OBJECTIVE: The purposes of this study were to identify (1) barriers and facilitators of exercise adherence in community-dwelling older adults and (2) behavior change techniques (BCTs) and implementation strategies that are potentially effective in improving adherence.
METHODS: A total of eight databases were searched: PubMed, Web of Science, EMBASE, CENTRAL, PsycINFO, SPORTDiscus, MEDLINE, and Scopus. Studies published from database inception to April 2023 were searched. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool (MMAT). The Capabilities, Opportunities, Motivations, Behavior (COM-B) model and the Theoretical Domain Framework (TDF) were used to identify potential barriers and facilitators. The BCTs were used to identify potential intervention implementation strategies.
RESULTS: A total of 64 studies were included, including 30 qualitative studies, 12 randomized controlled trials, 12 mixed methods studies, 6 quantitative descriptive studies, and 5 non-randomized trials. 54 factors influencing adherence and 38 potentially effective BCTs were identified from the included studies. The 38 BCTs were further categorized into 8 areas of implementation strategies (tailored exercise program, appropriate exercise environment, multidimensional social support, monitoring and feedback, managing emotional experiences and issues, participants education, enhancing self-efficacy, and exerting participants\' autonomy).
CONCLUSIONS: This study identified 54 influential factors affecting exercise adherence and identified 8 areas of intervention strategies (containing 38 BCTs). Further refinement, evaluation, and validation of these factors and strategies are needed in future studies.
目的:本研究的目的是确定(1)社区居住的老年人运动依从性的障碍和促进因素,以及(2)行为改变技术(BCT)和实施策略可能有效提高依从性。
方法:共检索了8个数据库:PubMed,WebofScience,EMBASE,中部,PsycINFO,SPORTDiscus,MEDLINE,还有Scopus.检索了从数据库开始到2023年4月发表的研究。使用混合方法评估工具(MMAT)评估纳入研究的质量。能力,机遇,动机,使用行为(COM-B)模型和理论领域框架(TDF)来识别潜在的障碍和促进因素。BCT用于确定潜在的干预实施策略。
结果:共纳入64项研究,包括30项定性研究,12项随机对照试验,12个混合方法研究,6个定量描述性研究,和5个非随机试验。从纳入的研究中确定了54个影响依从性的因素和38个潜在有效的BCT。38项BCT进一步分为8个实施战略领域(量身定制的锻炼计划,适当的运动环境,多维社会支持,监测和反馈,管理情感体验和问题,参与者教育,提高自我效能感,并发挥参与者的自主权)。
结论:本研究确定了54个影响运动依从性的影响因素,并确定了8个干预策略领域(包含38个BCT)。进一步完善,评估,在未来的研究中需要对这些因素和策略进行验证。