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: 3.09). 07/2008; 46(6):511-7. DOI: 10.1016/j.ypmed.2008.01.010
Source: PubMed


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.

Download full-text


Available from: Ian B Puddey, Jun 21, 2014
  • Source
    • "Moreover, research involving seniors has generally been undertaken with a small sample size [18,19,23], or targeting those with a specific chronic disease [15,19,23]. Another limitation is that the participants recruited were generally self-referrals and volunteers [17,18,24] as opposed to being randomly selected samples. Therefore, there is an urgent need to develop well-designed interventions that overcome such shortcomings [25]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: This intervention aimed to ascertain whether a low-cost, accessible, physical activity and nutrition program could improve physical activity and nutrition behaviours of insufficiently active 60–70 year olds residing in Perth, Australia. A 6-month home-based randomised controlled trial was conducted on 478 older adults (intervention, n = 248; control, n = 230) of low to medium socioeconomic status. Both intervention and control groups completed postal questionnaires at baseline and post-program, but only the intervention participants received project materials. A modified fat and fibre questionnaire measured nutritional behaviours, whereas physical activity was measured using the International Physical Activity Questionnaire. Generalised estimating equation models were used to assess the repeated outcomes over both time points. The final sample consisted of 176 intervention participants and 199 controls (response rate 78.5%) with complete data. After controlling for demographic and other confounding factors, the intervention group demonstrated increased participation in strength exercise (p < 0.001), walking (p = 0.029) and vigorous activity (p = 0.015), together with significant reduction in mean sitting time (p < 0.001) relative to controls. Improvements in nutritional behaviours for the intervention group were also evident in terms of fat avoidance (p < 0.001), fat intake (p = 0.021) and prevalence of frequent fruit intake (p = 0.008). A minimal contact, low-cost and home-based physical activity program can positively influence seniors’ physical activity and nutrition behaviours. Trial registration Identifier: ACTRN12609000735257
    Full-text · Article · Jan 2013 · International Journal of Behavioral Nutrition and Physical Activity
  • Source
    • "The moderate sample sizes provided sufficient statistical power for evaluation of the repeated measures (Burke et al., 2010). As expected, the attrition was higher among the intervention participants (29%) than the control group (13.5%), but the rates were comparable with similar physical activity trials in the literature (Cox et al., 2008; Jancey et al., 2008). Future studies should take account of barriers when designing programs for older adults, and may consider using computer-assisted telephone interviewing (Wilson et al., 2001) instead of self-completion postal questionnaire to improve the response rate. "
    [Show abstract] [Hide abstract]
    ABSTRACT: To investigate whether a home-based program, physical activity and nutrition for seniors (PANS), made positive changes to central obesity, measured by body mass index (BMI) and waist-to-hip ratio (WHR). A 6-month randomised controlled trial was conducted targeting overweight and sedentary older adults aged 60 to 70 years residing in low to medium socio-economic suburbs within metropolitan Perth. Intervention participants (n=248) received mailed materials and telephone/email support to improve nutrition and physical activity levels. Controls (n=230) received small incentives to complete baseline and post-intervention questionnaires. Both groups reported anthropometric measures following specific written instructions. Generalised estimating equation models were used to assess repeated outcomes of BMI and WHR over both time points. 176 intervention and 199 controls (response rate 78.5%) with complete data were available for analysis. After controlling for demographic and other confounding factors, the intervention group demonstrated a small (0.02) but significant reduction in WHR (p=0.03) compared to controls, no apparent change in BMI was evident for both groups. The 0.02 reduction in mean WHR corresponded to a 2.11 cm decrease in waist circumference for a typical hip circumference. PANS appears to improve the WHR of participants. Changes in BMI might require a longer term intervention to take effect, and/or a follow-up study to confirm its sustainability.
    Full-text · Article · Apr 2012 · Preventive Medicine
  • Source
    • "Passive/Active 3 11. Cox et al, 2008 1 Research assistants placed advertisements in the local community. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Most researchers who are conducting physical activity trials face difficulties in recruiting participants who are representative of the population or from specific population groups. Participants who are often the hardest to recruit are often those who stand to benefit most (the least active, from ethnic and other minority groups, from neighbourhoods with high levels of deprivation, or have poor health). The aim of our study was to conduct a systematic review of published literature of walking interventions, in order to identify the impact, characteristics, and differential effects of recruitment strategies among particular population groups. We conducted standard searches for studies from four sources, (i) electronic literature databases and websites, (ii) grey literature from internet sources, (iii) contact with experts to identify additional "grey" and other literature, and (iv) snowballing from reference lists of retrieved articles. Included studies were randomised controlled trials, controlled before-and-after experimental or observational qualitative studies, examining the effects of an intervention to encourage people to walk independently or in a group setting, and detailing methods of recruitment. Forty seven studies met the inclusion criteria. The overall quality of the descriptions of recruitment in the studies was poor with little detail reported on who undertook recruitment, or how long was spent planning/preparing and implementing the recruitment phase. Recruitment was conducted at locations that either matched where the intervention was delivered, or where the potential participants were asked to attend for the screening and signing up process. We identified a lack of conceptual clarity about the recruitment process and no standard metric to evaluate the effectiveness of recruitment. Recruitment concepts, methods, and reporting in walking intervention trials are poorly developed, adding to other limitations in the literature, such as limited generalisability. The lack of understanding of optimal and equitable recruitment strategies evident from this review limits the impact of interventions to promote walking to particular social groups. To improve the delivery of walking interventions to groups which can benefit most, specific attention to developing and evaluating targeted recruitment approaches is recommended.
    Full-text · Article · Dec 2011 · International Journal of Behavioral Nutrition and Physical Activity
Show more