Abstract
BackgroundDespite known health benefits of physical activity (PA), older adults remain among the least physically active age group globally with 30–60% not meeting guidelines. In Canada, 87% do not meet recommended guidelines. To influence population health, interventions that are effective in small trials must be disseminated at scale. Despite evidence for efficacy, few PA interventions are scaled up to reach the wider community. In 2015, British Columbia (BC) Ministry of Health released a PA strategy where older adults were identified as a priority. In partnership with the Ministry, the Active Aging Research Team co-created a health promotion program called Choose to Move (CTM). CTM will be implemented in three phases at increasingly greater scale across BC. The objective of this study is to evaluate the effectiveness of CTM during Phase I (pilot) and Phase II (initial scale up) on PA, mobility, and social connectedness among older adults in BC, Canada.MethodsWe used a type 2 hybrid effectiveness-implementation study design, and herein focus on effectiveness. The implementation evaluation will be published as a companion paper elsewhere. Two community delivery partner organizations delivered 56 CTM programs in 26 large and small urban locations across BC. Outcome measurement occurred at 0 (baseline), 3 (mid-intervention) and 6 (post-intervention) months. We collected survey data from all participants (n = 458; province-wide) and also conducted a subset evaluation (n = 209).ResultsPA increased significantly during the active intervention phase (baseline-3 months) in younger (60–74 yrs.; + 1.6 days/week; p < 0.001) and older (≥75 yrs.; + 1.0 days/week; p < 0.001) participants. The increase was sustained at 6 months in younger participants only, who remained significantly more active than at baseline (+ 1.4 days/week; p < 0.001). Social exclusion indicators declined significantly in the younger group. Mobility and strength improved significantly at 3 months in the younger group, and in both groups at 6 months.ConclusionsCTM adopted central tenets of implementation science that consider the complicated systems where interventions are delivered to improve public health. In this iteration of CTM we demonstrate that a partner-based health promotion intervention can be effectively implemented across settings to enhance PA, mobility and social connectedness in older adults.
Highlights
Despite known health benefits of physical activity (PA), older adults remain among the least physically active age group globally with 30–60% not meeting guidelines
There were no significant differences in age, education, number of chronic conditions, participation in the subset, self-rated health or self-efficacy for increasing PA between men and women; women had more self-reported mobility limitations at baseline than did men (p = 0.02)
Choose to Move (CTM) is one of the first PA initiatives for older adults to be delivered at scale anywhere in Canada and our findings provide empirical evidence to support its scalability
Summary
Despite known health benefits of physical activity (PA), older adults remain among the least physically active age group globally with 30–60% not meeting guidelines. The objective of this study is to evaluate the effectiveness of CTM during Phase I (pilot) and Phase II (initial scale up) on PA, mobility, and social connectedness among older adults in BC, Canada. On a global scale the population segment of those over age 65 is projected to reach 2 billion by 2050 [1]. Despite the clear benefits of PA, older adults are among the least physically active age group globally; 30–60% do not meet PA guidelines [14]. In Canada, 87% of older adults fail to meet PA guidelines [15]
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