Trial feasibility and process evaluation of a motivationally-embellished group peer led walking intervention in retirement villages using the RE-AIM framework: the residents in action trial (RiAT)

Abstract

Objective : The Residents in Action Trial (RiAT; ACTRN12616001177448) was a 16-week motivationally-embellished peer-led walking intervention designed to increase walking, reduce sitting, and improve mental health and well-being in insufficiently active residents in retirement villages. In this paper we report on 1) trial feasibility and acceptability, and 2) evaluate the processes involved in the implementation of the intervention using the RE-AIM framework. Method : A mixed methods design was employed, consisting of data from accelerometers, surveys, (individual, pair-based and focus group) interviews, and participant logbooks. Participants included 116 walkers ( M ( SD ) age = 78.37(8.30); 92% female), 8 peer leaders (i.e. ambassadors) and 3 retirement village managers from 14 retirement villages. Descriptives and linear mixed modelling were used to analyse the quantitative data and inductive thematic analyses were employed to analyse the interview data. Results : The intended cluster randomised controlled design became quasi-experimental due to insufficient numbers of recruited ambassadors. The perceived burden of the number and frequency of research assessments was a frequently mentioned reason for a poor recruitment. Facilitators to walking maintenance were the use of self-monitoring, goal setting, social support, and having a routine. Reach was modest (about 14% of eligible participants were recruited from each village), but retention was excellent (92%). The motivational strategies taught appeared to have been implemented, at least in part, by the ambassadors. The walkers in the main experimental condition increased marginally their step counts, but there were no group differences on mental health and well-being outcomes, partly because of low statistical power. Conclusions : Walkers and ambassadors who did take part in the study suggested that they enjoyed the programme and found it useful in terms of becoming more active and making social connections. However, the group format was not appealing to some participants, hence, other delivery options should be explored in the future.

Mobilising people as assets for active ageing promotion: a multi-stakeholder perspective on peer volunteering initiatives

“…From a theoretical perspective, both social cognitive theory [18] and self-determination theory [19] suggest that peer volunteers can enhance the self-efficacy of participants through modelling (e.g., seeing others cope with barriers to active ageing), verbal encouragement, reduction in perceived barriers and increase levels of social support and connectedness. Volunteers themselves also benefit by experiencing higher levels of competence and relatedness [20][21][22][23][24][25][26].…”

Older Adults’ Perceptions toward Walking: A Qualitative Study Using a Social-Ecological Model

“…This sample size met the sample size guidelines suggested by Moser and Korstjens that no new analytical information arises anymore [ 33 ]. Additionally, this sample size took reference of previous related studies [ 18 , 19 , 20 , 21 , 22 , 23 , 24 ] that the range of sample size was 15–57. The inclusion criteria for this study were as follows: (1) being aged ≥ 60 years, (2) having no diagnosed cognitive impairment, and (3) being able to walk with or without assistance.…”

“…Although several robust quantitative reviews [ 12 , 13 , 14 ] and other studies [ 15 , 16 ] have investigated PA and walking in older adults, only a few studies in this field have used qualitative approaches [ 17 ]. Some qualitative studies investigated perceptions of walking in middle-aged and older adults in Canada [ 18 ], Taiwan [ 19 ], Australia [ 20 , 21 ], and the United States [ 22 ]. Two qualitative studies examined the environmental factors influencing older adults’ walking habits in Belgium [ 23 ] and the United Kingdom [ 24 ].…”

“…The results found brisk walking was a good way to promote and maintain middle-aged and older adults’ health, and build social relationship and social interactions. Two studies were conducted in Australia [ 20 , 21 ] and both of these studies suggested to make group-based walking programs appealing and feasible to a diverse group of residents. Leading with walking ambassadors was also a recommended strategy to promote walking in older adults.…”

“…However, this inference needs more research to support it, especially in higher population density cities such as Hong Kong [ 23 ]. Crucially, only a few of the related studies were based on a solid theoretical framework such as Self-Determination Theory [ 20 , 21 ]. Reeves et al [ 24 ] highlighted the importance of a theoretical foundation in qualitative studies and noted that the use of theories guided data collection (by establishing a theory-based interview guide) and interpretation and helped clarify the underlying causes or influences of the observed phenomena.…”