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Development of a conceptual framework for a group-based format of the Lifestyle-integrated Functional Exercise (gLiFE) programme and its initial feasibility testing.

ABSTRACT: Background: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.

SUBMITTER: Kramer F

PROVIDER: S-EPMC6975023 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Development of a conceptual framework for a group-based format of the Lifestyle-integrated Functional Exercise (gLiFE) programme and its initial feasibility testing.

Kramer Franziska F Labudek Sarah S Jansen Carl-Philipp CP Nerz Corinna C Fleig Lena L Clemson Lindy L Becker Clemens C Schwenk Michael M

Pilot and feasibility studies 20200122

<h4>Background</h4>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.<h4>Methods</h4>The conceptual gLiFE framework (part I) is based on three pillars, <i>LiFE Activi ...[more]

PMID: 31993213

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Project description:BACKGROUND:Health systems in Australia and worldwide are increasingly expected to conduct research and quality improvement activities in addition to delivering clinical care and training health professionals. This study aims to inform a research impact evaluation at a regional Australian Hospital and Health Service by developing a programme theory showing how research investment is expected to have impact. METHODS:This qualitative study, representing the first phase of a larger mixed methods research impact evaluation at the Townsville Hospital and Health Service (THHS), adopts a realist-informed design involving the development of a programme theory. Data were obtained between February and May 2019 from strategic documentation and interviews with six current and former health service executives and senior employees. Inductive themes were integrated into a conceptual framework to visually represent the programme theory. RESULTS:Research at THHS has developed organically as the service has matured into a regional tertiary referral service serving a diverse rural and remote population across northern Queensland. Throughout this journey, individual THHS leaders often adopted a research development mantle despite disincentives arising from a performance-driven reporting and activity-based funding service context. Impact expectations from research investment at THHS were identified in the categories of enhanced research activity and capacity among clinicians, and improved clinical practice, health workforce capability and stability, and patient and population health. Seven contextual factors were identified as potential enablers or obstacles to these impact expectations and ambitions. CONCLUSIONS:By identifying both relevant impact types and key contextual factors, this study offers programme theory to inform a planned research impact evaluation at THHS. The conceptual framework may be useful in other regionally based health service settings. More broadly, there are opportunities for future research to test and refine hybrid versions of linear and realist research impact evaluation models that combine resource-intensive, theory-driven approaches with policy practicality.

Dataset Information

Development of a conceptual framework for a group-based format of the Lifestyle-integrated Functional Exercise (gLiFE) programme and its initial feasibility testing.

Publications

Development of a conceptual framework for a group-based format of the Lifestyle-integrated Functional Exercise (gLiFE) programme and its initial feasibility testing.

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