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Room J1,2,3, Boulton M4, Dawes H2, Barker K1,3
1Oxford University Hospitals NHS Foundation Trust, Physiotherapy Research Unit, Oxford, United Kingdom, 2Oxford Brookes University, The Centre for Movement, Occupational and Rehabilitation Sciences (MOReS), Oxford, United Kingdom, 3Oxford University, The Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford, United Kingdom, 4Oxford Brookes University, Department of Nursing, Oxford, United Kingdom
Background: Exercise programmes are a commonplace intervention in musculoskeletal physiotherapy. Surveys of practice confirm their use across a range of conditions. Adherence to exercise is a factor that can affect treatment outcomes. Older people are more likely to have one or more long term conditions, for which prescribed exercise is a treatment option. In addition to this there are also specific factors relating to both older age and sub-optimal exercise adherence. It is therefore important to establish if there is anything clinicians can do to enhance adherence to prescribed exercise in older people. Moreover, when developing effective interventions it is important that they are theoretically underpinned and can be integrated into current practice.
Purpose: To describe the development of a theoretically underpinned exercise adherence intervention for older people.
Methods: The development of the Adherence for Exercise Rehabilitation in Older people (AERO) intervention followed several phases. It was developed with consideration of the MRC guidelines for developing complex interventions and the TIDieR checklist for intervention description and replication. As exercise adherence involves asking people to change their behaviour the steps outlined in the Behaviour Change Wheel were considered. Following this the views of relevant stakeholders were sought. Two focus groups, one consisting of eight patient representatives and one of eight physiotherapists took place, in addition to semi-structured interviews with ten physiotherapists. These were audio recorded and transcribed verbatim. Transcripts were analysed using thematic analysis. Using the information collected in the focus groups and interviews a draft intervention was designed. This was reviewed by ten participants and following their comments changes were made. A final draft of the intervention was created and this will now be trialled in a feasibility study.
Results: The development phase identified the need for an intervention that was theoretically underpinned, and could be tailored to the individual. To that end The AERO intervention will involve a brief behavioural assessment as part of patients' physiotherapy appointment. On the basis of these assessment physiotherapists will be able to offer one or more targeted adherence strategies, these include a review of the exercise programme, considering how exercise programme information is given, cues, reminders, problem solving and action plans, motivational interviewing, decision balance sheets, behavioural contract, goal setting review, and a monitoring call.
Conclusion(s): This abstract describes the development of the AERO intervention. This will now be trialled in a feasibility study and results will be reported in due course
Implications: Before developing a complex intervention it is important to consider the relevant existing guidance and the views of relevant stakeholders.
Keywords: Exercise Adherence, Older people, Complex Intervention
Funding acknowledgements: This work was funded by MOReS, Oxford Brookes University and The Physiotherapy Research Unit, Nuffield Orthopaedic Centre, OUH NHS FT
Purpose: To describe the development of a theoretically underpinned exercise adherence intervention for older people.
Methods: The development of the Adherence for Exercise Rehabilitation in Older people (AERO) intervention followed several phases. It was developed with consideration of the MRC guidelines for developing complex interventions and the TIDieR checklist for intervention description and replication. As exercise adherence involves asking people to change their behaviour the steps outlined in the Behaviour Change Wheel were considered. Following this the views of relevant stakeholders were sought. Two focus groups, one consisting of eight patient representatives and one of eight physiotherapists took place, in addition to semi-structured interviews with ten physiotherapists. These were audio recorded and transcribed verbatim. Transcripts were analysed using thematic analysis. Using the information collected in the focus groups and interviews a draft intervention was designed. This was reviewed by ten participants and following their comments changes were made. A final draft of the intervention was created and this will now be trialled in a feasibility study.
Results: The development phase identified the need for an intervention that was theoretically underpinned, and could be tailored to the individual. To that end The AERO intervention will involve a brief behavioural assessment as part of patients' physiotherapy appointment. On the basis of these assessment physiotherapists will be able to offer one or more targeted adherence strategies, these include a review of the exercise programme, considering how exercise programme information is given, cues, reminders, problem solving and action plans, motivational interviewing, decision balance sheets, behavioural contract, goal setting review, and a monitoring call.
Conclusion(s): This abstract describes the development of the AERO intervention. This will now be trialled in a feasibility study and results will be reported in due course
Implications: Before developing a complex intervention it is important to consider the relevant existing guidance and the views of relevant stakeholders.
Keywords: Exercise Adherence, Older people, Complex Intervention
Funding acknowledgements: This work was funded by MOReS, Oxford Brookes University and The Physiotherapy Research Unit, Nuffield Orthopaedic Centre, OUH NHS FT
Topic: Older people
Ethics approval required: Yes
Institution: Oxford Brookes University
Ethics committee: Faculty of Health and Life Sciences Research Ethics Committee
Ethics number: 2017/07
All authors, affiliations and abstracts have been published as submitted.
