Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-23T04:54:04.989Z Has data issue: false hasContentIssue false
  • English
  • Français

Older adults at risk of a cardiovascular event: a preliminary investigation of their experiences of an active lifestyle scheme in England

Published online by Cambridge University Press:  01 August 2014

GRANIA FENTON ,
KATE HILL ,
RACHEL STOCKER  and
ALLAN HOUSE
GRANIA FENTON*
Affiliation:
Academic Unit of Psychiatry and Behavioural Sciences, Leeds Institute of Health Sciences, The University of Leeds, UK.
KATE HILL
Affiliation:
Academic Unit of Psychiatry and Behavioural Sciences, Leeds Institute of Health Sciences, The University of Leeds, UK.
RACHEL STOCKER
Affiliation:
Academic Unit of Psychiatry and Behavioural Sciences, Leeds Institute of Health Sciences, The University of Leeds, UK.
ALLAN HOUSE
Affiliation:
Academic Unit of Psychiatry and Behavioural Sciences, Leeds Institute of Health Sciences, The University of Leeds, UK.
*
Address for correspondence: Grania Fenton, Academic Unit of Psychiatry and Behavioural Sciences, Leeds Institute of Health Sciences, The University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Leeds LS2 9LJ, UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Reducing risk of a cardiovascular event involves adopting healthier lifestyles. Community-based active lifestyle schemes offer support, but problems with uptake, completion and evaluation are common. We report the engagement and experiences of older adults referred to a scheme in England. Data transcribed from a focus group or individual interviews were analysed using thematic framework analysis. Participants reported an increased awareness of health difficulties with age, and described attendance-related psychological benefits, including an increased sense of responsibility for change and having had negative beliefs about age, health and change challenged. Some physical benefits (including reduced weight and blood pressure) were also reported. Those who attended most consistently were more likely to report caring responsibilities and describe positive social and relational outcomes, but were not more likely to report marked physical benefits. We recommend several changes to ensure that schemes meet their objectives and the needs of those referred. Age-related, health and lifestyle beliefs do not prohibit change but influence attendance and so should be addressed. Outcomes should be publicised, and structured, fixed-term programmes, incorporating relapse-prevention strategies, should be delivered to a closed group at flexible times. Active follow-up of non-attenders and improved data collection are also recommended. These should reduce the risk of schemes providing social support at the expense of intended health benefits.

Keywords

older adultscardiovascularcommunitylifestyle behaviours and beliefsqualitative
Type
Articles
Information
Ageing & Society , Volume 35 , Issue 10 , November 2015 , pp. 2141 - 2155
Copyright
Copyright © Cambridge University Press 2014 

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

Avers, D. 2010. Community-based exercise programs for older adults. Topics in Geriatric Rehabilitation, 26, 4, 275–98.CrossRefGoogle Scholar
Babor, T., Higgins-Biddle, J., Saunders, J. and Monteiro, M. 2001. AUDIT: The Alcohol Use Disorders Identification Test. Guidelines for Use in Primary Care. Department of Mental Health and Substance Dependence, World Health Organization, Geneva.Google Scholar
Boyes, M. 2013. Outdoor adventure and successful ageing. Ageing & Society, 33, 4, 644–65.CrossRefGoogle Scholar
British Heart Foundation National Centre for Physical Activity and Health (BHFNC) 2010. A Toolkit for the Design, Implementation and Evaluation of Exercise Referral Schemes: A Guide to Evaluating Exercise Referral Schemes. BHFNC, Loughborough, UK.Google Scholar
British Heart Foundation National Centre for Physical Activity and Health (BHFNC) 2013. Making the Case for Physical Activity: Evidence Briefing. BHFNC, Loughborough, UK.Google Scholar
Burbank, P., Reibe, D., Padula, C. and Nigg, C. 2002. Exercise and older adults: changing behavior with the transtheoretical model. Orthopaedic Nursing, 21, 4, 51–61.CrossRefGoogle ScholarPubMed
Coghill, N. and Cooper, A. R. 2009. Motivators and de-motivators for adherence to a program of sustained walking. Preventive Medicine, 49, 1, 24–7.CrossRefGoogle ScholarPubMed
Cranney, M., Warren, E., Barton, S., Garder, K. and Walley, T. 2001. Why do GPs not implement evidence-based guidelines? A descriptive study. Family Practice, 18, 4, 359–63.CrossRefGoogle Scholar
Department of Health 2011. Start Active, Stay Active: A Report on Physical Activity for Health from the Four Home Countries’ Chief Medical Officers. Department of Health, London.Google Scholar
Dugdill, L., Graham, R. and McNair, F. 2005. Exercise referral: the public health panacea for physical activity promotion? A critical perspective of exercise referral schemes; their development and evaluation. Ergonomics, 48, 11–14, 1390–410.CrossRefGoogle ScholarPubMed
Frost, H., Haw, S. and Frank, J. 2010. Promoting Health and Wellbeing in Later Life: Interventions in Primary Care and Community Settings. Scottish Collaboration for Public Health Research and Policy, Edinburgh.Google Scholar
Gardiner, B., Cane, J., Rumsey, N. and Michie, S. 2012. Behaviour change among overweight and socially disadvantaged adults: a longitudinal study of the NHS health trainer service. Psychology and Health, 27, 10, 1178–93.CrossRefGoogle Scholar
Gourlan, M. J., Trouilloud, D. O. and Sarrazin, P. G. 2011. Interventions promoting physical activity among obese populations: a meta-analysis considering global effect, long-term maintenance, physical activity indicators and dose characteristics. Obesity Reviews, 12, 7, e633–45.CrossRefGoogle ScholarPubMed
Halbert, J. A., Silagy, C. A., Finucane, P. M., Withers, R. T. and Hamdorf, P. A. 2000. Physical activity and cardiovascular risk factors: effect of advice from an exercise specialist in Australian general practice. Medical Journal of Australia, 173, 2, 84–7.CrossRefGoogle ScholarPubMed
Harrison, R. A., McNair, F. and Dugdill, L. 2005. Access to exercise referral schemes – a population based analysis. Journal of Public Health, 27, 4, 326–30.CrossRefGoogle ScholarPubMed
Katikireddi, S. V., Higgins, M., Bond, L., Bonell, C. and Macintyre, S. 2011. How evidence based is English public health policy? British Medical Journal, 343, d7310.CrossRefGoogle ScholarPubMed
Murray, J., Craigs, C., Hill, K., Honey, S. and House, A. 2012 a. A systematic review of patient reported factors associated with uptake and completion of cardiovascular lifestyle behaviour change. BMC Cardiovascular Disorders, 12, 120.CrossRefGoogle ScholarPubMed
Murray, J., Fenton, G., Honey, S., Bara, A., Hill, K. and House, A. 2013. A qualitative synthesis of factors influencing maintenance of lifestyle behaviour change in individuals with high cardiovascular risk. BMC Cardiovascular Disorders, 13, 48.CrossRefGoogle ScholarPubMed
Murray, J., Honey, S., Hill, K., Craigs, C. and House, A. 2012 b. Individual influences on lifestyle change to reduce vascular risk: a qualitative literature review. British Journal of General Practice, 62, 599, e403–10.CrossRefGoogle Scholar
National Institute for Health and Clinical Excellence (NICE) 2007. Behaviour Change at Population, Community and Individual Levels. NICE, Department of Health, London.Google Scholar
National Institute for Health and Clinical Excellence (NICE) 2012. Obesity: Working with Local Communities. NICE, Manchester, UK.Google Scholar
Pentecost, C. and Taket, A. 2011. Understanding exercise uptake and adherence for people with chronic conditions: a new model demonstrating the importance of exercise identity, benefits of attending and support. Health Education Research, 26, 5, 908–22.CrossRefGoogle ScholarPubMed
Public Health England 2010. Your Guide to the Eatwell Plate. Helping You Eat a Healthier Diet. Food Standards Agency, London.Google Scholar
QSR International 2010. NVivo Qualitative Data Analysis Software. QSR International, Melbourne.Google Scholar
Ritchie, J. and Spencer, L. 1994. Qualitative data analysis for applied policy research. In Bryman, A. and Burgess, R. (eds), Analyzing Qualitative Data. Routledge, London, 173–94.CrossRefGoogle Scholar
Rush, S. R. 2003. Exercise prescription for the treatment of medical conditions. Current Sports Medicine Reports, 2, 3, 159–65.CrossRefGoogle ScholarPubMed
SPSS 2009. PASW Statistics for Windows. Version 18.0, SPSS, Chicago.Google Scholar
Swedish National Institute of Public Health 2007. Healthy Ageing: A Challenge for Europe. Swedish National Institute of Public Health, Sweden.Google Scholar
US Department of Health and Human Services 2008. Physical Activity Guidelines Advisory Committee Report 2008. US Department of Health and Human Services, Washington DC.Google Scholar
Washburn, R. A., Smith, K. W., Jette, A. M. and Janney, C. A. 1993. The Physical Activity Scale for the Elderly (PASE): development and evaluation. Journal of Clinical Epidemiology, 46, 2, 153–62.CrossRefGoogle ScholarPubMed
Williams, N. H., Hendry, M., France, B., Lewis, R. and Wilkinson, C. 2007. Effectiveness of exercise-referral schemes to promote physical activity in adults: systematic review. British Journal of General Practice, 57, 545, 979–86.CrossRefGoogle ScholarPubMed
World Health Organization 2011 a. Global Recommendations on Physical Activity for Health. Available online at http://www.who.int/dietphysicalactivity/pa/en/index.html [Accessed 16 May 2014].Google Scholar
World Health Organization 2011 b. Global Recommendations on Physical Activity for Health: 65 Years and Above. Available online at http://www.who.int/dietphysicalactivity/physical-activity-recommendations-65years.pdf [Accessed 16 May 2014].Google Scholar