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Factors influencing participation in physical activity for persons living with dementia in rural and northern communities in Canada: a qualitative study.
Freeman, Shannon; Pelletier, Chelsea; Ward, Kirsten; Bechard, Lauren; Regan, Kayla; Somani, Salima; Middleton, Laura Elizabeth.
  • Freeman S; School of Nursing, University of Northern British Columbia, Prince George, British Columbia, Canada shannon.freeman@unbc.ca.
  • Pelletier C; School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada.
  • Ward K; School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada.
  • Bechard L; Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada.
  • Regan K; Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada.
  • Somani S; School of Nursing, University of Northern British Columbia, Prince George, British Columbia, Canada.
  • Middleton LE; Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada.
BMJ Open ; 12(6): e060860, 2022 06 16.
Article in English | MEDLINE | ID: covidwho-1950191
ABSTRACT

OBJECTIVE:

In recognition that engagement in physical activities for persons living with dementia can be challenging in rural and northern communities, the objective of this study was to explore the factors influencing physical activity participation among persons living with dementia in rural/northern communities and to identify the locally-driven mitigation strategies participants used to address barriers to physical activity.

SETTING:

Interviews and focus groups were conducted in two locations in northern British Columbia, Canada including a rural community (<10 000 persons) and a medium-sized geographically isolated city (<80 000 persons). Both communities are located at substantial distances (>700 km) from larger urban centres.

PARTICIPANTS:

Twenty-nine individuals participated including healthcare providers (n=8), community exercise professionals (n=12), persons living with dementia (n=4) and care partners (n=5).

RESULTS:

Rural and northern contextual factors including aspects of the built and natural environment were the main drivers of physical activity for persons living with dementia. Limited capacity in the health system to support physical activity due to a lack of referrals, poor communication mechanisms and limited resources for programming created challenges for physical activity participation. At the community level, local champions filled gaps in physical activity programming by leveraging informal networks to organise opportunities. Programme-level factors included a lack of consistency in staff, and challenges defining programme scope given limited population size and the fear of stigma for persons living with dementia.

CONCLUSIONS:

Environmental context and limited access to specialised programming affect the opportunities for persons living with dementia to engage in physical activities. Rural and northern communities showed resiliency in providing physical activity opportunities yet remained fragile due to human resource challenges. Without reliable resources and sustained support from the health system, local champions remain vulnerable to burnout. Enhancing support for local champions may provide greater stability and support to physical activity promotion in rural and northern communities.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Rural Population / Dementia Type of study: Experimental Studies / Qualitative research / Randomized controlled trials Limits: Humans Country/Region as subject: North America Language: English Journal: BMJ Open Year: 2022 Document Type: Article Affiliation country: Bmjopen-2022-060860

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Rural Population / Dementia Type of study: Experimental Studies / Qualitative research / Randomized controlled trials Limits: Humans Country/Region as subject: North America Language: English Journal: BMJ Open Year: 2022 Document Type: Article Affiliation country: Bmjopen-2022-060860