Accountability and monitoring
This theme included external accountability to the trial team for PA engagement, and more general monitoring which were perceived as helpful. Overall, participants that reported a reliance on external accountability for motivation tended to be less successful in PABC. For example, ‘It inspired me to get out because you’re accounting to someone about what you’re doing. I do need that’ (Leah, 71, <PA) and ‘I think some kind of monitoring…having some commitment and it’s an authority outside of you’ (Annette, 66, >PA but insufficiently active). The exception was Rebecca, who was one of the most successful participants yet almost entirely externally motivated: ‘I was motivated to do [PA] because it’s [trial co-ordinator’s] study…since I’ve finished the trial…there’s no motivation to keep exercising. It was the study keeping me motivated’ (Rebecca, 64, >PA and M).Other participants reported that check-ins were motivational: ‘Maybe you’re more activated when someone is monitoring you’ (Christopher, 69, >PA and M) and ‘If I had a SMS or phone call to ask how it’s going or come have a review session that was a motivator’ (Graham, 67, >PA and M) or important for when encountering challenges: ‘I think the Fitbit, being aware of what I am doing, will be enough for me. Maybe if I knew there was a 3-monthly check-up would help me…when things go wrong like you get sick that’s when you need the motivation’ (Fiona, 67, >PA and M). Overall, most participants valued check-ins but most that successfully increased PA were not focused on external accountability for motivation.