Minnesota Nursing magazine

What moves seniors to move?

Friendly, social comparison may be key
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Barb Schlaefer
For older adults, an accidental fall can be a pivotal event causing lasting changes in mobility, independence, health and well-being.

Because the costs and consequences of falls among older adults are significant, new research on fall prevention has gained attention nationwide.

Not surprisingly, consistent physical activity to maintain strength and balance in the legs is key to preventing falls. Less clear, however, is the most effective way to inspire older adults to exercise regularly. A recent clinical trial led by Assistant Professor Siobhan McMahon, PhD, MPH, APRN, GNP-BC, explored this question, by comparing different approaches for encouraging increased physical activity.

The study’s 102 participants each received Fitbits, which track physical activity. They were assigned to one of four experimental groups. All groups were given the same instructions and practiced recommended physical activities. However, each group was given a different mix of behavior change strategies to encourage them to integrate these physical activities into their everyday lives.

“Our question was, ‘Which strategy, or combination of strategies, elicits increased physical activity, measured objectively using the Fitbits?” said McMahon.

The study results, about to be published in the Annals of Behavioral Medicine by Springer Publishing, suggest that those who participated in what McMahon’s team called the interpersonal strategy increased their physical activity more than others in the study, for up to six months after the intervention ended. This set of interpersonal strategies included small-group activities such as friendly social comparison. This approach required dialogue and exchange between peers — collaborative learning — about physical activity-related ideas and experiences to elicit individual change.

The other set of strategies was called intrapersonal because it involved more introspective activities such as receiving formal instruction, creating personal goals and plans and then discussing these in small groups. Although the intrapersonal strategies are traditional — used often in physical activity programs for younger adults — it was the interpersonal strategies in this study that elicited significant increases in participants’ physical activity.

McMahon says she was initially surprised by the findings, but should not have been. “When we look at lifespan developmental theory and the preferences of older adults, our findings make sense,” she said. “Older adults tend to value social connections that are emotionally satisfying. It may be that the exchange of knowledge and expertise among peers about physical activity motivated participants to engage more in physical activity in their everyday lives.”

While interpersonal strategies may be an innovative way to encourage older adults to move more, further research is needed before translating these strategies into practice. McMahon’s next study will attempt to reproduce these findings with a larger clinical trial and investigate intervention effects on falls and quality of life. Results could inform practice for falls prevention.

This KL2 study was funded by grants from the University of Minnesota Center for Translational Science Institute and a Grant in Aid.

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