Promoting physical activity among adults with sight loss: development of a socioecological model to inform interventions

Introduction: The aim of this thesis was to develop guidance underpinned by the socioecological model, for physical activity (PA) interventions targeting adults with sight loss.

Methods: The methods include: 1) a systematic review examining correlates of PA among adults with sight loss. 2) A survey of 100 adults with sight loss to understand which general healthcare, eyecare and sight loss service professionals, are best positioned to provide PA advice, and what resources are required to facilitate an increase in PA levels. 3) Qualitative interviews with eyecare and sight loss service professionals to identify barriers and facilitators to PA promotion. 4) Reflections on an unsuccessful PA promotion intervention. 5) A Delphi study to identify components of a training program to help sight loss service professionals promote PA. The findings from these studies were summarised using the socioecological model, which was then developed into a conceptual framework.

Results: The systematic review found evidence that poorer vision, female gender, lower self-efficacy, and environmental barriers, were associated with lower levels of PA among populations with sight loss. Most participants in the survey reported they would increase their PA if advised to by a general practitioner (n = 78), ophthalmologist or optometrist (n = 70) or a low vision rehabilitation officer (n = 75). Thirty-one participants would increase their PA if advised to by a dispensing optician. Sight loss specific and community-based PA groups, exercise specialists, sighted guides, and travel plans, were considered facilitators of PA by most participants. However, the interview studies identified personal, organisational, community and interpersonal barriers, which could hinder PA promotion in eyecare and sight loss services. After reflecting on an unsuccessful intervention, the Delphi study suggested training for sight loss service professionals should: educate professionals on PA benefits, injury prevention, and wellbeing, address myths associated with PA, address health and safety concerns, help professionals to find local PA opportunities, and include a networking session for sight loss services and local PA providers.

Conclusion: The conceptual framework developed from these results serves as a comprehensive tool to address barriers and leverage facilitators for promoting PA among adults with sight loss. The model could engage and inform a wide range of disciplines, facilitating collaborative efforts to tackle the multifaceted challenge of low PA within this population.