Short and long-term adherence to swimming and walking programs in older women - The Sedentary Women Exercise Adherence Trial (SWEAT 2)

School of Medicine and Pharmacology, University of Western Australia, Australia.
Preventive Medicine (Impact Factor: 2.93). 07/2008; 46(6):511-7. DOI: 10.1016/j.ypmed.2008.01.010
Source: PubMed

ABSTRACT To examine in previously sedentary older women the effects of exercise mode and a behavioural intervention on short and long-term retention and adherence.
Healthy, sedentary women aged 50-70 years (N=116) were randomly assigned to a supervised 6-month swimming or walking program 3 sessions a week. They were further randomised to usual care or a behavioural intervention. The same program was further continued unsupervised for 6 months. We assessed retention, adherence, stage of exercise behaviour and changes in fitness.
One hundred women (86%) completed 6 months and 86 (74%) continued for 12 months. Retention rates were similar for both exercise modes at 6 and 12 months. Adherence to swimming or walking was similar after 6 months (76.3 (95% CI: 69.5, 83.1)% vs. 74.3 (67.7, 80.9)%) and 12 months (65.8 (57.9, 73.8)% vs. 62.2 (54.6, 70.0)%). The behavioural intervention did not enhance retention or adherence. Fitness improved for both exercise modes after 6 months and was maintained at 12 months.
Either swimming or walking programs initiated with careful supervision over 6 months resulted in similar high retention and adherence rates by highly motivated older women over 12 months. Behavioural intervention in this setting did not improve these rates further.

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    ABSTRACT: Understanding motivators for exercise participation in post-menopausal women may impact retention to exercise programmes and inform intervention trial designs. The purpose of this investigation was to assess self-reported motivational factors influencing adherence and retention to a 24-week progressive resistance training programme. Post-menopausal females (n = 34) were passively recruited to undertake a 24-week progressive resistance training protocol, in small-group sessions, on three non-consecutive days of the week. Attendance was recorded by the researcher. Qualitative reports were sourced from the sample for four phases of the study: pre-study (prior to week 1), recruitment (week 1), during study (weeks 2 - 24), and post-intervention (beyond week 24). Responses were categorised according to ten descriptors: specific health index improvement, education, flexibility of time, social contact, conscience (loyalty to the researcher), wellness, weight management, organisation parameters (pertaining to the study programme) and enjoyment of the exercises. Of the initial sample, 76.5% (n = 26) met the specified ≥80% attendance criterion. The primary findings were that motivation to volunteer for the study was driven by a perceived need for a structured exercise programme (50% of respondents). A commitment to the researcher was the primary motivator for continued adherence to the study for 50% of participants. Social contact with other participants was cited by 60% of the sample as the primary reason for adherence for the full duration of 24 weeks. A desire to maintain the "wellness" derived from the programme was cited by 60% as a reason for continuing an exercise routine post-study. This study identified that routine and supervision initially attract women to exercise programmes, while social cohesion of the group setting contributes to retention over time. Understanding the changing nature of motivating factors may contribute to better overall adherence and retention to exercise programmes and interventions.
    BMC Public Health 12/2015; 15(1):1543. DOI:10.1186/s12889-015-1543-6 · 2.32 Impact Factor
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    ABSTRACT: Introduction: Cardiovascular disease affects a greater proportion of females than it does males, and is responsible for an estimated 52% of female deaths per annum, globally. Due to the loss of oestrogen associated with the menopause, post-menopausal females are at elevated risk for hypercholesterolaemia which is a primary risk factor for cardiovascular disease. It has not yet been conclusively established whether resistance training can be used to ameliorate hypercholesterolaemia. Aim: This randomized controlled trial investigated what effect 12 weeks of progressive resistance training would have on plasma lipoproteins in a sample of post-menopausal females. Methods: Caucasian women (n=30 intervention and n=18 control) between the ages of 55 and 65 years who were not taking hormone replacement therapy were recruited. Participants did not smoke, were sedentary, were not taking any form of cholesterol-lowering medication, had at least one cholesterol abnormality at baseline but were otherwise healthy and able to participate in a strength training programme. Following extensive medical pre-screening, information dissemination and voluntary consent, the sample was divided into two groups. The exercise sample undertook 12 weeks of resistance training on five days of the week. The control group received no intervention. Measurements were obtained at baseline and every four weeks thereafter and included measures of strength, biochemistry (oestradiol, testosterone, full blood lipid profile, glycated haemoglobin and sex hormone binding globulin), anthropometry, morphology and self-reports (dietary intake, energy expenditure and the profile of mood states questionnaire). Results: There was no change to low density lipoprotein cholesterol, high density lipoprotein cholesterol, triglyceride content or total cholesterol as a result of the intervention. Back, chest and leg strength increased significantly (p<0.01) (increases of 51%, 35% and 43% respectively from baseline); waist circumference dropped (p<0.01) by 5% overall and diastolic blood pressure decreased significantly (-9%, p<0.01) in the exercise cohort but no change was noted in the matched control. Dietary intake, energy expenditure and body mass remained unchanged in both samples. Morphology (sum of skinfolds, estimated body fat content and girth measures) did not change and nor did other biochemical measures (HbA1c and sex hormone binding globulin) or hormone levels (oestradiol and testosterone). Despite the lack of overall change, an important finding was noted in individual results where a clear indication of ‘responders’ and ‘non-responders’ emerged. Conclusion: Overall mean results suggest that 12 weeks resistance training undertaken five days of the week was ineffective in reducing hypercholesterolaemia in this sample. Despite there being no identifying characteristics determined in this sample, evidence of responders and non-responders to the intervention indicates that reliance on mean data may not be sufficient when analysing data from exercise interventions. Therefore, while progressive resistance training had a positive effect on strength, waist circumference and diastolic blood pressure, it did not positively influence the plasma lipoproteins in this cohort of post-menopausal women.
    04/2014, Degree: PhD, Supervisor: Candice J Christie


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Jun 21, 2014