Health Services Research & Development

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2017 HSR&D/QUERI National Conference Abstract

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4090 — Improving the Appeal of Regular Physical Activity for Older Veterans

Lead/Presenter: Kristyn Ertl
All Authors: Ertl K (Zablocki VA Medical Center and Medical College of Wisconsin) Dhaliwal T (Medical College of Wisconsin) Storch D (Clement J. Zablocki VA Medical Center) Fletcher K (Zablocki VA Medical Center and Medical College of Wisconsin) Whittle J (Zablocki VA Medical Center and Medical College of Wisconsin)

Objectives:
Regular physical activity confers important health benefits, but many Veterans do not achieve recommended levels of physical activity. We interviewed 25 older Veterans to identify their potentially unique barriers to exercise and understand the nature of and motivation for current and past physical activity.

Methods:
We recruited Veterans aged 65-89 years receiving primary care at the Milwaukee VA and without severe cognitive impairment or limited life expectancy. We conducted 25 semi-structured interviews; these were audio-recorded, transcribed verbatim, and coded by members of the study team. Coded text was reviewed for discrepancies, corrected, and thematically analyzed.

Results:
Prominent themes related to barriers and reductions in physical activity from previous levels included: 1) Acute injuries, chronic health conditions, and medical treatments precipitate/perpetuate reduced function; 2) aging reduces physical strength, energy, and limits options; and 3) retirement removes the necessity for physical activity and changes priorities. Spouses could be barriers to exercise (e.g., "she wants me to stay home more, so I don't go to the gym") or facilitators (e.g., "she's my walking buddy"). Activities mentioned were most often incidental to daily life or related to specific projects, often in the service of others. Activities done purposely were most often: 1) something they've "always done," 2) shared with an exercise buddy, or 3) part of a regularly scheduled group. Health was the most commonly stated motivator for physical activity, but friend/family encouragement ("wife uses the whip") and role modeling were also evident.

Implications:
Our findings suggest that future exercise programs may increase their appeal to older Veterans if they: 1) Help participants navigate/cope with changes in physical function and ability caused by injuries, chronic medical conditions, and aging; 2) Are project-oriented, i.e., have a beginning, middle, and end, and produce tangible results (e.g., something gets built/made/fixed); 3) Have a strong family (esp. spousal) and social component; 4) Benefit others in some way (e.g., volunteer work that involves physical activity).

Impacts:
Our study provides key insights into approaches that might increase the appeal of regular physical activity to a broader range of Veterans, particularly the older Veterans who are at highest risk of adverse consequences of inactivity.