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      What Moves People Living With Dementia? Exploring Barriers and Motivators for Physical Activity Perceived by People Living With Dementia in Care Homes

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          Abstract

          There is a lack of intervention promoting physical activity targeted toward people living with dementia because their input has not been prioritized in the development of exercise programs. The aim of this study is to investigate motivators and barriers concerning physical activity in people living with dementia in care homes and to give recommendations for intervention development. Qualitative semi-structured interviews were conducted; transcripts were analyzed using qualitative content analysis. Following a tailored procedural model, inductive and deductive category development was applied. The value of Cohen’s κ = .94 indicates the high intercoder reliability of the category system developed. Ten interviewees reported 24 different barriers and 12 motivators concerning physical activity in the context of the social-ecological model. The strong impact of intrapersonal factors and the living environment became apparent. Points of reference for how people living with dementia can overcome barriers and activate their motivators to achieve more physical activity are provided.

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          The qualitative content analysis process.

          This paper is a description of inductive and deductive content analysis. Content analysis is a method that may be used with either qualitative or quantitative data and in an inductive or deductive way. Qualitative content analysis is commonly used in nursing studies but little has been published on the analysis process and many research books generally only provide a short description of this method. When using content analysis, the aim was to build a model to describe the phenomenon in a conceptual form. Both inductive and deductive analysis processes are represented as three main phases: preparation, organizing and reporting. The preparation phase is similar in both approaches. The concepts are derived from the data in inductive content analysis. Deductive content analysis is used when the structure of analysis is operationalized on the basis of previous knowledge. Inductive content analysis is used in cases where there are no previous studies dealing with the phenomenon or when it is fragmented. A deductive approach is useful if the general aim was to test a previous theory in a different situation or to compare categories at different time periods.
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            An Ecological Perspective on Health Promotion Programs

            During the past 20 years there has been a dramatic increase in societal interest in preventing disability and death in the United States by changing individual behaviors linked to the risk of contracting chronic diseases. This renewed interest in health promotion and disease prevention has not been without its critics. Some critics have accused proponents of life-style interventions of promoting a victim-blaming ideology by neglecting the importance of social influences on health and disease. This article proposes an ecological model for health promotion which focuses attention on both individual and social environmental factors as targets for health promotion interventions. It addresses the importance of interventions directed at changing interpersonal, organizational, community, and public policy, factors which support and maintain unhealthy behaviors. The model assumes that appropriate changes in the social environment will produce changes in individuals, and that the support of individuals in the population is essential for implementing environmental changes.
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              The Equivalence of Weighted Kappa and the Intraclass Correlation Coefficient as Measures of Reliability

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                Author and article information

                Journal
                Qual Health Res
                Qual Health Res
                QHR
                spqhr
                Qualitative Health Research
                SAGE Publications (Sage CA: Los Angeles, CA )
                1049-7323
                1552-7557
                7 April 2021
                June 2021
                : 31
                : 7
                : 1319-1334
                Affiliations
                [1 ]Technical University of Munich, Munich, Germany
                [2 ]Carinthia University of Applied Sciences, Feldkirchen, Austria
                Author notes
                [*]Doris Gebhard, Department of Sport and Health Sciences, Technical University of Munich, Georg-Brauchle-Ring 62, Munich 80992, Germany. Email: doris.gebhard@ 123456tum.de
                Author information
                https://orcid.org/0000-0002-2984-3007
                Article
                10.1177_10497323211002822
                10.1177/10497323211002822
                8182331
                33825572
                9d7c6636-a9d6-491d-9c64-72b341babcea
                © The Author(s) 2021

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Funding
                Funded by: Fonds Gesundes Österreich, FundRef https://doi.org/10.13039/501100006145;
                Award ID: grant number 2622
                Categories
                Research Articles
                Custom metadata
                ts1

                Medicine
                dementia,physical activity,long-term care,successful aging,socio-ecological model,qualitative content analysis,qualitative interview,austria

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