title: What factors support older people to increase their physical activity levels? An exploratory analysis of the experiences of PACE-Lift trial participants.
abstract: Physical Activity (PA) has significant health benefits for older adults, but nearly all UK over 60's are not achieving recommended levels. The PACE-Lift primary care-based walking intervention for 60-75 year-olds used a structured, theoretically grounded intervention with pedometers, accelerometers, handbooks and support from practice nurses trained in behaviour change techniques. It demonstrated an objective increase in walking at 3 and 12 months. We investigated the experiences of intervention participants who did (and did not) increase their walking, in order to explore facilitators to increased walking.
  
  
  
  Semi-structured telephone interviews used an interview schedule with a purposive sample of 30 intervention participants, 19 who had objectively increased their walking over the previous year and 11 who had not. Interviews were audio-recorded, transcribed and coded independently by researchers to generate a thematic coding framework.
  
  
  
  Both groups confirmed that walking was an appropriate PA for people of 'their age'. The majority of those with increased walking participated in the trial as a couple, were positive about individualised goal-setting, developed strategies for maintaining their walking, and had someone to walk with. Non-improvers reported their attempts to increase walking were difficult because of lack of social support and were less positive about the intervention's behaviour change components.
  
  
  
  Walking is an acceptable and appropriate PA intervention for older people. The intervention's goal-setting components were important for those who increased their walking. Mutual support between partners participating as a couple and having someone to walk with also facilitated increased walking.
authors.affiliation: Department of Clinical Sciences, College of Health and Life Sciences, Brunel University London, Middlesex, UB8 3PH, UK. Electronic address: christina.victor@brunel.ac.uk.
authors.forename: Christina R
authors.initials: CR
authors.lastname: Victor
authors.affiliation: Population Health Research Institute, St George's University of London, SW17 ORE, UK. Electronic address: rogersac@hotmail.com.
authors.forename: Annabelle
authors.initials: A
authors.lastname: Rogers
authors.affiliation: Independent Psychology Research Consultant, Southampton, UK. Electronic address: alison.woodcock@chalto.co.uk.
authors.forename: Alison
authors.initials: A
authors.lastname: Woodcock
authors.affiliation: Faculty of Health, Social Care & Education, Kingston & St George's, University of London, SW17 ORE, UK. Electronic address: C.Beighton@sgul.kingston.ac.uk.
authors.forename: Carole
authors.initials: C
authors.lastname: Beighton
authors.affiliation: Population Health Research Institute, St George's University of London, SW17 ORE, UK. Electronic address: sgjd250@sgul.ac.uk.
authors.forename: Derek G
authors.initials: DG
authors.lastname: Cook
authors.affiliation: Pragmatic Clinical Trials Unit, Queen Mary's University of London, E1 2AT, UK. Electronic address: s.m.kerry@qmul.ac.uk.
authors.forename: Sally M
authors.initials: SM
authors.lastname: Kerry
authors.affiliation: Research Department of Primary Care & Population Health, University College, London NW3 2PF, UK. Electronic address: s.iliffe@ucl.ac.uk.
authors.forename: Steve
authors.initials: S
authors.lastname: Iliffe
authors.affiliation: Population Health Research Institute, St George's University of London, SW17 ORE, UK. Electronic address: pwhincup@sgul.ac.uk.
authors.forename: Peter
authors.initials: P
authors.lastname: Whincup
authors.affiliation: Population Health Research Institute, St George's University of London, SW17 ORE, UK. Electronic address: mussher@sgul.ac.uk.
authors.forename: Michael
authors.initials: M
authors.lastname: Ussher
authors.affiliation: Population Health Research Institute, St George's University of London, SW17 ORE, UK. Electronic address: christina.victor@brunel.ac.uk.
authors.forename: Tess J
authors.initials: TJ
authors.lastname: Harris
mesh_terms: D056044:Actigraphy; D000368:Aged; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000071069:Multiple Chronic Conditions; D009726:Nurses; D057184:Practice Patterns, Nurses'; D011320:Primary Health Care; D016032:Randomized Controlled Trials as Topic; D012944:Social Support; D018454:Spouses; D016138:Walking
keywords: Behaviour change; Couples; Older people; Physical activity; Walking intervention