Adherence to a physical activity intervention among older adults in a post-transitional middle income country: A quantitative and qualitative analysis Activity adherence and physical function in older adults with functional limitations. Promotion of self-management in vulnerable older people: a narrative literature review of outcomes of the Chronic Disease Self-Management Program (CDSMP) Study protocol of a cluster randomised controlled trial investigating the effectiveness of a tailored energy balance programme for recent retirees Aging, retirement, and changes in physical activity: prospective cohort findings from the GLOBE study. Promoting physical activity using an activity monitor and a tailored web-based advice: design of a randomized controlled trial [ISRCTN93896459] Harnessing Different Motivational Frames via Mobile Phones to Promote Daily Physical Activity and Reduce Sedentary Behavior in Aging Adults The Feasibility of Reducing Sitting Time in Overweight and Obese Older Adults Physical activity and the menopause experience: a cross-sectional study. Change in lifestyle factors and their influence on health status and all-cause mortality. Comparative effects of two physical activity programs on measured and perceived physical functioning and other health-related quality of life outcomes in older adults. Project GRAD: two-year outcomes of a randomized controlled physical activity intervention among young adults. Graduate Ready for Activity Daily. Change in physical activity and weight in relation to retirement: the French GAZEL Cohort Study Examining the theory‐effectiveness hypothesis: A systematic review of systematic reviews Exercise and well-being: a review of mental and physical health benefits associated with physical activity Physician-based physical activity counseling for middle-aged and older adults: A randomized trial Peer Volunteers Improve Long-Term Maintenance of Physical Activity With Older Adults: A Randomized Controlled Trial. The “Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies” (SPRINTT) randomized controlled trial: design and methods Beyond hearing aid fitting: improving communication for older adults Promoting physical activity: issues in primary health care. Identifying the content of home-based health behaviour change interventions for frail older people: a systematic review protocol Text Messaging for Exercise Promotion in Older Adults From an Upper-Middle-Income Country: Randomized Controlled Trial A systematic review of physical activity promotion in primary care office settings. 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Objectives The effectiveness of community level interventions depends to a great extent on adherence . Currently , information on factors related to adherence in older adults from developing countries is scarce . Our aim was to identify factors associated to adherence to a physical activity intervention in older adults from a post-transitional middle income country . Design , setting and participants Using a combination of quantitative and qualitative methods we studied 996 older Chilean subjects ( 65–67.9 years at baseline ) with low to medium socioeconomic status from 10 health centers r and omized to receive a physical activity intervention as part of the CENEX cluster trial ( IS RCT N48153354 ) . Measurements Using a multilevel regression model , the relationship between adherence ( defined a priori as attendance at a minimum of 24 physical activity classes spread over at least 12 months ) and individual , intervention-related and context ual factors was evaluated . We also conducted 40 semi-structured interviews with older adults ( n=36 ) and instructors ( n=4 ) . Transcripts of the interviews were analyzed using content analysis to identify barriers and facilitators to adherence . Results Adherence to physical activity intervention was 42.6 % ( CI 95 % 39.5 to 45.6 ) . Depression , diabetes mellitus , percentage of impoverished households and rate of arrests for violent crimes in the neighborhood predicted less adherence ( p<0.05 ) while being retired , participation in physical activity prior to the intervention , and green areas per habitant were positively associated with adherence ( p<0.05 ) . The qualitative interviews identified three primary barriers to adherence : current health problems , lack of time due to commitments for caring for family members , and being employed , and two primary facilitators to adherence : the health benefits attributed to the intervention and the opportunity the classes provided for social interaction with others . Conclusion In order to enhance effectiveness of community exercise interventions , strategies to improve participation should be targeted to older adults from deprived areas and those with psychological and medical conditions PURPOSE Lifestyle Interventions and Independence for Elders Pilot ( LIFE-P ) was a trial to examine the effects of a physical activity intervention ( PA ) compared with a health education control ( SA ) on measures of disability risk in sedentary older adults ( N = 424 ) . We examined adherence to the LIFE-P PA intervention for the first 12 months of the trial . METHODS The PA intervention consisted of walking , strength , flexibility , and balance training supplemented with behavioral skills training modules , and it used a phased , center-based schedule of adoption ( 3x wk(-1 ) , weeks 1 - 8 ) , transition ( 2x wk(-1 ) , weeks 9 - 24 ) , and maintenance ( 1x wk(-1 ) , weeks 25 to end of trial ) while transitioning to primarily home-based physical activity . SA consisted of weekly ( weeks 1 - 26 ) transitioning to monthly health education workshops . RESULTS Participation in moderate-intensity physical activity increased from baseline to months 6 and 12 in PA compared with SA ( P < 0.001 ) . At 12 months , PA participants who reported > or = 150 min x wk(-1 ) of moderate activity demonstrated a significantly greater improvement in their Short Physical Performance Battery score compared with participants who reported < 150 min.wk of moderate activity ( P < 0.017 ) . For the PA arm , center-based attendance was 76.3 + /- 24.5 , 65.4 + /- 28.6 , and 49.8 + /- 35.8 % in the adoption , transition , and maintenance phases , respectively . CONCLUSIONS Adherence to physical activity in LIFE-P was associated with greater improvement in SPPB score and was consistent with adherence in physical activity trials of shorter duration in this subgroup of older adults . Older individuals at risk for disability can adhere to a regular program of physical activity in a long-term r and omized trial With ageing , older people can become frail , and this has been shown to be associated with a decrease in well-being . Observational studies provide evidence of a positive effect of coping re sources on well-being . The question is : can coping re sources be improved in vulnerable older people ? The Chronic Disease Self-Management Program ( CDSMP ) is a target group-specific intervention which aims to promote the self-management of older people who are confronted with deteriorating health . The aim of this study was to review intervention studies focusing on the CDSMP and to draw conclusions on the benefits of the program . A systematic search was conducted in PubMed and PsychINFO to identify r and omized controlled trials ( RCTs ) focusing on the CDSMP .  Nine RCTs focusing on relatively young older adults , 75 % of whom with an average age between 49 and 65 years , were included . We found that the CDSMP was consistently beneficial for Health behaviour , especially with regard to the variables of exercise and self-care . For Health status , the majority of studies only showed improvement in the domain of health distress . Most of the studies that investigated Self-efficacy showed convincing improvement in self-efficacy , cognitive symptom management and mental stress management . In Health care utilization , there was no significant decrease . On the whole , the studies showed that CDSMP led to an increase in physical exercise , a decrease in health distress , an improvement in self-care , and it had a beneficial effect on self-efficacy Background People in transitional life stages , such as occupational retirement , are likely to gain weight and accumulate abdominal fat mass caused by changes in physical activity and diet . Hence , retirees are an important target group for weight gain prevention programmes , as described in the present paper . Methods / Design A systematic and stepwise approach ( Intervention Mapping ) is used to develop a low-intensity energy balance intervention programme for recent retirees . This one-year , low-intensity multifaceted programme aims to prevent accumulation of abdominal fat mass and general weight gain by increasing awareness of energy balance and influencing related behaviours of participants ' preference . These behaviours are physical activity , fibre intake , portion size and fat consumption . The effectiveness of the intervention programme is tested in a cluster r and omised controlled trial . Measurements of anthropometry , physical activity , energy intake , and related psychosocial determinants are performed at baseline and repeated at 6 months for intermediate effect , at 12 months to evaluate short-term intervention effects and at 24 months to test the sustainability of the effects . Discussion This intervention programme is unique in its focus on retirees and energy balance . It aims at increasing awareness and takes into account personal preferences of the users by offering several options for behaviour change . Moreover , the intervention programme is evaluated at short-term and long-term and includes consecutive outcome measures ( determinants , behaviour and body composition ) There is increased recognition that determinants of health should be investigated in a life-course perspective . Retirement is a major transition in the life course and offers opportunities for changes in physical activity that may improve health in the aging population . The authors examined the effect of retirement on changes in physical activity in the GLOBE Study , a prospect i ve cohort study known by the Dutch acronym for " Health and Living Conditions of the Population of Eindhoven and surroundings , " 1991 - 2004 . They followed respondents ( n = 971 ) by postal question naire who were employed and aged 40 - 65 years in 1991 for 13 years , after which they were still employed ( n = 287 ) or had retired ( n = 684 ) . Physical activity included 1 )  work-related transportation , 2 ) sports participation  , and 3 ) nonsports leisure-time physical activity .  Multinomial logistic regression analyses indicated that retirement was associated with a significantly higher odds for a decline in physical activity from work-related transportation ( odds ratio ( OR ) = 3.03 , 95 % confidence interval ( CI ) : 1.97 , 4.65 ) , adjusted for sex , age , marital status , chronic diseases , and education , compared with remaining employed . Retirement was not associated with an increase in sports participation ( OR = 1.12 , 95 % CI : 0.71 , 1.75 ) or nonsports leisure-time physical activity ( OR = 0.80 , 95 % CI : 0.54 , 1.19 ) . In conclusion , retirement introduces a reduction in physical activity from work-related transportation that is not compensated for by an increase in sports participation or an increase in nonsports leisure-time physical activity Background Ageing is associated with a decrease in physical activity . This decrease particularly occurs during specific transitional life stages . Especially during adolescence and young adulthood a steep decrease in physical activity is observed . Inactive people are often not aware of their inactivity . Providing feedback on the actual physical activity level by an activity monitor can increase awareness and may in combination with an individually tailored physical activity advice stimulate a physically active lifestyle . Methods In a r and omized controlled trial the effectiveness of providing an activity monitor in combination with a personal physical activity advice through the Internet will be examined . Outcome measures are level of physical activity , determinants of physical activity , quality of life , empowerment , aerobic fitness and body composition .  Participants are relatively inactive adolescents and young adults who are measured at baseline , after 3 months intervention and 5 months after the end of the intervention . In addition , facilitating and hindering factors for implementation of the intervention will be investigated . Discussion The use of a personal activity monitor in combination with web-based assisted individually tailored health promotion offers a good opportunity to work interactively with large groups of adolescents and young adults and provide them with advice based on their actual activity level . It has great potential to motivate people to change their behaviour and to our knowledge has not been evaluated before Mobile devices are a promising channel for delivering just-in-time guidance and support for improving key daily health behaviors . Despite an explosion of mobile phone applications aim ed at physical activity and other health behaviors , few have been based on theoretically derived constructs and empirical evidence . Eighty adults ages 45 years and older who were insufficiently physically active , engaged in prolonged daily sitting , and were new to smartphone technology , participated in iterative design development and feasibility testing of three daily activity smartphone applications based on motivational frames drawn from behavioral science theory and evidence . An “ analytically ” framed custom application focused on personalized goal setting , self-monitoring , and active problem solving around barriers to behavior change . A “ socially ” framed custom application focused on social comparisons , norms , and support . An “ affectively ” framed custom application focused on operant conditioning principles of reinforcement scheduling and emotional transference to an avatar , whose movements and behaviors reflected the physical activity and sedentary levels of the user . To explore the applications ' initial efficacy in changing regular physical activity and leisure-time sitting , behavioral changes were assessed across eight weeks in 68 participants using the CHAMPS physical activity question naire and the Australian sedentary behavior question naire . User acceptability of and satisfaction with the applications was explored via a post-intervention user survey . The results indicated that the three applications were sufficiently robust to significantly improve regular moderate-to-vigorous intensity physical activity and decrease leisure-time sitting during the 8-week behavioral adoption period . Acceptability of the applications was confirmed in the post-intervention surveys for this sample of midlife and older adults new to smartphone technology . Preliminary data exploring sustained use of the applications across a longer time period yielded promising results . The results support further systematic investigation of the efficacy of the applications for changing these key health-promoting behaviors Background . Overweight and obese older adults have high sedentary time . We tested the feasibility and preliminary effects of a sedentary time reduction intervention among adults over age 60 with a body mass index over 27 kg/m2 using a nonr and omized one-arm design . Methods . Participants ( N = 25 , mean age = 71.4 , mean body mass index = 34 ) completed an 8-week theory-based intervention targeting reduced total sitting time and increased sit-to-st and transitions . An inclinometer ( activPAL ™ ) measured the primary outcomes , change in total sitting time and sit-to-st and transitions . Secondary outcomes included physical activity ( ActiGraph GT3X+ accelerometer ) , self-reported sedentary behaviors , physical function ( Short Physical Performance Battery ) , depressive symptoms ( 8-item Patient Health Question naire ) , quality of life ( PROMIS ) , and study satisfaction . Paired t tests examined pre – post test changes in sitting time , sit-to-st and transitions , and secondary outcomes . Results . Inclinometer measured sitting time decreased by 27 min/day ( p < .05 ) and sit-to-st and transitions increased by 2 per day ( p > .05 ) , while st and ing time increased by 25 min/day ( p < .05 ) . Accelerometer measured sedentary time , light-intensity , and moderate-to-vigorous physical activity improved ( all p values ≤ .05 ) . Self-reported sitting time , gait speed , and depressive symptoms also improved ( all p values < .05 ) . Effect sizes were small . Study satisfaction was high . Conclusions . Reducing sitting time is feasible , and the intervention shows preliminary evidence of effectiveness among older adults with overweight and obesity . R and omized trials of sedentary behavior reduction in overweight and obese older adults , most of whom have multiple chronic conditions , may be promising A r and omly selected community cohort of 2000 Australian born women aged 45 to 55 were interviewed on the telephone and information obtained on their health and well-being . These women were divided into pre- , peri- , natural and surgical menopausal groups on their menstrual history . A physical activity question naire was sent to 1181 women in the first three of these groups . These question naires were completed and returned by 61.6 % of the women . The response rate in all groups was significantly associated with the years of education , employment status , body mass index ( BMI ) and self-rated health of the participants . The aim of the study was to test the hypothesis that physical activity is a major contributor to health and well-being by establishing the relationships between physical activity and certain health outcomes , such as menopausal symptoms , psychological well-being , self-rated health and BMI in this cohort of mid-life women . The inter-relationship between physical activity and other variables , including menopausal status , interpersonal stress , health related and preventive health behaviours was examined . Levels of  physical activity  were significantly associated with better self-rated health , lower BMI measurements , moderate alcohol intake and self-breast examination . There was no significant association between levels of physical activity , psychological well-being and women 's experience of symptoms during the natural menopause transition BACKGROUND The purpose of this study was to analyse both cross-sectional associations and how longitudinal changes in lifestyle factors from one state in 1980 - 1981 to another in 1988 - 1989 influence self-reported health status . Another aim was to estimate the hazard ratios for all-cause mortality for the changes in lifestyle factors and self-reported hypertension during the same period of time . METHOD The cross-sectional and the longitudinal analyses are based on the same simple r and om sample of 3,843 adults , aged 25 - 74 , interviewed in 1980 - 1981 and 1988 - 1989 and is part of the Swedish Annual Level-of-Living Survey . About 85 % of the respondents in the first interview participated in a second interview in 1988 - 1989 . Cross-sectional odds ratios , based on a marginal model , were estimated using the generalized estimating equations . The transitional models were analysed using unconditional logistic regression . A proportional hazard model was applied to investigate the influence of lifestyle transitions on mortality . RESULTS Physical inactivity , being a current or former smoker and obesity ( women only ) were strong risk factors for poor health either as main effects and /or combined ( interactions ) . There was a strong interaction between physical activity and smoking , and for women , also between body mass index ( BMI ) and physical activity . Smoking , physically inactive and obese women had about a ten times higher risk of poor health status than non-smoking , physically active , and normal-weight women . The corresponding risk for men was about five times higher . Physically active , but smoking and obese individuals showed only moderately increased risks for poor health status . The transitional model showed that those who were physically inactive in 1980 - 1981 , but did exercise in 1988 - 1989 , improved their health after adjustments for sociodemographic and other lifestyle factors . Continuing to smoke or being physically inactive or having hypertension at both points in time were all associated with higher hazard ratios for all-cause mortality ( 1.6 , 1.9 and 1.8 , respectively ) than those who reported that they were in good status at both points in time . CONCLUSIONS We found that physical activity protects against poor health irrespective of an increased BMI and smoking . The major clinical implication s are the long-st and ing benefits of physical activity and not smoking BACKGROUND Although inactivity is an important contributor to impaired functioning and disability with age , little is known concerning how improvements in physical functioning and well-being in older adults vary with the type of physical activity undertaken . METHODS One hundred three adults age 65 years and older , recruited via population -based methods , were r and omized to 12 months of community-based , moderate-intensity endurance and strengthening exercises ( Fit & Firm ) or stretching and flexibility exercises ( Stretch & Flex ) . A combination of class- and home-based exercise formats was used . Measured and self-rated physical performance along with perceived functioning and well-being were assessed pre- and postintervention . RESULTS Fit & Firm subjects showed greater 12-month improvements in both measured and self-rated endurance and strength compared to Stretch & Flex subjects . Stretch & Flex subjects reported greater improvements in bodily pain , and Stretch & Flex men evidence d greater improvements in flexibility relative to Fit & Firm subjects . Although overall exercise adherence was high in both exercise conditions ( approximately 80 % ) , subjects in both conditions showed better adherence to the home- versus class-based portions of their exercise prescriptions . CONCLUSIONS Community-based programs focusing on moderate-intensity endurance and strengthening exercises or flexibility exercises can be delivered through a combination of formats that result in improvement in important functional and well-being outcomes . This represents one of the first studies to report significant improvements in an important quality of life outcome -bodily pain-with a regular regimen of stretching and flexibility exercises in a community-based sample of older adults INTRODUCTION Project Graduate Ready for Activity Daily evaluated a program to promote physical activity through the transition of university graduation in a r and omized controlled trial . METHODS Three hundred thirty-eight university seniors participated in either a cognitive-behavioral intervention course or a knowledge-oriented general health course during the semester before graduation .  Behaviorally oriented phone and mail follow-up was delivered to the intervention group for 18 months . Physical activity outcomes and mediating variables were assessed at baseline , 1 and 2 years ( 93 % retention rate ) . RESULTS There were no significant intervention effects on physical activity outcomes at 2 years for either men or women . Experiential and behavioral processes of change were significantly improved for intervention women over 2 years . CONCLUSIONS Despite excellent participation in a theoretically based , well-attended intervention , few long-term effects on physical activity or its mediators were found . Additional research is needed to determine optimal interventions for physical activity and to vali date or alter current behavior change theory Objectives To examine the trajectories of physical activity from preretirement to postretirement and to further clarify whether the changes in physical activity are associated with changes in body weight . Design Prospect i ve . Setting French national gas and electricity company ( GAZEL cohort ) . Participants From the original sample of 20 625 employees , only those retiring between 2001 and 2008 on a statutory basis were selected for the analyses ( analysis 1 : n=2711 , 63 % men ; analysis 2 : n=3812 , 75 % men ) . Persons with data on at least one preretirement and postretirement measurement of the outcome were selected . Primary and secondary outcome measures All outcome data were gathered by question naires . In analysis 1 , the annual prevalence of higher physical activity ( walking ≥5 km/week ) 4 years before and after retirement was analysed . In analysis 2 , changes in leisure-time sport activities ( engagement , frequency and manner ) from preretirement to postretirement were analysed with simultaneous changes in body weight ( kilogram ) . Results In analysis 1 ( n=2711 ) , prevalence estimates for 4 years before and 4 years after retirement showed that higher leisure-time physical activity ( walking at least 5 km/week ) increased by 36 % in men and 61 % in women during the transition to retirement . This increase was also observed among people at a higher risk of physical inactivity , such as smokers and those with elevated depressive symptoms . In a separate sample ( analysis 2 , n=3812 ) , change in weight as a function of preretirement and postretirement  physical activity was analysed . Weight gain preretirement to postretirement was 0.85 ( 95 % CI 0.48 to 1.21 ) to 1.35 ( 0.79 to 1.90 ) kg greater among physically inactive persons ( decrease in activity or inactive ) compared with those physically active ( p<0.001 ) . Conclusions Retirement transition may be associated with beneficial changes in lifestyle and may thus be a good starting point to preventive interventions in various groups of individuals in order to maintain long-term changes PURPOSE Health interventions based on theory may be more effective than those that are not . This review of review s synthesizes all published r and omized controlled trial ( RCT ) meta-analytic evidence from the last decade to examine whether theory-based interventions were found to be associated with more effective  adult health behaviour change interventions . METHODS Systematic review s including meta-analyses were identified by search ing Medline , CINAHL , PsycINFO , and CDSR . A narrative synthesis was used to summarize and analyse the evidence . Only review s including RCTs of health behaviour change interventions with adults aged 18 + published from 2007 to 2017 were included . RESULTS Of 8,659 articles , nine systematic review s met inclusion criteria . The majority of review s ( n = 8) suggested no increased effectiveness for theory-based compared to non-theory-based interventions for effectiveness of outcomes relating to health behaviour . Less than half of the RCTs included in the review s reported the use of theory ( 85/183 ) . Two review s suggested interventions based on control theory , motivational interviewing , or self-determination theory were associated with greater effectiveness for physical activity and /or dietary interventions and outcomes . Method ological and reporting issues limit the conclusions . CONCLUSIONS Theory-based interventions as currently operationalized in systematic review s were not found to be more effective than non-theory-based interventions . Method ological and reporting issues at study and review level may not reflect the true utility of theory use within health behaviour interventions . The promotion of theory use may benefit from using a multifaceted argument , rather than a narrow focus of increased effectiveness . Statement of contribution What is already known on this subject ? Theory use is regularly promoted by cl aim ing that it will lead to more effective behaviour change interventions . Theory use has been frequently linked to effectiveness within systematic review s of behaviour change interventions . The theory-effectiveness hypothesis has not been systematic ally examined at the systematic review level . What does this study add ? Theory use as operationalized by systematic review authors was not associated with increased effectiveness within systematic review s examining r and omized controlled trials of behaviour change interventions in adults . Interventions based on control theory , motivational interviewing , or self-determination theory were associated with greater effectiveness for physical activity and /or dietary interventions and outcomes . Theory use should be promoted using a multifaceted argument , and assertions for increased effectiveness of theory-based interventions should only be used in domains where specific evidence exists to support this cl aim Purpose of review This review highlights recent work evaluating the relationship between exercise , physical activity and physical and mental health . Both cross-sectional and longitudinal studies , as well as r and omized clinical trials , are included . Special attention is given to physical conditions , including obesity , cancer , cardiovascular disease and sexual dysfunction . Furthermore , studies relating physical activity to depression and other mood states are review ed . The studies include diverse ethnic population s , including men and women , as well as several age groups ( e.g. adolescents , middle-aged and older adults ) . Recent findings Results of the studies continue to support a growing literature suggesting that exercise , physical activity and physical-activity interventions have beneficial effects across several physical and mental-health outcomes . Generally , participants engaging in regular physical activity display more desirable health outcomes across a variety of physical conditions . Similarly , participants in r and omized clinical trials of physical-activity interventions show better health outcomes , including better general and health-related quality of life , better functional capacity and better mood states . Summary The studies have several implication s for clinical practice and research . Most work suggests that exercise and physical activity are associated with better quality of life and health outcomes . Therefore , assessment and promotion of exercise and physical activity may be beneficial in achieving desired benefits across several population s. Several limitations were noted , particularly in research involving r and omized clinical trials . These trials tend to involve limited sample sizes with short follow-up periods , thus limiting the clinical implication s of the benefits associated with physical activity . Abbreviations CAD : coronary artery disease ; COPD : chronic obstructive pulmonary disease ; CRP : cardiac rehabilitation program ; CVD : cardiovascular disease ; GMCB : group-mediated cognitive – behavioural ; HRQOL : health-related quality of life Sedentary behavior among older adults increases risk for chronic diseases . Physicians in a primary care setting can play an important role in promoting physical activity adoption among their older patients . The Physically Active for Life ( PAL ) project was a r and omized , controlled trial comparing the efficacy of brief physician-delivered physical activity counseling to usual care on self-reported physical activity levels . The physical activity counseling was based on the Transtheoretical Model of Change and social learning theory . Twenty-four community-based primary care medical practice s were recruited into the study ; 12 were r and omized to the Intervention condition and 12 to the Control condition . Physicians in the Intervention practice s received training in the delivery of brief physical activity counseling . Subjects in the Intervention practice s ( n=181 ) received brief activity counseling matched to their stage of motivational readiness for physical activity , a patient manual , a follow-up appointment with their physician to discuss activity counseling , and newsletter mailings . Subjects in the Control practice s ( n=174 ) received st and ard care .  Measures of motivational readiness for physical activity and the Physical Activity Scale for the Elderly ( PASE ) were administered to subjects in both conditions at baseline , 6 weeks following their initial appointment , and at 8 months . Results showed that at the 6-week follow-up , subjects in the Intervention condition were more likely to be in more advanced stages of motivational readiness for physical activity than subjects in the Control condition . This effect was not maintained at the 8 month follow-up and the intervention did not produce significant changes in PASE scores . Results suggest that more intensive , sustained interventions may be necessary to promote the adoption of physical activity among sedentary , middle-aged , and older adults in primary care medical practice BACKGROUND Using peer volunteers as delivery agents may improve translation of evidence -based physical activity promotion programs for older adults . This study examined whether tailored support from older peer volunteers could improve initiation and long-term maintenance of physical activity behavior . METHODS Participants were r and omized to 2 16-week , group-based  programs : ( 1 ) peer-delivered , theory-based support for physical activity behavior change ; or ( 2 ) an intervention typically available in community setting s ( basic education , gym membership , and pedometer for self-monitoring ) , attention-matched with health education .  Moderate-to-vigorous physical activity ( MVPA ) was assessed via daily self-report logs at baseline , at the end of the intervention ( 16 weeks ) , and at follow-up ( 18 months ) , with accelerometry validation ( RT3 ) in a r and om sub sample . RESULTS Seven peer volunteers and 81 sedentary adults were recruited .  Retention at the end of the trial was 85 % and follow-up at 18 months was 61 % . Using intent-to-treat analyses , at 16 weeks , both groups had similar significant improvements in MVPA . At 18 months , the group supplemented with peer support had significantly more MVPA . CONCLUSIONS Trained peer volunteers may enhance long-term maintenance of physical activity gains from a community-based intervention . This approach has great potential to be adapted and delivered inexpensively in community setting The sustainability of health and social care systems is threatened by a growing population of older persons with heterogeneous needs related to multimorbidity , frailty , and increased risk of functional impairment . Since disability is difficult to reverse in old age and is extremely burdensome for individuals and society , novel strategies should be devised to preserve adequate levels of function and independence in late life . The development of mobility disability , an early event in the disablement process , precedes and predicts more severe forms of inability . Its prevention is , therefore , critical to impede the transition to overt disability . For this reason , the Sarcopenia and Physical fRailty IN older people : multi-componenT Treatment strategies ( SPRINTT ) project is conducting a r and omized controlled trial ( RCT ) to test a multicomponent intervention ( MCI ) specifically design ed to prevent mobility disability in high-risk older persons . SPRINTT is a phase III , multicenter RCT aim ed at comparing the efficacy of a MCI , based on long-term structured physical activity , nutritional counseling/dietary intervention , and an information and communication technology intervention , versus a healthy aging lifestyle education program design ed to prevent mobility disability in 1500 older persons with physical frailty and sarcopenia who will be followed for up to 36 months . The primary outcome of the SPRINTT trial is mobility disability , operationalized as the inability to walk for 400 m within 15 min , without sitting , help of another person , or the use of a walker . Secondary outcomes include changes in muscle mass and strength , persistent mobility disability , falls and injurious falls , disability in activities of daily living , nutritional status , cognition , mood , the use of healthcare re sources , cost-effectiveness analysis , quality of life , and mortality rate . SPRINTT results are expected to promote significant advancements in the management of frail older persons at high risk of disability from both clinical and regulatory perspectives . The findings are also projected to pave the way for major investments in the field of disability prevention in old age Many older adults with hearing impairment continue to have substantial communication difficulties after being fitted with hearing aids , and many do not choose to wear hearing aids . Two group communication education programs aim ed at such older people are described . The ‘ Keep on Talking ’ program has a health promotion focus , and is aim ed at maintaining communication for older adults living in the community . An experimental group ( n=120 ) attended the program , and a control group ( n = 130 ) received a  communication assessment but no intervention . Significant improvements were found in the experimental participants in terms of knowledge about communication changes with age and about strategies to maintain communication skills . At the follow-up evaluation at 1 year , 45 % of the experimental group , compared to 10 % of the control group , had acted to improve their communication skills . The ‘ Active Communication Education ’ program focuses on the development of problem-solving strategies to improve communication in everyday life situations . Preliminary outcomes have been assessed on a small scale ( n=14 ) to date . It is concluded that communication programs represent an important adjunct to , or supplement for , the traditional approach that focuses on hearing aid fitting In the past few years , alliances between primary care and leisure services have become a popular strategy for exercise promotion in the Engl and . ' GP Referral Schemes ' typically involve referral to a local leisure centre by a General Practitioner ( GP ) , whereupon patients are inducted into a 10 - 12 week exercise programme at a reduced fee . Referred patients are usually white , middle aged and apparently healthy women , with the main reason for referral being overweight . The schemes are characterised by their lack of formal evaluation , making conclusions about effectiveness impossible . In the US , physicians advice to exercise has been the focus of interventions to date . Two controlled trials , one r and omised , have provided some evidence that exercise behaviour can be changed , at least in the short term . The ability to recruit sufficient numbers of patients , who have potentially the most to gain from increased physical activity , is the biggest barrier to primary care based interventions . One contributing factor to this problem , may be doctors and nurses ' knowledge about the benefits of physical activity Background Meeting the needs of the growing number of older people is a challenge for health and social care services . Home-based interventions aim ing to modify health-related behaviours of frail older people have the potential to improve functioning and well-being . Previous review s have focused on whether such interventions are effective , rather than what might make them effective . Recent advances in behavioural science make possible the identification of potential ‘ active ingredients ’ of effective interventions , such as component behaviour change techniques ( BCTs ) , and intended intervention functions ( IFs ; e.g. to educate , to impart skills ) . This paper reports a protocol for a systematic review that seeks to ( a ) identify health behaviour change interventions for older frail people , ( b ) describe the content of these interventions , and ( c ) explore links between intervention content and effectiveness . The protocol is reported in accordance with Preferred Reporting Items for Systematic Review s and Meta-Analyses Protocol s ( PRISMA -P ) 2015 guidelines . Methods / design Studies will be identified through a systematic search of 15 electronic data bases , supplemented by citation tracking . Studies will be retained for review where they report r and omised controlled trials focusing on home-based health promotion delivered by a health professional for frail older people in community setting s , written in English , and either published from 1980 onwards , or , for registered trials only , unpublished but completed with results obtainable from authors . Interventions will be coded for their content ( BCTs , IFs ) and for evidence of effectiveness ( outcome data relating to behavioural and health outcomes ) . Analyses will describe characteristics of all interventions . Interventions for which effectiveness data are available will be categorised into those showing evidence of effectiveness versus those showing no such evidence . The potential for each intervention characteristic to contribute to change in behaviour or health outcomes will be estimated by calculating the percentage of all interventions featuring those characteristics that have shown effectiveness . Discussion Results will reveal the strategies that have been drawn on within home-based interventions to modify the health behaviours of frail older people , and highlight those more associated with positive changes in behaviour and health . Findings from this review will provide a useful basis for underst and ing , developing , and implementing behaviour change interventions in this field . Systematic review registration PROSPERO Background : Mobile technology to promote exercise is effective ; however , most evidence is from studies of younger groups in high-income countries . Investigating if short message service ( SMS ) texting can affect exercise participation in older adults from an upper-middle-income country is important considering the proliferation of mobile phones in developing regions and the increased interest of older adults in using mobile phones . Objective : The main objective was to examine the short- and long-term effects of  SMS text messaging on exercise frequency in older adults . Secondary objectives were to investigate how SMS text messages impact study participants ’ exercise frequency and the effects of the intervention on secondary outcomes . Methods : The Malaysian Physical Activity for Health Study ( myPAtHS ) was a 24-week , 2-arm , parallel r and omized controlled trial conducted in urban Malaysia . Participants were recruited via health talks in resident associations and religious facilities . Older Malaysians ( aged 55 - 70 years ) who used mobile phones and did not exercise regularly were eligible to participate in the study . Participants r and omly allocated to the SMS texting arm received an exercise booklet and 5 weekly SMS text messages over 12 weeks . The content of the SMS text messages was derived from effective behavior change techniques . The non-SMS texting arm participants received only the exercise booklet . Home visits were conducted to collect outcome data : ( 1 ) exercise frequency at 12 and 24 weeks , ( 2 ) secondary outcome data ( exercise self-efficacy , physical activity-related energy expenditure , sitting time , body mass index , grip and leg strength ) at baseline and at 12 and 24 weeks . Intention-to-treat procedures were applied for data analysis . Semistructured interviews focusing primarily on the SMS text messages and their impact on exercise frequency were conducted at weeks 12 and 24 . Results : In total , 43 participants were r and omized into the SMS texting arm ( n=22 ) and the non-SMS texting arm ( n=21 ) . Study -unrelated injuries forced 4 participants to discontinue after a few weeks ( they were not included in any analyses ) . Overall retention was 86 % ( 37/43 ) . After 12 weeks , SMS texting arm participants exercised significantly more than non-SMS texting arm participants ( mean difference 1.21 times , bias-corrected and accelerated bootstrap [ BCa ] 95 % CI 0.18 - 2.24 ) . Interview analysis revealed that the SMS text messages positively influenced SMS texting arm participants who experienced exercise barriers . They described the SMS text messages as being encouraging , a push , and a reminder . After 24 weeks , there was no significant difference between the research arms ( mean difference 0.74 , BCa 95 % CI –0.30 to 1.76 ) . There were no significant effects for secondary outcomes . Conclusions : This study provides evidence that SMS text messaging is effective in promoting exercise in older adults from an upper-middle-income country . Although the effects were not maintained when SMS text messaging ceased , the results are promising and warrant more research on behavioral mobile health interventions in other regions OBJECTIVE To assess the efficacy of physical activity promotion in primary care office setting s. DESIGN Systematic review of clinical trials in which the efficacy of physical activity promotion was investigated in a primary care office setting with at least one month of follow up . SUBJECTS A total of 13,981 adults , aged 17 - 85 + , were included from 203 practice s in eight trials assessing physical activity promotion in primary care office setting s. MAIN OUTCOME MEASURES Odds ratios and 95 % confidence intervals were calculated comparing the number of participants who increased their physical activity or were active at follow up in the intervention group with a control group for each study . RESULTS Five of eight trials where positive with statistically significant results ( range 0.91 - 6.56 ) , but significant biases or limited clinical relevance of the outcomes were found in all trials . Short term trials of less than one year ( four of four were positive ) , single-risk-factor trials ( three of three were positive ) , r and omised clinical trials ( two of three were positive ) , and those assessing moderate levels of physical activity ( three of four were positive ) were most likely to find benefit . Only one of four trials lasting longer than a year were positive . CONCLUSION There is limited evidence from well design ed trials that office based physical activity promotion in primary care setting s is efficacious in promoting changes in physical activity that could conceivably have lasting clinical benefits OBJECTIVE health-related quality of life ( HRQOL ) and mental well-being are associated with healthy ageing . Physical activity positively impacts both HRQOL and mental well-being .  Yoga is a physical activity that can be modified to suits the needs of older people and is growing in popularity . We conducted a systematic review with meta- analysis to determine the impact of yoga-based exercise on  HRQOL and mental well-being in people aged 60 + . METHODS search es were conducted for relevant trials in the following electronic data bases ; MEDLINE , EMBASE , Cochrane Central Register of Controlled Trials , CINAHL , Allied and Complementary Medicine Data base , PsycINFO and the Physiotherapy Evidence Data base ( PEDro ) from inception to January 2017 . Trials that evaluated the effect of physical yoga on HRQOL and /or on mental well-being  in people aged 60 + years were included . Data on HRQOL and mental well-being were extracted . St and ardised mean differences and 95 % confidence intervals ( CI ) were calculated using r and om effects models . Method ological quality of trials was assessed using the PEDro scale . RESULTS twelve trials of high method ological quality ( mean PEDro score 6.1 ) , totalling 752 participants , were identified and provided data for the meta- analysis . Yoga produced a medium effect on HRQOL ( Hedges ' g = 0.51 , 95 % CI 0.25 - 0.76 , 12 trials ) and a small effect on mental well-being ( Hedges ' g = 0.38 , 95 % CI 0.15 - 0.62 , 12 trials ) . CONCLUSION yoga interventions result ed in small to moderate improvements in both HRQOL and mental well-being in people aged 60 + years . Further , research is needed to determine the optimal dose of yoga to maximise health impact . PROSPERO REGISTRATION NUMBER ( CRD42016052458 ) Increasing evidence suggests that physical activity can prevent some aspects of mental illness in older people such as depression , dementia and Alzheimer ’s disease . Additionally , limited research has shown that engagement in structured exercise can improve aspects of psychological well-being such as mood and self-perceptions in older adults . However , the relationship between incidental daily activity such as walking or time spent sedentary , with psychological well-being has not been investigated . The Better Ageing Project provided an opportunity to assess well-being and quality of life using st and ardised question naires with 176 adults aged 70 and over .  Accelerometry was used to objective ly assess daily energy expended in physical activity at different levels of intensity . In addition , an assessment of the impact of the 12-month Better Ageing structured group exercise programme was assessed through question naires and interviews . Total daily physical activity energy expenditure ( joules/day ) and amount of time spent in activity of at least moderate intensity were weakly related ( r = 0.20–0.28 ) to quality of life , subjective well-being and physical self-perceptions . Time spent sedentary ( min/day ) was weakly and negatively related to several mental health indicators . The quantitative data showed only minor psychological benefits of the exercise intervention . In contrast , interviews with 27 research participants and 4 exercise leaders suggested that important improvements in perceived function and social benefits had been experienced ABSTRACT We aim ed to evaluate a strength and balance program delivered in the community . There is little evidence of implementation of evidence -based exercise in practice . The program was a step-down model , design ed to encourage long-term exercise in community classes . The program consisted of a fully funded referral only evidence -based 12-week strength and balance ( Community Otago ) class  , followed by an evidence -based continuous open-access community strength and balance class ( Active Always ) . The program was offered to patients : 1 ) after formal falls rehabilitation ( falls and fracture service ) ; 2 ) after falls rehabilitation in intermediate care ; and 3 ) referred by a GP who were not eligible for rehabilitation ( preventative measure ) . Outcome evaluation used descriptive statistics to report changes in function , confidence in balance , hospital attendance/admission for falls/fractures and transition to community classes . Focus groups established participant experience/satisfaction . Seventy-nine participants were included , aged 56–96 , and 53 ( 67 % ) were women . About 63.3 % of patients transitioned to Active Always classes , demonstrating improvement in maintenance . Follow-up scores from baseline attendance at falls and fracture service to 12-weeks follow-up ( 24 weeks ) in Community Otago showed the majority of patients improved their function ( Timed up and Go ) , confidence ( ConfBal ) and lowered their falls risk ( Tinetti ) . Follow-up of participants from Community Otago baseline to the end of 12-weeks showed improvement in function and confidence , but only a third of participants lowered their falls risk . Focus groups data suggest that continuity of delivery , the role of the instructor , health professional , and social and physical outcomes were essential for maintenance . A supportive environment can be created which encourages older adults ’ continued participation in group-based strength and balance , helping the delivery of evidence -based practice Background Systematic review s have identified a range of brief interventions which increase physical activity in previously sedentary people . There is an absence of evidence about whether follow up beyond three months can maintain long term physical activity . This study assesses whether it is worth providing motivational interviews , three months after giving initial advice , to those who have become more active . Methods / Design Study c and i date s ( n = 1500 ) will initially be given an interactive DVD and receive two telephone follow ups at monthly intervals checking on receipt and use of the DVD . Only those that have increased their physical activity after three months ( n = 600 ) will be r and omised into the study . These participants will receive either a " mini booster " ( n = 200 ) , " full booster " ( n = 200 ) or no booster ( n = 200 ) . The " mini booster " consists of two telephone calls one month apart to discuss physical activity and maintenance strategies . The " full booster " consists of a face-to-face meeting with the facilitator at the same intervals . The purpose of these booster sessions is to help the individual maintain their increase in physical activity . Differences in physical activity , quality of life and costs associated with the booster interventions , will be measured three and nine months from r and omisation . The research will be conducted in 20 of the most deprived neighbourhoods in Sheffield , which have large , ethnically diverse population s , high levels of economic deprivation , low levels of physical activity , poorer health and shorter life expectancy . Participants will be recruited through general practice s and community groups , as well as by postal invitation , to ensure the participation of minority ethnic groups and those with lower levels of literacy . Sheffield City Council and Primary Care Trust fund a range of facilities and activities to promote physical activity and variations in access to these between neighbourhoods will make it possible to examine whether the effectiveness of the intervention is modified by access to community facilities . A one-year integrated feasibility study will confirm that recruitment targets are achievable based on a 10 % sample . Discussion The choice of study population , study interventions , brief intervention preceding the study , and outcome measure are discussed . Trial Registration Current Controlled Trials : IS RCT N56495859 ; Clinical Trials.gov : NCT00836459 Background Case management has been applied in community aged care to meet frail older people ’s holistic needs and promote cost-effectiveness . This systematic review aims to evaluate the effects of case management in community aged care on client and carer outcomes . Methods We search ed Web of Science , Scopus , Medline , CINAHL ( EBSCO ) and PsycINFO ( CSA ) from inception to 2011 July . Inclusion criteria were : no restriction on date , English language , community-dwelling older people and /or carers , case management in community aged care , published in refereed journals , r and omized control trials ( RCTs ) or comparative observational studies , examining client or carer outcomes . Quality of studies was assessed by using such indicators as quality control , r and omization , comparability , follow-up rate , dropout , blinding assessors , and intention-to-treat analysis . Two review ers independently screened potentially relevant studies , extracted information and assessed study quality . A narrative summary of findings were presented . Results Ten RCTs and five comparative observational studies were identified . One RCT was rated high quality . Client outcomes included mortality ( 7 studies ) , physical or cognitive functioning ( 6 studies ) , medical conditions ( 2 studies ) , behavioral problems ( 2 studies ) , unmet service needs ( 3 studies ) , psychological health or well-being ( 7 studies ) , and satisfaction with care ( 4 studies ) , while carer outcomes included stress or burden ( 6 studies ) , satisfaction with care ( 2 studies ) , psychological health or well-being ( 5 studies ) , and social consequences ( such as social support and relationships with clients ) ( 2 studies ) . Five of the seven studies reported that case management in community aged care interventions significantly improved psychological health or well-being in the intervention group , while all the three studies consistently reported fewer unmet service needs among the intervention participants . In contrast , available studies reported mixed results regarding client physical or cognitive functioning and carer stress or burden . There was also limited evidence indicating significant effects of the interventions on the other client and carer outcomes as described above . Conclusions Available evidence showed that case management in community aged care can improve client psychological health or well-being and unmet service needs . Future studies should investigate what specific components of case management are crucial in improving clients and their carers ’ outcomes BACKGROUND Poorly executed transfers of older patients from hospitals to long-term care facilities carry the risk of fragmentation of care , poor clinical outcomes , inappropriate use of emergency department services , and hospital readmission . OBJECTIVE This study was conducted to assess the impact of adding a pharmacist transition coordinator on evidence -based medication management and health outcomes in older adults undergoing first-time transfer from a hospital to a long-term care facility . METHODS This r and omized , single-blind , controlled trial enrolled hospitalized older adults awaiting transfer to a long-term residential care facility for the first time . Patients were r and omized either to receive the services of the pharmacist transition coordinator ( intervention group ) or to undergo the usual hospital discharge process ( control group ) . The intervention included medication-management transfer summaries from hospitals , timely coordinated medication review s by accredited community pharmacists , and case conferences with physicians and pharmacists . The primary outcome was the quality of prescribing , measured using the Medication Appropriateness Index ( MAI ) . Secondary outcomes were emergency department visits , hospital readmissions , adverse drug events , falls , worsening mobility , worsening behaviors , increased confusion , and worsening pain . RESULTS One hundred ten older adults ( 67 women , 43 men ; mean [ SD ] age , 82.7 [ 6.4 ] years ) were recruited from 3 metropolitan hospitals and assigned to 85 metropolitan long-term care facilities . Fifty-six patients were r and omized to the intervention group and 54 to the control group ; 44 patients in each group were evaluable at 8-week follow-up . There were no significant differences in baseline characteristics between treatment groups , with the exception of the number of medications discontinued during hospitalization : a mean of 1.1 more drugs was discontinued in the control group compared with the intervention group ( P = 0.011 ) . The majority of patients ( 35 [ 62.5 % ] in the intervention group , 41 [ 76.0 % ] in the control group ) changed physicians as part of the transition to a long-term care facility . At 8-week follow-up , there was no change in MAI from baseline in the intervention group , whereas it had worsened in the control group ( mean [ 95 % CI ] , 2.5 [ 1.4 - 3.7 ] vs 6.5 [ 3.9 - 9.1 ] , respectively ; P = 0.007 ) . Patients who received the intervention and were alive at follow-up exhibited a significant protective effect of the intervention against worsening pain ( relative risk ratio [ 95 % CI ] , 0.55 [ 0.32 - 0.94 ] ; P = 0.023 ) and hospital usage ( i.e. , the combination of emergency department visits and hospital readmissions ) ( 0.38 [ 0.15 - 0.99 ] ; P = 0.035 ) , but did not differ from control patients in terms of adverse drug events ( 1.05 [ 0.66 - 1.68 ] ) , falls ( 1.19 [ 0.71 - 1.99 ] ) , worsening mobility ( 0.39 [ 0.13 - 1.15 ] ) , worsening behaviors ( 0.52 [ 0.25 - 1.10 ] ) , or increased confusion ( 0.59 [ 0.28 - 1.22 ] ) . When data for patients who had died were included , the intervention had no effect on hospital usage in all patients ( 0.58 [ 0.28 - 1.21 ] ) . CONCLUSIONS Older people transferring from hospital to a long-term care facility are vulnerable to fragmentation of care and adverse events . In this study , use of a pharmacist transition coordinator improved aspects of inappropriate use of medicines across health sectors Objective : The aim of this study was to examine changes in health-related quality of life ( HRQL ) during the menopausal transition , controlling for chronological aging , symptoms , and other covariates . Methods : This was a prospect i ve , longitudinal study of women aged 42 to 52 years at baseline recruited at seven US sites ( N = 3,302 ) in the multiethnic Study of Women 's Health Across the Nation . Women eligible for the cohort had an intact uterus , had at least one ovary , were not currently using exogenous hormones , were either premenopausal or early perimenopausal , and were self-identified as one of the study 's design ated racial/ethnic groups . Data from the baseline interview and six annual follow-up visits are reported . HRQL was assessed with five subscales from the Medical Outcomes Study Short-Form Health Survey , with reduced functioning defined as being in the lowest 25 % on a subscale . Covariates included symptoms , medical conditions , sociodemographics variables , physical activity , and psychological factors . Results : With adjustment for baseline age , chronological aging , and relevant covariates , the odds of reduced role-physical functioning were significantly greater at late perimenopause ( odds ratio , 1.46 ; 95 % CI , 1.08 - 1.99 ) and postmenopause ( odds ratio , 1.49 ; 95 % CI , 1.09 - 2.04 ) compared with premenopause . Menopause status was unrelated to bodily pain , vitality , role-emotional , or social functioning .  Hormone therapy users were more likely to report reduced functioning . Other variables significantly related to HRQL across all domains included vasomotor symptoms , urine leakage , poor sleep , arthritis , depressed mood , perceived stress , and stressful life events . Conclusions : The menopausal transition showed little impact on HRQL when adjusted for symptoms , medical conditions , and stress Background Musculoskeletal disorders ( MSDs ) are the leading cause of work disability and sickness absence worldwide . The prevalence of MSDs increases with age , consequently challenging sustainable employability among the growing ageing workforce . Knowledge of feasible and efficient workplace-based interventions to rehabilitate MSD or prevent its consequences is therefore warranted . This systematic review will evaluate the effectiveness of workplace-based interventions on MSDs and its consequences among adult workers with physical and sedentary work tasks , respectively . Methods We will search the following bibliographic data bases : PubMed ( including the data base ‘ MEDLINE ’ ) and Web of Science Core Collection ( including the data bases ‘ Science Citation Index Exp and ed ’ , ‘ Social Sciences Citation Index ’ and ‘ Arts & Humanities Citation Index ’ ) . Manual search es will also be performed . We will include r and omised controlled trials ( RCTs ) and non- RCTs reported in English in which ( 1 ) participants are adult workers with MSD , ( 2 ) interventions are aim ing at rehabilitating pain symptoms of MSD or preventing the consequences of MSD and ( 3 ) interventions are initiated and /or carried out at the workplace . The review will adhere to the ‘ Preferred Reporting Items for Systematic review s and Meta-Analyses ’ ( PRISMA ) guidelines for reporting systematic review s and the Institute for Work and Health ( IWH ) guidelines for workplace-based interventions . For the primary evaluation of the review , the quality assessment and evidence synthesis will conform to the IWH guidelines . Secondary evaluation will include a meta- analysis ( unless the included studies do not allow this due to heterogeneity ) and employ the risk of bias domains recommended by Cochrane along with the Grading of Recommendations , Assessment , Development and Evaluations ( GRADE ) approach on the studies with pain intensity as an outcome . Discussion This systematic review will provide knowledge on effective workplace-based interventions among physical and sedentary workers with MSD . RCTs are considered the most powerful experimental design in clinical trials , but solely including these may be too restrictive to underst and effective workplace-based interventions where r and omised and carefully controlled trials ( RCTs ) are not always possible . In order to maximize practical relevance , the selection process will , therefore , include both RCTs and non- RCTs and the quality assessment and evidence synthesis will conform to IWH guidelines focusing on developing practical guidelines for stakeholders . The result of this work will form the basis for industry-specific evidence -based recommendations on effective workplace-based interventions for rehabilitation of MSDs and its consequences that will later be operationalised into concrete and user-friendly practical tools for workplaces . Systematic review registration International Prospect i ve Register of Systematic Review s ( PROSPERO ) number CRD42018116752 The objectives of this prospect i ve cohort study , conducted in New Haven , Connecticut , from 1998 to 2004 , were to describe disability states experienced by older persons , to evaluate the rate of transitions between states and the duration of disability episodes , and to determine whether these findings differ on the basis of physical frailty -- a condition of low physical capacity and vulnerability to adverse functional outcomes . Participants included 754 persons aged 70 years or older who were initially independent in four key activities of daily living : bathing , dressing , walking , or transferring .  Disability was assessed during monthly telephone interviews for a median of 60 months , and participants were classified each month according to the following four states : no disability , mild disability ( one or two activities ) , severe disability ( three or four activities ) , and death . Transitions between states of disability and independence were common , with a majority of both frail and nonfrail participants experiencing at least one transition . The rate of transitions varied greatly among individuals . Nonfrail participants had lower rates of transition from less to more disability , higher rates of transition from more to less disability , and slightly shorter duration s of disability . To fully underst and the disabling process , investigators and clinicians must consider the episodic and recurrent nature of disability Introduction Large proportions of the population are not meeting recommended levels of physical activity and have increasingly sedentary lifestyles . Low levels of physical activity are predictive of poor health outcomes and time spent sedentary is related to a host of risk factors independently of physical activity levels . Building an evidence base of the best approaches to intervene in the lifestyles of inactive individuals is crucial in preventing long-term disease , disability and higher mortality rates . Methods and analysis Systematic search es will be conducted on all relevant data bases ( eg , PubMed , Scopus , CINAHL , PsycINFO ) . Studies will be included if they assess interventions aim ed at changing physical activity or sedentary behaviour levels in adults ( over 18 ) who are inactive and do not suffer from chronic conditions . Studies must also be r and omised controlled trials ( RCTs ) , have a primary outcome of physical activity or sedentary behaviour , and measure outcomes at least 6 months after intervention completion . Studies will be coded using the Behaviour Change Technique ( BCT ) taxonomy v1 and Template for Intervention Description and Replication ( TIDieR ) guidelines . 2 review ers will independently screen full-text articles and extract data on study characteristics , participants , BCTs , intervention features and outcome measures . Study quality will also be assessed independently by 2 review ers using the Cochrane risk of bias tool . A meta- analysis will be considered if there is sufficient homogeneity across outcomes . GRADE criteria will be used to assess quality of evidence . Dissemination This will be the first review to systematic ally appraise interventions aim ed at changing the physical activity or sedentary behaviour of inactive individuals using RCT design s with a 6-month follow-up post-intervention . This review will better inform intervention design ers targeting inactive population s and inform the design of a future complex intervention . Review registration number This protocol was registered with the International Prospect i ve Register of Systematic Review s ( PROSPERO ) on 17 October 2014 ( registration number : CRD42014014321 ) There is compelling evidence supporting the benefits of increased regular physical activity in older adults . The Experience Corps program in Baltimore MD was design ed in part as a community based approach to increasing physical activity that would also appeal to older adults who have historically not utilized health promotion programs . The Baltimore Experience Corps program places older volunteers in public elementary schools for 15 h a week in roles design ed to improve the academic outcomes of children and , simultaneously , increase the physical , cognitive and social activity of volunteers . This paper reports on the change in physical activity levels among older adults associated with participation in the Baltimore Experience Corps . In a pilot r and omized controlled evaluation , older adults were r and omly assigned to  Experience Corps ( EC participants ) or a waiting list control group . Ages ranged from 59–86 years , 96 % were African American , 94 % were women , and 84 % had annual incomes less than $ 15,000 . EC participants were required to serve ≥15 h a week . At follow-up after 4–8 months , an analysis of 113 r and omized volunteers revealed 53 % of the EC participants were more  active than the previous year by self-report , as compared to 23 % of the controls ( p<0.01 ) . When adjusted for age , gender and education , there was a trend toward increased physical activity in the EC participants as calculated by a kilocalorie per week increase of 40 % , versus a 16 % decrease in the controls ( p=0.49 ) . EC participants who reported “ low activity ” at baseline experienced an average 110 % increase in their physical activity at follow-up . Among the controls who were in the “ low activity ” group at baseline , there was , on average , only a 12 % increase in physical activity ( p=0.03 ) . Among those who were previously active , there was no significant difference ( p=0.30 ) . The pilot results suggest that a high intensity volunteer program that is design ed as a health promotion intervention can lead , in the short-term , to significant improvements in the level of physical activity of previously inactive older adult volunteers Physical inactivity among middle- and older-aged adults is pervasive , and is linked with numerous chronic conditions that diminish health and functioning . Counselor-directed physical activity programs may enhance extrinsic motivation ( reflected in social influence theories , such as self-presentation theory ) and , in turn , physical activity adherence , while the counselor is in charge of program delivery . However , external influences can undermine intrinsic motivation , making it more difficult to maintain physical activity once counselor-initiated contact ends . In contrast , programs that diminish the socially evaluative and controlling aspects of the counseling interchange may promote intrinsic motivation ( described in cognitive evaluation theory ) , and , thus , physical activity maintenance , even when counselor-initiated contact ceases . The objective of the Community Health Advice by Telephone ( CHAT ) project is to compare these two theories by conducting a r and omized controlled trial evaluating the effects of a telephone-administered counseling program delivered by a person ( social influence enhancement ) or computer ( cognitive evaluation enhancement ) on physical activity adoption and maintenance over 18 months . Healthy , sedentary adults ( n = 225 ) aged 55 years and older are r and omized to one of these programs or to a control arm . This study will contribute to advancing motivational theory as well as provide information on the sustained effectiveness of interventions with substantial public health applicability Background : Promoting the health of transitional frail elders ( e.g. , through therapeutic-based yoga exercises ) is essential to reduce healthcare expenditures caused by chronic health problems . Objective : The purpose of this study was to determine the efficacy of 24 weeks of the senior-tailored silver yoga ( SY ) exercise program for transitional frail elders . Methods : A convenience sample of 69 elders in assisted living facilities were assigned r and omly to the  SY group ( n = 38 ) or to the  control group ( n = 31 ) on the basis of the facilities where they resided , and 55 of them completed this quasi-experimental pretest and posttest study . Intervention was conducted three times per week , 70 minutes per session , for 24 weeks . Physical fitness ( body composition , cardiovascular-respiratory functions , body flexibility , muscle power and endurance , balance , and agility ) were examined at baseline , at 12 weeks , and at the end of the 24th week of the study . Results : At the end of the study , the physical fitness indicators of participants in the SY group had improved significantly , and they had better physical fitness than participants in the control group ( all p values < .05 ) . Discussion : It was recommended that the SY exercises be incorporated as an activity program in assisted living facilities to promote the physical fitness of transitional frail elders Project GRAD ( Graduate Ready for Activity Daily ) was a r and omized controlled study to teach university seniors behavioral skills necessary for increasing and /or maintaining physical activity habits in preparation for the transition to working adult roles after graduation . This study examines the secondary effects of this intervention on body image concerns among college-aged men and women . Three hundred thirty-eight undergraduates ( 54 % female , M age = 24 years , SD = 1.95 ; M Body Mass Index = 24.26 , SD = 4.0 ) were studied . The sample was 61 % Anglo , 16 % Latino , 16 % Asian/Pacific Isl and er , 4 % African American , and 3 % Native American/Other .  Body image concerns were assessed at pre- and posttreatment using 2 subscales of the Eating Disorder Inventory : Drive for Thinness and Body Dissatisfaction . Because the latter concentrates on body parts typically associated with female concerns ( e.g. , thighs , hips , buttocks ) , a parallel scale was developed to target body parts that may be of more concern to men ( e.g. , legs , shoulders , arms , stomach ) . Results indicated that compared to the control group , women in the intervention showed a significant increase in drive for thinness without any changes in body dissatisfaction . For men , there were no significant changes in drive for thinness or body dissatisfaction . These results suggest that physical activity interventions may have some negative consequences of increasing concerns about thinness in women . This negative effect occurred despite intervention content design ed to prevent concern over eating , dieting , and the importance of weight . Health promotion studies should include assessment s of potential negative side effects The Lifestyle Interventions and Independence for Elders ( LIFE ) Study is a Phase III r and omized controlled clinical trial ( Clinical trials.gov identifier : NCT01072500 ) that will provide definitive evidence regarding the effect of physical activity ( PA ) on major  mobility disability in older adults ( 70–89 years old ) who have compromised physical function . This paper describes the methods employed in the delivery of the LIFE Study PA intervention , providing insight into how we promoted adherence and monitored the fidelity of treatment . Data are presented on participants ’ motives and self-perceptions at the onset of the trial along with accelerometry data on patterns of PA during exercise training . Prior to the onset of training , 31.4 % of participants noted slight conflict with being able to meet the dem and s of the program and 6.4 % indicated that the degree of conflict would be moderate . Accelerometry data collected during PA training revealed that the average intensity – 1,555 counts/minute for men and 1,237 counts/minute for women – was well below the cutoff point used to classify exercise as being of moderate intensity or higher for adults . Also , a sizable subgroup required one or more rest stops . These data illustrate that it is not feasible to have a single exercise prescription for older adults with compromised function . Moreover , the concept of what constitutes “ moderate ” exercise or an appropriate volume of work is dictated by the physical capacities of each individual and the level of comfort/stability in actually executing a specific prescription Background The increased prevalence of overweight and obesity warrants preventive actions , particularly among people in transitional stages associated with lifestyle changes , such as occupational retirement . The purpose is to investigate the effect of a one year low-intensity computer-tailored energy balance programme among recent retirees on waist circumference , body weight and body composition , blood pressure , physical activity and dietary intake . Methods A r and omised controlled trial was conducted among recent retirees ( N = 413 ; mean age 59.5 years ) . Outcome measures were assessed using anthropometry , bio-impedance , blood pressure measurement and question naires . Results Waist circumference , body weight and blood pressure decreased significantly in men of the intervention and control group , but no significant between-group-differences were observed at 12 or at 24-months follow-up . A significant effect of the programme was only observed on waist circumference ( -1.56 cm ( 95%CI : -2.91 to -0.21 ) ) at 12 month follow up among men with low education ( n = 85 ) . Physical activity and dietary behaviours improved in both the intervention and control group during the intervention period . Although , these behaviours changed more favourably in the intervention group , these between-group-differences were not statistically significant . Conclusions The multifaceted computer-tailored programme for recent retirees did not appear to be effective . Apparently the transition to occupational retirement and /or participation in the study had a greater impact than the intervention programme . Trial registration Clinical Trials NCT00122213 Background : Physical activity has been positively linked to quality of life ( QOL ) in older adults . Measures of health status and global well-being represent common methods of assessing QOL outcomes , yet little has been done to determine the nature of the relationship of these outcomes with physical activity . Purpose : We examined the roles played by physical activity , health status , and self-efficacy in global QOL ( satisfaction with life ) in a sample of older Black and White women . Method : Participants ( N = 249 , M age = 68.12 years ) completed multiple indicators of physical activity , self-efficacy , health status , and QOL at baseline of a 24-month prospect i ve trial . Structural equation modeling examined the fit of 3 models of the physical activity and QOL relationship . Results : Analyses indicated that relationships between physical activity and QOL , self-efficacy and QOL were all indirect . Specifically , physical activity influenced self-efficacy and QOL through physical and mental health status , which in turn influenced global QOL . Conclusions : Our findings support a social cognitives model of physical activity ’s relationship with QOL . Subsequent tests of hypothesized relationships across time are recommended BACKGROUND A r and omized controlled trial was conducted to examine : ( a ) the effect of two physical activity modes on changes in subjective well-being ( SWB ) over the course of a 12-month period in older , formerly sedentary adults ( N = 174 , M age = 65.5 years ) and ( b ) the role played by physical activity participation and social support in changes in SWB over time . METHOD Participants were r and omized into either an aerobic activity group or a stretching and toning group . Structural equation modeling was employed to conduct multiple sample latent growth curve analyses of individual growth in measures of SWB ( happiness , satisfaction with life , and loneliness ) over time . RESULTS A curvilinear growth pattern was revealed with well-being significantly improving over the course of the intervention followed by significant declines at the 6-month follow-up . Subsequent structural analyses were conducted showing that frequency of exercise participation was a significant predictor of improvement in satisfaction with life , whereas social relations were related to increases in satisfaction with life and reductions in loneliness . Improvements in social relations and exercise frequency also helped to buffer the declines in satisfaction with life at follow-up . CONCLUSIONS It appears that social relations integral to the exercise environment are significant determinants of subjective well-being in older adults . Findings are discussed in terms of how physical activity environments might be structured to maximize improvements in more global well-being constructs such as satisfaction with life
There was no evidence for a relationship between intervention effectiveness and mode of delivery or number of intervention contacts ; however , interventions which involved individually tailoring with personalized activity goals or provision of information about local opportunities in the environment may be more effective .
Conclusions Interventions in adults aged 55 to 70 years led to long term improvements in physical activity at 12 months ; however , maintenance beyond this is unclear .
Identified physical activity improvements are likely to have substantial health benefits in reducing the risk of age-related illnesses .
Background Retirement represents a major transitional life stage in middle to older age .
Changes in physical activity typically accompany this transition , which has significant consequences for health and well-being .
The aim of this systematic review was to evaluate the evidence for the effect of interventions to promote physical activity in adults aged 55 to 70 years , focusing on studies that reported long-term effectiveness .