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The working mechanisms of an environmentally tailored physical activity intervention for older adults: a randomized controlled trial.

van Stralen MM, de Vries H, Mudde AN, Bolman C, Lechner L - Int J Behav Nutr Phys Act (2009)

Bottom Line: Changes in environmental perceptions did not mediate the effect of the basic tailored intervention on behaviour.Compared with the basic tailored intervention, the environmentally tailored intervention significantly improved cycling behaviour (tau = 30.2).Additionally, the tailored letters of the environmentally tailored intervention were better appreciated and used, although these differences did not mediate the intervention effect.

View Article: PubMed Central - HTML - PubMed

Affiliation: Open University of the Netherlands, Department of Psychology, PO Box 2960, 6401 DL, Heerlen, The Netherlands. mm.vanstralen@vumc.nl.

ABSTRACT

Background: The aim of this study was to explore the working mechanisms of a computer tailored physical activity intervention for older adults with environmental information compared to a basic tailored intervention without environmental information.

Method: A clustered randomized controlled trial with two computer tailored interventions and a no-intervention control group was conducted among 1971 adults aged >/= 50. The two tailored interventions were developed using Intervention Mapping and consisted of three tailored letters delivered over a four-month period. The basic tailored intervention targeted psychosocial determinants alone, while the environmentally tailored intervention additionally targeted environmental determinants, by providing tailored environmental information. Study outcomes were collected with questionnaires at baseline, three and six months and comprised total physical activity (days/week), walking (min/week), cycling (min/week), sports (min/week), environmental perceptions and use and appreciation of the interventions.

Results: Mediation analyses showed that changes in cycling, sports and total physical activity behaviour induced by the environmentally tailored intervention were mediated by changes in environmental perceptions. Changes in environmental perceptions did not mediate the effect of the basic tailored intervention on behaviour. Compared with the basic tailored intervention, the environmentally tailored intervention significantly improved cycling behaviour (tau = 30.2). Additionally, the tailored letters of the environmentally tailored intervention were better appreciated and used, although these differences did not mediate the intervention effect.

Discussion: This study gave some first indications of the relevance of environmental perceptions as a determinant of changing physical activity behaviours and the potential effectiveness of providing environmental information as an intervention strategy aimed at enhancing physical activity behaviour among older adults.

No MeSH data available.


Flow diagram of the selection and enrolment of the study participants.
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Figure 1: Flow diagram of the selection and enrolment of the study participants.

Mentions: The study procedure, including the selection and enrolment of participants and the distribution of the questionnaires and interventions are shown in Figure 1. In 2007, all Dutch Regional Municipal Health Councils (MHCs) (n = 39) were invited to participate in the program. Nine MHCs agreed to participate, after which six MHCs were randomly selected and assigned to one of the three research arms: (1) basic tailored intervention, a motivational focused computer tailored intervention targeting psychosocial determinants; (2) intervention plus, an environmentally tailored intervention targeting environmental determinants in addition to the tailored feedback of the basic intervention, or (3) wait list control group. Randomization was stratified by urbanization level (rural vs urban (i.e. situated in the urban area of the Netherlands ("Randstad")). In total, 8,500 adults aged ≥ 50 years were invited to participate using an invitation letter that was accompanied by a baseline questionnaire and informed consent form. At the start of participation, study participants were eligible to win two city trips or several gift vouchers. At baseline, 1,971 older adults returned the questionnaire (response rate: 23%). Baseline measurement lasted from March to June 2007. Data analysis were conducted in 2008.


The working mechanisms of an environmentally tailored physical activity intervention for older adults: a randomized controlled trial.

van Stralen MM, de Vries H, Mudde AN, Bolman C, Lechner L - Int J Behav Nutr Phys Act (2009)

Flow diagram of the selection and enrolment of the study participants.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2800838&req=5

Figure 1: Flow diagram of the selection and enrolment of the study participants.
Mentions: The study procedure, including the selection and enrolment of participants and the distribution of the questionnaires and interventions are shown in Figure 1. In 2007, all Dutch Regional Municipal Health Councils (MHCs) (n = 39) were invited to participate in the program. Nine MHCs agreed to participate, after which six MHCs were randomly selected and assigned to one of the three research arms: (1) basic tailored intervention, a motivational focused computer tailored intervention targeting psychosocial determinants; (2) intervention plus, an environmentally tailored intervention targeting environmental determinants in addition to the tailored feedback of the basic intervention, or (3) wait list control group. Randomization was stratified by urbanization level (rural vs urban (i.e. situated in the urban area of the Netherlands ("Randstad")). In total, 8,500 adults aged ≥ 50 years were invited to participate using an invitation letter that was accompanied by a baseline questionnaire and informed consent form. At the start of participation, study participants were eligible to win two city trips or several gift vouchers. At baseline, 1,971 older adults returned the questionnaire (response rate: 23%). Baseline measurement lasted from March to June 2007. Data analysis were conducted in 2008.

Bottom Line: Changes in environmental perceptions did not mediate the effect of the basic tailored intervention on behaviour.Compared with the basic tailored intervention, the environmentally tailored intervention significantly improved cycling behaviour (tau = 30.2).Additionally, the tailored letters of the environmentally tailored intervention were better appreciated and used, although these differences did not mediate the intervention effect.

View Article: PubMed Central - HTML - PubMed

Affiliation: Open University of the Netherlands, Department of Psychology, PO Box 2960, 6401 DL, Heerlen, The Netherlands. mm.vanstralen@vumc.nl.

ABSTRACT

Background: The aim of this study was to explore the working mechanisms of a computer tailored physical activity intervention for older adults with environmental information compared to a basic tailored intervention without environmental information.

Method: A clustered randomized controlled trial with two computer tailored interventions and a no-intervention control group was conducted among 1971 adults aged >/= 50. The two tailored interventions were developed using Intervention Mapping and consisted of three tailored letters delivered over a four-month period. The basic tailored intervention targeted psychosocial determinants alone, while the environmentally tailored intervention additionally targeted environmental determinants, by providing tailored environmental information. Study outcomes were collected with questionnaires at baseline, three and six months and comprised total physical activity (days/week), walking (min/week), cycling (min/week), sports (min/week), environmental perceptions and use and appreciation of the interventions.

Results: Mediation analyses showed that changes in cycling, sports and total physical activity behaviour induced by the environmentally tailored intervention were mediated by changes in environmental perceptions. Changes in environmental perceptions did not mediate the effect of the basic tailored intervention on behaviour. Compared with the basic tailored intervention, the environmentally tailored intervention significantly improved cycling behaviour (tau = 30.2). Additionally, the tailored letters of the environmentally tailored intervention were better appreciated and used, although these differences did not mediate the intervention effect.

Discussion: This study gave some first indications of the relevance of environmental perceptions as a determinant of changing physical activity behaviours and the potential effectiveness of providing environmental information as an intervention strategy aimed at enhancing physical activity behaviour among older adults.

No MeSH data available.