Academic journal article Psychology, Community & Health

Increasing Physical Activity in Older Adults: Walking by Prescription in Primary Care

Academic journal article Psychology, Community & Health

Increasing Physical Activity in Older Adults: Walking by Prescription in Primary Care

Article excerpt

In older adults, health benefits due to regular physical activity have critical importance, contributing to lower rates of all mortality causes, such as coronary heart disease, high blood pressure, stroke, type 2 diabetes, colon cancer and breast cancer (World Health Organization [WHO], 2011). Physical activity contributes to a lower risk of falling, less functional limitations, higher level of cardiorespiratory and muscular fitness, healthier body mass and composition, higher levels of functional health, and improves independence and social interactions which help preserve cognitive functions (WHO, 2011). Therefore, is highly important to focus on education and interventions that can persuade older adults that they should change their behaviour because it has important consequences on their quality of life and longevity (Newsom, Kaplan, Huguet, & McFarland, 2004).

Physical inactivity has been considered one of the most important health problems in the 21st century (Blair, 2009) representing 1.5 to 3% of the total healthcare costs in the developed countries (Oldridge, 2008). Thus, increasing physical activity in older adults is a mandatory public health intervention that may result in individual, social, and economic benefits (Lamb, Bartlett, Ashley, & Bird 2002 ; WHO, 2011).

For the last few decades walking has been suggested as a particularly beneficial form of moderate physical activity that can easily be linked with primary care (Gusi, Reyes, Gonzales-Guerrero, Herrera, & Garcia, 2008 ; Orrow, Kinmonth, Sanderson, & Sutton, 2012), and as a more effective way of promoting physical activity for older adults comparing to the general adult population (Kassavou, Turner, & French, 2013). Intervention in Primary Health Care Centres is considered strategic for physical activity promotion among sedentary population (Garrett et al., 2011 ; Orrow et al., 2012). The main reason is that 70 to 80% of citizens from developed countries visit a General Practitioner (GP) at least once every twelve months (van Doorslaer et al., 2006). In addition, GP’s recommendation for physical activity improves older adult’s quality of life (Guallar-Castillón, Santa-Olalla Peralta, Ramón Banegas, López, & Rodríguez-Artalejo, 2004 ; King, Rejeski, & Buchner, 1998) and their interest in health (Gusi et al., 2008). However, people do not always follow the advice of their GP when it comes to physical activity (Burke & Dunbar-Jacob, 1995) thus, developing strategies to help people adhere to GP recommendations is needed (Atreja, Bellam, & Levy, 2005).

Physical activity behaviour change interventions should be based on theoretical models that explain and predict physical activity (Booth, Owen, Bauman, Clavisi, & Leslie, 2000), using techniques such as goal setting, planning, and self-monitoring (McMurdo et al., 2010). Social cognitive theories, like the theory of planned behaviour, assumes that a certain behaviour can be predicted by intention – the individual motivation to perform the behaviour (Ajzen & Fishbein, 1977). One of the main problems seems to be the link between intention and behaviour – people intend to perform the behaviour but do not act (Sheeran & Webb, 2016). According to Hardeman et al. (2002) “the theory of planned behaviour has rarely been applied to interventions (…), and it is most frequently used to measure process and outcome variables and to predict intention or behaviour (change), and less often to develop the intervention” (p. 148).

Recent interventions focused on volitional (post-intentional) processes (Koring et al., 2012). Planning interventions to increase health behaviour (Gollwitzer & Sheeran, 2006) have been suggested as an alternative to build the bridge between intention and behaviour by purposing more proximal factors that facilitate the translation of the intention into action (Schwarzer, 2008). The planning intervention distinguishes action planning and coping planning has components of a volitional phase (Schwarzer, 2008). …

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