AUTHOR=Soto Yuliana , Guzman Jacqueline , Morales Diana , Canton Imani , Selzer Ana , Aguinaga Susan 

TITLE=Barriers in motion: a multi-methods approach to exploring physical activity, physical function, and program challenges in adult day services

JOURNAL=Frontiers in Public Health

VOLUME=Volume 13 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1620038

DOI=10.3389/fpubh.2025.1620038

ISSN=2296-2565

ABSTRACT=IntroductionPhysical 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.MethodsThis study used a multi-methods cross-sectional design to assess PA and physical function among ADC participants, as well as directors’ 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.ResultsOn average, ADC participants (N = 48; MAge = 74.8 ± 7.2; 78.6% Female; 76.9% Low-Income; 70.7% Hispanic) engaged in 36.4 ± 28.8 min 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 (MSPPB = 8.8 ± 2.1, MTUG = 14.7 ± 4.0). 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.DiscussionFindings 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’ 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.