Aging and Physical Activity: A Qualitative Study of Basic Psychological Needs and Motivation in a Blended Home-Based Exercise Program for Older Adults

Mehra, Sumit; van den Helder, Jantine; Kröse, Ben J. A.; Engelbert, Raoul H. H.; Weijs, Peter J. M.; Visser, Bart

doi:10.1007/978-981-15-6968-5_7

Aging and Physical Activity: A Qualitative Study of Basic Psychological Needs and Motivation in a Blended Home-Based Exercise Program for Older Adults

Sumit Mehra^3,4,5,
Jantine van den Helder^6,7,
Ben J. A. Kröse^4,5,
Raoul H. H. Engelbert^6,8,
Peter J. M. Weijs^7,9,10 &
Bart Visser⁶

Chapter
First Online: 21 October 2020

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1 Citations

Abstract

Physical activity can prolong the ability of older adults to live independently at home. A blended intervention was developed to sustain healthy aging. During a clinical trial 133 participants, with an average age of 71 years old, received a tablet and coaching to support them in performing home-based exercises for 6 months. To investigate how the blended intervention influenced exercise motivation, 17 participants were interviewed. Transcripts were analyzed according to the directed content analysis method. The analysis revealed that the intervention supported the autonomy of participants, by letting them set their own personal goals and compile a personalized exercise program. It also supported their feelings of competence, by offering clear instructions, structure, and the ability to track their progress. Finally, some participants valued the emotional support offered by the personal coach, while others preferred combining the home-based exercises with group-based activities with peers to fulfill their relatedness needs.

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References

Assarroudi, A., Heshmati Nabavi, F., Armat, M. R., Ebadi, A., & Vaismoradi, M. (2018). Directed qualitative content analysis: The description and elaboration of its underpinning methods and data analysis process. Journal of Research in Nursing, 23(1), 42–55. https://doi.org/10.1177/1744987117741667.
CrossRef Google Scholar
Baert, V., Gorus, E., Mets, T., Geerts, C., & Bautmans, I. (2011). Motivators and barriers for physical activity in the oldest old: A systematic review. Aging Research Reviews, 10(4), 464–474. https://doi.org/10.1016/j.arr.2011.04.001.
CrossRef Google Scholar
Beauchamp, M. R., Carron, A. V., McCutcheon, S., & Harper, O. (2007). Older adults’ preferences for exercising alone versus in groups: Considering contextual congruence. Annals of Behavioral Medicine, 33(2), 200–206. https://doi.org/10.1007/BF02879901.
CrossRef Google Scholar
Bewegen, RIVM. (n.d.). Retrieved January 13, 2020, from https://www.rivm.nl/leefstijlmonitor/bewegen.
Biedenweg, K., Meischke, H., Bohl, A., Hammerback, K., Williams, B., Poe, P., & Phelan, E. A. (2014). Understanding older adults’ motivators and barriers to participating in organized programs supporting exercise behaviors. Journal of Primary Prevention, 35(1), 1–11. https://doi.org/10.1007/s10935-013-0331-2.
CrossRef Google Scholar
Brown, D. S., Finkelstein, E. A., Brown, D. R., Buchner, D. M., & Johnson, F. R. (2009). Estimating older adults’ preferences for walking programs via conjoint analysis. American Journal of Preventive Medicine, 36(3). https://doi.org/10.1016/j.amepre.2008.10.014.
Bunn, F., Dickinson, A., Barnett-Page, E., Mcinnes, E., & Horton, K. (2008). A systematic review of older people’s perceptions of facilitators and barriers to participation in falls-prevention interventions. Aging and Society, 28(4), 449–472. https://doi.org/10.1017/S0144686X07006861.
CrossRef Google Scholar
Chodzko-Zajko, W. J., Proctor, D. N., Fiatarone Singh, M. A., Minson, C. T., Nigg, C. R., Salem, G. J., & Skinner, J. S. (2009). Exercise and physical activity for older adults. Medicine and Science in Sports and Exercise, 41(7), 1510–1530. https://doi.org/10.1249/MSS.0b013e3181a0c95c.
CrossRef Google Scholar
Choi, J., Lee, M., Lee, J.-K., Kang, D., & Choi, J.-Y. (2017). Correlates associated with participation in physical activity among adults: A systematic review of reviews and update. BMC Public Health, 17(1). https://doi.org/10.1186/s12889-017-4255-2.
Christensen, K., Doblhammer, G., Rau, R., & Vaupel, J. W. (2009). Aging populations: The challenges ahead. The Lancet, 374(9696), 1196–1208. https://doi.org/10.1016/S0140-6736(09)61460-4.
CrossRef Google Scholar
Craig, P., Dieppe, P., Macintyre, S., Michie, S., Nazareth, I., & Petticrew, M. (2008). Developing and evaluating complex interventions: The new medical research council guidance revisiting the 2000 MRC framework. British Medical Journal, 337(a1655), 979–983. https://doi.org/10.1136/bmj.a1655.
CrossRef Google Scholar
Crombie, I. K., Irvine, L., Williams, B., McGinnis, A. R., Slane, P. W., Alder, E. M., & McMurdo, M. E. T. (2004). Why older people do not participate in leisure time physical activity: A survey of activity levels, beliefs and deterrents. Age and Aging, 33(3), 287–292. https://doi.org/10.1093/aging/afh089.
CrossRef Google Scholar
de Vries, N. M., van Ravensberg, C. D., Hobbelen, J. S., Olde Rikkert, M. G., Staal, J. B., & Nijhuis-van der Sanden, M. W. (2012). Effects of physical exercise therapy on mobility, physical functioning, physical activity and quality of life in community-dwelling older adults with impaired mobility, physical disability and/or multi-morbidity: A meta-analysis. Aging Research Reviews, 11(1), 136–149. https://doi.org/10.1016/j.arr.2011.11.002; https://doi.org/10.1016/j.arr.2011.11.002.
Deci, E. L. (1975). Intrinsic motivation. New York : Plenum Press.
Google Scholar
Deci, E. L. (1985). Intrinsic motivation and self-determination in human behavior. New York: Plenum.
Google Scholar
Deci, E. L., & Ryan, R. M. (2000). The what and why of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11(4), 227–268. https://doi.org/10.1207/S15327965PLI1104_01.
CrossRef Google Scholar
Edmunds, J., Ntoumanis, N., & Duda, J. L. (2006). A test of self-determination theory in the exercise domain. Journal of Applied Social Psychology, 36(9), 2240–2265. https://doi.org/10.1111/j.0021-9029.2006.00102.x.
CrossRef Google Scholar
Fälker, M. (2004). Aging and health policy. In Public Health in Europe (pp. 81–87). https://doi.org/10.1007/978-3-642-18826-8_11.
Forkan, R., Pumper, B., Smyth, N., Wirkkala, H., Ciol, M. A., & Shumway-Cook, A. (2006). Exercise adherence following physical therapy intervention in older adults with impaired balance. Physical Therapy, 86(3), 401–410.
CrossRef Google Scholar
Freedman, V. A., Martin, L. G., & Schoeni, R. F. (2002). Recent trends in disability and functioning among older adults in the United States: A systematic review. Journal of the American Medical Association, 288(24), 3137–3146. https://doi.org/10.1001/jama.288.24.3137.
CrossRef Google Scholar
Fried, L. P., Tangen, C. M., Walston, J., Newman, A. B., Hirsch, C., Gottdiener, J., … McBurnie, M. A. (2001). Frailty in older adults: Evidence for a phenotype. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 56(3), M146–M157. https://doi.org/10.1093/gerona/56.3.M146.
Geraedts, H., Zijlstra, A., Bulstra, S. K., Stevens, M., & Zijlstra, W. (2013). Effects of remote feedback in home-based physical activity interventions for older adults: A systematic review. Patient Education and Counseling, 91(1), 14–24. https://doi.org/10.1016/j.pec.2012.10.018.
CrossRef Google Scholar
Haber, D., & Rhodes, D. (2004). Health contract with sedentary older adults. The Gerontologist, 44(6), 827–835. https://doi.org/10.1093/geront/44.6.827.
CrossRef Google Scholar
Hallal, P. C., Andersen, L. B., Bull, F. C., Guthold, R., Haskell, W., Ekelund, U., … Wells, J. C. (2012). Global physical activity levels: Surveillance progress, pitfalls, and prospects. The Lancet, 380(9838), 247–257. https://doi.org/10.1016/S0140-6736(12)60646-1.
Hardy, S., & Grogan, S. (2009). Preventing disability through exercise. Journal of Health Psychology, 14(7), 1036–1046. https://doi.org/10.1177/1359105309342298.
CrossRef Google Scholar
Hébert, R. (1997). Functional decline in old age. CMAJ, 157(8), 1037–1045.
Google Scholar
Heesch, K. C., Brown, D. R., & Blanton, C. J. (2000). Perceived barriers to exercise and stage of exercise adoption in older women of different racial/ethnic groups. Women and Health, 30(4), 61–76. https://doi.org/10.1300/J013v30n04_05.
CrossRef Google Scholar
Hsieh, H.-F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15(9), 1277–1288. https://doi.org/10.1177/1049732305276687.
CrossRef Google Scholar
Inouye, S. K., Studenski, S., Tinetti, M. E., & Kuchel, G. A. (2007). Geriatric syndromes: Clinical, research, and policy implications of a core geriatric concept. Journal of the American Geriatrics Society, 55(5), 780–791. https://doi.org/10.1111/j.1532-5415.2007.01156.x.
CrossRef Google Scholar
Jones, S. A., Alicea, S. K., & Ortega, J. D. (2019). A Self-Determination theory approach for exercise motivation in rural dwelling older adults. Activities, Adaptation and Aging. https://doi.org/10.1080/01924788.2019.1581022.
CrossRef Google Scholar
King, A. C. (1991). Group- vs home-based exercise training in healthy older men and women. A community-based clinical trial. JAMA: The Journal of the American Medical Association, 266(11), 1535–1542. https://doi.org/10.1001/jama.266.11.1535.
Kirkby, R. J., Kolt, G. S., Habel, K., & Adams, J. (1999). Exercise in older women: Motives for participation. Australian Psychologist, 34(2), 122–127. https://doi.org/10.1080/00050069908257440.
CrossRef Google Scholar
Kirkland, R. A., Karlin, N. J., Megan, B. S., & Pulos, S. (2011). Basic psychological needs satisfaction, motivation, and exercise in older adults. Activities, Adaptation and Aging, 35(3), 181–196. https://doi.org/10.1080/01924788.2011.596764.
CrossRef Google Scholar
Kolt, G. S., Driver, R. P., & Giles, L. C. (2004). Why older Australians participate in exercise and sport. Journal of Aging and Physical Activity, 12(2), 185–198. https://doi.org/10.1123/japa.12.2.185.
CrossRef Google Scholar
Lutz, W., Sanderson, W., & Scherbov, S. (2008). The coming acceleration of global population aging. Nature, 451(7179), 716–719. https://doi.org/10.1038/nature06516.
CrossRef Google Scholar
Marengoni, A., Angleman, S., Melis, R., Mangialasche, F., Karp, A., Garmen, A., … Fratiglioni, L. (2011). Aging with multimorbidity: A systematic review of the literature. Aging Research Reviews, 10(4), 430–439. https://doi.org/10.1016/j.arr.2011.03.003.
McAuley, E., Jerome, G. J., Elavsky, S., Marquez, D. X., & Ramsey, S. N. (2003). Predicting long-term maintenance of physical activity in older adults. Preventive Medicine, 37(2), 110–118. https://doi.org/10.1016/S0091-7435(03)00089-6.
CrossRef Google Scholar
Mehra, S., Dadema, T., Kröse, B. J. A., Visser, B., Engelbert, R. H. H., Van Den Helder, J., & Weijs, P. J. M. (2016). Attitudes of older adults in a group-based exercise program toward a blended intervention; A focus-group study. Frontiers in Psychology, 7. https://doi.org/10.3389/fpsyg.2016.01827.
Mehra, S., van den Helder, J., Visser, B., Engelbert, R. H. H., Weijs, P. J. M., & Krose, B. J. A. (2020). Evaluation of a blended physical activity intervention for older adults: A mixed-method study. Journal of Medical Internet Research. https://doi.org/10.2196/16380.
Mehra, S., Visser, B., Cila, N., van den Helder, J., Engelbert, R. H., Weijs, P. J., & Kröse, B. J. (2019). Supporting older adults in exercising With a tablet: A usability study. JMIR Human Factors, 6(1), e11598. https://doi.org/10.2196/11598.
CrossRef Google Scholar
Mehra, S., Visser, B., Dadema, T., van den Helder, J., Engelbert, R. H., Weijs, P. J., & Kröse, B. J. (2018). Translating behavior change principles into a blended exercise intervention for older adults: Design study. JMIR Research Protocols, 7(5), e117. https://doi.org/10.2196/resprot.9244.
CrossRef Google Scholar
Moore, G. F., Audrey, S., Barker, M., Bond, L., Bonell, C., Hardeman, W., … Baird, J. (2015). Process evaluation of complex interventions: Medical research council guidance. BMJ, 350. https://doi.org/10.1136/bmj.h1258.
Nelson, M. E. M. M. E., Rejeski, W. J. W. J., Blair, S. N. S., Duncan, P. W., Judge, J. O., King, A. C., … Castaneda-Sceppa, C. (2007). Physical activity and public health in older adults: Recommendation from the American College of Sports Medicine and the American Heart Association. Circulation, 116(9), 1094–1105. https://doi.org/10.1161/CIRCULATIONAHA.107.185650.
Newson, R. S., & Kemps, E. B. (2007). Factors that promote and prevent exercise engagement in older adults. Journal of Aging and Health, 19(3), 470–481. https://doi.org/10.1177/0898264307300169.
CrossRef Google Scholar
Owen, K. B., Smith, J., Lubans, D. R., Ng, J. Y. Y., & Lonsdale, C. (2014). Self-determined motivation and physical activity in children and adolescents: A systematic review and meta-analysis. Preventive Medicine, 67, 270–279. https://doi.org/10.1016/j.ypmed.2014.07.033.
CrossRef Google Scholar
Päivi, M., Mirja, H., & Terttu, P. (2010). Changes in physical activity involvement and attitude to physical activity in a 16-year follow-up study among the elderly. Journal of Aging Research, 2010. https://doi.org/10.4061/2010/174290.
Patrick, H., & Canevello, A. (2011). Methodological overview of a self-determination theory-based computerized intervention to promote leisure-time physical activity. Psychology of Sport and Exercise, 12(1), 13–19. https://doi.org/10.1016/j.psychsport.2010.04.011.
CrossRef Google Scholar
Piercy, K. L., Troiano, R. P., Ballard, R. M., Carlson, S. A., Fulton, J. E., Galuska, D. A., … Olson, R. D. (2018). The physical activity guidelines for Americans. JAMA, 320(19), 2020–2028. https://doi.org/10.1001/jama.2018.14854.
Resnick, B. (2001). Testing a model of exercise behavior in older adults. Research in Nursing and Health, 24(2), 83–92. https://doi.org/10.1002/nur.1011.
CrossRef Google Scholar
Roser, M., Ortiz-Ospina, E., & Ritchie, H. (2019). Life Expectancy. Retrieved January 13, 2020, from https://ourworldindata.org/life-expectancy.
Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55(1), 68–78. https://doi.org/10.1037/0003-066X.55.1.68.
CrossRef Google Scholar
Schutzer, K. A. K. A., & Graves, B. S. S. (2004). Barriers and motivations to exercise in older adults. Preventive Medicine, 39(5), 1056–1061. https://doi.org/10.1016/j.ypmed.2004.04.003.
CrossRef Google Scholar
Simek, E. M., Mcphate, L., & Haines, T. P. (2012). Adherence to and efficacy of home exercise programs to prevent falls: A systematic review and meta-analysis of the impact of exercise program characteristics. Preventive Medicine, 55(4), 262–275. https://doi.org/10.1016/j.ypmed.2012.07.007.
CrossRef Google Scholar
Tak, E., Kuiper, R., Chorus, A., & Hopman-Rock, M. (2013). Prevention of onset and progression of basic ADL disability by physical activity in community dwelling older adults: A meta-analysis. Aging Research Reviews, 12, 329–338. https://doi.org/10.1016/j.arr.2012.10.001.
CrossRef Google Scholar
Teixeira, P. J. P. J., Carraça, E. V. E. V., Markland, D., Silva, M. N. M. N., & Ryan, R. M. R. M. (2012). Exercise, physical activity, and self-determination theory: A systematic review. International Journal of Behavioral Nutrition and Physical Activity, 9(1), 78. https://doi.org/10.1186/1479-5868-9-78.
CrossRef Google Scholar
Townsend, N., Bhatnagar, P., Wickramasinghe, K., Scarborough, P., Foster, C., & Rayner, M. (2012). Physical activity statistics 2012. London, United Kingdom: British Heart Foundation.
Google Scholar
Trost, S. G., Owen, N., Bauman, A. E., Sallis, J. F., & Brown, W. (2002). Correlates of adults’ participation in physical activity: Review and update. Medicine and Science in Sports and Exercise, 34(12), 1996–2001. https://doi.org/10.1097/00005768-200212000-00020.
CrossRef Google Scholar
United Nations. (2017). World Population Aging 2017. Retrieved from https://www.un.org/en/development/desa/population/publications/pdf/aging/WPA2017_Highlights.pdf.
Üstün, T. B., Chatterji, S., Bickenbach, J., Kostanjsek, N., & Schneider, M. (2003). The international classification of functioning, disability and health: A new tool for understanding disability and health. Disability and Rehabilitation, 25(11–12), 565–571. https://doi.org/10.1080/0963828031000137063.
CrossRef Google Scholar
van den Helder, J., van Dronkelaar, C., Tieland, M., Mehra, S., Dadema, T., Visser, B., … Weijs, P. J. M. (2018). A digitally supported home-based exercise training program and dietary protein intervention for community dwelling older adults: protocol of the cluster randomised controlled VITAMIN trial. BMC Geriatrics, 18(1), 183. https://doi.org/10.1186/s12877-018-0863-7.
van der Bij, A., Laurant, M. G. H., & Wensing, M. (2002). Effectiveness of physical activity interventions for older adults: A review. American Journal of Preventive Medicine, 22(2), 120–133. https://doi.org/10.1016/S0749-3797(01)00413-5.
CrossRef Google Scholar
Walston, J., Hadley, E. C., Ferrucci, L., Guralnik, J. M., Newman, A. B., Studenski, S. A., … Fried, L. P. (2006). Research agenda for frailty in older adults: Toward a better understanding of physiology and etiology: Summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults. Journal of the American Geriatrics Society, 54(6), 991–1001. https://doi.org/10.1111/j.1532-5415.2006.00745.x.
Word Bank. (2019). Population ages 65 and above (% of total population), Data. Retrieved October 7, 2019, from https://data.worldbank.org/indicator/SP.POP.65UP.TO.ZS?most_recent_value_desc=true.
World Health Organization. (2010). Global Recommendations on Physical Activity for Health.
Google Scholar
World Health Organization. (2011). Global Recommendations on Physical Activity for Health 65 Years and Above.
Google Scholar
World Health Organization. (2015). World Report on Aging and Health.
Google Scholar

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Acknowledgments

This work is part of the research projects MOTO-B (funded by NWO, the Dutch Research Council, grant number 023.006.013) and VITAMIN (funded by the AUAS program Urban Vitality). The authors thank the VITAMINE team for developing the blended intervention and Jordy Schouten and Samir van Rijn for their contributions to this study.

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Authors and Affiliations

Applied Psychology, Faculty of Applied Social Sciences and Law, Amsterdam University of Applied Sciences, Wibautstraat 3b, Amsterdam, 1091 GH, The Netherlands
Sumit Mehra
Faculty of Digital Media and Creative Industries, CREATE-IT Applied Research, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
Sumit Mehra & Ben J. A. Kröse
Faculty of Science, Informatics Institute, University of Amsterdam, Amsterdam, The Netherlands
Sumit Mehra & Ben J. A. Kröse
Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
Jantine van den Helder, Raoul H. H. Engelbert & Bart Visser
Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
Jantine van den Helder & Peter J. M. Weijs
Department of Rehabilitation, Amsterdam University Medical Centers, Amsterdam Movement Sciences, Amsterdam, The Netherlands
Raoul H. H. Engelbert
Department of Nutrition and Dietetics, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
Peter J. M. Weijs
Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
Peter J. M. Weijs

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Sumit Mehra
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Jantine van den Helder
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Ben J. A. Kröse
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National Institute of Education, Nanyang Technological University, Singapore, Singapore
Betsy Ng
Nanyang Technological University, Singapore, Singapore
Gloria Ho

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Mehra, S., van den Helder, J., Kröse, B.J.A., Engelbert, R.H.H., Weijs, P.J.M., Visser, B. (2020). Aging and Physical Activity: A Qualitative Study of Basic Psychological Needs and Motivation in a Blended Home-Based Exercise Program for Older Adults. In: Ng, B., Ho, G. (eds) Self-Determination Theory and Healthy Aging. Springer, Singapore. https://doi.org/10.1007/978-981-15-6968-5_7

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DOI: https://doi.org/10.1007/978-981-15-6968-5_7
Published: 21 October 2020
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