naa a22 4500 510786790 CHVBK 20180411083305.0 cr unu---uuuuu 180411e20130501xx s 000 0 eng 10.1007/s12603-012-0417-1 doi (NATIONALLICENCE)springer-10.1007/s12603-012-0417-1 Adherence to a physical activity intervention among older adults in a post-transitional middle income country: A quantitative and qualitative analysis [Elektronische Daten] [Maria Garmendia, A. Dangour, C. Albala, P. Eguiguren, E. Allen, R. Uauy] Objectives: The effectiveness of community level interventions depends to a great extent on adherence. Currently, information on factors related to adherence in older adults from developing countries is scarce. Our aim was to identify factors associated to adherence to a physical activity intervention in older adults from a post-transitional middle income country. Design, setting and participants: Using a combination of quantitative and qualitative methods we studied 996 older Chilean subjects (65-67.9 years at baseline) with low to medium socioeconomic status from 10 health centers randomized to receive a physical activity intervention as part of the CENEX cluster trial (ISRCTN48153354). Measurements: Using a multilevel regression model, the relationship between adherence (defined a priori as attendance at a minimum of 24 physical activity classes spread over at least 12 months) and individual, intervention-related and contextual factors was evaluated. We also conducted 40 semi-structured interviews with older adults (n=36) and instructors (n=4). Transcripts of the interviews were analyzed using content analysis to identify barriers and facilitators to adherence. Results: Adherence to physical activity intervention was 42.6% (CI 95% 39.5 to 45.6). Depression, diabetes mellitus, percentage of impoverished households and rate of arrests for violent crimes in the neighborhood predicted less adherence (p<0.05) while being retired, participation in physical activity prior to the intervention, and green areas per habitant were positively associated with adherence (p<0.05). The qualitative interviews identified three primary barriers to adherence: current health problems, lack of time due to commitments for caring for family members, and being employed, and two primary facilitators to adherence: the health benefits attributed to the intervention and the opportunity the classes provided for social interaction with others. Conclusion: In order to enhance effectiveness of community exercise interventions, strategies to improve participation should be targeted to older adults from deprived areas and those with psychological and medical conditions. Serdi and Springer-Verlag France, 2012 Patient compliance nationallicence aging nationallicence physical activity nationallicence PA : physical activity nationallicence RCT : Randomized Controlled Trial nationallicence PCHC : Primary Care Health Center nationallicence GDS-15 : Yesavage Geriatric Depression Scale, 15-question version nationallicence COPD : chronic obstructive pulmonary disease nationallicence LSHTM : London School of Hygiene & Tropical Medicine nationallicence SD : standard deviation nationallicence OR : odds ratio nationallicence CI : confidence interval nationallicence OA : older adults nationallicence P : physical education instructors nationallicence Garmendia Maria Institute of Nutrition and Food Technology, Universidad de Chile, Santiago, Chile aut Dangour A. Department of Nutrition and Public Health Intervention Research, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK aut Albala C. School of Public Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile aut Eguiguren P. Institute of Nutrition and Food Technology, Universidad de Chile, Santiago, Chile aut Allen E. Department of Nutrition and Public Health Intervention Research, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK aut Uauy R. Department of Nutrition and Public Health Intervention Research, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK aut The journal of nutrition, health & aging Springer-Verlag 17/5(2013-05-01), 466-471 1279-7707 17:5<466 2013 17 12603 https://doi.org/10.1007/s12603-012-0417-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12603-012-0417-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Garmendia Maria Institute of Nutrition and Food Technology, Universidad de Chile, Santiago, Chile aut NATIONALLICENCE 700 1- Dangour A. Department of Nutrition and Public Health Intervention Research, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK aut NATIONALLICENCE 700 1- Albala C. School of Public Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile aut NATIONALLICENCE 700 1- Eguiguren P. Institute of Nutrition and Food Technology, Universidad de Chile, Santiago, Chile aut NATIONALLICENCE 700 1- Allen E. Department of Nutrition and Public Health Intervention Research, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK aut NATIONALLICENCE 700 1- Uauy R. Department of Nutrition and Public Health Intervention Research, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK aut NATIONALLICENCE 773 0- The journal of nutrition, health & aging Springer-Verlag 17/5(2013-05-01), 466-471 1279-7707 17:5<466 2013 17 12603 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer