Study protocol: using the Q-STEPS to assess and improve the quality of physical activity programmes for the elderly

BMC Research Notes

Joana Carvalho³  Jorge Mota³  Rute Santos³  António Oliveira-Tavares³  Pedro Soares¹  Marlene Amorim²  Maria J Rosa²  Ana I Marques³ 

[1] José Estêvão High School, Avenida 25 de Abril, 3811-901, Aveiro, Portugal;Department of Economics, Management and Industrial Engineering, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal;Research Centre in Physical Activity, Health and Leisure - Faculty of Sports, Porto University, Rua Dr. Plácido Costa, 91-4200 450, Porto, Portugal

关键词: Quality;    Evaluation;    Elderly;    Physical activity programmes;    Feasibility;    Q-STEPS;   

Others  :  1166533
DOI  :  10.1186/1756-0500-5-171

 received in 2011-12-21, accepted in 2012-04-02,  发布年份 2012

【 摘 要 】

Background

Aging is one of the most important and obvious phenomenon observed in our society. In the past years, there has been a growing concern in designing physical activity (PA) programmes for elderly people, because evidence suggests that such health promotion interventions may reduce the deleterious effects of the ageing process. Accordingly, a growing body of literature points to the importance of a sound approach to planning and evaluation in order to improve the quality of PA programmes. However, while numerous PA programmes have been designed for the elderly in recent years, their evaluation has been scarce. Quality management processes and tools provide a practical way for organisations to assess, identify and shed light on the areas requiring improvement. The Quality Self-assessment Tool for Exercise Programmes for Seniors (Q-STEPS) seems to provide a framework tailored to evaluate PA programmes for the elderly.

Findings

The primary purpose of this study is 1) to determine feasibility, acceptability and usability of the Q-STEPS. Secondary purposes of the study are: 2) to examine the quality of the PA programmes for elderly people developed by the Portuguese Local Administration over a three-year period of self-assessments in terms of: a) Enabler domains (Leadership, Policy and Strategy, People, Partnership and Resources, Processes); b) Result domains (Customer Results, People Results, Society Results and Key Performance Results); 3) to estimate the association between the use of Q-STEPS and some indicators relating to the elderly participants, during the three self-assessments, such as: attendance rates, physical fitness, health-related quality of life and the elderly’s perceived quality of the programme. The study will be conducted in PA programmes for elderly adults from mainland Portuguese municipalities over a three-year period. The project will adopt a participative quality improvement approach that features annual learning cycles of: 1) self-assessment with the Q-STEPS; 2) feedback to and interpretation of results involving programme’s staff; 3) action planning to achieve system changes; 4) implementation of strategies for change; and 5) review process through further self-assessment. The study will collect a range of process and outcome data that will be used to achieve the research aims.

Discussion

It is our understanding that the results of the Q-STEPS study will contribute directly to the evidence based on effectiveness of continuous quality improvement approaches, in order to improve customer satisfaction and adherence to PA programmes targeting the ageing population. This comprehensive evaluation will also add significant new knowledge regarding the characteristics associated with a sustainable public service.

【 授权许可】

   
2012 Marques et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]European Commission: The life of women and men in Europe - A statistical portrait. 2008. Office for Official Publications of the European Communities, Luxembourg; 2008.
• [2]Siddall C, et al.: Healthy ageing: keystone for a sustainable Europe - EU health policy in the context of demographic change. Services of DG SANCO, DG ECFIN & DG EMPL, European Commissions Brussels; 2007.
• [3]Chodzko-Zajko WJ, et al.: American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc 2009, 41(7):1510-1530.
• [4]Bauman A, et al.: Physical activity measurement–a primer for health promotion. Promot Educ 2006, 13(2):92-103.
• [5]Kirsten W, Bauman A, Pratt M: Promoting physical activity globally for population health. Promot Educ 2006, 13(2):90-91. 147–8, 154–5
• [6]Weisser B, Preuß M, Predel HG: Physical activity and health - Positive effects of an active lifestyle ed. 39th edition. Thieme, Stuttgart; 2010:282-286.
• [7]Bouchard C, Shephard RJ, Stevens T: Physical activity, fitness, and health: international proceedings and consensus statement in International Conference on Physical Activity, Fitness, and Health. In . Edited by Bouchard C, Shephard RJ, Stevens T. Human Kinetics Publisher, Champaign, IL; 1994.
• [8]CDC, Increasing physical activity: A report on recommendations of the Task Force on Community Preventive Services. MMWR Recomm Rep 2001, 50(RR-18):1-14.
• [9]ACSM: ACSM's Guidelines for Exercise Testing and Prescription. 8th edition. Williams & Wilkins, Baltimore; 2009.
• [10]Schutzer KA, Graves BS: Barriers and motivations to exercise in older adults. Prev Med 2004, 39(5):1056-1061.
• [11]Finch H: Physical Activity ‘At Our Age’. Health Education Authority, London; 1997.
• [12]Wininger SR, Pargman D: Assessment of factors associated with exercise enjoyment. J Music Ther 2003, 40(1):57-73.
• [13]Henderson KA, Ainsworth BE: Enjoyment: A Link to Physical Activity, Leisure, and Health. J Park Recreat Adm 2002, 20(4):130-146.
• [14]Wankel LM: The importance of enjoyment to adherence and psychological benefits from physical activity. Int J Sport Psychol 1993, 24:151-169.
• [15]Williams NH, et al.: Effectiveness of exercise-referral schemes to promote physical activity in adults: systematic review. Br J Gen Pract 2007, 57(545):979-986.
• [16]Parasuraman A, Zeithaml VA, Berry LL: Reassessment of Expectations as a Comparison Standard in Measuring Service Quality: Implications for Further Research. J Marketing 1994, 58(1):111-124.
• [17]Taylor SA, Baker TL: An Assessment of the Relationship between Service Quality and Customer Satisfaction in the Formation of Consumers’ Purchase Intentions. J Retail 1994, 70(2):163-178.
• [18]EFQM: Introducing Excellence. European Foundation for Quality Management, Brussels; 2003a.
• [19]Marques AI, et al.: Evaluation of physical activity programmes for elderly people - a descriptive study using the EFQM’criteria. BMC Publ Health 2011, 11(1):123. BioMed Central Full Text
• [20]Levin Martin S, Vehige T: Establishing public health benchmarks for physical activity programs. Prev Chronic Dis 2006, 3(3):A110.
• [21]Ågren G, Berensson K: The Healthy Ageing – a Challenge for Europe. European Older People’s Platform (AGE), EuroHealthNet: Stockholm; 2006.
• [22]Schmid TL, et al.: A framework for evaluating community-based physical activity promotion programmes in Latin America. Promot Educ 2006, 13(2):112-118.
• [23]CDC: Physical Activity Evaluation Handbook. Centers for Disease Control and Prevention, Atlanta; 2002.
• [24]WHO: Health promotion evaluation: recommendations to policy makers. , World Health Organization Europe; 1999.
• [25]BHF: Guidelines on the promotion of physical activity with older people. British Heart Foundation, London; 2007.
• [26]Marques AI, et al.: A proposed adaptation of the European Foundation for Quality Management Excellence Model to physical activity programmes for the elderly - development of a quality self-assessment tool using a modified Delphi process. Int J Behav Nutr Phys Act 2011, 8(1):104. BioMed Central Full Text
• [27]EFQM: Assessing For Excellence - EFQM 2010. European Foundation for Quality Management, Brussels; 2010.
• [28]McAfee T, Thompson RS: Improving community-based prevention by transforming managed care organizations into health improvement organizations. J Public Health Manag Pract 1998, 4(2):55-65.
• [29]Mears P: Quality Improvement Tools & Techniques. McGraw-Hill, Inc, ; 1994.
• [30]McLaughlin CP, Kaluzny AD: Continuous Quality Improvement in Health Care. 3rd edition. Jones & Bartlett Publishers, Sudbury; 2005.
• [31]Deming WE: The New Economics for Industry, Government, Education. 2nd edition. The MIT Press, Cambridge, MA; 2000.
• [32]Laiteerapong N, et al.: A Resident-Led Quality Improvement Initiative to Improve Obesity Screening. Am J Med Qual 2011, :.
• [33]Booker JM, et al.: Quality improvement initiative in school-based health centers across new Mexico. J Sch Health 2011, 81(1):42-48.
• [34]Varkey P, Reller MK, Resar RK: Basics of quality improvement in health care. Mayo Clin Proc 2007, 82(6):735-739.
• [35]Svensson M, Klefsjö B: TQM-based self-assessment in the education sector: Experiences from a Swedish upper secondary school project. Qual Assur Educ 2006, 14(4):299-323.
• [36]Zairi M: Performance Excellence: A Practical Handbook. e-TQM College Publishing House, ; 2003.
• [37]Marques AI, et al.: Evaluation of physical activity programmes for the elderly - exploring the lessons from other sectors and examining the general characteristics of the programmes. BMC Res Notes 2011, 4(1):368. BioMed Central Full Text
• [38]Scott F, et al.: Expert Survey on Physical Activity Programmes and Physical Activity Promotion Strategies for Older People - Cross-National Report. European Network of Action on Aging and Physical Activity, ; 2008.
• [39]Roberts K, Brodie D: Inner city sport: Who plays, and what are the benefits?. Giordano Bruno, Culembourg; 1992.
• [40]Williams MA, et al.: Secondary prevention of coronary heart disease in the elderly (with emphasis on patients > or =75 years of age): an American Heart Association scientific statement from the Council on Clinical Cardiology Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention. Circulation 2002, 105(14):1735-1743.
• [41]Platts KW: A process approach to researching manufacturing strategy. Int J Operations Prod Manage 1993, 13(8):4-17.
• [42]Platts KW, et al.: Evaluating manufacturing strategy formulation processes. Int J Prod Econ 1996, 46–47(1):233-240.
• [43]Foster C: Guidelines for Health-enhancing Physical Activity Promotion Programmes. British Heart Foundation Health Promotion Research Group, University of Oxford; 2000.
• [44]Rikli RE, Jones CJ: Development and validation of a functional fitness test for community-residing older adults. J Aging Physical Activity 1999, 7(2):129-161.
• [45]Ferreira PL: Criação da versão portuguesa do Mos SF-36, Parte I - Adaptação cultural e linguística. Acta Médica Portuguesa 2000, 13:55-66.
• [46]Ferreira PL: Criação da versão portuguesa do Mos SF-36, Parte II - Teste de validação. Acta Médica Portuguesa 2000, 13:119-127.
• [47]Ware JE, Sherbourne CD: The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992, 30(6):473-483.
• [48]Dias IB, Carvalho PG: A qualidade percebida em programas municipais de actividade física para idosos: validação estatística para Portugal. Motriz 2011, 17(1):145-159.
• [49]Fielding RA, et al.: Activity adherence and physical function in older adults with functional limitations. Med Sci Sports Exerc 2007, 39(11):1997-2004.