Adherence Is More Than Just Being Present: Example of a Lay-Led Home-Based Programme with Physical Exercise, Nutritional Improvement and Social Support, in Prefrail and Frail Community-Dwelling Older Adults

Christian Lackinger, Igor Grabovac, Sandra Haider, Ali Kapan, Eva Winzer, K. Viktoria Stein and Thomas E. Dorner
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Christian Lackinger: Karl-Landsteiner Institute for Health Promotion Research, 3454 Sitzenberg-Reidling, Austria
Igor Grabovac: Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1080 Vienna, Austria
Sandra Haider: Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1080 Vienna, Austria
Ali Kapan: Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1080 Vienna, Austria
Eva Winzer: Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1080 Vienna, Austria
K. Viktoria Stein: Karl-Landsteiner Institute for Health Promotion Research, 3454 Sitzenberg-Reidling, Austria
Thomas E. Dorner: Karl-Landsteiner Institute for Health Promotion Research, 3454 Sitzenberg-Reidling, Austria

IJERPH, 2021, vol. 18, issue 8, 1-13

Abstract: Background: Little is known about the implementation of lifestyle interventions in frail, community-dwelling people. This study highlights different domains of adherence to explain an effectively delivered home-based intervention. Methods: Eighty prefrail and frail persons (?65 years) participated in a physical training, nutritional, and social support intervention over 24 weeks. A detailed log book was kept for comprehensive documentation in order to assess adherence and further organizational, exercise, and nutritional parameters. Results: Participants reached an adherence rate (performed home visits/number of planned visits) of 84.0/80.5% from week 1–12/13–24. Out of those, 59% carried out ?75% of the offered visits. Older age was associated with a higher adherence rate. A mean of 1.5 (0.6) visits/week (2 were planned) were realized lasting for a mean of 1.5 (0.9) hours (154% of the planned duration). Per visit, 1.2 (0.6) circuits of strength training were performed (60.5% of the planned value) and 0.5 (0.3) nutritional interventions (47%). After twelve months, 4.2% still carried out the home visits regularly and 25.0% occasionally. Conclusion: Adherence is much more than “being there”. Adherence rate and category are limited parameters to describe the implementation of a complex lifestyle intervention, therefore a comprehensive documentation is needed.

Keywords: complex intervention study; adherence; lay-led intervention; community-dwelling people; frailty; buddy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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