title: Assessing the effect of a physical activity intervention in a nursing home ecology: a natural lab approach.
abstract: BACKGROUND
  Physical activity (PA) is not only an important marker of physical impairment, but also a pathway to improve quality of life and enhance cognitive and social functioning of old individuals. Yet, making interventional use of PA training as a means for prevention and enhancement of quality of life of nursing home residents has found very limited attention worldwide so far. That said, the project 'Long-term Care in Motion' (LTCMo) as a part of the INNOVAGE consortium (funded by the European Commission) has the following aims: Overall: Install and assess a socially innovative intervention in the nursing home ecology. Concrete: (a) Conceptualization of a multidimensional intervention program (resident and staff oriented) with the potential to promote PA in nursing home residents; (b) Mixed-methods assessment of the program based on automated recording as well as questionnaire data.
  
  
  METHODS
  LTCMo's PA-related intervention has several components which are applied in parallel manner: (1) Residents are engaged in a physical exercise program that is based on multiple approaches: supervised group sessions, a serious games approach, and specific training in severely impaired persons; (2) Staff members will receive a competence training with a focus on PA motivation and facilitation of residents' PA engagement. Primary outcome assessment (movement-related behavior of residents) is completely conducted by means of automated data collection strategies (accelerometer-based activity recording, sensor-based life space recording). This is enriched by a broad range of secondary outcomes (e.g., cognitive performance, depression of residents; behavioral and attitudinal components of staff). Pre-, post- and 3-month follow-up assessment will take place in the target intervention setting as well as in a waiting control condition in which we will also replicate the training and its assessment in a later step.
  
  
  CONCLUSIONS
  Although we are faced with methodological challenges (e.g., rather small sample size; no randomized control trial), we believe that our approach has something to offer and indeed has some unique characteristics that may have the potential to contribute to the enhancement of nursing home residents' quality of life and at the same time further PA-related research with vulnerable populations at large.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN96090441. Registered 31 July 2014.
authors.affiliation: Institute of Psychology, Department of Psychological Aging Research, Heidelberg University, Bergheimer Str, 20, 69115 Heidelberg, Germany. carl-philipp.jansen@bethanien-heidelberg.de.
authors.forename: Carl-Philipp
authors.initials: CP
authors.lastname: Jansen
authors.forename: Katrin
authors.initials: K
authors.lastname: Claßen
authors.forename: Klaus
authors.initials: K
authors.lastname: Hauer
authors.forename: Mona
authors.initials: M
authors.lastname: Diegelmann
authors.forename: Hans-Werner
authors.initials: HW
authors.lastname: Wahl
mesh_terms: D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D003863:Depression / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D009735:Nursing Homes; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D011795:Surveys and Questionnaires