Understanding the influence of patterns, types, and contexts of physical activity on health, wellbeing and quality-of-life in older-adults receiving s

老年人的每日PA水平较低。对于需要独立生活支持（SIL）的老年人来说尤其如此，他们通常被孤立，行动不便，社交网络有限，以及长期护理机构（LTCF）中的居民可能在60-90%的清醒时间内不活动。据报告，旨在改善长期护理设施中成年人的PA和生活质量（QoL）的干预措施、方案和规定取得的成功有限。有效设计PA干预措施，政策和规定，以改善需要SIL和LTC的老年人的福祉和生活质量，取决于对PA如何在这些人群中发生以及PA模式如何与健康联系的深入和全面的了解。目前这两种都缺乏。PA行为是复杂的，其模式的分析需要精确的客观测量。然而，为了完全理解PA和QoL之间的联系，并为干预措施，政策和规定提供信息，还需要了解这些行为发生的环境/背景。这一关键信息最好通过严格的定性方法获得。到目前为止，还没有研究结合先进的定量和定性方法来全面描述PA模式及其对这些人群的健康和福祉的影响。这种混合方法的研究汇集了先进的定量和定性方法和数据科学，提供重要的高质量信息，可以为干预措施，政策和实践提供信息，以改善弱势和不断增长的人口群体的健康福祉和生活质量。目标和拟议的方法综合现有文献，检查SIL（接近过渡到LTC的点）老年人和已处于LTC的老年人的PA。研究方法：根据系统评价和Meta分析（PRISMA）的首选报告项目，对现有的观察性和定性研究进行系统评价，探讨SIL和LTCF中老年人PA与健康和生活质量指标之间的关联。了解并阐明老年SIL患者（即将过渡到LTC）和已进入LTC患者中PA的数量、类型和模式。研究PA的每日和每周模式与健康和QoL.Methods之间的关系，以实现目标2-3：精确的PA的客观数据将使用腕戴式加速度计收集。参与者将从两个人群中招募; 1）在埃克塞特由英国老年人管理的日间中心接受SIL的老年人，2）在合作伙伴LTCF的老年居民。然后将采用新的数据处理方法来提供这些人群中每日和每周活动量的首次全面表征以及PA在小时、天和周内的分布模式。然后，将对PA模式与幸福感和生活质量指标之间的关联进行详细分析。目标-4。了解PA在这些人群中的环境和背景，并确定机会。了解未来的PA指导或规定的哪些方面对这些人群是可行的、有帮助的和有价值的。实现目标4-5的方法：采用定性方法，通过与SIL和LTC的工作人员、支助工作者和老年人进行探索，以目标1-3的结果为基础;确切地说，PA在这些环境中发生的位置、时间和方式，以及如何建立PA;并与这些群体中的老年人合作，

Daily PA levels in older-adults are low. This is particularly true in older-adults requiring support for independent living (SIL) who are often isolated, have impaired mobility, and have limited social networks, and those in long term care facilities (LTCFs) where residents may be inactive for between 60-90% of waking hours. Interventions, programmes and provision aimed at improving PA and quality of life (QoL) in adults in LTC facilities have report limited success. Effective design of PA interventions, policy and provision to improve wellbeing and QoL for older-adults requiring SIL and those in LTC is contingent on an in-depth and comprehensive understanding of both how PA occurs in these population groups, and how patterns of PA link to health. Both are currently lacking. PA behaviour is complex, and analysis of its patterns necessitates precise objective measurement. However, in order to completely understand the link between PA and QoL, and inform interventions, policy and provision it is also necessary to understand the environments/context in which these behaviours occur. This critical information is best obtained using rigorous qualitative methods. To date no research has combined advanced quantitative and qualitative approaches to comprehensively describe PA patterns and their influence on health and wellbeing in these populations. This mixed-methods research brings together advanced quantitative and qualitative methods and data science to provide important high-quality information, which can inform interventions, policy and practice in order to improve the health wellbeing and QoL within a vulnerable and growing population group.Objectives and proposed methodologyObjective-1. To synthesise existing literature examining PA in older-adults in SIL (who are near the point of transition to LTC), and those already in LTC. Methods: Systematic reviews of existing observational and qualitative research exploring associations between PA and measures of wellbeing and QoL in older-adults in SIL, and those in LTCFs, conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA).Objective-2. To understand and characterise the amount, type and pattern of PA observed in older-adults in SIL (who are near transition to LTC), and those already in LTC.Objective-3. To examine the relationship between daily and weekly patterns of PA with wellbeing and QoL.Methods for achieving objectives 2-3: Precise objective data on PA will be collected using wrist worn accelerometry. Participants will be recruited from two populations; 1) older-adults who are receiving SIL who attend day centres run by Age UK in Exeter, 2) older-adult residents at partner LTCFs. Novel data processing methodology will then be employed to provide the first comprehensive characterisation of daily and weekly volumes of activity and the patterns of distribution of PA across hours days and weeks in these population groups. A detailed analyses of associations between patterns of PA with measures of wellbeing and QoL will then be undertaken. Objective-4. To understand the environments and contexts of PA in these populations and to identify opportunitiesObjective-5. To understand what aspects of future guidance or provision for PA would be considered feasible helpful and valuable for these population groups.Methods for achieving objectives 4-5: To employ qualitative methods in order to build on findings from objectives 1-3 by exploring with staff, support-workers and older-adults in both SIL, and LTC; precisely where, when and how PA occurs in these settings, and how it could be built upon; and to work with older-adults in these groups to u