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Cover of Peer-led walking programme to increase physical activity in inactive 60- to 70-year-olds: Walk with Me pilot RCT

Peer-led walking programme to increase physical activity in inactive 60- to 70-year-olds: Walk with Me pilot RCT

Public Health Research, No. 7.10

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Author Information
Southampton (UK): NIHR Journals Library; .

Headline

This study found that the peer-led intervention and methods were feasible and acceptable to participants, although some modifications are required prior to a full trial.

Abstract

Background:

Levels of physical activity decline with age. Some of the most disadvantaged individuals in society, such as those with a lower rather than a higher socioeconomic position, are also the most inactive. Peer-led physical activity interventions may offer a model to increase physical activity in these older adults and thus help reduce associated health inequalities. This study aims to develop and test the feasibility of a peer-led, multicomponent physical activity intervention in socioeconomically disadvantaged community-dwelling older adults.

Objectives:

The study aimed to develop a peer-led intervention through a rapid review of previous peer-led interventions and interviews with members of the target population. A proposed protocol to evaluate its effectiveness was tested in a pilot randomised controlled trial (RCT).

Design:

A rapid review of the literature and the pilot study informed the intervention design; a pilot RCT included a process evaluation of intervention delivery.

Setting:

Socioeconomically disadvantaged communities in the South Eastern Health and Social Care Trust and the Northern Health and Social Care Trust in Northern Ireland.

Participants:

Fifty adults aged 60–70 years, with low levels of physical activity, living in socioeconomically disadvantaged communities, recruited though community organisations and general practices.

Interventions:

‘Walk with Me’ is a 12-week peer-led walking intervention based on social cognitive theory. Participants met weekly with peer mentors. During the initial period (weeks 1–4), each intervention group participant wore a pedometer and set weekly step goals with their mentor’s support. During weeks 5–8 participants and mentors met regularly to walk and discuss step goals and barriers to increasing physical activity. In the final phase (weeks 9–12), participants and mentors continued to set step goals and planned activities to maintain their activity levels beyond the intervention period. The control group received only an information booklet on active ageing.

Main outcome measures:

Rates of recruitment, retention of participants and completeness of the primary outcome [moderate- and vigorous-intensity physical activity measured using an ActiGraph GT3X+ accelerometer (ActiGraph, LLC, Pensacola, FL, USA) at baseline, 12 weeks (post intervention) and 6 months]; acceptability assessed through interviews with participants and mentors.

Results:

The study planned to recruit 60 participants. In fact, 50 eligible individuals participated, of whom 66% (33/50) were female and 80% (40/50) were recruited from general practices. At 6 months, 86% (43/50) attended for review, 93% (40/43) of whom returned valid accelerometer data. Intervention fidelity was assessed by using weekly step diaries, which were completed by both mentors and participants for all 12 weeks, and checklists for the level of delivery of intervention components, which was high for the first 3 weeks (range 49–83%). However, the rate of return of checklists by both mentors and participants diminished thereafter. Outcome data indicate that a sample size of 214 is required for a definitive trial.

Limitations:

The sample was predominantly female and somewhat active.

Conclusions:

The ‘Walk with Me’ intervention is acceptable to a socioeconomically disadvantaged community of older adults and a definitive RCT to evaluate its effectiveness is feasible. Some modifications are required to ensure fidelity of intervention delivery is optimised. Future research needs to identify methods to recruit males and less active older adults into physical activity interventions.

Trial registration:

Current Controlled Trials ISRCTN23051918.

Funding:

This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 10. See the NIHR Journals Library website for further project information. Funding for the intervention was gratefully received from the Health Improvement Division of the Public Health Agency.

Contents

About the Series

Public Health Research
ISSN (Print): 2050-4381
ISSN (Electronic): 2050-439X

Article history

The research reported in this issue of the journal was funded by the PHR programme as project number 12/133/04. The contractual start date was in December 2014. The final report began editorial review in May 2018 and was accepted for publication in October 2018. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The PHR editors and production house have tried to ensure the accuracy of the authors’ report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.

Declared competing interests of authors

Frank Kee was a member of the Public Health Research (PHR) Funding Board 2009–19 and the PHR Prioritisation Group 2016–19. Ruth F Hunter has received a National Institute for Health Research (NIHR) Career Development Fellowship. Ruth F Hunter and Wendy Hardeman have received funding from the NIHR Public Health Research programme separately from the current project grant. Wendy Hardeman has received funding from AbbVie Ltd (North Chicago, IL, USA) for consultancy outside the current project. The Northern Ireland Clinical Trials Unit received funds through the NIHR Public Health Research programme for its involvement in the study.

Last reviewed: May 2018; Accepted: October 2018.

Copyright © Queen’s Printer and Controller of HMSO 2019. This work was produced by Tully et al. under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK.
Bookshelf ID: NBK540938PMID: 31067019DOI: 10.3310/phr07100

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