Experiencing locality based group exercise provision for older people: a qualitative study

Living longer brings the challenge of ageing well. Older people who participate in exercise have better health and social outcomes, functional ability and quality of life. A key challenge is to reverse the trajectory for older people to reduce activity by 50% from age 60 to 85 and promote exercise alongside everyday living. This thesis explores the views and experience of older people and exercise in a local context, to better understand and inform practice and policy.An ethnographically informed approach was used to understand the experiences of older people who participate in exercise in a local context, using focus groups, interviews and participation observation. Focus groups and interviews were held with older people who regularly undertake exercise (Tai Chi, falls prevention, and Pulmonary Rehabilitation) and those who do not exercise, staff and commissioners. Interviews and focus group data were analysed using thematic analysis.Key themes identified in the literature, which concurred with the study findings for participation in exercise were knowledge about exercise, life course experience, and the capability of the instructors. Novel findings from this study were the seasonal variation in exercise uptake, the concept of describing concordance rather than adherence to exercise to enable genuine co-production, the impact of staff advising older people to stop exercising without offering a substitute, and the identification of behaviour change at source, intervention and policy level.In conclusion, most prescribers of exercise were poorly informed of national guidelines or local provision for older people.Some instructors lacked skills in supporting older people with their exercise engagement.Older people hold views around exercise which conflict with the evidence base