Despite the benefits of physical activity, residents living in long-term care (LTC) are relatively sedentary. Designing successful physical activity and restorative care programs requires a good understanding of implementation barriers. A database search (2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013) yielded seven studies (nine articles) that met our inclusion criteria. We also reviewed 31 randomized controlled trials (RCTs) to determine if the authors explicitly discussed the barriers encountered while implementing their interventions. Eleven RCTs (13 articles) included a discussion of the barriers. Hence, a total of 18 studies (22 articles) were included in this review. Barriers occurred at resident (e.g., health status), environmental (e.g., lack of space for physical activity), and organizational (e.g., staffing and funding constraints) levels. These barriers intersect to adversely affect the physical activity of older people living in LTC. Future studies targeting physical activity interventions for residents living in LTC are needed to address these multiple levels of influence.
Physical inactivity is a global health concern. Evidence suggests low levels of physical activity among Arabic adults living in Middle Eastern countries. To help ensure the success of strategies to promote physical activity, a better understanding of the barriers and facilitators to physical activity is needed. The objective of this article is to present a review of the literature that focuses on the barriers and facilitators to physical activity among Arabic adults. A socio-ecological framework was used to guide this review. Following a database search (2002–2013), a total of 15 studies were included in this review. The findings revealed that barriers (i.e., factors that impede physical activity), occurred at the individual level (e.g., lack of time, health status), social/cultural/policy level (e.g., traditional roles for women, lack of social support, use of housemaids), and the environmental level (e.g., hot weather, lack of exercise facilities). Some of the facilitators (i.e., factors that enable/promote physical activity) were: Muslim religion, desire to have slimmer bodies, and having good social support systems. Future intervention studies aimed at promoting physical activity among Arabic adults need to address these multiple influencing factors.
In 2006, the authors conducted a multisite qualitative study in Ottawa, Ontario, Canada to examine organizational and environmental factors that influence physical activity for long-term-care (LTC) residents. The article describes the results of interviews with 9 administrators from nonprofit and for-profit LTC facilities. A content analysis revealed that despite having positive views about the value of physical activity, the administrators encountered challenges related to funding, human resources, and the built (physical) environment. The intersection of staffing issues and challenges in the built environment created less than optimal conditions for physical activity programs. Findings suggest that until there are adequate human and financial resources, it will be difficult to implement evidence-informed physical activity programs for residents in LTC settings in Ontario. A review of provincial LTC standards for physical activity program requirements and the built environment is warranted.
Caring for an individual in the home is inherently complex. The physical environment, family dynamics and the cognitive abilities of the client and family members are only a few of the factors to be considered in delivering services. Although targeted initiatives have been established to reduce preventable injuries and deaths in the hospital sector, there has not been a corresponding level of research or patient safety initiatives in other healthcare delivery sectors. A coordinated and collaborative approach to generate new knowledge pertaining to safety in home care in Canada has therefore been undertaken by the Canadian Patient Safety Institute (CPSI), VON Canada, and Capital Health (Edmonton). Actions included the development of a background paper (Lang and Edwards 2006) that informed an invitational roundtable discussion, where key safety issues in home care were identified and priority actions discussed. Over 40 individuals from across Canada participated, reflecting various disciplinary and organizational affiliations in the delivery of home care services. This paper describes key findings from the background paper, outcomes from the ensuing roundtable discussions and implications for practice, research and policy.
Physical activity has been linked to positive health outcomes for frail seniors. However, our understanding of factors that influence the physical activity of residents in the long-term care (LTC) setting is limited. This article describes our work with focus groups, one component of a multi-component study that examined factors influencing the physical activity of LTC residents. Residents, significant others, and staff from nine LTC facilities participated in these focus groups. Analysis of group discussions revealed three themes reflecting factors that mitigate the provision of physical activity: (a) inadequate support for physical activity, (b) pervasive institutional routines, and (c) physical environment constraints. All participants considered physical activity important to health preservation. Individual, structural, and environmental factors affected the quantity and quality of physical activity accessed by residents. These findings confirm the need to develop practical strategies and ways to address modifiable barriers and embed physical activity into LTC systems of care.
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