Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-28T08:09:14.308Z Has data issue: false hasContentIssue false
  • English
  • Français

Behaviour change techniques to facilitate physical activity in older adults: what and how

Published online by Cambridge University Press:  03 October 2017

URSKA ARNAUTOVSKA ,
FRANCES O'CALLAGHAN  and
KYRA HAMILTON
URSKA ARNAUTOVSKA*
Affiliation:
School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.
FRANCES O'CALLAGHAN
Affiliation:
School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.
KYRA HAMILTON
Affiliation:
School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia. School of Psychology and Speech Pathology and Health Psychology and Behavioural Medicine Research Group, Curtin University, Perth, Australia.
*
Address for correspondence: Urska Arnautovska, Griffith University, Health and Psychology Innovations (HaPI) Research Lab, Building M24 Psychology, 176 Messines Ridge Road, Mt Gravatt, QLD 4122, Australia E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Physical inactivity in older adults presents a significant problem within modern societies globally. Using a mixed-method approach, this study explored strategies for the development and delivery of physical activity (PA) interventions by investigating what behaviour change techniques (BCTs) are useful, and how these techniques should be implemented to be feasible for older adults. Sixty-six older adults completed a survey indicating the most useful BCTs, mapping on to motivational, volitional and automatic factors. Of these, 48 older adults participated in an interview exploring strategies for a PA intervention targeted at older adults. The most useful BCT identified in the survey was autonomy support (61.3%), followed by instruction to perform the behaviour (43.5%) and having a credible source of information about PA (42.6%). The key themes discussed in the interviews included providing support in making an informed choice, instruction on how to perform PA, information about health consequences, social support, goal setting, action and coping plans, behavioural demonstration and practice, and monitoring PA. The interviews also revealed key aspects of programme implementation including face-to-face delivery, followed up with additional materials; low cost; age-appropriate PA level; and individualised approach. Interventions assisting older adults in increasing their PA participation across a range of settings should incorporate BCTs targeting multiple processes, while tailoring their delivery to older adults’ preferences to ensure their feasibility in supporting regular PA engagement.

Keywords

physical activityolder adultsbehaviour change techniquesimplementation strategiesintervention development
Type
Article
Information
Ageing & Society , Volume 38 , Issue 12 , December 2018 , pp. 2590 - 2616
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Addy, C. L., Wilson, D. K., Kirtland, K. A., Ainsworth, B. E., Sharpe, P. and Kimsey, D. 2004. Associations of perceived social and physical environmental supports with physical activity and walking behavior. American Journal of Public Health, 94, 3, 440–3.Google Scholar
Ajzen, I. 1991. The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 2, 179–11.Google Scholar
Allom, V., Mullan, B., Cowie, E. and Hamilton, K. 2016. Physical activity and transitioning to college: the importance of intentions and habits. American Journal of Health Behavior, 40, 2, 280–90.Google Scholar
Arnautovska, U., Fleig, L., O'Callaghan, F. and Hamilton, K. 2017. A longitudinal investigation of older adults’ physical activity: testing an integrated dual-process model. Psychology & Health, 32, 2, 166–85.Google Scholar
Arnautovska, U., O'Callaghan, F. and Hamilton, K. 2017 a. Older adults’ perceptions of physical activity within the process of ageing. Health Behavior and Policy Research, 4, 1, 76–86.Google Scholar
Arnautovska, U., O'Callaghan, F. and Hamilton, K. 2017 b. Applying the Integrated Behaviour Change model to understanding physical activity among older adults: a qualitative study. Journal of Sport & Exercise Psychology. Advance online publication. doi.org/10.1123/jsep.2015-0300.Google Scholar
Baert, V., Gorus, E., Mets, T., Geerts, C. and Bautmans, I. 2011. Motivators and barriers for physical activity in the oldest old: a systematic review. Ageing Research Reviews, 10, 4, 464–74.Google Scholar
Barnett, I., Guell, C. and Ogilvie, D. 2012. The experience of physical activity and the transition to retirement: a systematic review and integrative synthesis of qualitative and quantitative evidence. International Journal of Behavioral Nutrition and Physical Activity, 9, 1, 97–06.Google Scholar
Brunet, J. and Sabiston, C. M. 2011. Exploring motivation for physical activity across the adult lifespan. Psychology of Sport and Exercise, 12, 2, 99–05.Google Scholar
Chase, J. A. 2015. Interventions to increase physical activity among older adults: a meta-analysis. The Gerontologist, 55, 4, 706–18.Google Scholar
Clarke, L. H. and Bennett, E. 2013. ‘You learn to live with all the things that are wrong with you’: gender and the experience of multiple chronic conditions in later life. Ageing & Society, 33, 2, 342–60.Google Scholar
Courtney, M., Edwards, H., Chang, A., Parker, A., Finlayson, K. and Hamilton, K. 2009. Fewer emergency readmissions and better quality of life for older adults at risk of hospital readmission: a randomized controlled trial to determine the effectiveness of a 24-week exercise and telephone follow-up program. Journal of the American Geriatrics Society, 57, 3, 395–402.Google Scholar
Cowie, E. and Hamilton, K. 2014. Key beliefs related to decisions for physical activity engagement among first-in-family students transitioning to university. Journal of Community Health, 39, 4, 719–26.Google Scholar
Darker, C., French, D., Eves, F. and Sniehotta, F. 2010. An intervention to promote walking amongst the general population based on an ‘extended’ theory of planned behaviour: a waiting list randomised controlled trial. Psychology and Health, 25, 1, 71–88.Google Scholar
Day, L., Trotter, M. J., Donaldson, A., Hill, K. D. and Finch, C. F. 2016. Key factors influencing implementation of falls prevention exercise programs in the community. Journal of Ageing and Physical Activity, 24, 1, 45–52.Google Scholar
Deci, E. L. and Ryan, R. M. 2008. Self-determination theory: a macrotheory of human motivation, development, and health. Canadian Psychology, 49, 3, 182–5.Google Scholar
Department of Health 2014. Recommendations on Physical Activity for Health for Older Australians. Available online at http://www.health.gov.au/internet/main/publishing.nsf/Content/phd-physical-rec-older-guidelines [Accessed 5 March 2017].Google Scholar
Dionigi, R. A., Horton, S. and Baker, J. 2013. How do older masters athletes account for their performance preservation? A qualitative analysis. Ageing & Society, 33, 2, 297–19.Google Scholar
Emile, M., Chalabaev, A., Stephan, Y., Corrion, K. and d'Arripe-Longueville, F. 2014. Aging stereotypes and active lifestyle: personal correlates of stereotype internalization and relationships with level of physical activity among older adults. Psychology of Sport and Exercise, 15, 2, 198–204.Google Scholar
Epton, T., Norman, P., Harris, P., Webb, T., Snowsill, F. A. and Sheeran, P. 2014. Development of theory-based health messages: three-phase programme of formative research. Health Promotion International, 30, 3, 756–68.Google Scholar
Ferrand, C., Martinent, G. and Bonnefoy, M. 2014. Exploring motivation for exercise and its relationship with health-related quality of life in adults aged 70 years and older. Ageing & Society, 34, 3, 411–27.Google Scholar
Fitbit 2017. Fitbit Inc. Available online at https://www.fitbit.com/au/store?gclid=CP-9zqO2w9ICFYYsvQodEUMH8Q [Accessed 7 March 2017].Google Scholar
Fleig, L., McAllister, M. M., Chen, P., Iverson, J., Milne, K., McKay, H. A., Clemson, L. and Ashe, M. C. 2016. Health behaviour change theory meets falls prevention: feasibility of a habit-based balance and strength exercise intervention for older adults. Psychology of Sport and Exercise, 22, 1, 114–22.Google Scholar
Fleig, L., Pomp, S., Schwarzer, R. and Lippke, S. 2013. Promoting exercise maintenance: how interventions with booster sessions improve long-term rehabilitation outcomes. Rehabilitation Psychology, 58, 4, 323–33.Google Scholar
French, D. P., Olander, E. K., Chisholm, A. and Mc Sharry, J. 2014. Which behaviour change techniques are most effective at increasing older adults’ self-efficacy and physical activity behaviour? A systematic review. Annals of Behavioral Medicine, 48, 2, 225–34.Google Scholar
French, S. D., Green, S. E., O'Connor, D. A., McKenzie, J. E., Francis, J. J., Michie, S., Buchbinder, R., Schattner, P., Spike, N. and Grimshaw, J. M. 2012. Developing theory-informed behaviour change interventions to implement evidence into practice: a systematic approach using the Theoretical Domains Framework. Implementation Science, 7, 1, 38–46.Google Scholar
Gale, N. K., Heath, G., Cameron, E., Rashid, S. and Redwood, S. 2013. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Medical Research Methodology, 13, 1, 117–29.Google Scholar
Gardner, B. 2015. A review and analysis of the use of ‘habit’ in understanding, predicting and influencing health-related behaviour. Health Psychology Review, 9, 3, 277–95.Google Scholar
Hagger, M. S. 2010. Current issues and new directions in psychology and health: physical activity research showcasing theory into practice. Psychology & Health, 25, 1, 1–5.Google Scholar
Hagger, M. S. and Chatzisarantis, N. L. D. 2009. Integrating the theory of planned behaviour and self-determination theory in health behaviour: a meta-analysis. British Journal of Health Psychology, 14, 2, 275–302.Google Scholar
Hagger, M. S. and Chatzisarantis, N. L. D. 2014. An integrated behavior change model for physical activity. Exercise and Sport Sciences Reviews, 42, 2, 62–9.Google Scholar
Hagger, M. S. and Luszczynska, A. 2014. Implementation intention and action planning interventions in health contexts: state of the research and proposals for the way forward. Applied Psychology: Health and Well-being, 6, 1, 1–47.Google Scholar
Hagger, M. S., Luszczynska, A., de Wit, J., Benyamini, Y., Burkert, S., Chamberland, P.-E., Chater, A., Dombrowski, S. U., van Dongen, A., French, D. P., Gauchet, A., Hankonen, N., Karekla, M., Kinney, A. Y., Kwasnicka, D., Lo, S. H., López-Roig, S., Meslot, C., Moreira Marques, M., Neter, E., Plass, A. M., Potthoff, S., Rennie, L., Scholz, U., Stadler, G., Stolte, E., ten Hoor, G., Verhoeven, A., Wagner, M., Oettingen, G., Sheeran, P. and Gollwitzer, P. M. 2016. Implementation intention and planning interventions in health psychology: recommendations from the Synergy expert group for research and practice. Psychology & Health, 31, 7, 814–39.Google Scholar
Hagger, M. S., Trost, N., Keech, J., Chan, D. K. C. and Hamilton, K. 2017. Predicting sugar consumption: application of an integrated dual-process, dual-phase model. Appetite, 116, 9, 147–56.Google Scholar
Hamilton, K., Cox, S. and White, K. M. 2012. Testing a model of physical activity among mothers and fathers of young children: integrating autonomous motivation, planning, and the theory of planned behavior. Journal of Sport and Exercise Psychology, 34, 1, 124–45.Google Scholar
Hamilton, K. and Hagger, M. S. 2014. The ‘health’ of health psychology in Australia: behavioural approaches and interventions. Australian Psychologist, 49, 2, 63–5.Google Scholar
Hamilton, K., Kirkpatrick, A., Rebar, A. and Hagger, M. S. 2017. Child sun safety: application of the Integrated Behaviour Change model. Health Psychology. Advanced online publication. doi:10.1037/hea0000533.Google Scholar
Hamilton, K. and White, K. M. 2012. Social influences and the physical activity intentions of parents of young-children families: an extended theory of planned behavior approach. Journal of Family Issues, 33, 10, 1351–72.Google Scholar
Hamilton, K. and White, K. M. 2014. Strategies for developing and delivering a parental physical activity intervention: answers to the what and how. Journal of Physical Activity and Health, 11, 1, 152–64.Google Scholar
Hamilton, K., White, K. M. and Cuddihy, T. 2012. Using a single-item physical activity measure to describe and validate parents’ physical activity patterns. Research Quarterly for Exercise and Sport, 83, 2, 340–45.Google Scholar
Hill, A., McPhail, S., Hoffman, T., Hill, K., Oliver, D., Beer, C., Brauer, S. and Haines, T. P. 2009. A randomised trial comparing digital video disc with written delivery of falls prevention education for older patients in hospital. Journal of the American Geriatrics Society, 57, 8, 1458–63.Google Scholar
Hobbs, N., Godfrey, A., Lara, J., Errington, L., Meyer, T. D., Rochester, L., White, M., Mathers, J. C. and Sniehotta, F. F. 2013. Are behavioral interventions effective in increasing physical activity at 12 to 36 months in adults aged 55 to 70 years? A systematic review and meta-analysis. BioMed Central Medicine, 11, 1, 75–86.Google Scholar
King, A. C. and King, D. K. 2010. Physical activity for an aging population. Public Health Reviews, 32, 2, 401–26.Google Scholar
Kok, G., Gottlieb, N. H., Peters, G.-J. Y., Mullen, P. D., Parcel, G. S., Ruiter, R. A., Fernandez, M. E., Markham, C. and Bartholomew, L. K. 2015. A taxonomy of behaviour change methods: an Intervention Mapping approach. Health Psychology Review, 10, 3, 297–12.Google Scholar
Kosma, M. 2014. Self-determination for physical activity among adults with physical disabilities. Research Quarterly for Exercise and Sport, 85, 1, 31–31.Google Scholar
Kwasnicka, D., Presseau, J., White, M. and Sniehotta, F. F. 2013. Does planning how to cope with anticipated barriers facilitate health-related behaviour change? A systematic review. Health Psychology Review, 7, 2, 129–45.Google Scholar
Lally, P. and Gardner, B. 2013. Promoting habit formation. Health Psychology Review, 7, 1, 137–58.Google Scholar
Lawton, R., Conner, M. and McEachan, R. 2009. Desire or reason: predicting health behaviors from affective and cognitive attitudes. Health Psychology, 28, 1, 56–65.Google Scholar
Lloyd, J. J., Logan, S., Greaves, C. J. and Wyatt, K. M. 2011. Evidence, theory and context-using intervention mapping to develop a school-based intervention to prevent obesity in children. International Journal of Behavioral Nutrition and Physical Activity, 8, 1, 73–87.Google Scholar
Lord, S. R., Tiedemann, A., Chapman, K., Munro, B., Murray, S. M. and Sherrington, C. 2005. The effect of an individualized fall prevention program on fall risk and falls in older people: a randomized, controlled trial. Journal of the American Geriatrics Society, 53, 8, 1296–304.Google Scholar
Maher, J. P. and Conroy, D. E. 2015. Habit strength moderates the effects of daily action planning prompts on physical activity but not sedentary behavior. Journal of Sport and Exercise Psychology, 37, 1, 97–107.Google Scholar
Michie, S., Richardson, M., Johnston, M., Abraham, C., Francis, J., Hardeman, W., Eccles, M. P., Cane, J. and Wood, C. E. 2013. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Annals of Behavioral Medicine, 46, 1, 81–95.Google Scholar
Muellmann, S., Forberger, S., Möllers, T., Zeeb, H. and Pischke, C. R. 2016. Effectiveness of eHealth interventions for the promotion of physical activity in older adults: a systematic review protocol. Systematic Reviews, 5, 1, 47–51.Google Scholar
Mullan, B., Henderson, J., Kothe, E., Allom, V., Orbell, S. and Hamilton, K. 2016. The role of habit and perceived control on health behaviour among pregnant women. American Journal of Health Behavior, 40, 3, 291–301.Google Scholar
Müller, A. M. and Khoo, S. 2014. Non-face-to-face physical activity interventions in older adults: a systematic review. International Journal of Behavioral Nutrition and Physical Activity, 11, 1, 35–45.Google Scholar
Müller-Riemenschneider, F., Reinhold, T., Nocon, M. and Willich, S. N. 2008. Long-term effectiveness of interventions promoting physical activity: a systematic review. Preventive Medicine, 47, 4, 354–68.Google Scholar
Noar, S. M., Benac, C. N. and Harris, M. S. 2007. Does tailoring matter? Meta-analytic review of tailored print health behavior change interventions. Psychological Bulletin, 13, 34, 673–93.Google Scholar
Orbell, S. and Sheeran, P. 1998. ‘Inclined abstainers’: a problem for predicting health-related behaviour. British Journal of Social Psychology, 37, 2, 151–65.Google Scholar
Ory, M., Hoffman, M. K., Hawkins, M., Sanner, B. and Mockenhaupt, R. 2003. Challenging aging stereotypes: strategies for creating a more active society. American Journal of Preventive Medicine, 25, 3, 164–71.Google Scholar
Pereira, C., Baptista, F. and Cruz-Ferreira, A. 2016. Role of physical activity, physical fitness, and chronic health conditions on the physical independence of community-dwelling older adults over a 5-year period. Archives of Gerontology and Geriatrics, 65, 4, 45–53.Google Scholar
Phoenix, C and Orr, N. 2014. Pleasure: a forgotten dimension of physical activity in older adults. Social Science and Medicine, 115, 8, 94–2.Google Scholar
Prestwich, A., Webb, T. L. and Conner, M. 2015. Using theory to develop and test interventions to promote changes in health behaviour: evidence, issues, and recommendations. Current Opinion in Psychology, 5, 1–5. Available online at https://doi.org/10.1016/j.copsyc.2015.02.011.Google Scholar
Rebar, A. L., Dimmock, J. A., Jackson, B., Rhodes, R. E., Kates, A., Starling, J. and Vandelanotte, C. 2016. A systematic review of the effects of non-conscious regulatory processes in physical activity. Health Psychology Review, 10, 4, 395–407.Google Scholar
Reyes Fernández, B., Knoll, N., Hamilton, K. and Schwarzer, R. 2016. Social-cognitive antecedents of hand washing: action control bridges the planning–behavior gap. Psychology & Health, 31, 8, 993–1004.Google Scholar
Rhodes, R. E. and Courneya, K. S. 2003. Investigating multiple components of attitude, subjective norm, and perceived control: an examination of the theory of planned behaviour in the exercise domain. British Journal of Social Psychology, 42, 1, 129–46.Google Scholar
Rhodes, R. E. and de Bruijn, G. J. 2013. How big is the physical activity intention–behaviour gap? A meta-analysis using the action control framework. British Journal of Health Psychology, 18, 2, 296–309.Google Scholar
Rhodes, R. E. and Mistry, C. D. 2016. Understanding the reasons behind anticipated regret for missing regular physical activity. Frontiers in Psychology, 67, 8, 282–7.Google Scholar
Schwarzer, R. 2008. Modeling health behavior change: how to predict and modify the adoption and maintenance of health behaviors. Applied Psychology, 57, 1, 1–29.Google Scholar
Sheeran, P., Bosch, J. A., Crombez, G., Hall, P. A., Harris, J. L., Papies, E. K. and Wiers, R. W. 2016 b. Implicit processes in health psychology: diversity and promise. Health Psychology, 35, 8, 761–6.Google Scholar
Sheeran, P., Maki, A., Monanaro, E., Avishai-Yitshak, A., Bryan, A., Klein, W. P., Miles, E. and Rothman, A. J. 2016 a. The impact of changing attitudes, norms, and self-efficacy on health-related intentions and behavior: a meta-analysis. Journal of Health Psychology, 35, 11, 1178–88.Google Scholar
Sherrington, C., Tiedemann, A., Fairhall, N., Close, J. C. T. and Lord, S. R. 2011. Exercise to prevent falls in older adults: an updated meta-analysis and best practice recommendations. New South Wales Public Health Bulletin, 22, 4, 78–83.Google Scholar
Sims, J., Birrell, C. L., Hunt, S., Browning, C., Burns, R. A. and Mitchell, P. 2014. Prevalence of physical activity behaviour in older people: findings from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project and Australian national survey data. Australasian Journal on Ageing, 33, 2, 105–13.Google Scholar
Sims, J., Hill, K., Hunt, S., Haralambus, B., Brown, A., Engel., L., Huang, N., Kerse, N. and Ory, M. 2016. Physical activity recommendations for older Australians. Discussion document, Australian Government Department of Health and Ageing, Canberra.Google Scholar
Sniehotta, F. F., Schwarzer, R., Scholz, U. and Schüz, B. 2005. Action planning and coping planning for long-term lifestyle change: theory and assessment. European Journal of Social Psychology, 35, 4, 565–76.Google Scholar
Sun, F., Norman, I. J. and While, A. E. 2013. Physical activity in older people: a systematic review. BioMed Central Public Health, 13, 1, 449–61.Google Scholar
Thøgersen-Ntoumani, C., Shepherd, S. O., Ntoumanis, N., Wagenmakers, A. J. and Shaw, C. S. 2016. Intrinsic motivation in two exercise interventions: associations with fitness and body composition. Health Psychology, 35, 2, 195–8.Google Scholar
Verplanken, B. and Melkevik, O. 2008. Predicting habit: the case of physical exercise. Psychology of Sport and Exercise, 9, 1, 15–26.Google Scholar
Warner, L. M., Wolff, J. K., Ziegelmann, J. P., Schwarzer, R. and Wurm, S. 2016. Revisiting self-regulatory techniques to promote physical activity in older adults: null-findings from a randomised controlled trial. Psychology & Health, 31, 10, 1145–65.Google Scholar
Warner, L. M., Ziegelmann, J. P., Schüz, B., Wurm, S. and Schwarzer, R. 2011. Synergistic effect of social support and self-efficacy on physical exercise in older adults. Journal of Aging and Physical Activity, 19, 3, 249–61.Google Scholar
Welmer, A. K., Morck, A. and Dahlin-Ivanoff, S. 2012. Physical activity in people age 80 years and older as a means of counteracting disability, balanced in relation to frailty. Journal of Aging and Physical Activity, 20, 3, 317–31.Google Scholar
Williams, S. L., Michie, S., Dale, J., Stallard, N. and French, D. P. 2015. The effects of a brief intervention to promote walking on theory of planned behavior constructs: a cluster randomized controlled trial in general practice. Patient Education and Counseling, 98, 5, 651–9.Google Scholar
Wolff, J. K., Warner, L. M., Ziegelmann, J. P., Wurm, S. and Kliegel, M. 2016. Translating good intentions into physical activity: older adults with low prospective memory ability profit from planning. Journal of Behavioral Medicine, 39, 3, 472–82.Google Scholar
Zhou, G., Gan, Y., Miao, M., Hamilton, K., Knoll, N. and Schwarzer, R. 2015 a. The role of action control and action planning on fruit and vegetable consumption. Appetite, 91, 1, 64–8.Google Scholar
Zhou, G., Sun, C., Knoll, N., Hamilton, K. and Schwarzer, R. 2015 b. Self-efficacy, planning, and action control in an oral self-care intervention. Health Education Research, 30, 4, 671–81.Google Scholar
Ziegelmann, J. P. and Knoll, N. 2015. Future directions in the study of health behavior among older adults. Gerontology, 61, 5, 469–76.Google Scholar