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Access Type

WSU Access

Date of Award

January 2025

Degree Type

Dissertation

Degree Name

Ph.D.

Department

Health Education

First Advisor

Mariane Fahlman

Second Advisor

Jeffrey Martin

Abstract

The purpose of this mixed methods study was to determine how multimodal delivery of a functional fitness exercise program influences functional outcomes in older adults while examining influences on participation adherence. With a rapid decline in functional fitness capacity in older adults, increasing exercise in older adults is evident. Furthermore, understanding exercise delivery modes and their influences on participation may impact accessibility and adherence in older adults. This study focused on answering the following research questions: “How does a 12-week multimodal functional fitness intervention improve functional fitness outcomes in older adults? What multi-level social factors influence participation in both online and in-person delivery of a 12-week functional fitness intervention in older adults?” This study utilizes a mixed methods approach to attain objective functional fitness measures and subjective qualitative data from one-on-one interviews. Quantitative data analysis via a paired sample t-test will determine mean changes in pre- and post-measures across five domains of functional fitness assessment in 38 participants. Thematic analysis of interview transcriptions in 8 participants for the qualitative one-on-one interview was used to gain insight into participants' participation influences. The quantitative findings of this study highlight that multimodal delivery effectively improves upper and lower body strength, cardiorespiratory endurance, and lower extremity flexibility, as measured by the Senior Fitness Test. The qualitative findings give insight into participation adherence barriers and facilitators through participant interviews in older adults, which included several themes related to technological barriers, intrinsic and extrinsic motivators, social support, environmental barriers, and self-efficacy. These insights may be essential in designing multimodal exercise delivery for older adults. Our results illustrate the importance of addressing technological literacy and reducing environmental barriers impacting exercise participation adherence for online access. Our findings highlight promising improvements in functional independence based on criterion-referenced standards for any age, even at low exercise doses.

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