Challenges in pilot study | Proposed changes to study protocol |
---|---|
Conceptual framework | |
A conceptual framework was developed based on the literature. Participants made numerous enlightening comments regarding barriers to walking outdoors and personal changes they noted during the study in qualitative interviews. | The conceptual framework was enhanced based on qualitative findings |
Recruitment | |
During qualitative interviews, participants suggested additional recruitment strategies. | Public service announcements and advertisements on “oldies” radio stations will be a part of the recruitment approach. |
Screening | |
PAR-Q+ was used as a screen for physical activity readiness | The Get Active Questionnaire will be used, as the PAR-Q+ has since been replaced by the Get Active Questionnaire |
Randomization | |
A couple wanted to be in the same group. | Because participation as a couple may be a facilitator of outdoor walking activity (primary outcome), participants will be stratified as singlets or dyads prior to randomization |
Had planned to stratify participants by gait speed (< 0.8 m/s vs ≥ 0.8 m/s); however, no participants walked slower than 0.8 m/s. | Will not stratify by gait speed. |
Data collection, outcomes and analysis | |
One participant did not meet minimum wear time for activity monitor and GPS. | Participants will be reminded verbally when receiving the activity monitor and in writing on an activity log that they need to wear the monitor morning to night and for a minimum of 10 h per day. IF they do not achieve a min 4 days of wear time, they will be asked to wear the monitor on additional days. |
Participants had very low activity by activity monitors. | Analysis of activity monitor and GPS data will define bouts as “Lifestyle 5 min” and will also present daily sporadic minutes of Lifestyle MVPA. |
Analysis of cadence will also be used to better describe continuous purposeful walking | |
Time intensive to match GPS and activity bouts. Some bouts difficult to determine if indoors or outdoors. | Introduce an outdoor walking time log, to assist with identification and analysis of outdoor activity. |
Did not objectively quantify extent and intensity of walking activity during the outdoor walking sessions (process indicator). | GO-OUT participants will be asked to wear the activity monitor/GPS during two outdoor walking group sessions to evaluate extent and intensity of walking activity and compare across sites. |
Scores on the Berg Balance Scale and Geriatric Depression Scale were similar across study evaluations. | The Berg Balance Scale and Geriatric Depression Scale will not be used. The Berg Balance Scale will be replaced with the Mini-BESTest [73], which may be more sensitive to change resulting from the GO-OUT intervention. The Emotional Well Being subscale of the RAND-36 will substitute for the GDS as a measure of emotional health. |
Intervention | |
One participant suggested that for a future study, regular phone follow-up asking how much they were walking would be beneficial for the workshop group. | The workshop group will have weekly phone reminders to re-iterate information learned in the workshop and to encourage outdoor walking. |
Duration of GO-OUT intervention was 9 weeks due to the start time of project. | GO-OUT program will be 12 weeks. |
For personal safety, GO-OUT participants did not like one park with isolated parking and forested walking trails with few other walkers. | Ensure that parks used for GO-OUT do not have isolated parking areas and have numerous walkers in the area. |