title: Adherence to community based group exercise interventions for older people: A mixed-methods systematic review.
abstract: Lifelong physical activity provides some of the best prospects for ageing well. Nevertheless, people tend to become less physically active as they age. This systematic review assessed the views and adherence of participants attending community based exercise programmes of ≥6month's duration.
  
  
  
  Searches were carried out in eight online scientific databases (January 1995-May 2014) to identify relevant primary studies. Studies were assessed for quality and data extracted. Results were synthesised thematically and narratively. Qualitative findings were compared against quantitative studies.
  
  
  
  A total of 2958 studies were identified and screened against the inclusion/exclusion criteria. Ten studies met the inclusion criteria (five quantitative, three qualitative and two mixed-methods study designs). None were excluded on the basis of quality. Six key themes were identified from the qualitative studies as important for adherence to group exercise programmes: social connectedness, participant perceived benefits, programme design, empowering/energising effects, instructor and individual behaviour. The mean adherence rate of studies with comparable measures was (69.1% SD 14.6). When the views of participants from the qualitative synthesis were juxtaposed against the quantitative studies, programme design was a common feature across all studies.
  
  
  
  Evidence surrounding these programmes is limited both in terms of long-term adherence measures and the views of participants. However, based on limited findings there is some indication that community based group exercise programmes have long-term adherence rates of almost 70%. Incorporating the views of older people into programme designs may provide guidance for innovative interventions leading to sustained adherence.
authors.affiliation: Royal London House, R313, Faculty of Health and Social Sciences, Bournemouth University, Christchurch Road, Bournemouth BH1 3LT, United Kingdom. Electronic address: cfarrance@bournemouth.ac.uk.
authors.forename: Clare
authors.initials: C
authors.lastname: Farrance
authors.affiliation: Royal London House, R312, Faculty of Health and Social Sciences, Bournemouth University, Christchurch Road, Bournemouth BH1 3LT, United Kingdom. Electronic address: ftsofliou@bournemouth.ac.uk.
authors.forename: Fotini
authors.initials: F
authors.lastname: Tsofliou
authors.affiliation: Royal London House, R601, Faculty of Health and Social Sciences, Bournemouth University, Christchurch Road, Bournemouth BH1 3LT, United Kingdom. Electronic address: cclark@bournemouth.ac.uk.
authors.forename: Carol
authors.initials: C
authors.lastname: Clark
mesh_terms: D000375:Aging; D003153:Community Health Services / Q000379:methods*; D005081:Exercise Therapy / Q000523:psychology*; D006293:Health Promotion / Q000379:methods; D006801:Humans; D007398:Interpersonal Relations; D010349:Patient Compliance / Q000523:psychology*; D036301:Qualitative Research
keywords: Adherence; Community based exercise programme; Mixed-methods; Older people; Physical activity; Review