title: A novel method to promote physical activity among older adults in residential care: an exploratory field study on implicit social norms.
abstract: Physical activity (PA) levels of older adults living in a care setting are known to be very low. This is a significant health(care) problem, as regular PA has many health benefits also at advanced age. Research on automatic processes underlying PA behaviour in physically inactive older adults is yet non-existing. Since people are unconsciously influenced by people around them (i.e. by 'social norms') automatic processes could be used to promote PA. We developed an explorative intervention method to assess the effects of automatically processed (implicit) descriptive social norms ('What most people do') on behavioral intention and participation in PA offered in a local residential care setting.
  
  
  
  Forty-seven care clients met the inclusion criteria. Participants (response 45%; unaware of the intention of the research) were randomly assigned to an experimental (N = 10) or a control group (N = 11). The experimental group was exposed to photos and text heading on active peers (physically active implicit descriptive norm) using a draft newsletter article they were asked to comment on, whereas the control group was exposed to a newsletter with photos and text heading of inactive peers (physically inactive implicit descriptive norm). Subsequently, we tested (Fishers exact p < 0.10) whether this unaware exposure predicted intention (implicit and explicit) to participate in PA offered and organized by the care center (e.g. walking, gymnastics) and self-reported participation in organised PA at three months follow-up. Participants were debriefed later.
  
  
  
  Mean age was 87 years (SD = 3.6; range 80-95) and 53% of the participants were male. At baseline, there were no significant differences in self-rated health and PA between the experimental and control group. Results indicated that implicit descriptive norm information was associated with implicit PA intention (p = .056, Fisher's exact test). No significant effects were found on explicit intention. At 3 months follow-up the experimental group self-reported 80% participation in PA versus 22% in the control group (Fisher's exact test p = 0.027).
  
  
  
  Implicit descriptive social norm information could indeed be a potentially effective way to encourage inactive older adults in residential care to engage in organized PA.
authors.affiliation: Body@Work, Research Center for Physical Activity, Work and Health, TNO-VU University Medical Center, Amsterdam, The Netherlands.|Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.|TNO Netherlands organisation for applied scientific research, TNO PO Box 3005, 2301 DA, Leiden, The Netherlands.
authors.forename: Margot A
authors.initials: MA
authors.lastname: Koeneman
authors.affiliation: TNO Netherlands organisation for applied scientific research, TNO PO Box 3005, 2301 DA, Leiden, The Netherlands.
authors.forename: Astrid
authors.initials: A
authors.lastname: Chorus
authors.affiliation: Body@Work, Research Center for Physical Activity, Work and Health, TNO-VU University Medical Center, Amsterdam, The Netherlands. marijke.hopman@tno.nl.|Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands. marijke.hopman@tno.nl.|TNO Netherlands organisation for applied scientific research, TNO PO Box 3005, 2301 DA, Leiden, The Netherlands. marijke.hopman@tno.nl.
authors.forename: Marijke
authors.identifier: 0000-0001-6373-4560
authors.initials: M
authors.lastname: Hopman-Rock
authors.affiliation: Body@Work, Research Center for Physical Activity, Work and Health, TNO-VU University Medical Center, Amsterdam, The Netherlands.|Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
authors.forename: Mai J M
authors.initials: MJ
authors.lastname: Chinapaw
mesh_terms: D000369:Aged, 80 and over; D001294:Attitude to Health; D015444:Exercise / Q000523:psychology*; D005260:Female; D006293:Health Promotion / Q000379:methods / Q000458:organization & administration; D006801:Humans; D008297:Male; D009043:Motor Activity; D010358:Patient Participation; D012925:Social Conformity; D012932:Social Facilitation; D066262:Social Norms; D016138:Walking / Q000523:psychology
keywords: Aging; Automaticity; Dependency; Disability; Prevention