The online version of this article (doi:10.1186/1471-2318-14-46) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
TH, DC and CV conceived the idea for the PACE-Lift study. TH, DC, CV, SK, AW, SI, UE, PW, CB, MU and FA participated in the design of the study, including the idea of a comparison of participants and non-participants. CV, AW, TH and AR designed the qualitative aspects of the study. AR carried out all the non-participant interviews and qualitative analyses. EL carried out the statistical comparisons between participants and non-participants. All the authors have read and approved the final manuscript.
Physical activity is of vital importance to older peoples’ health. Physical activity intervention studies with older people often have low recruitment, yet little is known about non-participants.
Patients aged 60–74 years from three UK general practices were invited to participate in a nurse-supported pedometer-based walking intervention. Demographic characteristics of 298 participants and 690 non-participants were compared. Health status and physical activity of 298 participants and 183 non-participants who completed a survey were compared using age, sex adjusted odds ratios (OR) (95% confidence intervals). 15 non-participants were interviewed to explore perceived barriers to participation.
Recruitment was 30% (298/988). Participants were more likely than non-participants to be female (54% v 47%; p = 0.04) and to live in affluent postcodes (73% v 62% in top quintile; p < 0.001). Participants were more likely than non-participants who completed the survey to have an occupational pension OR 2.06 (1.35-3.13), a limiting longstanding illness OR 1.72 (1.05-2.79) and less likely to report being active OR 0.55 (0.33-0.93) or walking fast OR 0.56 (0.37-0.84). Interviewees supported general practice-based physical activity studies, particularly walking, but barriers to participation included: already sufficiently active, reluctance to walk alone or at night, physical symptoms, depression, time constraints, trial equipment and duration.
Gender and deprivation differences suggest some selection bias. However, trial participants reported more health problems and lower activity than non-participants who completed the survey, suggesting appropriate trial selection in a general practice population. Non-participant interviewees indicated that shorter interventions, addressing physical symptoms and promoting confidence in pursuing physical activity, might increase trial recruitment and uptake of practice-based physical activity endeavours.
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- Which older people decline participation in a primary care trial of physical activity and why: insights from a mixed methods approach
Derek G Cook
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