1. Barriers and Facilitators to Maintaining Physical Activity in a Church-Based Exercise Program
Dr. Angela Wooton

2. Objectives
By the conclusion of this presentation learners will have an increased awareness of:
Importance of physical activity
Barriers and facilitators to physical activity
Implications for healthcare providers

3. Acknowledgement
The author wishes to acknowledge there was no conflict of interest or outside funding sources for this project

4. Ethnographic Research
“An attempt to attain as holistic a picture as possible of a particular society, group, institution, or situation. The emphasis in ethnographic research is on documenting or portraying the everyday experiences of individuals by observing and interviewing them and relevant others.”
(Frankel & Wallen, 2006)

5. What is Incorporated into the Ethnographic Process…Three Step Process
Provides a detailed description of culture-sharing group being studied
An analysis of the group in terms of perceived themes or perspectives
Interpretation of the group by the researcher as to the meanings or generalizations about the social life of human beings in general

6. Advantages Richer comprehensive prospective
Lends itself well to research topics that are not easily quantifiable
Particularly appropriate to behaviors that are best understood by observation within their natural settings
Especially suited to studying group behavior over time

7. “70 is the new 50” ETHNOGRAPHIC DATA COLLECTION
1. Participant Observation
a. Field Notes
b. Field Jottings
c. Reflective Field Notes
2. Interviewing
a. Structured
b. Semi structured
c. Informal
d. Retrospective

8. Defining Physical Activity
Physical activity is defined as any bodily movement produced by skeletal muscles that requires energy expenditure (WHO, 2015).

9. Background/Significance of the Problem
Physical inactivity has been identified as the fourth leading risk factor for global mortality causing an estimated 3.2 million deaths globally
The global cost of physical inactivity puts the tab at $67.5 billion per year
The costliest disease was type 2 diabetes, which was determined to be $37.6 billion annually in direct costs due to physical inactivity and obesity
World Health Organization, 2014

10. Inactivity Globally, 1 in 4 adults are inactive
Physical inactivity is estimated as being the principal cause for approximately 21–25% of breast and colon cancer burden, 27% of diabetes and approximately 30% of ischemic heart disease burden
Insufficient physical activity is a key risk factor for cardiovascular diseases, cancer and diabetes
WHO Board of Directors have agreed to reduce insufficient physical activity by 10% by 2025

11. Physical Inactivity Insufficient physical activity is one of the leading risk factors for death worldwide

12. Inactivity Inactivity was higher for women compared with men
The percentage of inactivity by race and ethnicity varied
Inactivity significantly increased with age
By region, inactivity was highest in the South followed by the Midwest

13. Goal
Improve health, fitness, and quality of life through daily physical activity
Objectives
PA-1: Reduce the proportion of adults who engage in no leisure-time physical activity
PA-2.1 Increase the proportion of adults who engage in aerobic physical activity of at least moderate intensity for at least 150 minutes/week, or 75 minutes/week of vigorous intensity, or an equivalent combination

14. Obesity
According to the most recent data from Robert Woods Johnson Foundation (2016), adult obesity rates now exceed 35 percent in four states, 30 percent in 25 states and are above 20 percent in all states
Louisiana has the highest adult obesity rate at 36.2 percent and Colorado has the lowest at 20.2 percent (Purple >35%)

15. Challenges Meet the demands of an aging population
The U.S. Public Health Service estimates that 66 percent (2/3) of deaths related to inactivity are preventable
Strategies to keep the population physically active

16. Overview of Health and Wellness in the Aging Adult
Demographics
During the past two decades, the older adult population has grown twice as fast as the rest of the population
Projections are by 2030, over 21% of the population will be 65 years of age or older

17. Research Question
What are the barriers and facilitators to maintaining physical activity in a church-based exercise program for adults 65 years of age and older?
Miss Betty

18. Setting

19. Research Method Ethnography: Qualitative Design Data collection:
Demographic tool, participant observation, reflective journal, and both focused and semi-structured interviews
Thematic Analysis

20. Insufficiently Active
Demographic Data
N = 20 Older Adults
Regularly Active
(n=9)
Insufficiently Active
(n=11)
Age (Mean)
68.3 years of age
Range: 63-82
Education
High School 05 02 03
Some College 08
College or More 07
Marital Status
Married 15 12
Widowed 01 04
Income
20,000-29,000 17
30,

21. Insufficiently Active
Demographic Data Cont.
N = 20
Total
Regularly Active
(n = 9)
Insufficiently Active
(n=11)
Self-reported health
Very Good 02
Good 10 08
Poor 06
Chronic Disease (#) 04 03 01
1-2 11 05
3 or >
Medication (#) 09

22. Thematic Analysis Facilitators to Physical Activity Church Fellowship
Group Support
Health
Stable Environment
Good Weather
Facilitators to
Physical Activity
Facilitators

23. Individual Factors Personal benefits of PA on their own health
Mental Health
Relief of chronic pain
Reduces stress
Feel more energetic
Desire to live a long and healthy lives
Social opportunity
Didn’t want to miss class and disappoint group members

24. Barriers to Physical Activity

25. Individual Barriers Illness Injury Lack of energy
Difficulty of staying motivated to exercise and not making exercise a priority
Time constraints
Competing priorities
Environmental: weather, mosquitoes, and busy streets without sidewalks

26. Implications for Healthcare Providers
Exercise programs may not be successful unless coupled with facilitators to promote maintenance of regular physical activity
Group Participants can serve as experts to assist in development of strategies which eliminate barriers to maintenance of regular participation in physical activity

27. Dr. Angela Wooton Assistant Professor of Nursing Graduate Nursing Department University of Southern Indiana (812)