Core Outcome Measures in Effectiveness Trials

Targets for older adults’ physical activity and sedentary behaviour during hospitalisation: an international Delphi study

General Information

Inactivity and sedentary behaviour (SB) have significant and independent effects on health. Older Australians account for a high proportion of the disease burden from low physical activity and SB, and, hospitalisations. The problems of inactivity and SB in hospital impact other patient-centred outcomes. Research on the activity and SB of older hospitalised patients is growing, but progress to intervention studies has been limited. This may be due to heterogeneity in the choice of objective PA/SB outcomes and how they are measured, and/or, unknown targets for increasing activity or reducing SB in hospital. The gap between physical activity guidelines and the physical activity and sedentary behaviour of older adults who are hospitalised with an acute medical illness needs to be reconciled. This study aims to gain consensus on the following:
1. targets: what should patients and health care teams be aiming for in terms of physical activity and minimisation of sedentary behaviour
2. for primary research studies including older adults hospitalised with medical, non-surgical admissions, which outcomes relating to physical activity and sedentary behaviour should be measured? Are these the same/different to routine clinical practice?

Principal Investigator: Dr Claire Baldwin (Flinders University)
Co-investigators: Dr Lucy Lewis (Flinders University), Dr Anna Phillips (UniSA), Sarah Edney (UniSA)

Further Study Information

Current Stage:
January 2019 - October 2019
Funding source(s):
Establishment Grant, College of Nursing and Health Sciences, Flinders University.

Health Area

Disease Category
Health care of older people

Disease Name

Target Population

Age Range
65 - 120


Nature / type of Intervention


Delphi process

For the purposes of this study, our definition of “acute medical illness” does not include: “elective” or planned admissions, an admission for which surgery is the main form of treatment, admission for a mental health condition. The acute hospital setting refers to: a place providing 24-hour care for people who are unwell and had an unplanned admission, this could be a public or private hospital. It does not include: hospitals (or wards within an acute hospital) that are for rehabilitation, surgery only, palliative care, respite or recuperation, or long term care or residential nursing home facilities for older adults.

Target sample of 50 representatives across stakeholder groups (aim for consumers to have 20% representation). Researchers identified from corresponding author list of publications included in existing relevant review articles, invitations to represent particular fields of research, and, nomination from other invited panel members. Clinical experts identified through medical, nursing and physiotherapy professional associations in Australia, UK, USA and Canada. Policy (guideline) developers identified from the Australian, UK, USA and Canadian physical activity guidelines for older adults. Consumers (supported by caregivers as required) responding to advertising within Australia.

Up to 4 survey rounds running for 3 weeks at a time, new rounds distributed every 6-8 weeks. Open ended questions in round 1 (following pilot testing of round 1 survey). Rounds 2-4 to include open ended and closed questions as required, moving to rating with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) scale as used in other Delphi studies. Thus the 9-point scale will be divided into 3 categories: not Important (1-3), important but not critical (4-6), and critical (7-9). Consensus will be defined a priori as: =70% of respondents rating an item as “critical” (score =7) and =15% of respondents rating an item as “not important” (score =3). ‘Unable to score’ options will also be provided.

Retention to be facilitated by targeted pre-participation survey (intent to participate) and weekly reminders for survey completion. Feedback on previous rounds provided in the form of individual feedback (view previous responses) and group aggregates.
Survey management and distribution using the Qualtrics platform.
Ethics approval obtained from Flinders University SBREC: application number 8254.

Stakeholders Involved

Clinical experts
Consumers (patients)
Policy makers

Study Type

Recommendations made

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