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Factors that influence older adults’ participation in physical activity: a systematic review of qualitative studies

Factors that influence older adults’ participation in physical activity: a systematic review of qualitative studies
Factors that influence older adults’ participation in physical activity: a systematic review of qualitative studies

Background: despite the advantages of physical activity (PA), older adults are often insufficiently active to maximise health. Understanding factors that influence PA engagement will support well-designed interventions for older people. Our aim was to review the qualitative evidence exploring the factors affecting older adults' engagement in PA. 

Methods: we searched six electronic databases for studies of community-dwelling older adults (≥70 years) including qualitative methods. We excluded studies of a single-disease group, individuals with cognitive impairment and care home residents. Methodological rigour was assessed with the Critical Appraisal Skills Programme, and framework synthesis was applied using the Capability Opportunity Motivation - Behaviour (COM-B) model, which hypothesises that behaviour is influenced by three factors: capability, opportunity and motivation.

Results: twenty-five studies were included in the review (N = 4,978; mean 79 years) and 32 themes were identified. Older adults' capability was influenced by functional capacity (e.g. strength) and perceived risk of injury from PA (e.g. falls). Opportunity was impacted by the environment 'fit' (e.g. neighbourhood safety), the availability of social interaction and socio-cultural ageing stereotypes. PA was motivated by identifying as an 'exerciser', health gains and experiencing positive emotions (e.g. enjoyment), whereas negative sensations (e.g. pain) reduced motivation. 

Conclusions: the qualitative synthesis showcased a complex web of interacting factors influencing PA between the sub-domains of COM-B, pinpointing directions for intervention, including a focus on whole systems approaches. There was a lack of research exploring PA influences in the oldest old and in low-income countries. Future research should seek to involve under-served groups, including a wider diversity of older people.

Capability Opportunity Motivation - Behaviour (COM-B) Model, older adults, older people, physical activity, qualitative synthesis, systematic review, Humans, Cognitive Dysfunction, Exercise, Aged, 80 and over, Aging, Aged, Qualitative Research, Databases, Factual
0002-0729
Meredith, Samantha J.
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Cox, Natalie J.
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Ibrahim, Kinda
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Higson, Joanna
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McNiff, Jessica
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Mitchell, Stephanie
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Rutherford, Matthew
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Wijayendran, Anusan
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Shenkin, Susan D.
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Kilgour, Alixe H.M.
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Lim, Stephen E.R.
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Meredith, Samantha J.
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Cox, Natalie J.
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Ibrahim, Kinda
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Higson, Joanna
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McNiff, Jessica
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Mitchell, Stephanie
5818f93a-d39f-41e9-9fce-8178ea5f6637
Rutherford, Matthew
231f8db1-ee8e-4606-aded-85252bbad891
Wijayendran, Anusan
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Shenkin, Susan D.
de7fe6ec-aae0-411a-a15f-541fab7a76c7
Kilgour, Alixe H.M.
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Lim, Stephen E.R.
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Meredith, Samantha J., Cox, Natalie J., Ibrahim, Kinda, Higson, Joanna, McNiff, Jessica, Mitchell, Stephanie, Rutherford, Matthew, Wijayendran, Anusan, Shenkin, Susan D., Kilgour, Alixe H.M. and Lim, Stephen E.R. (2023) Factors that influence older adults’ participation in physical activity: a systematic review of qualitative studies. Age and Ageing, 52 (8), [afad145]. (doi:10.1093/ageing/afad145).

Record type: Article

Abstract

Background: despite the advantages of physical activity (PA), older adults are often insufficiently active to maximise health. Understanding factors that influence PA engagement will support well-designed interventions for older people. Our aim was to review the qualitative evidence exploring the factors affecting older adults' engagement in PA. 

Methods: we searched six electronic databases for studies of community-dwelling older adults (≥70 years) including qualitative methods. We excluded studies of a single-disease group, individuals with cognitive impairment and care home residents. Methodological rigour was assessed with the Critical Appraisal Skills Programme, and framework synthesis was applied using the Capability Opportunity Motivation - Behaviour (COM-B) model, which hypothesises that behaviour is influenced by three factors: capability, opportunity and motivation.

Results: twenty-five studies were included in the review (N = 4,978; mean 79 years) and 32 themes were identified. Older adults' capability was influenced by functional capacity (e.g. strength) and perceived risk of injury from PA (e.g. falls). Opportunity was impacted by the environment 'fit' (e.g. neighbourhood safety), the availability of social interaction and socio-cultural ageing stereotypes. PA was motivated by identifying as an 'exerciser', health gains and experiencing positive emotions (e.g. enjoyment), whereas negative sensations (e.g. pain) reduced motivation. 

Conclusions: the qualitative synthesis showcased a complex web of interacting factors influencing PA between the sub-domains of COM-B, pinpointing directions for intervention, including a focus on whole systems approaches. There was a lack of research exploring PA influences in the oldest old and in low-income countries. Future research should seek to involve under-served groups, including a wider diversity of older people.

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e-pub ahead of print date: 17 August 2023
Additional Information: Funding Information: SL is funded by the National Institute for Health and Care Research (NIHR) Advanced Fellowship. The NIHR played no role in the design, execution, analysis and interpretation of data, or writing of the study. AHMK has received funding from Alzheimer’s Scotland Dementia Research Centre and the Lothian Birth Cohort Studies to undertake this work.
Keywords: Capability Opportunity Motivation - Behaviour (COM-B) Model, older adults, older people, physical activity, qualitative synthesis, systematic review, Humans, Cognitive Dysfunction, Exercise, Aged, 80 and over, Aging, Aged, Qualitative Research, Databases, Factual

Identifiers

Local EPrints ID: 481850
URI: http://eprints.soton.ac.uk/id/eprint/481850
ISSN: 0002-0729
PURE UUID: 0b90af0e-31d9-40d5-9c8b-c0a638127ce0
ORCID for Samantha J. Meredith: ORCID iD orcid.org/0000-0003-4925-002X
ORCID for Natalie J. Cox: ORCID iD orcid.org/0000-0002-4297-1206
ORCID for Kinda Ibrahim: ORCID iD orcid.org/0000-0001-5709-3867
ORCID for Stephen E.R. Lim: ORCID iD orcid.org/0000-0003-2496-2362

Catalogue record

Date deposited: 11 Sep 2023 17:02
Last modified: 12 Nov 2024 03:15

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Contributors

Author: Samantha J. Meredith ORCID iD
Author: Natalie J. Cox ORCID iD
Author: Kinda Ibrahim ORCID iD
Author: Joanna Higson
Author: Jessica McNiff
Author: Stephanie Mitchell
Author: Matthew Rutherford
Author: Anusan Wijayendran
Author: Susan D. Shenkin
Author: Alixe H.M. Kilgour

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