Patients participating in FOCUS

The World Health Organization recommends for older adults the same amount of physical activity as for adults aged 18–64 years, i.e. at least 150 min weekly of moderate-intensity physical activity. It is known that older people are less keen than younger adults to attend gyms regularly for multiple reasons (e.g., different aptitudes, fear of being compared to more performing peers, economic reasons). Studies have shown that exercise group-based programs led by professionals might be effective at increasing the level of physical activity, improving the physical performance and preventing frailty progression. However, because of sustainability issues, these projects have often been characterized by limited follow-up, rendering difficult the capacity to persistently induce the beneficial behavioural modifications over time. Educational and psycho-educational interventions might be less resource demanding and more sustainable on the long-term. However, the evidence on the efficacy of such interventions is controversial, also because they might be extremely heterogeneous in their content and implementation. One of the most used psycho-educational approaches is the constructivist learning theory. This approach allows the person to become more competent with his physical health and activates his ability to create new knowledge in order to make sense out of his own condition (e.g. to be an older person, to be at risk of frailty). Moreover, it helps in setting goals and self-monitoring, building self-efficacy and social support, overcoming barriers, preventing relapses, and building lasting habits. However, to date, few studies have evaluated the effect of the application of this theory in older people. Similarly, pedometers have also been indicated as potentially useful for for psycho-educational purposes. In fact, they provide direct step-count feedback and seem to increase daily steps count in users. Unfortunately, even in this case, their effect in promoting physical activity is still debated. Given the uncertainty around the efficacy of psycho-educational interventions, we planned to test their efficacy in the promotion of appropriate levels of physical activity in older adults. In particular, we conducted a follow-on study (i.e. the PoliFIT-INFOcus study), part of the workpackage 7 of the FOCUS project (Frailty Management Optimisation Though EIP AHA Commitments And Utilisation Of Stakeholders Input; 664367 — FOCUS — HP-PJ-2014). The aim of this workpackage was to test the impact of the guidelines concerning interventions to prevent or treat frailty in older people when implemented in practice.