultural contexts indicated that older people are in urgent need of policy reform from a needs-based to rights-based approach to foster empowerment and fulfill older people’s rights of financial security, dignity and participation. Improving the retirement protection system should go hand in hand with encouraging family support and caregiving and creating age-friendly working environment for older residents. The findings of this study may have crucial policy implications for Hong Kong and other aging societies, especially those that share similar filial piety values and have seemingly ungenerous welfare systems.     

Does yoga engender fitness in older adults? A critical review

Interest in yoga is growing, especially among older adults. This review critically summarizes the current literature to investigate whether physical fitness and function benefits are engendered through the practice of yoga in older adults. A comprehensive search yielded 507 studies; 10 studies with 544 participants (69.6 ± 6.3 yr, 71% female) were included. Large variability in yoga styles and measurement outcomes make it challenging to interpret results across studies. Studies reported moderate improvements for gait (ES = 0.54, 0.80), balance (ES = 0.25-1.61), upper/lower body flexibility (ES = 0.25, 0.70), lower body strength (ES = 0.51), and weight loss (ES = 0.73, 0.99).Yoga may engender improvements in some components of fitness in older adults. However, more evidence is needed to determine its effectiveness as an alternative exercise to promote fitness in older adults. Further investigation into yoga as an exercise activity for older adults is warranted.     

Physical and psychological outcomes of a supported physical activity program for older carers

This study evaluated health benefits of a supported physical activity program for 116 older carers (mean age 64.4 [SD = 7.9], 85% women). Participants undertook a 6-month center-based physical activity program (strength training, yoga, or Tai Chi). Eighty-eight participants (76%) completed the program. Multivariate repeated-measures ANOVA identified overall significant improvement postintervention (p = .004). Univariate analyses revealed significant improvements for balance, strength, gait endurance, depression, and SF-36 (physical component; p < .05). There was no change in the Zarit Carer Burden Scale (p > .05). Change in performance scores did not differ significantly between those with higher and lower attendance at classes, although there was significantly greater improvement in gait endurance and balance (p < .05) in those attending classes run twice weekly than in those attending once-weekly classes. In conclusion, a carer physical activity program, providing additional carer support to facilitate participation, can achieve high levels of involvement by carers and significant health benefits.     

The Effects of Subjective Age and Aging Attitudes on Mid- to Late-Life Sexuality

This study examined the effects of subjective age and attitudes about aging on frequency of sex and interest in sexual activity among middle-aged and older adults. Data were drawn from two waves of the Midlife in the United States (MIDUS) study (n = 1,170 adults, mean age Time 1 = 53.70 years, SD = 9.08). Regression analyses were used to investigate the effects of subjective age and attitudes about aging on three measures of sexuality: frequency of sex, perceived quality of sexual activity, and interest in sexual activity, over 10 years. The older participants felt and the less positive their views of aging, the less they rated sexual activity as enjoyable over time. Feeling older (though not attitudes about aging) also predicted less interest in sex. Subjective age and beliefs about aging did not have an impact on frequency of sex. Although frequency of sex was not predicted by subjective aging and aging attitudes, the results suggested that subjective age and stereotypic views on aging may shape the experience of sex in later life.     

Physical activity and psychological distress in older men: findings from the New South Wales 45 and up study

Physical activity is an important factor in healthy aging and has been shown to reduce depressive symptoms. This association, however, is relatively understudied in older men. This study was a cross-sectional analysis of the association between physical activity (Active Australia Survey) and psychological distress (Kessler-10). Participants were a sample of 17,689 men age ≥ 65 yr drawn from a large-scale Australian cohort study of people age 45 years and over (The 45 and Up Study). The likelihood of reporting high or very high levels of psychological distress decreased with increasing weekly sessions of physical activity. Compared with participants reporting no sessions of physical activity, the fully adjusted odds ratio for high or very high psychological distress was .66 (95% CI .51-.85) for men who undertook 1-6 sessions of physical activity per week and decreased to .57 (95% CI, .43-.79) for men who reported 16 or more weekly sessions. The cross-sectional findings show that older men who are more active are less likely to report psychological distress, regardless of their level of functional limitation. Further research, informed by these findings, is required to investigate causal pathways and the temporal sequence of events.     

“My nest is full:” Intergenerational relationships at midlife

Incorporating a life course perspective, this qualitative study used focus groups to explore the experiences of midlife adults who were simultaneously providing support to emerging adult children and aging parents. Results indicated that adults situated in middle generations held beliefs that endorsed family-based responsibility to both younger and older members. Parents gladly supported children despite their longer transition to adulthood. Often unanticipated but accepted, provisions of care to aging parents were experienced with ambivalence — a joy and a burden. The transition of their parents to greater dependence helped participants gain insights into the terrain of late life and encouraged reflections about the intersection of aging, independence, and family responsibility. Participants expressed intentions to preserve their own independence and spare their children of caregiving burdens through self-directed actions. Implications focused on negotiations of family relationships around issues of independence and family responsibilities as a way to reduce intergenerational ambivalence.     

Patronizing Speech to Older Adults

We measured the use of patronizing speech among young adults who were instructed to provide directions (via an internet connection) to a newcomer to campus described as 21 or 65?years old. As predicted, the acoustic properties used with older adults were moderated by the speakers?? history with older unrelated adults (no comparable effects were found for speakers?? history with grandparents). Participants with relatively low contact with unrelated older adults were more likely than those with high contact to be judged as sounding ??patronizing?? and to display acoustical properties associated with patronization (high vocal intensity, high pitch) with older newcomers. However, participants showed a shared tendency to speak more slowly to older than young adults. Findings inform our understanding of the circumstances under which ageist speech is amplified or attenuated.     

The effects of life events and interpersonal loss on exercise adherence in older adults

Associations of life events and interpersonal loss with participation in home- and group-based exercise were studied in 97 older adults (64 % women, 70.2 +/- 4.1 years). Life events were assessed with a modified Social Readjustment Rating Scale at baseline and 6 and 12 months. Exercise logs and class-attendance records documented exercise participation. Participants experienced 3.62 +/- 3.56 unique life events over the course of the study, and 28 participants reported an interpersonal loss (5 men, 23 women). Number of life events was negatively associated with home-based exercise participation (p <.05); among women, this association approached significance (p =.06) for class-based exercise. Women who experienced an interpersonal loss had lower class-based participation than those who did not (p =.02), but home-based participation rates were unaffected. Life events, particularly interpersonal loss, appear to have a negative impact on exercise in women, and this effect appears greater for class-based than for home-based exercise.     

An extended theory of planned behavior intervention for older adults with type 2 diabetes and cardiovascular disease

A randomized controlled trial evaluated the effectiveness of a 4-wk extended theory of planned behavior (TPB) intervention to promote regular physical activity and healthy eating among older adults diagnosed with Type 2 diabetes or cardiovascular disease (N = 183). Participants completed TPB measures of attitude, subjective norm, perceived behavioral control, and intention, as well as planning and behavior, at preintervention and 1 wk and 6 wk postintervention for each behavior. No significant time-by-condition effects emerged for healthy eating. For physical activity, significant time-by-condition effects were found for behavior, intention, planning, perceived behavioral control, and subjective norm. In particular, compared with control participants, the intervention group showed short-term improvements in physical activity and planning, with further analyses indicating that the effect of the intervention on behavior was mediated by planning. The results indicate that TPB-based interventions including planning strategies may encourage physical activity among older people with diabetes and cardiovascular disease.