Engaging diverse midlife and older adults in a multilevel participatory physical activity intervention: evaluating impacts using Ripple Effects Mapping

Author:

Rodriguez Espinosa Patricia123ORCID,King Abby C134ORCID,Blanco-Velazquez Isela13,Banchoff Ann W13,Campero Maria Ines13,Chen Wei-ting2,Rosas Lisa G123

Affiliation:

1. Department of Epidemiology and Population Health, Stanford University School of Medicine , USA

2. Office of Community Engagement, Stanford School of Medicine , USA

3. Our Voice Global Citizen Science Research Initiative , USA

4. Department of Medicine (Stanford Prevention Research Center Division), Stanford University School of Medicine , USA

Abstract

Abstract Multilevel interventions are increasingly recommended to increase physical activity (PA) but can present evaluation challenges. Participatory qualitative evaluation methods can complement standard quantitative methods by identifying participant-centered outcomes and potential mechanisms of individual and community-level change. We assessed the feasibility and utility of Ripple Effects Mapping (REM), a novel qualitative method, within the context of a multi-level cluster randomized trial, Steps for Change. Housing sites with ethnically diverse, low-income aging adults were randomized to a PA behavioral intervention alone or in combination with a citizen science-based intervention (Our Voice) for promoting PA-supportive neighborhoods. Four REM sessions were conducted after 12 months of intervention and involved six housing sites (n = 35 participants) stratified by intervention arm. Interviews (n = 5) were also conducted with housing site staff. Sessions leaders engaged participants in visually mapping intended and unintended outcomes of intervention participation and participant-driven solutions to reported challenges. Maps were analyzed using Excel and Xmind 8 Pro and data were classified according to the socio-ecological model. Eight themes were identified for outcomes, challenges, and solutions. Most themes (6/8) were similar across intervention arms, including increasing PA and PA tracking, improving health outcomes, and increasing social connectedness. Groups (n = 2) engaged in Our Voice additionally identified increased community knowledge and activities directly impacting local environmental change (e.g., pedestrian infrastructure changes). Housing staff interviews revealed additional information to enhance future intervention recruitment, sustainability, and implementation. Such qualitative methodologies can aid in evaluating multi-level, multi-component interventions and inform future intervention optimization, implementation, and dissemination.

Funder

National Cancer Institute

National Institutes of Health

National Center for Advancing Translational Sciences

Publisher

Oxford University Press (OUP)

Subject

Behavioral Neuroscience,Applied Psychology

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