External validity of physical activity interventions for community‐dwelling older adults with fall risk: a quantitative systematic literature review

Abstract

Aim To appraise the external validity of physical activity interventions designed to reduce falls among community-dwelling older adults, using the reach, efficacy/effectiveness, adoption, implementation, and maintenance framework. Background Falls are a globally common, significant, and preventable problem. The efficacy of physical activity interventions to reduce falls among older adults is well established. Translation of this research into practice is slow as evidenced by persistently low proportions of older adults who engage in physical activities and the rising incidence of falls. Data Sources Four electronic databases were searched for relevant studies published between 2000 and 2010. Studies that examined the effects of physical activity interventions designed to reduce falls among community dwelling older adults were included in this review (n = 46). Review Methods This was a quantitative systematic review with narrative synthesis. The reach, efficacy/effectiveness, adoption, implementation, and maintenance framework guided the identification, appraisal, and synthesis of indicators representing study validity. Results The majority of studies in this review described indicators representing internal validity. Details about indicators representing external validity were reported infrequently, limiting the generalizability of fall-preventive physical activity interventions in diverse cultures and social contexts over time. Conclusions To foster translational research in real world settings, additional programmatic intervention research is needed that: (a) targets diverse populations; (b) incorporates theories of behavioural change; (c) describes and operationalizes critical content that enables replication and translation; (d) tests innovative measures of fall risk and physical activity; and (e) evaluates feasibility and acceptability.

Physical activity interventions to promote positive youth development among indigenous youth: a RE-AIM review

“…This suggests that even studies designed to demonstrate effectiveness and thus illustrate potential for widespread dissemination prioritize the reporting of items associated with internal validity. This is consistent with previous findings [31,43] reporting that there is an emphasis on efficacy and internal validity factors in the health promotion literature rather than on effectiveness and external validity.…”

“…While Canuto [20] thoroughly discusses the implementation protocol, measures of cost are missing. Reporting on indicators of fidelity strengthens confidence that the effects of an intervention are due to the intervention implemented [31], while cost is a practical consideration in determining feasibility [27,43,45,48]. Finally, reporting on individual outcomes and organization-level maintenance of the program after the original intervention is completed denotes a program with potential for sustainability, in both long-term effectiveness and viability in the realm of public health.…”

Combining Motivational and Physical Intervention Components to Promote Fall-Reducing Physical Activity Among Community-Dwelling Older Adults

“…8 There is substantial evidence supporting the basis for Ready~Steady's physical component, Otago, delivered to community-dwelling individuals by physical therapists and trained nurses. 24 Our findings also add to growing evidence of Otago's positive effects on fall risk when delivered to small groups.…”

“…Although the knowledge about factors influencing motivation among older adults has increased over the past several decades, intervention content supporting motivation for behavioral change has been formally evaluated in very few fall-reducing PA interventions. 8 …”

Community-Based Recreational Football: A Novel Approach to Promote Physical Activity and Quality of Life in Prostate Cancer Survivors

“…Accordingly, we aim to initiate the FC Prostate Community Study with the purpose to explore the effectiveness of community-based recreational football to promote physical activity adoption and quality of life in a heterogeneous group of prostate cancer survivors [47,48]. …”