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  • 1
    In: BMC Geriatrics, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: The Lifestyle-integrated Functional Exercise (LiFE) program is an effective but resource-intensive fall prevention program delivered one-to-one in participants’ homes. A recently developed group-based LiFE (gLiFE) could enhance large-scale implementability and decrease resource intensity. The aim of this qualitative focus group study is to compare participants’ experiences regarding acceptability of gLiFE vs LiFE. Methods Programs were delivered in seven group sessions (gLiFE) or seven individual home visits (LiFE) within a multi-center, randomized non-inferiority trial. Four structured focus group discussions (90–100 min duration; one per format and study site) on content, structure, and subjective effects of gLiFE and LiFE were conducted. Qualitative content analysis using the method of inductive category formation by Mayring was applied for data analysis. Coding was managed using NVivo. Results In both formats, participants ( N  = 30, 22 women, n gLiFE  = 15, n LiFE  = 15, mean age 78.8 ± 6.6 years) were positive about content, structure, and support received by trainers. Participants reflected on advantages of both formats: the social aspects of learning the program in a peer group (gLiFE), and benefits of learning the program at home (LiFE). In gLiFE, some difficulties with the implementation of activities were reported. In both formats, the majority of participants reported positive outcomes and successful implementation of new movement habits. Conclusion This is the first study to examine participants’ views on and experiences with gLiFE and LiFE, revealing strengths and limitations of both formats that can be used for program refinement. Both formats were highly acceptable to participants, suggesting that gLiFE may have similar potential to be adopted by adults aged 70 years and older compared to LiFE. Trial registration ClinicalTrials.gov , NCT03462654 . Registered on March 12, 2018.
    Type of Medium: Online Resource
    ISSN: 1471-2318
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2059865-8
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  • 2
    In: Journal of Aging and Physical Activity, Human Kinetics, Vol. 29, No. 5 ( 2021-10-1), p. 744-752
    Abstract: This study examined the applicability of the health action process approach (HAPA) to walking duration in older adults and the added value of extending the HAPA by intrinsic motivation. Self-reports from older adults ( N  = 309; M age  = 78.7, 70–95 years) regarding activity-related intrinsic motivation and HAPA variables were collected at the baseline of a fall prevention intervention study. Walking duration at ≥3 metabolic equivalents of task was measured for 7 days via body-worn accelerometers. Two structural equation models with walking duration as a manifest outcome were specified. In both models, the model fit was acceptable, but intention and planning were not associated with walking duration. Intrinsic motivation was significantly related to most HAPA variables and walking duration. Variance explained for walking duration was R 2  = .14 in the HAPA and R 2  = .17 in the extended model. For explaining older adults’ walking duration, intrinsic motivation, but not HAPA-based intention and planning, seemed to be important.
    Type of Medium: Online Resource
    ISSN: 1063-8652 , 1543-267X
    Language: Unknown
    Publisher: Human Kinetics
    Publication Date: 2021
    SSG: 31
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  • 3
    In: BMC Geriatrics, Springer Science and Business Media LLC, Vol. 18, No. 1 ( 2018-12)
    Type of Medium: Online Resource
    ISSN: 1471-2318
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2018
    detail.hit.zdb_id: 2059865-8
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  • 4
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2020
    In:  Innovation in Aging Vol. 4, No. Supplement_1 ( 2020-12-16), p. 302-302
    In: Innovation in Aging, Oxford University Press (OUP), Vol. 4, No. Supplement_1 ( 2020-12-16), p. 302-302
    Abstract: Some persons have low functional risk (FR) but also high levels of fear of falling (FOF), in some it may be the exact opposite; in others, FOF matches actual functional risk. In order to characterise older persons in this respect, Delbaere et al. (2010) defined four groups: ‘vigorous’ (low FR/FOF), ‘anxious’ (low FR/high FOF), ‘stoic’ (high FR/low FOF), and ‘aware’ (high FR/FOF). We examined how the proposed group model translates into actual walking behaviour and explored whether group differences in walking occur due to FR level rather than the amount of FOF. Group allocation of N=294 participants was determined based on previously published cut-offs for FR (high vs. low Timed Up-and-Go) and FOF (high vs. low Short Falls-Efficacy Scale International). Walking activity was operationalised as mean number of steps per day over one week, assessed using ‘activPAL4™ micro’ accelerometers. Number of steps in the four groups were 6,335 (‘vigorous’), 5,782 (‘anxious’), 4,851 (‘stoic’), and 4,627 (‘aware’). Linear regression results showed that in the two low FR groups, those with high FOF did not differ significantly from the reference group with low FOF (anxious - vigorous: B=-645.3 steps, p=.157); however, the two groups with high FR showed a significantly different number of steps than the ‘vigorous’ group, irrespective of their FOF (aware-vigorous: B=-1536.1 steps, p=.002; stoic-vigorous: B=-1314.8 steps, p=.005). This means that FR outperformed FOF in their association with walking behaviour, i.e., participants can be better separated in their daily walking behaviour by FR than by FOF.
    Type of Medium: Online Resource
    ISSN: 2399-5300
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2905697-4
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  • 5
    In: Clinical Interventions in Aging, Informa UK Limited, Vol. Volume 17 ( 2022-04), p. 637-652
    Type of Medium: Online Resource
    ISSN: 1178-1998
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2022
    detail.hit.zdb_id: 2212420-2
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  • 6
    In: Pilot and Feasibility Studies, Springer Science and Business Media LLC, Vol. 6, No. 1 ( 2020-12)
    Abstract: The Lifestyle-integrated Functional Exercise (LiFE) programme is a fall prevention programme originally taught in a resource-intensive one-to-one format with limited feasibility for large-scale implementation. The aim of this paper is to present the conceptual framework and initial feasibility evaluation of a group-based LiFE (gLiFE) format developed for large-scale implementation. Methods The conceptual gLiFE framework (part I) is based on three pillars, LiFE Activities and Principles , Theory of Behaviour Change and Behaviour Change Techniques , and Instruction . The feasibility of gLiFE was tested (part II) within a multimodal approach including quantitative questionnaires measuring safety, acceptability (1 = best to 7 = insufficient), and adherence to the LiFE activities (range = 0–14) as well as a focus group interview. Exploratory self-reported measures on behaviour change including self-determined motivation (range = 1–5), intention, planning, action control, and habit strength (range = 1–6) were assessed pre and post intervention. Data analyses were performed using descriptive statistics and qualitative content analysis. Results The development process resulted in a manualised gLiFE concept containing standardised information on gLiFE’s content and structure. Feasibility testing: Six older adults (median = 72.8 years, 5 female) completed the feasibility study and rated safety (median = 7.0, IQR = 0.3) and acceptability as high (median = 1, IQR = 1). Participants implemented 9.5 LiFE activities (IQR = 4.0) into their daily routines. No adverse events occurred during the study. In the focus group, the group format and LiFE activities were perceived as positive and important for maintaining strength and balance capacity. Self-determined motivation intention, planning, and habit strength were rated higher post intervention. Conclusion The developed conceptual gLiFE framework represents the basis for a gLiFE format with potential for standardised large-scale implementation. Proof-of-concept could be demonstrated in a group of community-dwelling older adults at risk of falling. The public health potential of gLiFE in terms of (cost-)effectiveness is currently being evaluated in a large trial. Trial registration ClinicalTrials.gov NCT03412123 . Registered on January 26, 2018
    Type of Medium: Online Resource
    ISSN: 2055-5784
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2809935-7
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  • 7
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2020
    In:  Innovation in Aging Vol. 4, No. Supplement_1 ( 2020-12-16), p. 187-187
    In: Innovation in Aging, Oxford University Press (OUP), Vol. 4, No. Supplement_1 ( 2020-12-16), p. 187-187
    Abstract: In a randomised noninferiority trial, it is investigated whether a group version of the Lifestyle-integrated Functional Exercise program (gLiFE) is non-inferior to the individually delivered LiFE in terms of feasibility and effectiveness. While effectiveness evaluation is ongoing, feasibility results are already available. Participants ( & gt;70 years; confirmed fall risk) were randomized in either LiFE or gLiFE and participated in the same strength and balance exercises, however, based on different approaches of delivery. LiFE participants received seven home visits; gLiFE was delivered in seven group sessions. Feasibility was defined as willingness to participate, adherence to group/home visits, and drop-outs. Predictors for intention to participate were calculated using regression. N=310 participants were randomized to LiFE (n=156) or gLiFE (n=154). n=51 (16%) of the participants dropped out after baseline. Attendance analyses showed that when excluding drop-outs, 100% (iLiFE) and 88% (gLiFE) took part in at least 5 of the 7 meetings. Self-efficacy and outcome expectancies, but not risk perception, were predictors of the intention to participate (F(3,193)=24.84, p & lt;.001). In this first study comparing a group-based LiFE format with the original LiFE, feasibility of both formats was shown in terms of high attendance and less drop-outs than expected in this target group. Compared to other studies involving group based training, compliance to intervention (defined as having absolved at least 5 sessions) was high in both formats. Lower attendance in gLiFE can be explained by inflexible scheduling as compared to making individual home visit appointments. Whether lower gLiFE adherence translates into lower effectiveness is currently analysed.
    Type of Medium: Online Resource
    ISSN: 2399-5300
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2905697-4
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  • 8
    In: International Journal of Behavioral Nutrition and Physical Activity, Springer Science and Business Media LLC, Vol. 18, No. 1 ( 2021-09-03)
    Abstract: The ‘Lifestyle-integrated Functional Exercise’ (LiFE) program successfully reduced risk of falling via improvements in balance and strength, additionally increasing physical activity (PA) in older adults. Generally being delivered in an individual one-to-one format, downsides of LiFE are considerable human resources and costs which hamper large scale implementability. To address this, a group format (gLiFE) was developed and analyzed for its non-inferiority compared to LiFE in reducing activity-adjusted fall incidence and intervention costs. In addition, PA and further secondary outcomes were evaluated. Methods Older adults (70 + years) at risk of falling were included in this multi-center, single-blinded, randomized non-inferiority trial. Balance and strength activities and means to enhance PA were delivered in seven intervention sessions, either in a group (gLiFE) or individually at the participant’s home (LiFE), followed by two “booster” phone calls. Negative binomial regression was used to analyze non-inferiority of gLiFE compared to LiFE at 6-month follow-up; interventions costs were compared descriptively; secondary outcomes were analyzed using generalized linear models. Analyses were carried out per protocol and intention-to-treat. Results Three hundred nine persons were randomized into gLiFE ( n  = 153) and LiFE ( n  = 156). Non-inferiority of the incidence rate ratio of gLiFE was inconclusive after 6 months according to per protocol (mean = 1.27; 95% CI: 0.80; 2.03) and intention-to-treat analysis (mean = 1.18; 95% CI: 0.75; 1.84). Intervention costs were lower for gLiFE compared to LiFE (-€121 under study conditions; -€212€ under “real world” assumption). Falls were reduced between baseline and follow-up in both groups (gLiFE: -37%; LiFE: -55%); increases in PA were significantly higher in gLiFE (+ 880 steps; 95% CI 252; 1,509). Differences in other secondary outcomes were insignificant. Conclusions Although non-inferiority of gLiFE was inconclusive, gLiFE constitutes a less costly alternative to LiFE and it comes with a significantly larger enhancement of daily PA. The fact that no significant differences were found in any secondary outcome underlines that gLiFE addresses functional outcomes to a comparable degree as LiFE. Advantages of both formats should be evaluated in the light of individual needs and preferences before recommending either format. Trial registration The study was preregistered under clinicaltrials.gov (identifier: NCT03462654 ) on March 12 th 2018
    Type of Medium: Online Resource
    ISSN: 1479-5868
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2134691-4
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  • 9
    In: Zeitschrift für Gerontologie und Geriatrie, Springer Science and Business Media LLC, Vol. 56, No. 6 ( 2023-10), p. 448-457
    Type of Medium: Online Resource
    ISSN: 0948-6704 , 1435-1269
    RVK:
    Language: German
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1463317-6
    detail.hit.zdb_id: 1227032-5
    SSG: 5,2
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  • 10
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2023
    In:  Zeitschrift für Gerontologie und Geriatrie Vol. 56, No. 6 ( 2023-10), p. 464-469
    In: Zeitschrift für Gerontologie und Geriatrie, Springer Science and Business Media LLC, Vol. 56, No. 6 ( 2023-10), p. 464-469
    Type of Medium: Online Resource
    ISSN: 0948-6704 , 1435-1269
    RVK:
    Language: German
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1463317-6
    detail.hit.zdb_id: 1227032-5
    SSG: 5,2
    Location Call Number Limitation Availability
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