Cluster-randomised trial on participatory community-based outdoor physical activity promotion programs in adults aged 65–75 years in Germany: protocol of the OUTDOOR ACTIVE intervention trial

Abstract

BackgroundDespite its well-known benefits for health and well-being physical activity levels are insufficient and declining with age in Germany. Physical activity promotion programs for older adults are often not successful, one reason is insufficient relevance of intervention measures for the study population. Community-based participatory research (CBPR) is a possible key strategy for tailoring more meaningful intervention programs to a specific community. However, evidence for the effectiveness of CBPR in the general population is scarce. This study aims to formally evaluate the efficacy of a CBPR approach for developing and implementing an outdoor physical activity program for older adults.Methods/designThe OUTDOOR ACTIVE intervention trial is a cluster-randomised intervention study carried out in a random sample of eight subdistricts in the city of Bremen, Germany. The eight subdistricts are grouped into four homogenous pairs with regard to socioeconomic level and land use mix of the subdistrict. Within the pairs, the subdistricts are assigned randomly to the two study arms: participatory development and implementation of a community-based program to promote outdoor physical activity (intervention) versus no intervention (controls). For evaluation, a survey is carried out before (baseline) and after (follow-up) the intervention period. The measurements include 7-day accelerometer measurement, physical fitness test, blood pressure, basic anthropometry, and self-administered questionnaire.DiscussionThe OUTDOOR ACTIVE intervention trial will provide detailed information on PA intervention for older adults in an urban setting. Through the participatory nature of the study it will provide valuable insights into drivers and barriers to PA in this group, and it will inform policy makers and other stakeholders how to benefit from the results.Trial registrationGerman Clinical Trials Register DRKS00015117 (Date of registration 17-07-2018).

Effects of a Personalized Physical Exercise Program in the Arterial Stiffness in Older Adults

“…The present study evaluated the effects of a multidisciplinary intervention program on AS in community dwelling old adults, with a focus on the particular role of a tailored physical exercise program on top of other ongoing actions such as nutritional counseling, cognitive stimulation, and control of comorbidities and promotion of overall wellbeing. The health benefits of exercise have been extensively documented in all age groups, mainly due to its direct benefits on muscular strength, motor skills, cardiorespiratory fitness and overall health [1]. Accordingly, our results demonstrated significant benefits of the physical exercise intervention program, mainly a significant decrease in brachial BP, particularly in the pulsatile components (SBP and PP), and an improvement in PWV, illustrating a significant BP-independent de-stiffening effect.…”

“…One additional benefit of the physical activity program was the increased motivation for adopting healthy lifestyles as the person becomes physically more fit, which translated into a better nutritional profile as depicted in the MNA scores from baseline to post-intervention. Of course, these behavioral changes, if maintained, can contribute to delaying the onset of chronic diseases, supporting functional mobility and independent living, which is pivotal to promoting health, autonomy and social participation [1][2][3][4][5][6][7][8]. The functional gains are also of the utmost importance, and our results shown that tailored exercise training program produces a better body composition (positive modulation of the lean-to-fat body ratio), more strength (handgrip) and better self-efficacy for exercise.…”

“…One added feature of the intervention program tested in our study was the inclusion of an outdoor aerobic component, following previous evidence showing additional benefits of outdoor physical activity, promoting higher levels of vitamin D, mental well-being and high emotional scores due to sensory involvement with nature [1].…”

“…Demographic aging is a major societal challenge, imposing the need to implement strategies to promote a healthy aging and meet the challenges of this phenomenon and the additional burdens expected in the health systems [1]. In Portugal, the percentage of the elderly population aged over 65 years increased from 16% in 2001 to 21.5% in 2017, with 13.4% of the 21.5% of the older population being above 85 years of age [2].…”

Time allocation to active daily domains, physical activity, and health indicators in older adults: Cross-sectional results from the OUTDOOR ACTIVE study.

“…The OUTDOOR ACTIVE study is part of the regional prevention network AEQUIPA (Physical activity and health equity: primary prevention for healthy ageing) [16]. Research goals of OUTDOOR ACTIVE are to assess prevalence of PA in older adults, explore barriers and drivers for being physically active, and to develop and implement a community-based outdoor PA promotion program [17]. First baseline data were collected between October 2015 and August 2016 using 1) a self-administered paper-pencil questionnaire regarding intrapersonal, interpersonal, and environmental determinants of PA, 2) a short physical examination (anthropometry and blood pressure) followed by a tness test (modi ed public domain Senior Fitness Test [18] and handgrip strength test), and 3) accelerometry to objectively measure PA over the course of seven consecutive days.…”