Return to Everyday Activity in the Community and Home: a feasibility study for a lifestyle intervention to sit less, move more, and be strong

Maureen C Ashe, Nicola Y Edwards, Amanda Taylor, Laura Burnett, Lora Giangregorio, Kate Milne, Lindy Clemson, Lena Fleig, Maureen C Ashe, Nicola Y Edwards, Amanda Taylor, Laura Burnett, Lora Giangregorio, Kate Milne, Lindy Clemson, Lena Fleig

Abstract

Background: Many interventions designed to meet physical activity guideline recommendations focus on a single component (e.g., walking), to the detriment of other elements of a healthy lifestyle, such as reducing prolonged sitting and doing balance and strength exercises (i.e., bundled multiple behaviors). Adopting these multiple health behaviors within daily life routines may facilitate uptake and support longer-term behavior change. We tested feasibility for a three-part lifestyle intervention to support older women to sit less, move more, and complete balance and strength exercises.

Methods: We used a convergent parallel mixed-methods, single-arm study design to test feasibility for a 6-week lifestyle intervention: Return to Everyday Activities in the Community and Home (REACH). We collected information at baseline, 3 and 6 weeks (final), and 6 months (follow-up) using questionnaires, semi-structured interviews, and performance-based measures. We describe three key elements: (1) implementation factors such as recruitment, retention, program delivery, and adherence; (2) participants' acceptability and experience with the program; and (3) health outcomes, including participants' global mobility, activity, and perceptions of their physical activity identity, and habit strength for (i) physical activity, (ii) breaking up sitting time, and (iii) balance and strength exercises.

Results: We were able to recruit enough participants in the allotted time to conduct one cycle of the REACH group-based program. There were 10 community-dwelling women, median (p25, p75) age 61 (57.5, 71) years, who completed the study. The program was feasible to deliver, with high attendance (mean 5/6 sessions) and positive overall ratings (8/10). Participants rated session content and length high, and educational materials as highly acceptable and understandable. Although participants were active walkers at baseline, few were breaking up prolonged sitting or participating in any balance and strength exercises. At final and follow-up assessments, participants reported developing habits for all three health behaviors, without diminishing physical activity.

Conclusion: These results show acceptability of the program and its materials, and feasibility for bundling multiple health behaviors within the REACH program. It also provides confirmation to advance to testing feasibility of this three-part lifestyle intervention with older, less active, adults.

Trial registration: ClinicalTrials.gov Identifier, NCT02786394; May 18, 2016.

Keywords: Balance and strength; Dual-process theory of behavior change; Habit strength; Physical activity identity.

Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
CONSORT flow diagram
Fig. 2
Fig. 2
Boxplots for physical activity identity. a Data from 10 participants and b data from the eight participants who provided data at baseline, final, and follow-up (6 months) for physical activity identity. The total possible score is 63 points, and a higher number indicates a stronger identity with physical activity
Fig. 3
Fig. 3
Boxplots for habit strength for physical activity, (breaking up) sedentary behavior, and balance and strength exercises. a Data from 10 participants and b data from the eight participants who provided data at baseline, final, and follow-up (6 months) for habit strength for the three activities. Scores are based on a 7-point Likert scale (strongly disagree–strongly agree)

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