Evidence mapPaperPMID 41668027Full record

Trial reportBMC geriatrics2026

Barriers and facilitators to prehabilitation participation among older adults undergoing major elective surgery: a qualitative study using the capability, opportunity, motivation - behavior model.

Kuan-Yuan Wang, Christine Y Nguyen, Kailin Xu, Yuchen Liu, Natalie Newmeyer, Sussan Alshanniek, Jennifer A Palmer, Dae Hyun Kim

Registry-linked trialAbstract readClinical Trial
In one paragraph

Trial report in BMC geriatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05752474 (Multi-Component Prehabilitation Program for High-Risk Older Adults Undergoing Major Elective Surgery), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05752474 nacompletednot on this map

Multi-Component Prehabilitation Program for High-Risk Older Adults Undergoing Major Elective Surgery: A Pilot and Feasibility Study

TypeinterventionalSponsorBeth Israel Deaconess Medical CenterRan2023 to 2025Enrolled30ConditionsFrailty, Functional Recovery, PrehabilitationArmsExercise, Nutrition, Meditation, Cognitive Behavioral Intervention
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kuan-Yuan WangFrailty Research Center, Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, 1200 Centre Street, Boston, MA, USA.
Christine Y NguyenDivision of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Kailin XuFrailty Research Center, Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, 1200 Centre Street, Boston, MA, USA.
Yuchen LiuFrailty Research Center, Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, 1200 Centre Street, Boston, MA, USA.
Natalie NewmeyerFrailty Research Center, Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, 1200 Centre Street, Boston, MA, USA.
Sussan AlshanniekStructural Heart Center, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Jennifer A PalmerSection of General Internal Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
Dae Hyun KimFrailty Research Center, Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, 1200 Centre Street, Boston, MA, USA. daehyunkim@hsl.harvard.edu.

Funding

Mid-Career Mentoring Award For Patient-Oriented Research in Frailty and Health OutcomesK24AG073527 · HEBREW REHABILITATION CENTER FOR AGED · 2025 to 2025
$172k
National Institute on Aging of the National Institutes of Health K24AG073527NIA NIH HHS K24 AG073527
6 · The paper itself

Abstract

backgroundPrehabilitation may improve patients’ functional capacity before surgery and enhance postoperative recovery. This study aimed to identify facilitators and barriers to participation in a multi-component prehabilitation program among older adults undergoing major elective surgery.

methodsThis qualitative study, nested within a single-arm feasibility trial, included patients aged ≥ 65 years who participated in a prehabilitation program consisting of exercise, nutrition counseling, and meditation. Semi-structured interviews were conducted, and a hybrid deductive–inductive thematic analysis approach was applied. Finalized thematic summaries were subsequently organized using the Capability, Opportunity, Motivation-Behavior framework.

resultsTwenty-four participants completed interviews (mean age 76.5 years; 42% female; 8% black; 17% frail; 75% undergoing cardiovascular surgery). Fewer barriers and more facilitators were identified for the exercise and nutrition components, whereas more barriers than facilitators were found for meditation. Limited physical opportunity (e.g., limitations of physical environment, resources, and time) was the most prominent barrier to engagement, while social opportunity and reflective motivation emerged as major facilitators. Barriers to engagement, across program components, included physical symptoms, limited knowledge, environmental and logistical constraints, negative social influence, habit formation challenges, personal skepticism, lack of discipline, and negative emotional responses. Facilitators encompassed enhanced self-efficacy, guided instruction, prior experience, accessible resources, individualized planning, support from instructors and family, positive beliefs, emotional reinforcement, goal setting, and integration of routines.

conclusionThis study highlights the importance of a person-centered approach to maximize participation in multi-component prehabilitation among older adults before major elective surgery. Targeting barriers related to physical opportunity, while simultaneously fostering a supportive social environment and strengthening internal motivation through personalized goals and positive reinforcement, may enhance adherence and contribute to the success of prehabilitation programs. CLINICAL

trial registrationNCT05752474.

Indexed as

Elective Surgical ProceduresMotivationPatient ParticipationPreoperative CarePreoperative ExerciseQualitative ResearchAgedAged, 80 and overFeasibility StudiesFemaleHumansMaleCOM-B modelOlder adultsPrehabilitationQualitative researchSurgery

Identifiers

PMID41668027
PMCPMC13107701

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.