Barriers And Facilitators Flashcards
What barriers to physical activity were evident for George?
Decline in age decline in muscle mass and VO2 max
Injury risk/ fall risk
What facilitators to physical activity were evident for George?
Pace maker
Health
Running group
Mary
Enjoyment
Motivation from a a loved one
Older people’s perspective on participation in physical activity: a systemic review and thematic synthesis of qualitative literature
The problem this study is addressing
Inactivity is a pandemic condition, with far reaching health, economic, environmental, and social consequences. Inactivity rates grow
Older people’s perspective on participation in physical activity: a systemic review and thematic synthesis of qualitative literature
The rationale for this study:
The identification of barriers
and facilitators to physical activity of older adults can help inform effective population-wide physical activity policies and
strategies.
Older people’s perspective on participation in physical activity: a systemic review and thematic synthesis of qualitative literature
Methods:
Systematic review and Participants 60 years +
Results:
132 studies included; 5987 participants
24 countries represented (USA, UK, and
Canada contributed the most)
Older people’s perspective on participation in physical activity: a systemic review and thematic synthesis of qualitative literature
Methods:
Wide range of physical activity domains
18% of the studies included solely
participants who identify as Indigenous
or as immigrants
Older people’s perspective on participation in physical activity: a systemic review and thematic synthesis of qualitative literature
Methods:
Qualitative studies & structure
Most participants lived within their own
residences in the community
Structured exercise programs were
investigated in 46% of the studies.
Older people’s perspective on participation in physical activity: a systemic review and thematic synthesis of qualitative literature
Six themes
Six themes: Social influences; physical
limitations; competing priorities; access
difficulties; personal benefits of physical
activity; motivation and beliefs
Theme 1: Physical Limitations
Pain or discomfort during PA (Barrier)
Concerns about falling during PA (Barrier)
Comorbidities prevent participation in PA (Barrier)
Theme 1: Physical Limitations
Pain or discomfort during PA (Barrier)
Experienced a range of unpleasant sensations (e.g. muscle aches,
chest pain, shortness of breath, dizziness)
High intensity physical activity was considered distressing and
intolerable
Theme 1: Physical Limitations
Concerns about falling during PA (Barrier)
Fear of falling, fear of sustaining serious injuries, lack of confidence to
exercise independently
Participants who had fallen in the past were more anxious about
getting injured during exercise
1/3 of older adult fall each year, injuries are more substantial than the younger adult
Theme 1: Physical Limitations
Comorbidities prevent participation in PA (Barrier)
Symptoms and physical limitations caused by existing comorbidities
prevented participants from exercising (e.g. joint pain from
osteoarthritis, urinary incontinence, cancer)
How might the exercise and health industry contribute to fear about exercise in older adults?
Liability-focused practices like waivers and pre-screening questionnaires (e.g., Get Active Questionnaire) can unintentionally highlight risks, making older adults feel hesitant or fearful about starting or continuing physical activity.
Why is it important for the exercise industry to balance safety measures with positive messaging for older adults?
Focusing too much on risks in waivers and health screenings can reinforce fear, whereas positive messaging encourages older adults that exercise is safe, beneficial, and key to maintaining health and independence.
How can you instruct someone to perform a squat using neutral, non-risk associated language?
Stand with feet shoulder-width apart. Lower hips back as if sitting into a chair, keeping the chest up and weight evenly distributed through the feet. Lower until thighs are parallel to the ground or comfortable, then push back up. Keep the movement smooth and controlled, engaging the core throughout.
Theme 2: Social Influences
Valuing interaction with peers (Facilitator)
Social awkwardness (Barrier)
Encouragement from others (Facilitator)
Dependence on professional instruction (Barrier/Facilitator)
Theme 2: Social Influences
Valuing interaction with peers (Facilitator)
Sense of belonging; establishing friendships
Appreciation of friendly and fair competition
Good rapport with instructors motivated participants to continue exercising
Theme 2: Social Influences
Social awkwardness (Barrier)
Lack of confidence in social settings
Self-conscious and intimidated exercising in a group with younger people (“couldn’t keep up”); or men felt uncomfortable in group classes with mostly women
Theme 2: Social Influences
Encouragement from others (Facilitator)
Verbal encouragement; practical help (transportation); assistance with purchase of
equipment
Encouragement from health professionals to start exercising was a big motivator for some
participants
Theme 2: Social Influences
Dependence on professional instruction (Barrier/Facilitator)
A well-trained instructor improved quality of experience and decreased fear in participants
Exercise without an instructor was viewed as not as safe
Theme 3: Motivation and Beliefs
Apathy (Barrier)
Irrelevance and inefficacy (Barrier)
Maintaining habits (Facilitator)
Theme 3: Motivation and Beliefs
Apathy (Barrier)
Disinterest in physical activity believing there are not health benefits
Laziness or low motivation
Theme 3: Motivation and Beliefs
Irrelevance and inefficacy (Barrier)
Some believed that exercise is unnecessary for older adults or
harmful
Exercise could not slow the aging process so “why bother?”
Some believed that the are “too young to fall”, thus exercise to
prevent falls is irrelevant
Theme 3: Motivation and Beliefs
Maintaining habits (Facilitator)
Participants were active at an older age because they have been active their whole lives.
How might the exercise and health industry contribute to apathy towards exercise in older adults?
By overemphasizing health benefits without addressing deeper motivational factors like autonomy, enjoyment, and social connection, the industry may make exercise feel like a chore, reducing long-term engagement.
Theme 4: Personal Benefits of Physical Activity
Strength, balance and flexibility (Facilitator)
Self-confidence (Facilitator)
Independence (Facilitator)
Improved health and mental well-being (Facilitator)
Theme 5: Competing Priorities
Participants reported having little or no time for physical activity due to work or family responsibilities (e.g. caregiving for partners or grandchildren was mentioned often) (Barrier)
Assumption that older adult are retired, if they are retire don’t they have alll this free time in there hand.
Theme 6: Access Difficulties
Environmental Barriers
Affordability (Barrier)
Theme 6: Access Difficulties
Environmental Barriers
Poor access to transport, unsuitable weather, neighborhood
safety, and unavailability of exercise programs or equipment
Theme 6: Access Difficulties
Affordability (Barrier)
Inability to pay for programs
Sometimes participants mentioned an unwillingness to spend
money on physical activity (“these programs should be government subsidized”
Difference in value, most likely a generational thing
Resourcefulness
Resourcefulness
consists of self-help
strategies that are used
to maintain
independence in daily
tasks despite adverse
situations
Resourcefulness: key concepts
Self-efficacy
Self-control
Adaptability
Resourcefulness:
Self-efficacy
Definition: Is the belief in one’s ability to cope effectively when faced with adversity
Example: “I’m fit and I can walk two hour”
Resourcefulness:
Self-control
Definition:
Involves self-monitoring of
internal events, including thoughts, feelings, and sensations to prevent interference with functioning or task performance
Example: “I find that being physically active keeps your mind more alert. Keeps your attitude up, you know, I’m a much happier person when I’m busy and doing things”
Resourcefulness:
Adaptability
Definition:
Involves taking the initiative to employ
problem-solving strategies when faced with stressful situations or conditions (Zauszniewski, 1996).
Highly resourceful individuals have more adaptive functioning.
Example: “I’ll walk down the alley through 13th Avenue rather than on the street because on the street you have all the pollution from the cars”
