Exploring The Implementation Of Physical Activity Interventions In Long-Term Care

Abstract

Background: Canada’s population is aging and with it so is the demand for long-term care (LTC). Older persons living in LTC facilities can benefit from increasing their levels of physical activity however the majority of older residents spend most of their time engaged in sedentary activities and are inactive. Objective: The overarching purpose of this dissertation is to examine the implementation of physical activity interventions in LTC settings. Methods: To achieve this objective, a three-manuscript style dissertation was undertaken. Study One involved a scoping review that summarized the current use of implementation strategies and their related outcomes in the implementation of physical activity interventions in LTC. This study identified how interventions are being implemented. Study Two, focused on understanding the perspectives and experiences of researchers who have led the implementation of physical activity interventions in LTC. As part of this study, six semi-structured interventions were conducted with researchers who were involved in the interventions identified through the scoping review. Study three explored the role and contribution of allied health professionals during implementation efforts through a secondary analysis of the Safer Care for Older Persons in (residential) Environments (SCOPE) trial. Results: The scoping review identified both the implementation strategies and related outcomes that have been reported in the implementation of physical activity interventions. A consultation exercise conducted as part of this review revealed unreported implementation strategies and offered further insight into the implementation of physical activity interventions. Results from researcher interviews, conducted as part of Study Two, provided new and novel insights into the experiences and perspectives of researchers, who despite being very involved in implementation efforts have historically not been included as participants in this type of research. The third and final study explored the role and contributions of allied health professionals, another group of professionals who have similarly been underrepresented in implementation research on this topic, during implementation efforts. Conclusion: Collective, this dissertation provides new and novel insights to the understanding of physical activity intervention implementation in LTC settings. While implementation is inherently complex, these findings highlight opportunities for future research, practical implications for implementation efforts, considerations for policy development which supports activity, and broader societal implications regarding how we view and understand aging.