“Someone’s Got My Back”: Older People’s Experience of the Coaching for Healthy Ageing Program for Promoting Physical Activity and Preventing Falls

Abstract

The Coaching for Healthy Ageing trial evaluated the impact on physical activity (PA) and falls based on a year-long intervention in which participants aged 60+ receive a home visit, regular health coaching by physiotherapists, and a free activity monitor. This interview study describes the participants’ experiences of the intervention and ideas for improvement. The authors sampled purposively for maximum variation in experiences. The data were analyzed thematically by two researchers. Most of the 32 participants reported that the intervention increased PA levels, embedded activities, and generated positivity about PA. They were motivated by quantified PA feedback, self-directed goals, and person-centered coaching. Social connectivity motivated some, but the intervention did not support this well. The intervention structure allowed participants to trial and embed activities. Autonomy and relatedness were emphasized and should be included in future program theory. The authors identified synergistic effects, likely “essential ingredients,” and potential areas for improving this and similar interventions.

Using self-determination theory to understand and improve recruitment for the Coaching for Healthy Ageing (CHAnGE) trial

“…This resonates with the spectrum of behavioural regulation proposed by SDT where competence-supporting autonomy and relatedness enable people to internalise the 'rules' of a practice and thus become more intrinsically motivated [63]. Indeed, findings from the wider evaluation of CHAnGE [75,84] highlight interviewees' sense of "freedom" in developing their own program and tackling it at times and in locations of their choosing: ". .…”

“…With reducing capacities, we can also become more isolated and lonely in our homes and less able to make a significant contribution to others or society in general. [74, p.26] The current study utilises data from a wider qualitative process evaluation of the CHAnGE trial which was informed by SDT and which confirmed that the theory's three core constructs were crucial to the intervention's functioning [75].…”

“…This approach incorporates common qualitative analytical techniques including immersion in the data, 'constant comparison' of data to identify thematic patterns and relationships across cases, and theorising about explanatory factors. The coding frame is available elsewhere [75]. A second round of thematic analysis was conducted for this substudy in which we inductively examined previously coded categories relating to recruitment and participation to identify themes regarding interviewees' reasons for enrolment in CHAnGE [79,80].…”

“…Prompts that were informed by SDT were used to generate reflective in-depth responses about their reasons, including their perceptions of the recruitment process and any expectations of the intervention. More information, including the full interview guide, is available elsewhere [75].…”

“….. I didn't know whether it would be just exercise or nutrition or mental health or emotional health or what exactly the whole thing would entail" (female, 75).…”