{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T05:34:52Z","timestamp":1761284092468,"version":"build-2065373602"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T00:00:00Z","timestamp":1761264000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Physical activity (PA) helps older adults age in place and retain independence. Adult Day Centers (ADCs) are critical community-based spaces that provide PA programming, yet the dosage and impact of PA in these settings remains empirically unassessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study used a multi-methods cross-sectional design to assess PA and physical function among ADC participants, as well as directors\u2019 perspectives on PA programming. PA was assessed via an ActivPAL inclinometer, and physical function was assessed via the Short Physical Performance Battery (SPPB) and the Timed Up and Go (TUG) test. Semi-structured interviews were conducted with ADC directors. Data from interviews was coded openly and axially, and analyzed inductively and deductively to extract major themes. The qualitative analysis was subsequently guided by the Frequency, Intensity, Type, and Time principles to assess PA dosage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      On average, ADC participants (\n                      <jats:italic>N<\/jats:italic>\n                      \u202f=\u202f48; M\n                      <jats:sub>Age<\/jats:sub>\n                      \u202f=\u202f74.8\u202f\u00b1\u202f7.2; 78.6% Female; 76.9% Low-Income; 70.7% Hispanic) engaged in 36.4\u202f\u00b1\u202f28.8\u202fmin of moderate to vigorous PA per day, with 68% of participants meeting the PA guidelines. Physical function scores indicated an elevated risk for falls, morbidity, and mortality (M\n                      <jats:sub>SPPB<\/jats:sub>\n                      \u202f=\u202f8.8\u202f\u00b1\u202f2.1, M\n                      <jats:sub>TUG<\/jats:sub>\n                      \u202f=\u202f14.7\u202f\u00b1\u202f4.0). Interviews with five ADC directors revealed overarching themes: (1) PA dosage and programming at ADCs, (2) barriers to PA (staff shortages, funding, and safety and liability), and (3) programming facilitators.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Findings reflect broader systemic challenges that influence PA programming at ADCs. The directors cited barriers such as staffing limitations, funding constraints, and safety concerns, emphasizing the need for and desire to receive additional support. These challenges were also reflected in the ADC participants\u2019 PA and physical function. It is imperative to support ADCs in delivering evidence-based programming as they can be key to retaining physical functional status and improving the quality of life of ADC participants. Future studies should consider community-based strategies involving liaisons and PA experts to support ADC staff, increase PA training, and reduce staff burden and turnover.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1620038","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T05:28:06Z","timestamp":1761283686000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Barriers in motion: a multi-methods approach to exploring physical activity, physical function, and program challenges in adult day 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Assoc"},{"volume-title":"Adult day services center participant characteristics: United States, 2018","year":"2021","author":"Lendon","key":"ref9"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e12150","DOI":"10.1111\/opn.12150","article-title":"Ageing out of place: the meaning of home among Hispanic older persons living in the United States","volume":"12","author":"Curtin","year":"2017","journal-title":"Int J Older People Nursing"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1421","DOI":"10.1177\/07334648211069269","article-title":"Convivir (to coexist) and other insights: results from the positive aging for Latinos study","volume":"41","author":"Piedra","year":"2022","journal-title":"J Appl Gerontol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/geroni\/igy007","article-title":"When adults don\u2019t exercise: behavioral strategies to increase physical activity in sedentary middle-aged and older adults","volume":"2","author":"Lachman","year":"2018","journal-title":"Innov Aging"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1327","DOI":"10.1177\/0733464815617286","article-title":"Aging in place of vulnerable older adults: person\u2013environment fit perspective","volume":"36","author":"Park","year":"2017","journal-title":"J Appl Gerontol"},{"volume-title":"ACSM\u2019S guidelines for exercise testing and prescription","year":"2020","author":"Liguori","key":"ref14"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"2020","DOI":"10.1001\/jama.2018.14854","article-title":"The physical activity guidelines for Americans","volume":"320","author":"Piercy","year":"2018","journal-title":"JAMA"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","article-title":"\u201cMini-mental state\u201d. A practical method for grading the cognitive state of patients for the clinician","volume":"12","author":"Folstein","year":"1975","journal-title":"J Psychiatr Res"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"M85","DOI":"10.1093\/geronj\/49.2.m85","article-title":"A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission","volume":"49","author":"Guralnik","year":"1994","journal-title":"J Gerontol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1111\/j.1532-5415.1991.tb01616.x","article-title":"The timed \u201cup & go\u201d: a test of basic functional mobility for frail elderly persons","volume":"39","author":"Podsiadlo","year":"1991","journal-title":"J Am Geriatr Soc"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1177\/0269215510367993","article-title":"Dual task interference in estimating the risk of falls and measuring change: a comparative, psychometric study of four measurements","volume":"24","author":"Hofheinz","year":"2010","journal-title":"Clin Rehabil"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1682\/JRRD.2015.03.0042","article-title":"Validity of the 8-foot up and go, timed up and go, and activities-specific balance confidence scale in older adults with and without cognitive impairment","volume":"53","author":"Rolenz","year":"2016","journal-title":"J Rehabil Res Dev"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1016\/j.jshs.2016.02.002","article-title":"Considerations when using the activPAL monitor in field-based research with adult populations","volume":"6","author":"Edwardson","year":"2017","journal-title":"J Sport Health Sci"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1177\/160940690600500107","article-title":"Demonstrating rigor using thematic analysis: a hybrid approach of inductive and deductive coding and theme development","volume":"5","author":"Fereday","year":"2006","journal-title":"Int J Qual Methods"},{"volume-title":"Basics of qualitative research: techniques and procedures for developing grounded theory","year":"1998","author":"Strauss","key":"ref23"},{"volume-title":"The discovery of grounded theory: strategies for qualitative research","year":"1967","author":"Glaser","key":"ref24"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1093\/ptj\/80.9.896","article-title":"Predicting the probability for falls in community-dwelling older adults using the timed up & go test","volume":"80","author":"Shumway-Cook","year":"2000","journal-title":"Phys Ther"},{"volume-title":"WHO guidelines on physical activity and sedentary behaviour","year":"2020","key":"ref26"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1539","DOI":"10.1136\/bjsports-2016-097210","article-title":"Sedentary time in older adults: a critical review of measurement, associations with health, and interventions","volume":"51","author":"Copeland","year":"2017","journal-title":"Br J Sports Med"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"l4570","DOI":"10.1136\/bmj.l4570","article-title":"Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis","volume":"366","author":"Ekelund","year":"2019","journal-title":"BMJ"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2018\/7856823","article-title":"The importance of physical activity exercise among older people","volume":"2018","author":"Langhammer","year":"2018","journal-title":"Biomed Res Int"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"e16218","DOI":"10.1097\/MD.0000000000016218","article-title":"Physical activity programs for balance and fall prevention in elderly: a systematic review","volume":"98","author":"Thomas","year":"2019","journal-title":"Medicine"},{"article-title":"Sedentary behavior, physical activity and functionality of older care home residents [preprint]","year":"2024","author":"Scheidt","key":"ref31"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"101704","DOI":"10.1016\/j.arr.2022.101704","article-title":"Association of clinical outcome assessments of mobility capacity and incident disability in community-dwelling older adults - 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