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Physical activity is good for older adults—but is programme implementation being overlooked? A systematic review of intervention studies that reported frameworks or measures of implementation
  1. Samantha M Gray1,
  2. Heather A McKay1,2,
  3. Lindsay Nettlefold1,
  4. Douglas Race1,
  5. Heather M Macdonald1,2,
  6. Patti-Jean Naylor3,
  7. Joanie Sims-Gould1,2
  1. 1Active Aging Research Team, The University of British Columbia, Vancouver, British Columbia, Canada
  2. 2Department of Family Practice, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
  3. 3School of Exercise Science, Physical and Health Education, Faculty of Education, University of Victoria, Victoria, British Columbia, Canada
  1. Correspondence to Professor Heather A McKay, Faculty of Medicine, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada; heather.mckay{at}ubc.ca

Abstract

Objective To examine older adult physical activity (PA) intervention studies that evaluated implementation and/or scale-up. Research question 1: What implementation and/or scale-up indicators (specific, observable and measurable characteristics that show the progress of implementation) were reported? Research question 2: What implementation and/or scale-up frameworks were reported? Research question 3: Did studies evaluate the relationship between implementation or scale-up of the intervention and individual level health/behaviour outcomes? If yes, how?

Design Systematic review.

Data sources Publications from electronic databases and hand searches (2000 to December 2019).

Eligibility criteria for selecting studies Any PA intervention studies with community-dwelling older adult participants (mean age ≥60 years). Required indicators: (a) Must report amount of PA as an outcome, with validated self-report or objective measures, and (b) Must have reported at least one implementation or scale-up framework and/or one implementation or scale-up indicator.

Results 137 studies were included for research question 1, 11 for question 2 and 22 for question 3. 137 studies reported an implementation indicator: 14 unique indicators. None were specified as indicators for scale-up evaluation. 11 studies were guided by an implementation or scale-up framework. 22 studies described a relationship between an implementation indicator and an individual-level health outcome.

Conclusion There is need for implementation research that extends beyond analysis at the individual level, includes clearly defined indicators and provides a guiding framework to support PA initiatives in older adults. Such implementation studies should evaluate factors in the broader context (eg,political, environmental) that influence scale-up.

PROSPERO registration CRD42018091839

  • physical activity
  • senior
  • implementation
  • review

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Footnotes

  • Correction notice This article has been corrected since it published Online First. The competing interests statement has been updated.

  • Contributors SMG: participated in study design and coordination, performed the systematic searches, contributed to data extraction and analysis, drafted the first version of the manuscript, and edited subsequent versions. HAM: conceived of the review, guided its design, provided substantive feedback and revised versions of the manuscript to completion of the submitted manuscript. LN: participated in study design and coordination, contributed to data extraction and analysis, and edited the manuscript. DR: contributed to the systematic searches, contributed to data extraction and analysis, and critically revised the manuscript. HMM: contributed to data extraction and analysis, and critically revised the manuscript. PJN: conceived of the review, participated in its design, and critically revised the manuscript. JS-G: participated in the study design and critically revised the manuscript.

  • Funding SMG is supported by a Four Year Fellowship from the Faculty of Graduate Studies, University of British Columbia.

  • Competing interests Professor Heather McKay is married to BJSM Editor-in-Chief Karim Khan. Professor Khan was blinded to the submission and the manuscript was handled for the BJSM by Editor Professor Babette Pluim.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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