Improving the Promotion of Older Adults' Physical Activity in Institutional Long-Term Care: Participatory Action Research.

Older adults' physical activity engagement in institutional long-term care is insufficient, despite the importance of physical activity for their health, functioning, and wellbeing. The purpose of this study was to improve the promotion of the physical activity of older adults in institutional long-term care by co-developing, implementing, and evaluating changes to care practices and the care environment in collaboration with staff members, older adults, and their family members. A participatory action research study was conducted in one unit with 18 staff members, 17 older adults, and 6 family members. Qualitative data were collected throughout the research process using interviews, focus groups, observations, workshops, and meetings, and analyzed with thematic analysis. Quantitative data collection was used to measure changes in older adult and staff outcomes before and after implementation of changes in activity promotion, and analyzed with statistical methods. Qualitative and quantitative findings were integrated in the results section. Three themes were developed, including (i) there is a need for a paradigm shift to improve physical activity promotion, (ii) change requires collaboration and time, and (iii) produced change can be beneficial in many ways and for different actors. Opportunities exist that are not currently used to promote older adults' physical activity. Implementing physical activity in different parts of daily life and employing the environment could facilitate the sustainability of physical activity promotion. The role of nursing professionals is important in the implementation. Engaging staff members in co-development facilitates context-fitting change and care culture change, producing benefits also for themselves.