Optimizing older adults’ home space to enhance physical activity and minimize sedentary behaviour

MEGHANI, NAUREEN

doi:10.23889/SUThesis.69221

E-Thesis 448 views 2297 downloads

Optimizing older adults’ home space to enhance physical activity and minimize sedentary behaviour / NAUREEN MEGHANI

Swansea University Author: NAUREEN MEGHANI

PDF | E-Thesis – open access

Copyright: The Author, Naureen Akber Ali Meghani, 2024
Download (10.21MB)

DOI (Published version): 10.23889/SUThesis.69221

Abstract

Many older adults (OAs) are sedentary and do not participate in adequate levels of physical activity (PA) which would improve body function and reduce frailty, both of which are important for OA’s health and well-being. However, the situation is even worse with ethnically diverse OAs, considering th...

Full description

Published:	Swansea University, Wales, UK 2024
Institution:	Swansea University
Degree level:	Doctoral
Degree name:	Ph.D
Supervisor:	Hudson, J., Stratton, G., and Mullins, J.
URI:	https://cronfa.swan.ac.uk/Record/cronfa69221

first_indexed	2025-04-03T14:09:05Z
last_indexed	2025-04-04T05:16:25Z
id	cronfa69221
recordtype	RisThesis
fullrecord	<?xml version="1.0"?><rfc1807><datestamp>2025-04-03T15:31:02.3312696</datestamp><bib-version>v2</bib-version><id>69221</id><entry>2025-04-03</entry><title>Optimizing older adults’ home space to enhance physical activity and minimize sedentary behaviour</title><swanseaauthors><author><sid>9363b01457e98022545c419a7a2599d0</sid><firstname>NAUREEN</firstname><surname>MEGHANI</surname><name>NAUREEN MEGHANI</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2025-04-03</date><abstract>Many older adults (OAs) are sedentary and do not participate in adequate levels of physical activity (PA) which would improve body function and reduce frailty, both of which are important for OA’s health and well-being. However, the situation is even worse with ethnically diverse OAs, considering the high burden of chronic disease in this group. Therefore, PA and SB research with this group is particularly important. Ethnically diverse groups of OAs may have complex and diﬀerent perspectives on healthcare, academia and research compared with other groups within the OA population. Therefore, cultural and social elements need speciﬁc consideration (such as privacy, lack of motivation, language, literacy and care giving responsibilities and location) as they might aﬀect recruitment and retention of OAs from underrepresented groups within the population. Evidence has shown that an increasingly diverse OA population is observed in the United Kingdom (UK), partly inﬂuenced by present immigration and population trends, which is associated with complexity in terms of language, socioeconomic level, and the acculturation and immigration experience. Therefore, it is important to increase the representation of this group in research. In this regard the present research focuses on ethnically diverse OAs who are aged ≥65 years to improve their activity and reduce their SB.Given that OAs spend a signiﬁcant time at home being sedentary, increased knowledge of the factors related to this behaviour in the home environment would present signiﬁcant insight for intervention planning. A key element of any intervention developed with this knowledge is the assessment of its feasibility and acceptability with this population group to determine any required modiﬁcations in a subsequent larger eﬀectiveness trial. In addition, exploring the perspectives of stakeholders will direct the implementation of this intervention in practice or in a real-world setting. Therefore, the primary aim of this research thesis was to create and test the feasibility and acceptability of an intervention to optimise OAs’ home space to increase their activity and reduce their SB.Study 1 investigated perceptions of ethnically diverse OAs regarding their activity and sedentary patterns within the home setting using the socio-ecological model (SEM) as a theoretical framework. Using purposive sampling, 33 in-depth interviews and 5 focus group discussions were carried out. Reﬂexive thematic analysis was applied to generate themes from the data which were subsequently interpreted using the constructs and proposals of the SEM. The study ﬁndings showed that PA and SB of OAs are inﬂuenced by diﬀerent levels of the SEM. These include: 1) Individual level such as insight, attitude and motivation behind PA and SB; 2) Interpersonal level such as relatives’ and friends’ support to be more active and less sedentary within the home; 3) Organisational level such as healthcare organisations promoting PA initiatives; 4) Community level factors such as social groups, and the importance of culture-sensitive group activities; 5) Physical Environment level factors such as home space characteristics (e.g., available space and stairs), and, 6) Policy level factors including lockdown constraints impacting PA and SB at home. These ﬁndings provide a suitable underpinning to design and execute a multi-component person-centred intervention for community dwelling ethnically diverse OAs in Study 2.In this study, a multi-method approach using semi-structured interviews and self-reported measures (n = 23) was employed to explore participants’ experiences, and the eﬀect of this intervention on activity and sedentary patterns (the Home space intervention). SEM and the habit formation model guided this intervention (that included a health coaching session, information pamphlet, reminder messages and wearable activity tracker; WAT that emitted vibrations and sound alerts after an hour of sitting designed by the research team). Study ﬁndings showed improvements in PA and reductions in sedentary time, improved scores in mental well-being, self-eﬃcacy, PA habits and reductions in SB habit index after the intervention. The participants viewed the intervention as acceptable and expressed satisfaction with the intervention components and the research. However, study participants suggested some modiﬁcations in the WAT size and functionality to make it more user- friendly. These results could have a substantial eﬀect on public health by showing that sedentary ethnically diverse OAs can gain beneﬁts from even small increases in PA. Therefore, shifting from a sedentary lifestyle could have a signiﬁcant eﬀect for these individuals.Given the established feasibility of the 12-week intervention in study 2, the thesis extends to Study 3 to determine the perceptions of stakeholders regarding the transfer of the intervention into real world settings using the PIET-T (Population, Intervention, Environment, Transfer, model of transferability). Exploratory qualitative research was undertaken using purposive sampling and in-depth interviews (IDIs) to recruit 10 stakeholders from different local organisations that are involved in improving OAs' activity and/or health and well-being and therefore could implement the Home space intervention as part of their work. Reflexive thematic analysis was used to analyse the qualitative data which were interpreted using the PIET-T model. The intervention was found to be appealing and feasible, and most of the stakeholders felt their organisations could play a role in supporting it. Regardless, they highlighted the need to consider cultural equalities (translation of the intervention content into native languages), timely identiﬁcation of funding and delivery opportunities to increase the possibility of its successful implementation along, working in partnership with non-governmental (NGOs) and community organisations, involvement of healthcare professionals and health trainers, training of staﬀ, and, they identiﬁed various facilitators and barriers (e.g., lack of resources, team instability, community engagement, incentives) that they felt would help in the transferability of the intervention into real-world settings.This novel research attempts to address the low amount of PA and high sedentary level among ethnically diverse OAs. The results of the study indicate that altering PA and SB in the physical environment of the home is a complex process that is impacted by several SEM levels. The multi- component intervention developed from these findings was acceptable to a group of ethnically diverse OAs and led to improvements in their PA and a reduction in their sedentary time. If supported by a future effectiveness trial, this could have a substantial effect on public health as sedentary OAs can gain health benefits from even small increases in PA. Therefore, performing LPA to shift from a sedentary lifestyle has a significant effect on OAs. There is, however, a lack of transferability research in the domain of PA and SB with ethnically diverse OAs. This research highlights the importance of collaborating with stakeholders in transferring the intervention into real-world settings to promote PA and minimize SB among ethnically diverse OAs. The study ﬁndings inform the transferability of the intervention as well as increasing awareness in the wider research community of crucial intervention elements, obstacles, and enablers for implementing public health interventions into real- world contexts.</abstract><type>E-Thesis</type><journal/><volume/><journalNumber/><paginationStart/><paginationEnd/><publisher/><placeOfPublication>Swansea University, Wales, UK</placeOfPublication><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic/><keywords>Sedentary behaviour, physical activity and older adults</keywords><publishedDay>12</publishedDay><publishedMonth>12</publishedMonth><publishedYear>2024</publishedYear><publishedDate>2024-12-12</publishedDate><doi>10.23889/SUThesis.69221</doi><url/><notes>A selection of content is redacted or is partially redacted from this thesis to protect sensitive and personal information.</notes><college>COLLEGE NANME</college><CollegeCode>COLLEGE CODE</CollegeCode><institution>Swansea University</institution><supervisor>Hudson, J., Stratton, G., and Mullins, J.</supervisor><degreelevel>Doctoral</degreelevel><degreename>Ph.D</degreename><degreesponsorsfunders>ESRC</degreesponsorsfunders><apcterm/><funders>ESRC</funders><projectreference/><lastEdited>2025-04-03T15:31:02.3312696</lastEdited><Created>2025-04-03T14:37:53.9371751</Created><path><level id="1">Faculty of Science and Engineering</level><level id="2">School of Engineering and Applied Sciences - Sport and Exercise Sciences</level></path><authors><author><firstname>NAUREEN</firstname><surname>MEGHANI</surname><order>1</order></author></authors><documents><document><filename>69221__33940__81fb60e69f3446f5aa5359578fdfd125.pdf</filename><originalFilename>2024_Meghani_N.final.69221.pdf</originalFilename><uploaded>2025-04-03T15:06:56.9010697</uploaded><type>Output</type><contentLength>10704305</contentLength><contentType>application/pdf</contentType><version>E-Thesis – open access</version><cronfaStatus>true</cronfaStatus><documentNotes>Copyright: The Author, Naureen Akber Ali Meghani, 2024</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language></document></documents><OutputDurs/></rfc1807>
spelling	2025-04-03T15:31:02.3312696 v2 69221 2025-04-03 Optimizing older adults’ home space to enhance physical activity and minimize sedentary behaviour 9363b01457e98022545c419a7a2599d0 NAUREEN MEGHANI NAUREEN MEGHANI true false 2025-04-03 Many older adults (OAs) are sedentary and do not participate in adequate levels of physical activity (PA) which would improve body function and reduce frailty, both of which are important for OA’s health and well-being. However, the situation is even worse with ethnically diverse OAs, considering the high burden of chronic disease in this group. Therefore, PA and SB research with this group is particularly important. Ethnically diverse groups of OAs may have complex and diﬀerent perspectives on healthcare, academia and research compared with other groups within the OA population. Therefore, cultural and social elements need speciﬁc consideration (such as privacy, lack of motivation, language, literacy and care giving responsibilities and location) as they might aﬀect recruitment and retention of OAs from underrepresented groups within the population. Evidence has shown that an increasingly diverse OA population is observed in the United Kingdom (UK), partly inﬂuenced by present immigration and population trends, which is associated with complexity in terms of language, socioeconomic level, and the acculturation and immigration experience. Therefore, it is important to increase the representation of this group in research. In this regard the present research focuses on ethnically diverse OAs who are aged ≥65 years to improve their activity and reduce their SB.Given that OAs spend a signiﬁcant time at home being sedentary, increased knowledge of the factors related to this behaviour in the home environment would present signiﬁcant insight for intervention planning. A key element of any intervention developed with this knowledge is the assessment of its feasibility and acceptability with this population group to determine any required modiﬁcations in a subsequent larger eﬀectiveness trial. In addition, exploring the perspectives of stakeholders will direct the implementation of this intervention in practice or in a real-world setting. Therefore, the primary aim of this research thesis was to create and test the feasibility and acceptability of an intervention to optimise OAs’ home space to increase their activity and reduce their SB.Study 1 investigated perceptions of ethnically diverse OAs regarding their activity and sedentary patterns within the home setting using the socio-ecological model (SEM) as a theoretical framework. Using purposive sampling, 33 in-depth interviews and 5 focus group discussions were carried out. Reﬂexive thematic analysis was applied to generate themes from the data which were subsequently interpreted using the constructs and proposals of the SEM. The study ﬁndings showed that PA and SB of OAs are inﬂuenced by diﬀerent levels of the SEM. These include: 1) Individual level such as insight, attitude and motivation behind PA and SB; 2) Interpersonal level such as relatives’ and friends’ support to be more active and less sedentary within the home; 3) Organisational level such as healthcare organisations promoting PA initiatives; 4) Community level factors such as social groups, and the importance of culture-sensitive group activities; 5) Physical Environment level factors such as home space characteristics (e.g., available space and stairs), and, 6) Policy level factors including lockdown constraints impacting PA and SB at home. These ﬁndings provide a suitable underpinning to design and execute a multi-component person-centred intervention for community dwelling ethnically diverse OAs in Study 2.In this study, a multi-method approach using semi-structured interviews and self-reported measures (n = 23) was employed to explore participants’ experiences, and the eﬀect of this intervention on activity and sedentary patterns (the Home space intervention). SEM and the habit formation model guided this intervention (that included a health coaching session, information pamphlet, reminder messages and wearable activity tracker; WAT that emitted vibrations and sound alerts after an hour of sitting designed by the research team). Study ﬁndings showed improvements in PA and reductions in sedentary time, improved scores in mental well-being, self-eﬃcacy, PA habits and reductions in SB habit index after the intervention. The participants viewed the intervention as acceptable and expressed satisfaction with the intervention components and the research. However, study participants suggested some modiﬁcations in the WAT size and functionality to make it more user- friendly. These results could have a substantial eﬀect on public health by showing that sedentary ethnically diverse OAs can gain beneﬁts from even small increases in PA. Therefore, shifting from a sedentary lifestyle could have a signiﬁcant eﬀect for these individuals.Given the established feasibility of the 12-week intervention in study 2, the thesis extends to Study 3 to determine the perceptions of stakeholders regarding the transfer of the intervention into real world settings using the PIET-T (Population, Intervention, Environment, Transfer, model of transferability). Exploratory qualitative research was undertaken using purposive sampling and in-depth interviews (IDIs) to recruit 10 stakeholders from different local organisations that are involved in improving OAs' activity and/or health and well-being and therefore could implement the Home space intervention as part of their work. Reflexive thematic analysis was used to analyse the qualitative data which were interpreted using the PIET-T model. The intervention was found to be appealing and feasible, and most of the stakeholders felt their organisations could play a role in supporting it. Regardless, they highlighted the need to consider cultural equalities (translation of the intervention content into native languages), timely identiﬁcation of funding and delivery opportunities to increase the possibility of its successful implementation along, working in partnership with non-governmental (NGOs) and community organisations, involvement of healthcare professionals and health trainers, training of staﬀ, and, they identiﬁed various facilitators and barriers (e.g., lack of resources, team instability, community engagement, incentives) that they felt would help in the transferability of the intervention into real-world settings.This novel research attempts to address the low amount of PA and high sedentary level among ethnically diverse OAs. The results of the study indicate that altering PA and SB in the physical environment of the home is a complex process that is impacted by several SEM levels. The multi- component intervention developed from these findings was acceptable to a group of ethnically diverse OAs and led to improvements in their PA and a reduction in their sedentary time. If supported by a future effectiveness trial, this could have a substantial effect on public health as sedentary OAs can gain health benefits from even small increases in PA. Therefore, performing LPA to shift from a sedentary lifestyle has a significant effect on OAs. There is, however, a lack of transferability research in the domain of PA and SB with ethnically diverse OAs. This research highlights the importance of collaborating with stakeholders in transferring the intervention into real-world settings to promote PA and minimize SB among ethnically diverse OAs. The study ﬁndings inform the transferability of the intervention as well as increasing awareness in the wider research community of crucial intervention elements, obstacles, and enablers for implementing public health interventions into real- world contexts. E-Thesis Swansea University, Wales, UK Sedentary behaviour, physical activity and older adults 12 12 2024 2024-12-12 10.23889/SUThesis.69221 A selection of content is redacted or is partially redacted from this thesis to protect sensitive and personal information. COLLEGE NANME COLLEGE CODE Swansea University Hudson, J., Stratton, G., and Mullins, J. Doctoral Ph.D ESRC ESRC 2025-04-03T15:31:02.3312696 2025-04-03T14:37:53.9371751 Faculty of Science and Engineering School of Engineering and Applied Sciences - Sport and Exercise Sciences NAUREEN MEGHANI 1 69221__33940__81fb60e69f3446f5aa5359578fdfd125.pdf 2024_Meghani_N.final.69221.pdf 2025-04-03T15:06:56.9010697 Output 10704305 application/pdf E-Thesis – open access true Copyright: The Author, Naureen Akber Ali Meghani, 2024 true eng
title	Optimizing older adults’ home space to enhance physical activity and minimize sedentary behaviour
spellingShingle	Optimizing older adults’ home space to enhance physical activity and minimize sedentary behaviour NAUREEN MEGHANI
title_short	Optimizing older adults’ home space to enhance physical activity and minimize sedentary behaviour
title_full	Optimizing older adults’ home space to enhance physical activity and minimize sedentary behaviour
title_fullStr	Optimizing older adults’ home space to enhance physical activity and minimize sedentary behaviour
title_full_unstemmed	Optimizing older adults’ home space to enhance physical activity and minimize sedentary behaviour
title_sort	Optimizing older adults’ home space to enhance physical activity and minimize sedentary behaviour
author_id_str_mv	9363b01457e98022545c419a7a2599d0
author_id_fullname_str_mv	9363b01457e98022545c419a7a2599d0_***_NAUREEN MEGHANI
author	NAUREEN MEGHANI
author2	NAUREEN MEGHANI
format	E-Thesis
publishDate	2024
institution	Swansea University
doi_str_mv	10.23889/SUThesis.69221
college_str	Faculty of Science and Engineering
hierarchytype
hierarchy_top_id	facultyofscienceandengineering
hierarchy_top_title	Faculty of Science and Engineering
hierarchy_parent_id	facultyofscienceandengineering
hierarchy_parent_title	Faculty of Science and Engineering
department_str	School of Engineering and Applied Sciences - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Engineering and Applied Sciences - Sport and Exercise Sciences
document_store_str	1
active_str	0
description	Many older adults (OAs) are sedentary and do not participate in adequate levels of physical activity (PA) which would improve body function and reduce frailty, both of which are important for OA’s health and well-being. However, the situation is even worse with ethnically diverse OAs, considering the high burden of chronic disease in this group. Therefore, PA and SB research with this group is particularly important. Ethnically diverse groups of OAs may have complex and diﬀerent perspectives on healthcare, academia and research compared with other groups within the OA population. Therefore, cultural and social elements need speciﬁc consideration (such as privacy, lack of motivation, language, literacy and care giving responsibilities and location) as they might aﬀect recruitment and retention of OAs from underrepresented groups within the population. Evidence has shown that an increasingly diverse OA population is observed in the United Kingdom (UK), partly inﬂuenced by present immigration and population trends, which is associated with complexity in terms of language, socioeconomic level, and the acculturation and immigration experience. Therefore, it is important to increase the representation of this group in research. In this regard the present research focuses on ethnically diverse OAs who are aged ≥65 years to improve their activity and reduce their SB.Given that OAs spend a signiﬁcant time at home being sedentary, increased knowledge of the factors related to this behaviour in the home environment would present signiﬁcant insight for intervention planning. A key element of any intervention developed with this knowledge is the assessment of its feasibility and acceptability with this population group to determine any required modiﬁcations in a subsequent larger eﬀectiveness trial. In addition, exploring the perspectives of stakeholders will direct the implementation of this intervention in practice or in a real-world setting. Therefore, the primary aim of this research thesis was to create and test the feasibility and acceptability of an intervention to optimise OAs’ home space to increase their activity and reduce their SB.Study 1 investigated perceptions of ethnically diverse OAs regarding their activity and sedentary patterns within the home setting using the socio-ecological model (SEM) as a theoretical framework. Using purposive sampling, 33 in-depth interviews and 5 focus group discussions were carried out. Reﬂexive thematic analysis was applied to generate themes from the data which were subsequently interpreted using the constructs and proposals of the SEM. The study ﬁndings showed that PA and SB of OAs are inﬂuenced by diﬀerent levels of the SEM. These include: 1) Individual level such as insight, attitude and motivation behind PA and SB; 2) Interpersonal level such as relatives’ and friends’ support to be more active and less sedentary within the home; 3) Organisational level such as healthcare organisations promoting PA initiatives; 4) Community level factors such as social groups, and the importance of culture-sensitive group activities; 5) Physical Environment level factors such as home space characteristics (e.g., available space and stairs), and, 6) Policy level factors including lockdown constraints impacting PA and SB at home. These ﬁndings provide a suitable underpinning to design and execute a multi-component person-centred intervention for community dwelling ethnically diverse OAs in Study 2.In this study, a multi-method approach using semi-structured interviews and self-reported measures (n = 23) was employed to explore participants’ experiences, and the eﬀect of this intervention on activity and sedentary patterns (the Home space intervention). SEM and the habit formation model guided this intervention (that included a health coaching session, information pamphlet, reminder messages and wearable activity tracker; WAT that emitted vibrations and sound alerts after an hour of sitting designed by the research team). Study ﬁndings showed improvements in PA and reductions in sedentary time, improved scores in mental well-being, self-eﬃcacy, PA habits and reductions in SB habit index after the intervention. The participants viewed the intervention as acceptable and expressed satisfaction with the intervention components and the research. However, study participants suggested some modiﬁcations in the WAT size and functionality to make it more user- friendly. These results could have a substantial eﬀect on public health by showing that sedentary ethnically diverse OAs can gain beneﬁts from even small increases in PA. Therefore, shifting from a sedentary lifestyle could have a signiﬁcant eﬀect for these individuals.Given the established feasibility of the 12-week intervention in study 2, the thesis extends to Study 3 to determine the perceptions of stakeholders regarding the transfer of the intervention into real world settings using the PIET-T (Population, Intervention, Environment, Transfer, model of transferability). Exploratory qualitative research was undertaken using purposive sampling and in-depth interviews (IDIs) to recruit 10 stakeholders from different local organisations that are involved in improving OAs' activity and/or health and well-being and therefore could implement the Home space intervention as part of their work. Reflexive thematic analysis was used to analyse the qualitative data which were interpreted using the PIET-T model. The intervention was found to be appealing and feasible, and most of the stakeholders felt their organisations could play a role in supporting it. Regardless, they highlighted the need to consider cultural equalities (translation of the intervention content into native languages), timely identiﬁcation of funding and delivery opportunities to increase the possibility of its successful implementation along, working in partnership with non-governmental (NGOs) and community organisations, involvement of healthcare professionals and health trainers, training of staﬀ, and, they identiﬁed various facilitators and barriers (e.g., lack of resources, team instability, community engagement, incentives) that they felt would help in the transferability of the intervention into real-world settings.This novel research attempts to address the low amount of PA and high sedentary level among ethnically diverse OAs. The results of the study indicate that altering PA and SB in the physical environment of the home is a complex process that is impacted by several SEM levels. The multi- component intervention developed from these findings was acceptable to a group of ethnically diverse OAs and led to improvements in their PA and a reduction in their sedentary time. If supported by a future effectiveness trial, this could have a substantial effect on public health as sedentary OAs can gain health benefits from even small increases in PA. Therefore, performing LPA to shift from a sedentary lifestyle has a significant effect on OAs. There is, however, a lack of transferability research in the domain of PA and SB with ethnically diverse OAs. This research highlights the importance of collaborating with stakeholders in transferring the intervention into real-world settings to promote PA and minimize SB among ethnically diverse OAs. The study ﬁndings inform the transferability of the intervention as well as increasing awareness in the wider research community of crucial intervention elements, obstacles, and enablers for implementing public health interventions into real- world contexts.
published_date	2024-12-12T05:26:22Z
_version_	1851369541724012544
score	11.089572

Optimizing older adults’ home space to enhance physical activity and minimize sedentary behaviour / NAUREEN MEGHANI

Similar Items