Impact of a community-based participatory physical activity intervention for community-dwelling older adults in a low-income neighbourhood in Hong Kong: A mixed methods study

Abstract

Background and Objectives: To investigate the impact of the neighbourhood-based physical activity (PA) intervention co-designed by community-dwelling older adults, social worker, and researcher using the convergent parallel mixed-methods approach. Methods: A pre-post design approach was used. World Health Organization criteria on PA and Rapid Assessment on Physical Activity were used to assess the change in PA. Chinese self-efficacy for exercise scale, Chinese barriers to exercise scale, five-item neighbourhood cohesion scale, environmental supports for physical activity questionnaires were used to assess changes in participants at individual, social, and environmental levels. 30-second chair stand test and tandem stance test were used to assess physical functional change. Individual semi-structured interviews were conducted to collect qualitative feedback to compare with quantitative data. Results: Following the intervention, twenty participants (43%) were able to fulfill PA recommendations suggested by WHO. For acute intervention effects, RAPA score on aerobic physical activity at post-intervention (Mdn = 6.0) was statistically significantly higher than preintervention (Mdn = 3.0), Z=-5.452, p=<0.001. RAPA score on anaerobic physical activity at postintervention (Mdn = 3.0) was statistically significantly higher than pre-intervention (Mdn = 2.0), Z=-5.082, p=<0.001. In terms of change in exercise attitude, there were significant increase in exercise self-efficacy and decrease in exercise barriers. In terms of changes in the physiological and physical parameter, there were significant reduction in blood pressure and improvement in balance. The effect ranged from small to medium (Cohen’s d: 0.30-0.53, all p<0.01). Integration of quantitative and qualitative data reveals that while quantitative evaluation suggested insignificant change in participant’s usage of public PA resources in the neighbourhood, qualitative data reveals that participants increased usage and has better utilization of public outdoor exercise facilities after the intervention. Conclusions: The positive findings suggest that PA intervention developed using communitybased participatory research approach is effective in promoting PA in the community.