Involving older adults and relevant stakeholders in the design and evaluation of the SITLESS complex intervention to reduce sedentary behaviour

Session: 

Oral session: Patient or healthcare consumers involvement and shared decision-making (1)

Date: 

Sunday 16 September 2018 - 11:20 to 11:40

Location: 

Ochil 1

All authors in correct order:

Coll-Planas L1, Tully M2, Roqué i Figuls M1, Giné-Garriga M3, Caserotti P4, Rothenbacher D5, Denkinger M6, Salvà-Casanovas A1
1 Fundació Salut i Envelliment UAB, Spain
2 Queen University Belfast, UK
3 Universitat Ramon Llull, Spain
4 Syddansk Universitet, Denmark
5 Ulm University, Germany
6 Agaplesion Bethesda Clinic, Germany
Presenting author and contact person

Presenting author:

Marta Roqué i Figuls

Contact person:

Laura Coll-Planas
Marta Roqué i Figuls
Abstract text
Background:
Promoting physical activity (PA) and reducing sedentary behaviour (SB) in community-dwelling older adults remains a challenge. Public health interventions targeting these lifestyle behaviours are usually developed using a top-down approach in isolation from end-users.

Objectives:
SITLESS aims to provide new evidence on how to design, implement and evaluate a complex intervention enhancing exercise-referral schemes (ERS) with self-management strategies (SMS) to decrease SB and increase PA in older adults, considering end-users' views, forming co-operative teams of stakeholders, and distributing actions and decisions.

Methods:
The SITLESS intervention used a stepwise design. We conducted a systematic review on SB interventions targeting older people to identify potentially effective behaviour change techniques (BCTs) and theories. In parallel, we convened four advisory boards in Spain, Denmark, Germany and the UK with stakeholders from older people organisations, health professionals, PA providers and policy-makers. We conducted four focus groups with older adults, one at each site, to explore cultural values and personal preferences for the BCTs identified. Finally, we designed and implemented a pilot intervention combining PA and SMS at each site to assess its feasibility and optimise its design for the main trial. We held focus groups with all participants at the end of the pilot to explore their experiences.

Results:
Studies included in the systematic review (n = 5) employed the following BCTs: goal-setting, self-monitoring, feedback, health consequences and instructions on how to perform the behaviour. Participants in the focus groups discussed the pros and cons of the BCTs and requested clear and concise information and easy to use self-monitoring tools to help facilitate behaviour change. In the pilot study, 95 participants were randomised (mean age 76). Randomisation to the control group caused disappointment and rejection. Participants experiencing the SMS were highly satisfied with self-monitoring (pedometers) and the goal-setting. Social support was perceived as an effective mechanism to increase physical activity.

Conclusions:
Involving end-users to consider their preferences, cultural values and experiences early in the process of designing an intervention might be a key factor in developing a successful trial.

Relevance to patients and consumers: 

SITLESS is a clinical trial that aims to provide new evidence on how to develop and evaluate a complex intervention enhancing exercise-referral schemes (physical activity prescribed by professionals) with self-management strategies (based on behavior change techniques) to decrease sedentary behavior and promote physical activity in community-dwelling older adults, considering end-users’ interests, forming cooperative teams of stakeholders and distributing actions and decisions. We aim to improve physical function and quality of life producing sustainable changes towards a more healthy and active ageing.