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"Phoenix, Cassandra"
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Physical activity interventions for older adults – an overview of systematic reviews
2026
Background
The proportion of people meeting recommended physical activity (PA) guidelines declines with age. Older adults who are physically inactive have an increased risk of: all-cause mortality; chronic diseases; injury and reduced cognitive functioning. Multiple systematic reviews aim to understand the effectiveness of PA interventions but the evidence is fragmented and it is unclear how well the research reflects the needs of older people. We conducted an overview of existing systematic reviews (PROSPERO reference: CRD42015023796) to map evidence on interventions to encourage older people to be more active.
Methods
Nine electronic databases were searched, most recently in October 2023. Older people were defined as those aged 50+, with physical activity including active daily living (walking the dog, gardening, etc.), organised activities and clubs and more formal exercise or sport. Screening of records, data extraction, and assessments of quality (using AMSTAR-2) and inequality (using Progress-Plus) were completed independently by two reviewers.
Results
A total of 35 reviews (reported in 36 papers) published between 2002 and 2023 were included. Reviews included between 3 and 79 studies (total 480 unique studies) with a median of 162 and 184 participants per study in meta-analyses (overall AMSTAR-2 median quality low) and narrative syntheses (median quality critically low) respectively. Eighteen included a mixture of interventions (e.g. supporting lifestyle change, walking groups, exercise classes), nine focussed on remote delivery, six on wearable devices, five on 1-to-1 interventions, two on walking, and two focussed on group-based interventions. Interventions to increase physical activity in older people were shown to be effective in the short term (< 12 months). The use of wearable devices as interventions had a small-to-medium effect on increasing physical activity and daily steps. Remote delivery approaches, including the use of text messaging, web- or mobile-technology, and social media, were effective in increasing PA.
Conclusions
A range of interventions are effective in increasing PA in older adults. Newer research highlights the usefulness of technology - including wearable devices, social media, text messaging - as useful tools. Improved effectiveness seems to relate to theory-based interventions, but without further research, caution should be taken when interpreting the effectiveness of individual behaviour change techniques. Identifying and resolving wider barriers and facilitators, social and environmental interactions influencing PA may improve future interventions. Better reporting of equity by future studies will improve understanding of who benefits from such interventions. Increased knowledge of potential wider social, economic and environmental determinants of physical activity in older adults, and specifically more vulnerable and minority populations, will help policy makers and practitioners develop more effective interventions.
Journal Article
Relationships between Recreation and Pollution When Striving for Wellbeing in Blue Spaces
2022
Our aim for this research was to identify and examine how recreation enthusiasts cope with and mitigate the violence of pollution as they strive for wellbeing in polluted “blue spaces” (e.g., seas, oceans). Our methodology to undertake the research was ethnography (online and offline), including autoethnography and informal interviews (40). The study proceeded from a constructivist epistemology which emphasizes that knowledge is situated and perspectival. The study site was a post-industrial area of northeast England where a long-standing but also rapidly growing surfing culture has to live with pollution (legacy and ongoing). We found evidence of what have become quotidian tactics that attach to themes of familiarity, embodiment, resignation, denial, and affect/emotion used by enthusiasts to cope with and mitigate the violence of pollution. We argue that by necessity some surfers are persisting in striving for wellbeing not simply in spite of pollution but rather with pollution. We assert surfers enact a “resigned activism” that influences their persistence. We extend critical scholarship concerning relationships between recreation, blue spaces, and wellbeing by moving beyond a restrictive binary of focusing on either threats and risks or opportunities and benefits of blue space to health and wellbeing, instead showing how striving for wellbeing through recreation in the presence of pollution provides evidence of how such efforts are more negotiated, fluid, situated, uncertain, dissonant, and even political than any such binary structure allows for.
Journal Article
OP14 Community gardening ‘prescriptions’: an ethnographic exploration of getting well and keeping well in nature
by
Phoenix, Cassandra
,
Pollard, Tessa
,
McGuire, Laura
in
Ethnography
,
Gardens & gardening
,
Green infrastructure
2023
BackgroundCommunity gardening has frequently been promoted as an activity that can improve wellbeing, and there have been recent efforts to include it within social prescribing offerings. These activities seem to align with a number of health imperatives: to increase time spent in green space, to be ‘person-centred’, and to reduce isolation and loneliness. They also appeal to broader desires to widen connection with the outdoors, wildlife, and community. The aim of this research was to understand the experiences of the users of these spaces, and to consider the place of social prescribing in the facilitation of these activities.MethodsThis paper is informed by 13 months of ethnographic research at community gardening and growing spaces. The spaces were located in the north of England, with gardening sessions facilitated by small VCSE organisations. One of the regularly attended sessions was tailored directly towards those experiencing mental ill health. The research involved participant observation and interviewing, with a purposive sample (n = 33, aged 23–70) of garden attendees, Voluntary, Community and Social Enterprise (VCSE) sector practitioners, and practitioners associated with social prescribing pathways. Interviews were audio-recorded and transcribed, and fieldnotes were taken following each gardening session attended (approximately 3 per week). Data were imported into NVivo 12, and analysed using thematic analysis.ResultsCommunity gardening became a part of the routines of attendees, for whom it provided opportunities to learn, socialise, be active, and give and receive support from practitioners and empathic others. For participants, the gardens were safe, flexible, and non-judgemental socio-ecological spaces. They valued the enduring therapeutic communities and garden spaces that developed over time at some of the sites, with support from skilled VCSE practitioners.ConclusionsThis research suggests that community gardening can provide structure, enjoyment, activity, and connection for some of those who regularly participate. The question of how these spaces and communities can be sustained speaks to calls to consider both the long-term funding of socially-prescribed activities, and to recognise the labour of VCSE practitioners in delivering, funding, and planning them.
Journal Article
Negotiating nature's weather worlds in the context of life with sight impairment
2019
We have seen longstanding research interest in diverse nature-society relations, including contentious debates regarding what nature is, the role of humans within or apart from it, and how varied types of non-human nature shape different societies and individuals within society. Within this work, relatively little attention has been paid to an important aspect of nature experienced everyday: people's \"weatherworlds.\" These encompass the qualities of sensory experience that are shaped by fluxes in the medium - the air - in which we routinely live and breathe. Such currents, forces and pressure gradients underwrite our capacities to act and interact with both the animate and inanimate materials and beings we encounter as we negotiate our everyday lives. We focus on these weather worlds here, drawing on the findings of an in-depth qualitative study exploring how people with varying forms and severities of sight impairment describe their nature experiences, with the weather emerging as an immediate and often highly visceral form of everyday nature encounter among all participants. We reflect on the ephemeral qualities of people's weatherworlds, highlighting their potential to comfort, invigorate and connect, but also to disorientate, threaten and isolate, at times supporting moments of well-being or exacerbating experiences of impairment and disability. In doing so, we highlight how attending to the weather is essential if we are to fully understand people's emplaced experiences of well-being, impairment and disability with(in) diverse forms of multi-elemental, assembled nature.
Journal Article
Narratives at work: what can stories of older athletes do?
2013
Previous research has shown that young adults tend to identify and reinforce negative stereotypes of growing older. They can express both fear and trepidation regarding the bodily changes that occur with advancing age. With this in mind, in this paper we draw upon Frank's (2010) theoretical framework of socio-narratology to examine the work that stories can do. We take as a working example the impact that stories of ageing told by masters athletes might have upon young adults, and specifically their perceptions of (self-)ageing. Three focus groups were carried out with the young adults to examine their perceptions of (self-)ageing prior to and following their viewing of a digital story portraying images and narratives of mature, natural (‘drug-free’) bodybuilders. Our analysis pointed to a number specific capacities that stories of masters athletes might have, namely the potential to re-open young adults sense of narrative foreclosure, the stretching and expanding of existing imagined storylines, and increasing the availability of narrative options. We propose that understanding what stories can do, what they can do best, and the narrative environments that help and hinder this process is essential if our programmes and policies are to produce the results that are wanted.
Journal Article
Using Geonarratives to Explore the Diverse Temporalities of Therapeutic Landscapes: Perspectives from \Green\ and \Blue\ Settings
by
Phoenix, Cassandra
,
Bell, Sarah L.
,
Wheeler, Benedict W.
in
agencia individual
,
blue space
,
espacio azul
2017
A growing evidence base highlights \"green\" and \"blue\" spaces as examples of \"therapeutic landscapes\" incorporated into people's lives to maintain a sense of well-being. A commonly overlooked dimension within this corpus of work concerns the dynamic nature of people's therapeutic place assemblages over time. This article provides these novel temporal perspectives, drawing on the findings of an innovative three-stage interpretive geonarrative study conducted in southwest England from May to November 2013, designed to explore the complex spatial-temporal ordering of people's lives. Activity maps produced using accelerometer and Global Positioning system (GPS) data were used to guide in-depth geonarrative interviews with thirty-three participants, followed by a subset of go-along interviews in therapeutic places deemed important by participants. Concepts of fleeting time, restorative time, and biographical time are used, alongside notions of individual agency, to examine participants' green and blue space experiences in the context of the temporal structures characterizing their everyday lives and the biographical experiences contributing to the perceived importance of such settings over time. In a culture that by and large prioritizes speed, dominated by social ideals of, for example, the productive worker and the good parent, participants conveyed a desire to shift from fleeting time to restorative time, seeking a balance between embodied stillness and therapeutic mobility. This was deemed particularly important during more stressful life transitions, such as parenthood, employment shifts, and the onset of illness or impairment, when participants worked hard to tailor their therapeutic geographies to shifting well-being needs and priorities.
Journal Article
Using GPS and geo-narratives: a methodological approach for understanding and situating everyday green space encounters
by
Phoenix, Cassandra
,
Lovell, Rebecca
,
Bell, Sarah L
in
Everyday life
,
geo-narratives
,
Geography
2015
This methods paper contributes to the recent proliferation of methodological innovation aimed at nurturing research encounters and exchanges that facilitate in-depth insights into people's everyday practices and routine place encounters. By drawing on the experiences of an interpretive study seeking to situate people's green space wellbeing practices within their daily lives, we suggest value in using personalised maps – produced using participant accelerometer (physical activity) and Global Positioning System (GPS) data – alongside in-depth and mobile 'go-along' qualitative interview approaches. After introducing the study and the methods adopted, the paper discusses three opportunities offered by this mixed method approach to contribute a more nuanced, contextualised understanding of participants' green space experiences. These include: (a) the benefits of engaging participants in the interpretation of their own practices; (b) the value of using maps to provide a visual aid to discussion about the importance of participants' routine, often pre-reflective practices; and (c) the production of a layered appreciation of participants' local green and blue space wellbeing experiences. Used in combination, such methods have the potential to provide a more comprehensive picture of how current green space experiences, be they infrequent and meaningful, or more routine and habitual, are shaped by everyday individual agency, life circumstances and past place experiences.
Journal Article
‘Thinking you're old and frail’: a qualitative study of frailty in older adults
2016
Many older adults experience what is clinically recognised as frailty but little is known about the perceptions of, and attitudes regarding, being frail. This qualitative study explored adults' perceptions of frailty and their beliefs concerning its progression and consequences. Twenty-nine participants aged 66–98 with varying degrees of frailty, residing either in their homes or institutional settings, participated in semi-structured interviews. Verbatim transcripts were analysed using a Grounded Theory approach. Self-identifying as ‘frail’ was perceived by participants to be strongly related to their own levels of health and engagement in social and physical activity. Being labelled by others as ‘old and frail’ contributed to the development of a frailty identity by encouraging attitudinal and behavioural confirmation of it, including a loss of interest in participating in social and physical activities, poor physical health and increased stigmatisation. Using both individual and social context, different strategies were used to resist self-identification. The study provides insights into older adults' perceptions and attitudes regarding frailty, including the development of a frailty identity and its relationship with activity levels and health. The implications of these findings for future research and practice are discussed.
Journal Article