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Sonja Kalinowski, Ines Wulff, Marita Kölzsch, Kirsten Kopke, Reinhold Kreutz and Dagmar Dräger

Purpose:

To explore different institutional barriers to and facilitators of physical activity (PA) in nursing homes.

Methods:

Cross-sectional survey of 40 German nursing homes and 217 nursing-home residents (NHRs; M ± SD age 80 ± 10.2 yr, 55% women, MMSE ≥20). Quantitative data were collected on the structural characteristics of nursing homes and the PA services available.

Results:

Forms of exercise available were not adequately communicated to residents. Overall participation was below 50%. Awareness was significantly higher in residents with informed relatives (p = .003). A broad range of forms of exercise was generally available (M ± SD 5 ± 2.22, range 0–10), but they were rarely tailored to NHRs’ needs and their effectiveness remains questionable.

Conclusion:

Multidimensional opportunities to promote PA in NHRs are identified.

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Jessie M. Wall, Janelle L. Kwee, Marvin J. McDonald and Richard A. Bradshaw

This study was the first to explore the treatment effects of observed and experiential integration (OEI) therapy for the salient psychological barriers to performance experienced by athletes. The hermeneutic single case efficacy design was used to explore the relationship between OEI therapy and athlete psychological functioning. The participant was a student-athlete who met the criteria for the performance dysfunction (multilevel classification system of Sport psychology) category, which indicates that subclinical issues were present. After five phases of data collection, a rich case record was compiled and referenced to develop skeptic and affirmative briefs and corresponding rebuttals by two research teams of three experts (OEI clinician, non-OEI clinician, and sport expert). Three independent judges adjudicated the cases and unanimously concluded that the client changed considerably to substantially and that OEI, the therapeutic relationship, and client expectancy were active variables in the change process.

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Rona Macniven, Victoria Pye, Dafna Merom, Andrew Milat, Claire Monger, Adrian Bauman and Hidde van der Ploeg

Background:

Physical activity interventions targeting older adults are optimized if barriers and enablers are better understood. This study identified barriers and enablers of physical activity and examined whether these were associated with meeting physical activity recommendations.

Methods:

2225 adults aged 65 years and above who perceived themselves to be insufficiently active but would like to be more physically active self-reported their barriers and enablers to physical activity in the 2009 New South Wales Falls Prevention Survey. Binary logistic regression analyses examined associations between barriers and enablers and meeting the physical activity recommendation.

Results:

After adjusting for gender, age, BMI, and education, people who listed ill health (52%; OR = 0.56, 95% CI 0.45 to 0.70) as a barrier or who listed people to exercise with (4%; OR = 0.49, 95% CI 0.27 to 0.88) as an enabler had significantly lower odds of meeting recommendations. Those citing too expensive (3%) as a barrier (OR = 2.07, 95% CI 1.11 to 3.87) or who listed nothing will help (29%; OR = 1.40, 95% CI 1.10 to 1.77) and making time to be active (9%; OR = 1.78, 95% CI 1.23 to 2.58) as enablers had significantly higher odds of meeting physical activity recommendations.

Conclusions:

These findings give insights into older adults’ perceptions of factors that influence their physical activity, which could assist physical activity program planning in this population.

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Katja Siefken, Grant Schofield and Nico Schulenkorf

Background:

The Pacific region has experienced rapid urbanization and lifestyle changes, which lead to high rates of noncommunicable disease (NCD) prevalence. There is no information on barriers and facilitators for healthy lifestyles in this region. In response, we present the first stage of a rigorous development of an urban Pacific health intervention program. This paper describes formative work conducted in Port Vila, Vanuatu. The objective of this paper was to understand cultural barriers and facilitators in Pacific women to lifestyle change and use the findings to inform future health interventions.

Methods:

Semistructured focus groups with 37 female civil servants divided into 6 groups were held verbally to understand barriers and facilitators for healthy lifestyles.

Results:

Several perceived barriers and facilitators were identified. Inter alia, barriers include financial limitations, time issues, family commitments, environmental aspects, and motivational hindrances that limit time and opportunities for healthy lifestyle behavior. Facilitators include more supportive environments, social support mechanisms, and the implementation of rigorous health policies.

Conclusions:

Formative work is essential in designing health intervention programs. Uncovered barriers and facilitators help inform the development of culturally relevant health interventions.

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Aviva Must, Sarah Phillips, Carol Curtin and Linda G. Bandini

Background:

Individual, social, and community barriers to physical activity (PA) experienced by children with autism spectrum disorder (ASD) make PA participation more difficult and may contribute to increased screen time.

Methods:

We compared the prevalence of parent-reported barriers to PA among 58 typically developing (TD) children and 53 children with an ASD, 3 to 11 years, and assessed the association between barriers and PA participation and screen time among children with ASD.

Results:

Parents of children with ASD reported significantly more barriers than parents of TD children. Based on parent-report, 60% of children with ASD required too much supervision compared with no TD children (P < .001). Parents of children with ASD were more likely to report that adults lack skills needed to include their child (58%), that their child has few friends (45%), and that other children exclude their child (23%). The number of parent-reported barriers to PA was inversely correlated with the hours spent in PA per year (r = −0.27, P = .05) and positively related to total screen time (r = .32, P < .03).

Conclusions:

These findings underscore the need for community-based PA programs designed to meet the special requirements of this population and policies that compel schools and other government-supported organizations for inclusion and/or targeted programming.

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Stephanie M. Mazerolle, Thomas M. Dodge and Thomas G. Bowman

Context:

Reciprocal learning appears to be occurring in athletic training clinical education. Students and preceptors can learn from one another, particularly if both parties are open to learning from each other.

Objective:

Examine facilitators and barriers to reciprocal learning in the athletic training clinical education setting.

Design:

Exploratory qualitative study.

Setting:

Athletic training programs.

Patients or Other Participants:

Our recruitment, which was based upon data redundancy, included 10 preceptors and 10 athletic training students. The preceptors had an average of 5 ± 3.5 years of experience supervising students. The athletic training student sample consisted of 8 seniors and 2 juniors.

Main Outcome Measures:

Participants responded to a series of questions by journaling their thoughts and opinions. Data were collected and stored on QuestionPro, a secure website. Data were analyzed by a general inductive approach. Credibility was established by (1) researcher triangulation, (2) peer review, and (3) member checks.

Results:

The relationship between the preceptor and the student along with reception to reciprocal learning emerged as facilitators, while a lack of confidence on the students’ behalf and time constraints can limit chances for reciprocal learning.

Conclusions:

Reciprocal learning has been identified as being mutually beneficial to the student and preceptor. Our findings highlight that for this type of learning to be successful, there has to be a communal interest in learning and that the use of current clinical cases and students’ current coursework provide benchmarks for discussion and learning.

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Robert Eley, Robert Bush and Wendy Brown

Background:

Interventions addressing chronic disease through physical activity are hampered by the low evidence base from rural areas. The purpose of the study was to provide information which may contribute to the development of future policy and strategy applicable to rural Queensland.

Methods:

Six diverse rural shires were chosen. A mixed-method design included more than 100 interviews with community representatives; surveys to 3000 community members; audits of facilities, amenities, and other relevant resources in each shire; and detailed observation during repeated site visits.

Results:

Half the respondents failed to meet Australian physical activity guidelines and 1 in 5 reported no activity. Queensland’s rural communities offer good access to a wide variety of structured and nonstructured activities. Some barriers to physical activity (eg, family commitments) are similar to those reported from urban areas; however, others including climate, culture of exercise, and community leadership are unique to the rural environment.

Conclusions:

Unique characteristics of rural environments and populations affect engagement in physical activity. Promotion of healthy lifestyle in rural environments need to be informed by local context and not merely extrapolated from urban situations. Attention must be paid to specific local circumstances which may affect implementation, adoption and participation.

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Heidi I. Stanish, Carol Curtin, Aviva Must, Sarah Phillips, Melissa Maslin and Linda G. Bandini

Background:

Youths with intellectual disabilities (ID) exhibit low levels of physical activity, but the underlying contributors to behavior are unclear. We compared physical activity enjoyment, perceived barriers, beliefs, and self-efficacy among adolescents with ID and typically developing (TD) adolescents.

Methods:

A questionnaire was administered to 38 adolescents with ID (mean age, 16.8 years) and 60 TD adolescents (mean age, 15.3 years). Of the original 33 questionnaire items, 23 met the test-retest reliability criteria and were included in the group comparisons.

Results:

Fewer adolescents with ID reported that they have someone with whom to do physical activity (64% vs 93%: P < .001), and a greater percentage of adolescents with ID perceived that physical activities were too hard to learn (41% vs 0%; P < .001). Fewer adolescents with ID believed that physical activity would be good for their health (92% vs 100%; P = .05). More adolescents with ID reported a dislike of individual physical activities (P = .02). A large percentage of adolescents with ID (84%) responded that they were good at doing physical activities, but the difference between groups was only of borderline significance (95% of TD adolescents, P = .06).

Conclusions:

Adolescents shared many of the same perceptions about physical activity, but some important differences between groups were identified.

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Cristina Caperchoine, William K. Mummery and Kelly Joyner

Background:

The Women’s Active Living Kits (WALK) Pilot Program was an Australian federal government initiative designed to identify an effective model for extending physical activity participation in government identified priority women’s groups. The purpose of this study is to address the barriers and challenges to physical activity participation in selected priority women’s groups and present possible strategies to assist with engaging these groups in physical activity.

Methods:

Ten focus group evaluation sessions were undertaken with priority women’s groups who took part in the WALK program. Participants were encouraged to share their opinions, perceptions and beliefs regarding their physical activity behaviors, in a semistructured, open table discussion.

Results:

Participants reported a number of psychological and cognitive, sociocultural, and environmental factors which restricted their participation in physical activity. Participants also highlighted strategies they felt would enable physical activity participation.

Conclusions:

These findings are valuable and should be used as a platform to inform the design and implementation of future physical activity interventions for priority women’s groups.

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Divya Rajaraman, Natasha Correa, Zubin Punthakee, Scott A. Lear, Krishnaswamy G. Jayachitra, Mario Vaz and Sumathi Swaminathan

Objectives:

The purpose of this study was to understand perceived benefits, facilitators, disadvantages, and barriers for physical activity among South Asian adolescents in India and Canada.

Methods:

Thirteen focus group discussions with South Asian (origin) adolescent boys and girls of different nutritional status and socioeconomic status in rural and urban India and urban Canada.

Results:

Across the groups, fitness and ‘energy’ were perceived to be major benefits of physical activity. In India, better academic performance was highlighted, while health benefits were well detailed in Canadian groups. In all settings, friends, family, and teachers were perceived as facilitators of as well as barriers to physical activity. Lack of a safe space to play was a major concern for urban adolescents, while academic pressures and preference for other sedentary recreational activities were common barriers across all groups. Girls were less likely than boys to be interested in physical activity, with girls’ participation in India further limited by societal restrictions.

Conclusions:

The study suggests key areas for promotion of physical activity among South Asian adolescents: balance between academic pressure and opportunities for physical activity, especially in India; urban planning for a built environment conducive to physical activity; and gender-sensitive programming to promote girls’ activity which also addresses culture-specific barriers.