O2-2 Should I stay or should I go? A mixed-methods, longitudinal investigation of predictors, barriers and enablers of adherence to REACT, a 12-month group-based, active-ageing programme

Abstract Background Physical activity (PA) programmes targeting older adults often report relatively low attendance rates which limits impact. Research into barriers and enablers of PA adherence is often qualitative and rarely tests outcomes against objectively monitored adherence to assess whether what people say is actually reflected in what they do. This study adopts a rare, mixed methods, longitudinal perspective identifying subjective and objective predictors of and associations with adherence to REtirement in ACTion (REACT), a 12-month physical activity intervention for frail or pre-frail older adults. Methods Semi-structured interviews conducted at six (n = 17) and 12 months (n = 10) explored barriers and enablers to adherence. Thematic analysis led to ten adherence related research hypotheses. These were tested by examining correlations between REACT programme attendance and physical function (Short Physical Performance Battery), self-rated physical function (mobility assessment tool-short form (MAT-sf)), dominant hand grip strength assessed by digital dynamometer, Ageing Well profile (social scale), process evaluation data at baseline (n = 411) and six-months (n = 348) and open-ended participant feedback at six-months (n = 307). Each participant response was scored -1) for a negative comment, 1 for positive or zero for no comment or balancing negative and positive comments. Results Higher adherence correlated with younger age (r=-0.162, p > 0.001), better physical function, both objectively measured (r = 0.118, p > 0.05) and self-rated (r = 0.134, p > 0.01), greater grip strength (r = 0.118, p > 0.05) and having less social contact (r=-0.134, p > 0.01), at baseline. It also correlated with an improvement in objectively measured physical function between baseline and six months (r = 0.200, p > 0.001). At 6-months enjoyment of the programme (r = 0.263, p > 0.001), specifically enjoyment of muscle-strengthening exercises (r = 0.142, p > 0.027), perception of positive social interactions (from questionnaire data (r = 0.212, p > 0.001) and open-ended feedback (r = 0.157, p > 0.01)) and perceptions of an autonomy-supportive teaching style (r = 0.213, p > 0.001) all correlated with higher adherence. Conclusions PA programmes for older adults should encourage the development of social connections and group cohesion but should take a flexible approach to avoid negatively affecting adherence amongst those with pre-existing high levels of social contact. Building confidence in PA and physical function as these improve during the programme, promoting enjoyment and utilising an autonomy-supportive leader teaching style are important in order to support adherence.


Background
Adequate nutrition and regular physical activity (PA) are key elements in healthy aging. In France, behavioural interventions promoting healthy eating and PA in older adults consist mainly in collective workshops organised by pension and health insurance funds. After analyzing pre-existing workshops, we designed the co-constructed project ALAPAGE to improve these workshops and assess their impact on diet and PA. Methods ALAPAGE is a cluster randomized controlled trial; 60 collective workshops in southeastern France will be randomized in a 2:1 (intervention/control) ratio. We will recruit 900 autonomous older adults (? 60 years) living at home and will make specific efforts to recruit socially isolated and/or economically vulnerable people. In the intervention group, collective workshop period will include 7 sessions (1 session/ week): 1 introductory, 4 diet and 2 PA (to teach principles of functional dual-task exercise focused on strength, flexibility and physical functioning). During the following 3-months, participants will be recommended to perform exercises as often as possible and will participate in post-workshop activities. The control group will first participate to other types of workshops and then to a diet and PA workshop (waiting-list design).

Results
The dietary practices (using experimental economics), physical activity (battery of field test and habitual PA), quality of life, and cost-effectiveness will be assessed at the first and last session, and 3 months later.

Conclusion
Results will guide decision-makers to organize actions and their dissemination. Transferability to other regions will be Background Physical activity (PA) programmes targeting older adults often report relatively low attendance rates which limits impact. Research into barriers and enablers of PA adherence is often qualitative and rarely tests outcomes against objectively monitored adherence to assess whether what people say is actually reflected in what they do. This study adopts a rare, mixed methods, longitudinal perspective identifying subjective and objective predictors of and associations with adherence to REtirement in ACTion (REACT), a 12-month physical activity intervention for frail or pre-frail older adults. Methods Semi-structured interviews conducted at six (n = 17) and 12 months (n = 10) explored barriers and enablers to adherence. Thematic analysis led to ten adherence related research hypotheses. These were tested by examining correlations between REACT programme attendance and physical function (Short Physical Performance Battery), self-rated physical function (mobility assessment tool-short form (MAT-sf)), dominant hand grip strength assessed by digital dynamometer, Ageing Well profile (social scale), process evaluation data at baseline (n = 411) and six-months (n = 348) and open-ended participant feedback at six-months (n = 307). Each participant response was scored -1) for a negative comment, 1 for positive or zero for no comment or balancing negative and positive comments.

Results
Higher adherence correlated with younger age (r=-0.162, p > 0.001), better physical function, both objectively measured (r = 0.118, p > 0.05) and self-rated (r = 0.134, p > 0.01), greater grip strength (r = 0.118, p > 0.05) and having less social contact (r=-0.134, p > 0.01), at baseline. It also correlated with an improvement in objectively measured physical function between baseline and six months (r = 0.200, p > 0.001). At 6months enjoyment of the programme (r = 0.263, p > 0.001), specifically enjoyment of muscle-strengthening exercises (r = 0.142, p > 0.027), perception of positive social interactions (from questionnaire data (r = 0.212, p > 0.001) and openended feedback (r = 0.157, p > 0.01)) and perceptions of an autonomy-supportive teaching style (r = 0.213, p > 0.001) all correlated with higher adherence. Conclusions PA programmes for older adults should encourage the development of social connections and group cohesion but should take a flexible approach to avoid negatively affecting adherence amongst those with pre-existing high levels of social contact. Building confidence in PA and physical function as these improve during the programme, promoting enjoyment and utilising an autonomy-supportive leader teaching style are important in order to support adherence. Keywords: Physical activity, older adults, physical function, randomised control trial, adherence Abstract citation ID: ckac094.011 O2-3 Feasibility of the Move for Life intervention to help inactive adults 50 years and over increase their physical activity Background Substantial evidence shows that meeting physical activity guidelines is important for disease prevention, promoting physical and mental health and quality of life. In Ireland, only 38% of older adults are sufficiently active to meet the guidelines. The primary aim of this research was to conduct a feasibility study of the Move for Life intervention to reach and help inactive adults 50+ increase their physical activity.

Methods
Move for Life is a feasibility cluster randomised control trial where the Local Sports Partnerships hubs are the units of randomisation and individuals within the hubs are the units of analysis. The intervention augments regular programme content with behavioural skills, social support and group cohesion strategies, and includes a peer-mentoring component. Over seven hundred (N = 733) participants registered to become part of the intervention. Most (98%, n = 724) completed baseline measures. Participants were asked to complete self-report process evaluation questionnaires immediately after and 12 weeks after their programme had finished. Interviews were conducted with participants, physical activity instructors and peer mentors. Questionnaire responses across groups were compared with tests of statistical significance. Qualitative data complemented and assisted with interpretation of quantitative findings.

Results
A total of 601 participants met eligibility criteria (average age 63.06 years, range 50-91, 80.4% female). The study retention rate was 63%. Reported compliance rate with intervention strategies was over 75%. The intervention group were more likely to enjoy the programme than usual provision. Intervention participants were more likely to report the programme as interesting and worth the time they invested in it, and to recommend it to a friend than usual provision. They were also more likely to report enjoying learning about different strategies to keep physically active (ORs ranging from 2.56 to 3.76). At 3-month follow up, the intervention group were more likely to be aware of their Local Sports Partnership opportunities and to have contacted their Local Sports Partnership more frequently in comparison to usual provision (all p >.05).

Conclusions
Move for Life is a realistic and promising augmentation to