Feasibility of the JOIN4JOY Programme to Reduce Sedentary Behaviour and Increase Physical Activity in Older Adults.

Study Overview
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Brief Summary
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Physical activity (PA) and sedentary behavior (SB) programmes for older people in the community and long-term care facilities traditionally focus on achieving functional and health improvements. These approaches face frequent challenges in reaching older people with more social disadvantages and in achieving and maintaining attendance. The aim is to evaluate the acceptability, implementation process and potential impact of a co-created JOIN4JOY PA programme focused on enjoyment and social inclusion for 65+-year-old community-dwelling adults as well as for 65+-year-olds nursing-home residents who live in nursing homes.

Detailed Description
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Physical activity (PA) and sedentary behavior (SB) programmes for older people in the community and long-term care facilities traditionally focus on achieving functional and health improvements. These approaches face frequent challenges in reaching older people with more social disadvantages and in achieving and maintaining attendance. The aim is to evaluate the acceptability, implementation process and potential impact of a co-created JOIN4JOY PA programme focused on enjoyment and social inclusion for 65+-year-old community-dwelling adults as well as for 65+-year-olds nursing-home residents who live in nursing homes. Two related multicentric, pragmatic, feasibility studies using mixed methods will be conducted. The programme consists of a novel, co-created PA intervention focusing on enjoyment and social inclusion, grounded in self-management strategies to promote behaviour change. Participants will be offered one weekly, 1-hour session of structured, supervised PA and encouraged to hold more active lifestyles and engage in autonomous physical activity practice. Group sessions will take place in the participant's nursing home or in collaborating social institutions in the community. Participants will additionally be invited to join virtual communities of practice. At least 72 end-users will be recruited for each setting in 5 European countries (i.e., Spain, Denmark and Italy will focus on the community settings while and Spain, Germany, and France will do so inon nursing homes). The implementation process and its acceptability will be assessed for acceptability, fidelity, participation and satisfaction by means ofwill be assessed by semi-structured interviews, field diaries of sessions and quantitative 5-point Likert-type scales. To evaluate the potential impact, physical function (Short Physical Performance Battery test), quality of life (EUROQOL-5D scale), enjoyment (Physical Activity Enjoyment Scale), perceived improvement (Patient Global Impression of Improvement scale), activities of daily living (Barthel index) and SB patterns (accelerometers) will be assessed. SPSS software will be used for the analysis of quantitative variables with paired t-tests. Qualitative data collected . Ppre- and post-intervention changes will be assessed using determined themathematic analysis following the steps described by of qualitative data.will follow the Braun and Clarke steps. Ethics and dissemination: A favorable report by the Research Ethics Committee of UVic-UCC (282/2023) was obtained on June 26th, 2023. Participation and withdrawal will be voluntary. When necessary, written permission by the legal guardian will be requested. A broad action of dissemination and communication activities will be targetting both the scientific and the general public.

Official Title
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Enjoy Physical Activity to Battle Sedentary Behaviour and Inactivity Among Older Adults From a Socially Inclusive Perspective (JOIN4JOY).

Conditions
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Physical Inactivity, Sedentary Behavior

Intervention / Treatment
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* Other: Complex intervention involving physical activity and behaviour change techniques


Participation Criteria
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Eligibility Criteria
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Inclusion criteria for participants in JOIN4JOY-C include: Being 65 years of age or above. Living in the community. No cognitive decline as per short form Mini-Mental State Examination (SMMSE). Exclusion criteria for participants in JOIN4JOY-C: * Health condition that contraindicates physical exercise interventions (as per Physical Activity Readiness Questionnaire, PAR-Q). Inclusion criteria for participants in JOIN4JOY-NH include: Being 65 years of age or above. Living in a nursing home. Ability to participate in group-based, structured PA. Exclusion criteria for participants in JOIN4JOY-NH include: Severe cognitive decline (7 points or above as per Global Deterioration Scale of Reisberg, reported by professional caregivers). Severe dependence that requires being bed-bound.

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: Complex intervention involving physical activity and behaviour change techniques|The intervention protocol derives from a previous, extensive, co-creation phase involving end-users as well as relatives, experts, professionals working working with older adults, university students and researchers. It will be based on a structured group-based PA programme supervised by trained professionals, tailored to participants' needs to include joyful components combined with self-management strategies to encourage behaviour change also beyond the sessions. All participants (including end-users but not only) will also be encouraged to join virtual communities of practice (VCoP) for further support and knowledge exchange.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Self-reported Physical activity | measured with de Physical Activity Questionnaire (IPAQ) - Short Form. | Before (week 0) and after (week 13) | 
| Physical activity level | Measured via Accelerometry . For 7 consecutive days before, and 7 consecutive days after the JOIN4JOY PA programme. | Before (week 0) and after (week 13) | 
| Sedentary Behavior | Assessed via the Sedentary Behaviour Questionnaire (SBQ), | Before (week 0) and after (Week 13) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Physical function | Short Physical Performance Battery (SPPB) test, | Before (week 0) and after (week 13) | 
| Quality of life | EUROQOL-5D-5L scale | Before (week 0) and after (week 13) | 
| Perceived improvement | Patient Global Impression of Improvement (PGI-I) scale | Before (week 0) and after (week 13) | 
| Enjoyment | Physical Activity Enjoyment Scale (PACES) | After end of physical activity sessions (week 13) | 
| Sense of community | Sense of community index (SCI-2) | Before (week 0) and after (week 13) | 
| Participation in the virtual communities of practice | Number of entries in virtual communities of practice, per individual. | Through study completion and follow-up (estimated 6 months). | 
| Quality of interactions in the virtual communities of practice | Assessed subjectively by the researchers | Through study completion and follow-up (estimated 6 months). | 
| Degree of satisfaction | 5-point Likert Scale | Post intervention (week 13) | 
| Participation in physical activity sessions | Field diaries to be completed by trainers on a weekly basis | Intervention duration (weeks 1 through 12) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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physical activity, joy, social inclusion, older adults, sedentary behaviour, sedentary behavior, nursing homes, enjoyment