BackgroundCompelling evidence supports the cost effectiveness and potential impact of physical activity on chronic disease prevention and health promotion. Quality of evidence is one piece, but certainly not the sole determinant of whether public health interventions, physical activity focused or otherwise, achieve their full potential for impact. Health promotion at both population and community levels must progress beyond health intervention models that isolate individuals from social, environmental, and political systems of influence.We offer a critical evaluation of lessons learned from two successful research initiatives to provide insights as to how health promotion research contributes to sustained impact. We highlight factors key to success including the theoretical and methodological integration of: i) a social ecological approach; ii) participatory action research (PAR) methods; and iii) an interdisciplinary team.MethodsTo identify and illustrate the key elements of our success we layered an evaluation of steps taken atop a review of relevant literature.ResultsIn the school-based case study (Action Schools! BC), the success of our approach included early and sustained engagement with a broad cross-section of stakeholders, establishing partnerships across sectors and at different levels of government, and team members across multiple disciplines. In the neighbourhood built environment case study, the three domains guided our approach through study design and team development, and the integration of older adults’ perspectives into greenway design plans. In each case study we describe how elements of the domains serve as a guide for our work.ConclusionTo sustain and maximize the impact of community-based public health interventions we propose the integration of elements from three domains of research that acknowledge the interplay between social, environmental and poilitical systems of influence. We emphasize that a number of key factors determine whether evidence from public health interventions in school and built environment settings is applied in practice and policy sectors. These include relationship building at individual, community, and societal levels of the social ecological model, using participatory action research methods, and involving an engaged and committed interdisciplinary team.
In this article we examine the experiences of older women who participated in a randomized controlled trial (RCT) physical activity intervention designed to test the influence of exercise on executive function (cognition). Specifically, we were interested in why these women joined the RCT exercise program (uptake) and why they continued (adherence). Data were collected from 84 older women enrolled in the RCT (average age 69.6 years) in 10 focus group sessions at two time points. Data were analyzed using framework analysis. The findings showed that a range of factors influence both exercise uptake and adherence: timing in one's life, previous experience, physical benefits, personal barriers, and commitment.
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