Purpose: The PRECEDE-PROCEED model (PPM) is a community-based participatory research (CBPR) framework for health promotion, yet the direct application of the PPM into practice is unclear. This paper describes how the PPM was adapted for the development and application of a pilot intervention study to promote outdoor physical activity (PA) in older adults (OUTDOOR ACTIVE). We illustrate the steps and adaptations we applied to put the PPM into practice and present the developed interventions. Design: The PPM was adapted by incorporating a socio-ecological model. This ensured the design of any resultant intervention would explicitly address multi-level determinants of physical activity. The list of possible program components to select from for the design of an intervention was also extended. Setting: Bremen, Germany. Participants: Participants in the intervention development were 924 noninstitutionalized older adults, aged 65-75 years (response: 25.2%), living in Bremen-Hemelingen, Germany. For implementation of the intervention and to ensure sustainability, several groups of stakeholders were involved throughout the process. Methods: A mixed method design was employed (e.g., focus groups, quantitative survey) to identify determinants. A round table and participatory workshops were held to involve the target group and community stakeholders in the design of an intervention using the adapted PPM model. Results: A conceptual model was developed illustrating the integration of a socio-ecological model into the PPM. The model received ecological validity, as it was affirmed by community stakeholders as an appropriate method for designing a community-level PA intervention. Target goals to address PA determinants were selected by target group members. An intervention to meet the goals was developed and implemented with target group input. Conclusion: The adapted PPM is a promising starting point for developing multi-level interventions. Steps should be taken to ensure all social groups are participating in the process and all levels of determinants are addressed.

Background Regular physical activity (PA) is an important strategy for healthy ageing. Socioeconomic status was found to be a key determinant of PA, however, evidence on associations between socioeconomic status and PA among older adults is limited. The aim of this study was to contribute to research on the associations of socioeconomic status and PA among older adults by including self-reported and objectively measured PA data. Furthermore, we examined the self-reported PA data more closely by looking at the activities separately. Methods Cross-sectional data of 1507 participants (52.5% female) of the OUTDOOR ACTIVE study between 65 and 75 years, residing in Bremen, Germany, were included in the analyses. Self-reported PA was assessed via questionnaire and comprised all organised and non-organised activities. For analyses, mean hours per week of total and moderate to vigorous PA, and mean metabolic equivalents per week were used. Objectively measured PA was assessed using accelerometers over seven consecutive days. Socioeconomic status was included as an additive social class index containing education, income, and occupation. To test for associations between PA and socioeconomic status, linear regressions were carried out. Results Self-reported PA showed significant negative associations with socioeconomic status for both men and women. Objectively measured PA was positively associated with socioeconomic status, which was significant in men but not in women. When examining physical activities separately, time spent on housework, gardening, biking, and walking decreased with increasing socioeconomic status. Women in the second SES quintile and men in the third quintile reported the most, and women in the first quintile and men in the fifth quintile the least hours per week spent on exercise. Conclusions The results of this study contributed to the existing research gap on the associations of socioeconomic status and PA among older adults. Moreover, we provided information on both self-reported and objectively measured PA, and showed the discrepancies in the two methods’ results. These findings can help to develop PA promotion interventions targeting specific socioeconomic status groups and to develop accurate, valid, and reliable self-reported and objective measurements of PA for older adults.

Background Meteorological conditions are potential determinants of physical activity (PA). A profound understanding of the determinants of PA behaviour is required for PA promotion. This study examined the association between accelerometer-assessed PA and meteorological conditions among older adults. Methods This cross-sectional study included data of 577 adults aged 65-75 years living in Bremen, Germany (52% female; 3278 days). PA was measured with accelerometers for seven consecutive days (10/15-08/16). A threshold of 240 lx was used to differentiate between outdoor physical activity (OPA) and indoor physical activity (IPA). Linear mixed models estimated the association between PA (daily accelerometer counts per minute (CPM)) and meteorological factors (temperature, cloud cover, wind, and no precipitation) derived by principal component analysis. Results The analyses showed associations between PA in CPM and the meteorological factors tem

Sustaining good bone health into older age is key for preventing osteoporosis. Bone health is associated with several lifestyle factors. This study investigates older adults’ adherence to bone health-promoting lifestyle recommendations dependent on osteoporosis status. Cross-sectional data of 1610 community-dwelling older adults (65–75 years) residing in Bremen, Germany (53.4% female) were included. The Osteoporosis Self-Assessment Tool and self-reported osteoporosis diagnosis were used to classify participants by osteoporosis status (low risk, high risk, diagnosis). Adherence to bone health recommendations regarding calcium and vitamin D intake, sun exposure, alcohol consumption, resistance/weight-bearing exercise, and physical activity were assessed. Descriptive statistics were applied, stratified by sex and osteoporosis status. A total of 91 women (10.6%) and 15 men (2.0%) reported an osteoporosis diagnosis, 457 women (43.2%) and 311 men (41.4%) were classified as having a high risk, and 311 women (36.2%) and 425 men (56.6%) as having a low risk. Adherence to bone health recommendations was high for calcium intake (93.3–100.0%), vitamin D intake (77.8–93.3%), and sun exposure (86.7–97.7%). Lower adherence was observed regarding resistance/weight-bearing exercise (36.3–54.4%), physical activity (14.3–57.7%), and alcohol consumption (40.0–72.4%). In conclusion, tailored prevention strategies are needed that focus on older adults with an osteoporosis diagnosis or who are at high risk.

Men’s Sheds are a community-based health promotion concept which brings men together to engage in joint activities. Prior research reported beneficial effects on health and well-being of the participants; however, evidence is limited. The main objective of this systematic review is to provide an extensive overview of current research on the effectiveness of Men’s Sheds on self-rated health, social isolation, and well-being by applying a mixed-methods approach. In addition, this review aims to identify how to successfully transfer and implement the concept. Eligible for inclusion were all studies published in English, German, or French that specifically referred to the concept of Men’s Sheds. Four databases were searched for eligible studies, followed by a hand search on websites and reference lists. Methodological quality of included studies was assessed using checklists developed by the Joanna Briggs Institute. Following the convergent integrated approach, quantitative data were transformed and merged with qualitative data to conduct a thematic analysis. Overall, 35 qualitative, nine quantitative, and eight mixed-methods studies were included. We found evidence regarding benefits of shed participation on self-rated health, social isolation, and well-being. We identified three key characteristics of a successful Men’s Shed, including appropriate shed facilities, sufficient funding as well as a participant-driven management and organization of the shed. This mixed-methods systematic review provides a comprehensive overview of the evidence base concerning Men’s Sheds and highlights the need for longitudinal studies investigating causal relationships and gathering sufficient information on how to successfully transfer and implement the concept of Men’s Sheds in other countries.