Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-24T02:01:14.508Z Has data issue: false hasContentIssue false

Predictors of Adherence in a Community-Based Tai Chi Program*

Published online by Cambridge University Press:  28 April 2015

Suhayb Shah*
Affiliation:
School of Kinesiology & Health Science, York University
Chris Ardern
Affiliation:
School of Kinesiology & Health Science, York University
Hala Tamim
Affiliation:
School of Kinesiology & Health Science, York University
*
La correspondance et les demandes de tirés-à-part doivent être adressées à: / Correspondence and requests for offprints should be sent to: Suhayb Shah, M.Sc. York University Dept. Kinesiology and Health Science 4700 Keele St. Toronto, ON M3J1P3 ([email protected])

Abstract

This study examined factors affecting adherence in a 16-week tai chi program among multi-ethnic middle-aged and older adults living in a low socioeconomic environment in Toronto. Analysis was based on data collected from three tai chi program cohorts that took place from August 2009 to March 2012. The main outcome variable, adherence, was measured by the total number of sessions attended by each of the participants. Total sample size was 210 participants with a mean age of 68.1 ± 8.6. Based on the regression model, greater adherence was significantly associated with older age, greater perceived stress, higher education, and higher mental and physical scores of Short Form-36 components. Conversely, lower adherence was significantly associated with higher baseline weekly physical activity. Our findings suggest that we target less-educated individuals with poor mental and physical health to optimize adherence for future community-based tai chi programs.

Résumé

Cette étude a examiné les facteurs qui influent l'adhésion dans un programme de de tai-chi à 16 semaines parmi les adultes multi-ethniques d'âge moyen et plus âgés qui vivent dans un environnement faible socio-économique à Toronto. L'analyse a été basée sur des données recueillies auprès de trois cohortes du programme de tai-chi qui ont eu lieu à partir d'août 2009 à mars 2012. La variable principale de résultat, l'adhésion, a été mesurée par le nombre total de sessions suivies par chacun des participants. L'échantillon total était de 210 participants, avec un âge moyen de 68,1 ± 8,6. Basé sur le modèle de régression, l'adhésion a été associée de façon significative à l'âge plus avancé, au stress plus perçu, à l'enseignement supérieur, et aux scores mentales et physiques plus élevés de composants sur le Questionnaire Abrégée 36. Inversement, une faible observance était significativement associée à une activité physique hebdomadaire de base plus élevée. Nos résultats suggèrent que nous devrions cibler les personnes les moins instruites, à la santé mentale et physique médiocre, pour optimiser l'adhésion aux futurs programmes de tai-chi communautaires.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2015 

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.)

Footnotes

*

The project was funded by Social Sciences and Humanities Research Council of Canada and Sport Canada Research Initiative.

References

Adams, J., & White, M. (2003). Are activity promotion interventions based on the transtheoretical model effective? A critical review. British Journal of Sports Medicine, 37, 106114.CrossRefGoogle ScholarPubMed
Ainsworth, B. E., Haskell, W. L., Whitt, M. C., Irwin, M. L., Swartz, A. M., Strath, S. J., et al. (2000). Compendium of physical activities: An update of activity codes and MET intensities. Medicine and Science in Sports and Exercise, 32(9), S498S504.Google Scholar
American College of Sports Medicine. (2000). American College of Sports Medicine's guidelines for exercise testing and prescription (6th ed.). New York, NY: Lippincott Williams & Wilkins.Google Scholar
Arikawa, A. Y., O’Dougherty, M., Kaufman, B. C., Schmitz, K. H., & Kurzer, M. S. (2012). Attrition and adherence of young women to aerobic exercise: Lessons from the WISER study. Contemporary Clinical Trials, 33(2), 298301.CrossRefGoogle ScholarPubMed
Canadian Society for Exercise Physiology. (2003). The Canadian Physical Activity, Fitness and Lifestyle Approach (CPAFLA) (3rd ed.). Ottawa, ON: Author.Google Scholar
Chisholm, D. M., Stewart, G., & Cooks, R. (1987). PAR-Q/PAR-X, correspondence to Fitness Canada. Ottawa, ON: Fitness Canada.Google Scholar
Church, J., Goodall, S., Norman, R., & Haas, M. (2012). The cost-effectiveness of falls prevention interventions for older community-dwelling Australians. Australian and New Zealand Journal of Public Health, 36(3), 241248.Google Scholar
City of Toronto. (2003). Urban development services. Retrieved 15 May 2013 fromhttp://www.toronto.ca/wards2000/pdf/wardprofiles_23.pdf.Google Scholar
City of Toronto. (2011). Profile of low income in the City of Toronto. Retrieved May 5, 2013 fromhttp://www.toronto.ca/demographics/pdf/poverty_profile_2010.pdf.Google Scholar
Cohen, S., Kamarack, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385396.Google Scholar
Deforche, B., & de Bourdeaudhuij, I. (2000). Differences in psychosocial determinants of physical activity in older adults participating in organised versus non-organised activities. Journal of Sports Medicine and Physical Fitness, 40, 362372.Google ScholarPubMed
Dishman, R. K. (1988). Exercise adherence. Champaign, IL: Human Kinetics Books.Google Scholar
Elavsky, S., McAuley, E., Motl, R. W., Konopack, J. F., Marquez, D. X., Hu, L., et al. (2005). Physical activity enhances long-term quality of life in older adults: efficacy, esteem, and affective influences. Annals of Behavioural Medicine, 30, 138145.Google Scholar
Ferrucci, L., Izmirlian, G., Leveille, S., Phillips, C., Corti, M., & Brock, D. (1999). Smoking, physical activity, and active life expectancy. American Journal of Epidemiology, 149, 645653.CrossRefGoogle ScholarPubMed
Gillespie, L. D., Robertson, M. C., Gillespie, W. J., Sherrington, C., Gates, S., Clemson, L. M., et al. (2012). Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, 15(2), CD007146.Google Scholar
Haskell, W. L., Lee, I. M., Pate, R. R., Powell, K. E., Blair, S. N., Franklin, B. A., et al. (2007). Physical activity and public health: Updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Medicine and Science in Sports and Exercise, 39, 14231434.CrossRefGoogle Scholar
Hawley-Hague, H., Horne, M., Campbell, M., Demack, S., Skelton, D. A., & Todd, C. (2014). Multiple levels of influence on older adults’ attendance and adherence to community exercise classes. The Gerontologist, 54(4), 599610.Google Scholar
Health Canada and Canadian Society for Exercise Physiology. (1999). Canada’s physical activity guide to healthy active living for older adults. Ottawa, ON: Author.Google Scholar
Hopman-Rock, M., Borghouts, J. A., & Leurs, M. T. (2005). Determinants of participation in a health education and exercise program on television. Preventative Medicine, 41(1), 232239.Google Scholar
Huang, H., Gua, M. L., Lin, W. C., & Kernohan, G. (2003). Assessing risk of falling in older adults. Public Health Nursing, 20(5), 399411.Google Scholar
Jette, A. M., Rooks, D., Lachman, M., Lin, T. H., Levenson, C., Heislein, D., et al. (1998). Home-based resistance training: Predictors of participation and adherence. The Gerontologist, 38(4), 412421.CrossRefGoogle ScholarPubMed
Jones, A. Y., Dean, E., & Scudds, R. J. (2005). Effectiveness of a community-based Tai Chi program and implications for public health initiatives. Archives of Physical Medical and Rehabilitation, 86(4), 619625.CrossRefGoogle ScholarPubMed
Jones, K. D., Sherman, C. A., Mist, S. D., Carson, J. W., Bennett, R. M., & Li, F. (2012). A randomized controlled trial of 8-form Tai Chi improves symptoms and functional mobility in fibromyalgia patients. Clinical Rheumatology, 31(8), 12051214.Google Scholar
Klein, P. J., & Adams, W. D. (2004). Comprehensive therapeutic benefits of Taiji: A critical review. American Journal of Physical and Medical Rehabilitation, 83, 735774.Google Scholar
Latka, R. N., Alvarez-Reeves, M., Cadmus, L., & Irwin, M. L. (2009). Adherence to a randomized controlled trial of aerobic exercise in breast cancer survivors: The Yale exercise and survivorship study. Journal of Cancer Survivorship, 3(3), 148157.CrossRefGoogle ScholarPubMed
Laugero, K. D., Falcon, L. M., & Tucker, K. L. (2011). Relationship between perceived stress and dietary and activity patterns in older adults participating in the Boston Puerto Rican Health Study. Appetite, 56(1), 194204.Google Scholar
Lee, L. Y., Lee, D. T., & Woo, J. (2010). The psychosocial effect of Tai Chi on nursing home residents. Journal of Clinical Nursing, 19(78), 927938.Google Scholar
Lee, M. S., Pittler, M. H., & Ernst, E. (2008). Tai Chi for osteoarthritis: a systematic review. Clinical Rheumatology, 27, 211218.Google Scholar
Li, F., Harmer, P., Fisher, K. J., McAuley, E., Chaumeton, N., Eckstrom, E., et al. (2005). Tai Chi and fall reductions in older adults: a randomized controlled trial. Journal of Gerontology Series A: Biological Sciences and Medical Sciences, 60(2), 187194.Google Scholar
Lindwall, M., Larsman, P., & Hagger, M. S. (2011). The reciprocal relationship between physical activity and depression in older European adults: a prospective cross-lagged panel design using SHARE data. Health Psychology, 30(4), 453462.Google Scholar
Ling, K. W., Wong, F. S., Chan, W. K., Chan, S. Y., Chan, E. P., Cheng, Y. L., et al. (2003). Effect of a home exercise program based on Tai Chi in patients with end-stage renal disease. Peritoneal Dialysis International, 23(2), S99S103.Google Scholar
Manson, J., Rotondi, M., Jamnik, V., Ardern, C., & Tamim, H. (2013). Effect of Tai Chi on musculoskeletal health-related fitness and self-reported physical health changes in low income, multiple ethnicity mid to older adults. BMC Geriatrics, 13(1), 114.CrossRefGoogle ScholarPubMed
McAuley, E., Jerome, G. J., Elavsky, S., Marquez, D. X., & Ramsey, S. N. (2003). Predicting long-term maintenance of physical activity in older adults. Preventative Medicine, 37(2), 110118.Google Scholar
Menec, V. H., Shooshtari, S., Nowicki, S., & Fournier, S. (2010). Does the relationship between neighborhood socioeconomic status and health outcomes persist into very old age? A population-based study. Journal of Aging and Health, 22(1), 2747.Google Scholar
Mullen, S. P., Wójcicki, T. R., Mailey, E. L., Szabo, A. N., Gothe, N. P., Olson, E. A., et al. (2013). A profile for predicting attrition from exercise in older adults. Preventative Science, 14(5), 489496.Google Scholar
Region of Waterloo. (2012). Epidemiology and Health Analytics. Average income for older adults. Retrieved January 12, 2014 fromhttp://chd.region.waterloo.on.ca/en/researchResourcesPublications/resources/AverageAnnualIncome_OlderAdults_Brief.pdf.Google Scholar
SWP Community Ministries. (2005). Jane Finch Neighbourhood Action Plan Report. Allocation of funds to support neighbourhood and community safety. Retrieved 5 May 2013 from, http://www.twpcommunityministry.org/jane-finch/reports/61-jane-finch-neighbourhood-action-plan-report-.html.Google Scholar
Schaller, K. J. (1996). Tai Chi Chih: An exercise option for older adults. Journal of Gerontological Nursing, 22(10), 1217.Google Scholar
Shang, J., Wenzel, J., Krumm, S., Griffith, K., & Stewart, K. (2012). Who will drop out and who will drop in: exercise adherence in a randomized clinical trial among patients receiving active cancer treatment. Cancer Nursing, 35(4), 312322.Google Scholar
Song, R., Lee, E. O., Lam, P., & Bae, S. C. (2003). Effects of Tai Chi exercise on pain, balance, muscle strength, and perceived difficulties in physical functioning in older women with osteoarthritis: A randomized clinical trial. The Journal of Rheumatology, 30, 20392044.Google Scholar
Song, R., Lee, E. O., Lam, P., & Bae, S. C. (2007). Effects of a Sun-style Tai Chi exercise on arthritic symptoms, motivation and the performance of health behaviors in women with osteoarthritis. Daehan Ganho Haghoeji, 37(2), 249256.Google Scholar
Statistics Canada (2005). Annual Demographic Statistics, Catalogue no. 91-213-XIB. Ottawa, ON: Author.Google Scholar
Stineman, M. G., Strumpf, N., Kurichi, J. E., Charles, J., Grisso, J. A., & Jayadevappa, R. (2011). Attempts to reach the oldest and frailest: recruitment, adherence, and retention of urban elderly persons to a falls reduction exercise program. The Gerontologist, 51(1), S59S72Google Scholar
Tiedemann, A., Sherrington, C., Dean, C. M., Rissel, C., Lord, S. R., Kirkham, C., et al. (2012). Predictors of adherence to a structured exercise program and physical activity participation in community dwellers after stroke. Stroke Research and Treatment, 2012, 136525, 18.CrossRefGoogle ScholarPubMed
Tiedemann, A., Sherrington, C., & Lord, S. R. (2011). Predictors of exercise adherence in older people living in retirement villages. Preventative Medicine, 52(6), 480481.Google Scholar
Tobi, P., Estacio, E., Yu, G., Renton, A., & Foster, N. (2012). Who stays, who drops out? Biosocial predictors of longer-term adherence in participants attending an exercise referral scheme in the UK. BMC Public Health, 12(1), 347.Google Scholar
Wang, C. (2012). Role of Tai Chi in the treatment of rheumatologic diseases. Current Rheumatology Reports, 14(6), 598603.Google Scholar
Warburton, D. E. R., Katzmarzyk, P. T., Rhodes, R. E., & Shephard, R. J. (2007). Evidence-informed physical activity guidelines for Canadian adults. Applied Physiology, Nutrition, and Metabolism, 32, S16S68.Google Scholar
Ware, J., & Sherbourne, C. D. (1992). The MOS 36-Item Short-Form Health Survey (SF-36): I. Conceptual Framework and Item Selection. Medical Care, 30(6), 473483.Google Scholar
Yip, Y. B., Sit, J. W., Fung, K. K., Wong, D., Chong, S. Y., Chung, L. H., et al. (2007). Effects of a self-management arthritis programme with an added exercise component for osteoarthritic knee: Randomized controlled trial. Journal of Advanced Nursing, 59(1), 2028.Google Scholar