Peer Volunteers Improve Long-Term Maintenance of Physical Activity With Older Adults: A Randomized Controlled Trial

Abstract

Background Using peer volunteers as delivery agents may improve translation of evidence-based physical activity promotion programs for older adults. This study examined whether tailored support from older peer volunteers could improve initiation and long-term maintenance of physical activity behavior. Methods Participants were randomized to two 16-week, group-based programs: (1) peer-delivered, theory-based support for physical activity behavior change; or (2) an intervention typically available in community settings (basic education, gym membership, and pedometer for self-monitoring), attention-matched with health education. Moderate-to-vigorous physical activity (MVPA) was assessed via daily self-report logs at baseline, at the end of the intervention (16 weeks), and at follow-up (18 months), with accelerometry validation (RT3) in a random subsample. Results Seven peer volunteers and 81 sedentary adults were recruited. Retention at the end of the trial was 85% and follow-up at 18 months was 61 %. Using intent-to-treat analyses, at 16 weeks, both groups had similar significant improvements in MVPA. At 18 months, the group supplemented with peer support had significantly more MVPA. Conclusions Trained peer volunteers may enhance long-term maintenance of physical activity gains from a community-based intervention. This approach has great potential to be adapted and delivered inexpensively in community settings.

Peer-delivered physical activity interventions: an overlooked opportunity for physical activity promotion

“…In the seven studies with experimental or quasiexperimental designs, peer-delivered intervention conditions were compared with the following control conditions: professionally delivered physical activity intervention condition [44,45]; attention control conditions (peer-delivered health education [46] and professional-delivered nutrition advice [45]); non-peer, student-delivered PA intervention [47][48][49]; and no intervention [50]. Various physical activity behavioral measures were employed including self-reported activity [45,46,[50][51][52], accelerometry [45,46], pedometry [44], attendance and retention at fitness classes [47][48][49], and direct researcher observation [53].…”

“…Various physical activity behavioral measures were employed including self-reported activity [45,46,[50][51][52], accelerometry [45,46], pedometry [44], attendance and retention at fitness classes [47][48][49], and direct researcher observation [53]. In the final column of Table 1, we present the results for every physical activity measure reported and analyzed in each study.…”

“…Very little information was provided about the peers' activity levels. In three studies, peers were described as regularly active at the time of the intervention [44][45][46], and in another study, peers were described as having a "healthy and active lifestyle" [50]. In three studies, there was no indication of peer physical activity status [51][52][53].…”

“…All but one study [44] provided detailed information on the training that peer mentors underwent prior to taking on their role in the intervention. Three studies [45,46,53] had protocols for monitoring/evaluating the implementation of mentorship activities.…”

“…Five studies included a description of a theoretical base that guided intervention development. Three interventions were framed within social cognitive theory [44,50,51], one [46] was framed in a combination of social cognitive and self-determination theories, and one was framed in a combination of social cognitive theory and the transtheoretical model [45].…”