A qualitative longitudinal study of motivation in the REtirement in ACTion (REACT) physical activity intervention for older adults with mobility limitations

Rosina Cross, Colin Greaves, Janet Withall, Marlene Kritz, Afroditi Stathi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Physical activity (PA) is beneficial for older adults’ health, however they remain the least active age group in the UK. This qualitative longitudinal study aims to understand motivations in older adults receiving the REACT physical activity intervention, through the lens of self-determination theory. Methods: Participants were older adults randomised to the intervention arm of the Retirement in ACTion (REACT) Study, a group-based physical activity and behaviour maintenance intervention to prevent decline of physical functioning in older adults (≥ 65 years). Stratified purposive sampling by physical functioning (Short Physical Performance Battery scores) and 3-month attendance was employed. Fifty-one semi-structured interviews were conducted at 6, 12 and 24-months with twenty-nine older adults (Mean age (baseline) = 77.9 years, SD 6.86, 69% female) and at 24-months with twelve session leaders and two service managers. Interviews were audio recorded, transcribed verbatim and analysed using Framework Analysis. Results: Perceptions of autonomy, competence and relatedness were associated with adherence to the REACT programme and maintenance of an active lifestyle. Motivational processes and participants’ support needs, changed during the 12-month REACT intervention and across the 12-months post-intervention. Group interactions were an important source of motivation during the first six months but increased competence and mobility drove motivation at the later stages (12 months) and post-intervention (24 months). Conclusions: Motivational support needs vary in different stages of a 12-month group-based programme (adoption and adherence) and post-intervention (long-term maintenance). Strategies to accommodate those needs include, (a) making exercise social and enjoyable, (b) understanding participants’ capabilities and tailoring the programme accordingly, (c) capitalising on group support to motivate participants to try other activities and prepare sustainable active living plans. Trial registration: The REACT study was a pragmatic multi-centre, two-arm, single-blind, parallel-group, RCT (ISRCTN registration number 45627165).

Original languageEnglish
Article number50
Number of pages14
JournalInternational Journal of Behavioral Nutrition and Physical Activity
Volume20
Issue number1
DOIs
Publication statusPublished - 26 Apr 2023

Bibliographical note

Funding Information:
This work was supported by the National Institute for Health Research, Public Health Research Programme (13/164/51). The corresponding author (RC) was supported in their research by a PhD studentship funded by the University of Bath. We wish to extend our thanks to the REACT research team, Jolanthe De Koning (JdK) for contributing to data collection, Sophie Wilson (PhD candidate University of Birmingham) for her work coding the 24 month interviews, the REACT research participants, the Clinical Research Networks at each REACT site and the GP practices and community organisations who supported REACT recruitment. Delivery of the REACT programme was supported by our partners, Exeter City Council; Bath and North East Somerset Council; Solihull City Council; Solihull Borough Council, Birmingham; Agewell, West Midlands; St Monica’s Trust, Bristol; Westbank Charity; St John’s Hospital Bath; Sandwell and West Birmingham Hospitals NHS Trust; Bristol Ageing Better; Age UK Birmingham; the Portway Lifestyle Centre.

Funding Information:
The REACT study was funded by the National Institute for Health Research (NIHR) – Public Health Research Programme (13/164/51). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. The study was generously supported by the Clinical Research Network at each site. The funder approved the study design but had no role in data collection, data analysis, data interpretation and publications related to the REACT study dataset. The corresponding author was funded by a University of Bath PhD studentship.

Keywords

  • Ageing
  • Exercise
  • Group
  • Maintenance
  • Motivation
  • Randomised Controlled Trial

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Nutrition and Dietetics

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