scholarly journals Technology support challenges and recommendations for adapting an evidence-based exercise program for remote delivery to older adults: Exploratory mixed-methods study (Preprint)

JMIR Aging ◽  
10.2196/27645 ◽  
2021 ◽  
Author(s):  
Nancy Gell ◽  
Elise Hoffman ◽  
Kushang Patel
Keyword(s):  
Older Adults ◽  
Mixed Methods ◽  
Exercise Program ◽  
Mixed Methods Study ◽  
Evidence Based ◽  
Technology Support

Technology support challenges and recommendations for adapting an evidence-based exercise program for virtual delivery to older adults: Mixed-methods study (Preprint)

2021 ◽  
Author(s):  
Nancy Gell ◽  
Elise Hoffman ◽  
Kushang Patel
Keyword(s):  
Older Adults ◽  
Technical Assistance ◽  
Exercise Program ◽  
Barriers And Facilitators ◽  
Support Needs ◽  
Evidence Based ◽  
Technology Support ◽  
Symptomatic Knee Osteoarthritis ◽  
Technology Orientation ◽  
Exercise Classes

BACKGROUND Tele-exercise has emerged as a way for older adults to participate in group exercise during the COVID-19 pandemic. Yet, little is known about the technology support needs of older adults for accessing tele-exercise. OBJECTIVE Examine the interests and needs of older adults for transition to tele-exercise, 2) Identify barriers and facilitators of tele-exercise uptake and continued participation, and 3) Describe technology support challenges and successes encountered among older adults beginning tele-exercise. METHODS We used an exploratory sequential mixed method study design. Participants were older adults with symptomatic knee osteoarthritis (n=44) who started participating in remotely delivered Enhance Fitness. Prior to the start of classes, a subsample of participants (n=10) completed semi-structured phone interviews about technology support needs and barriers and facilitators for technology adoption. All participants completed surveys including the PROMIS-57, the Senior Technology Acceptance Model scale, and a technology needs assessment. The study team recorded technology challenges encountered when participants engaged in tele-exercise classes and attendance rates. RESULTS Four themes emerged from the interviews: Participants desire features in a tele-exercise program that foster accountability; importance of direct access to helpful people who can troubleshoot and provide guidance with technology; opportunities to participate in high value activities motivates willingness to persevere through technology concerns; and belief in the ability to learn new things supersedes technology-related anxiety. Among participants in the tele-exercise classes (mean age 74.0 years ± 6.3; 86.4% female; mean of 2.5 ± 0.9 chronic conditions), 70.5% had a computer with a webcam, but 40.9% had little or no experience with videoconferencing. Initial technology orientation sessions lasted, on average, 19.3 (±10.3) minutes and 23.9% required a follow-up assistance call. During the first two weeks of tele-exercise, 47.6% required technical assistance which decreased to 11.9% for weeks 3-16. Median attendance was 100% for the first six sessions and 93% for the subsequent 42 sessions. CONCLUSIONS With appropriate support, older adults can successfully participate in tele-exercise. Recommendations include individualized technology orientation sessions, experiential learning, and availability of stand-by technical assistance, particularly during the first two weeks of classes. Continued development of best practices in this area may allow previously hard-to reach populations of older adults to participate in health-enhancing, evidence-based exercise programs. CLINICALTRIAL NCT04099394

scholarly journals Feasibility and Acceptability of Tele-Enhance Fitness in Older Adults With Knee Osteoarthritis

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 282-282
Author(s):  
Elise Hoffman ◽  
Neta Simon ◽  
Nancy Gell ◽  
Kushang Patel
Keyword(s):  
Older Adults ◽  
Knee Osteoarthritis ◽  
Social Cognitive Theory ◽  
Social Cognitive ◽  
Cognitive Theory ◽  
Exercise Program ◽  
Mixed Methods Study ◽  
Evidence Based ◽  
Interactive Instruction ◽  
Key Stakeholders

Abstract Enhance Fitness (EF) is an evidence-based, group exercise program for older adults. When COVID-19 halted in-person EF classes nationally, we adapted EF for remote delivery (tele-EF) by engaging key stakeholders. To determine feasibility and acceptability of tele-EF, we conducted a mixed methods study among 42 older adults (≥65 years) with knee osteoarthritis. Participants attended EF classes for 1-hour, 3 days/week for 4-5 months (1-3 months in-person EF and 2-4 months in tele-EF). Attendance for in-person EF was 80.0% versus 91.0% for tele-EF. Nearly all participants (95.2%) reported that they were satisfied or very satisfied with tele-EF. Qualitative exit interview data mapped well onto Social Cognitive Theory constructs. With tele-EF, participants found that livestream classes facilitated accountability and self-efficacy to participate in exercise and that interactive instruction provided encouragement and support to exercise. Thus, tele-EF is a viable remotely-delivered exercise program for older adults that retains many features of in-person EF.

Translating a Functional Exercise Program for Fall Prevention Among Diverse Older Adults in Urban Medically Underserved Areas: A Mixed Methods Study

2020 ◽  
pp. 1-8
Author(s):  
Yi-Ling Hu ◽  
Marian Keglovits ◽  
Emily Somerville ◽  
Makenna Snyder ◽  
Susan Stark
Keyword(s):  
Older Adults ◽  
Mixed Methods ◽  
Service Providers ◽  
Exercise Program ◽  
Mixed Methods Study ◽  
Medically Underserved ◽  
Sequential Mixed Methods ◽  
High Adherence ◽  
Functional Exercise ◽  
Good Retention

The Lifestyle-integrated Functional Exercise Program (LiFE) is proven to have high adherence rates and can significantly reduce falls, but it has not yet been implemented for diverse older adults residing in urban medically underserved (MU) areas. An exploratory sequential mixed methods study was conducted to adapt LiFE and test the adapted program’s preliminary feasibility. Focus groups with MU older adults and service providers were conducted to identify modifications. The new adapted program, Diverse Older Adults Doing LiFE (DO LiFE), was then evaluated with older adults. Thematic analysis revealed health literacy and lack of racial representation as barriers to implementing LIFE in this population. The pilot study showed that DO LiFE was feasible with good retention (89%) and high adherence (81.27%) rates. DO LiFE demonstrated preliminary feasibility for diverse MU older adults. Researchers should proceed to larger studies for translating DO LiFE from research to the community.

scholarly journals Engaging primary care providers in managing pediatric eating disorders: a mixed methods study

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Jocelyn Lebow ◽  
Cassandra Narr ◽  
Angela Mattke ◽  
Janna R. Gewirtz O’Brien ◽  
Marcie Billings ◽  
...  
Keyword(s):  
Primary Care ◽  
Eating Disorders ◽  
Mixed Methods ◽  
Care Setting ◽  
Primary Care Setting ◽  
Primary Care Providers ◽  
Mixed Methods Study ◽  
Evidence Based ◽  
Care Providers ◽  
Evidence Based Treatment

Abstract Background The primary care setting offers an attractive opportunity for, not only the identification of pediatric eating disorders, but also the delivery of evidence-based treatment. However, constraints of this setting pose barriers for implementing treatment. For interventions to be successful, they need to take into consideration the perspectives of stakeholders. As such, the purpose of this study was to examine in-depth primary care providers’ perspective of challenges to identifying and managing eating disorders in the primary care setting. Methods This mixed methods study surveyed 60 Pediatric and Family Medicine providers across 6 primary care practices. Sixteen of these providers were further interviewed using a qualitative, semi-structured interview. Results Providers (n = 60, response rate of 45%) acknowledged the potential of primary care as a point of contact for early identification and treatment of pediatric eating disorders. They also expressed that this was an area of need in their practices. They identified numerous barriers to successful implementation of evidence-based treatment in this setting including scarcity of time, knowledge, and resources. Conclusions Investigations seeking to build capacities in primary care settings to address eating disorders must address these barriers.

scholarly journals Insights from an early stage development mixed methods study on arts-based interventions for older adults following hospitalisation

2021 ◽  
pp. 102745
Author(s):  
Amanda M. Clifford ◽  
Joanne Shanahan ◽  
Hilary Moss ◽  
Triona Cleary ◽  
Morgan Senter ◽  
...  
Keyword(s):  
Older Adults ◽  
Mixed Methods ◽  
Early Stage ◽  
Mixed Methods Study ◽  
Stage Development

scholarly journals 0721 Daytime Sleepiness and Napping in Nursing-Home Eligible Community Dwelling Older Adults: A Mixed Methods Study

SLEEP ◽  
2018 ◽  
Vol 41 (suppl_1) ◽  
pp. A268-A268
Author(s):  
M V McPhillips ◽  
J Li ◽  
P Z Cacchione ◽  
V V Dickson ◽  
N S Gooneratne ◽  
...  
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Mixed Methods ◽  
Daytime Sleepiness ◽  
Community Dwelling ◽  
Mixed Methods Study ◽  
Community Dwelling Older Adults

scholarly journals Evidence-based intrapartum practice and its associated factors at a tertiary teaching hospital in the Philippines, a descriptive mixed-methods study.

2020 ◽  
Author(s):  
Chisato Masuda ◽  
Shirley Kristine Ferolin ◽  
Ken Masuda ◽  
Chris Smith ◽  
Mitsuaki Matsui
Keyword(s):  
Mixed Methods ◽  
Associated Factors ◽  
Healthcare Providers ◽  
The Philippines ◽  
Mixed Methods Study ◽  
Evidence Based ◽  
Factors Associated ◽  
Second Stage ◽  
Assisted Delivery ◽  
Fundal Pressure

Abstract Background Evidenced-based practice is a key component of quality care. However, studies in the Philippines have identified gaps between evidence and actual maternity practices. This study aims to describe the practice of evidence-based intrapartum care and its associated factors, as well as exploring the perceptions of healthcare providers in a tertiary hospital in the Philippines. Methods A mixed-methods study was conducted, which consisted of direct observation of intrapartum practices during the second and third stages, as well as semi-structured interviews and focus group discussions with care providers to determine their perceptions and reasoning behind decisions to perform episiotomy or fundal pressure. Univariate and multivariate logistic regression were used to analyse the relationship between observed practices and maternal, neonatal, and environmental factors. Qualitative data were parsed and categorised to identify themes related to the decision-making process. Results A total of 170 deliveries were included. Recommended care, such as prophylactic use of oxytocin and controlled cord traction in the third stage, were applied in almost all the cases. However, harmful practices were also observed, such as intramuscular or intravenous oxytocin use in the second stage (14%) and lack of foetal heart rate monitoring (57%). Of primiparae, 92% received episiotomy and 31% of all deliveries received fundal pressure. Factors associated with the implementation of episiotomy included primipara (adjusted Odds Ratio [aOR] 62.3), duration of the second stage of more than 30 minutes (aOR 4.6), and assisted vaginal delivery (aOR 15.0). Factors associated with fundal pressure were primipara (aOR 3.0), augmentation with oxytocin (aOR 3.3), and assisted delivery (aOR 4.8). Healthcare providers believe that these practices can prevent laceration. The rate of obstetric anal sphincter injuries (OASIS) was 17%. Associated with OASIS were assisted delivery (aOR 6.0), baby weights of more than 3.5 kg (aOR 7.8), episiotomy (aOR 26.4), and fundal pressure (aOR 6.2). Conclusions Our study found that potentially harmful practices are still conducted that contribute to the occurrence of OASIS. The perception of these practices is divergent with current evidence, and empirical knowledge has more influence. To improve practices the scientific evidence and its underlying basis should be understood among providers.

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