Abstract
BackgroundHealthy ageing is an important concern for many societies facing the challenge of an ageing population. Physical activity (PA) is a major contributor to healthy ageing; however insufficient PA levels are prevalent in old age in Germany. Community capacity building and community involvement are often recommended as key strategies to improve equitable access to prevention and health promotion. However, evidence for the effectiveness of these strategies is scarce. This study aims to assess the community readiness for PA promotion in local environments and to analyse the utility of strategies to increase community readiness for reaching vulnerable groups.Methods/DesignWe designed a mixed method intervention trial comprising three study modules. The first module includes an assessment of community readiness for PA interventions in older adults. The assessment is carried out in a sample of 24 municipalities in the Northwest of Germany using structured key informant interviews. In the second module, eight municipalities with the low community readiness are selected from the sample and randomly assigned to one of two study groups: active enhancement of community readiness (intervention) versus no enhancement (control). After enhancing community readiness in the active enhancement group, older adults in both study groups will be recruited for participation in a PA intervention. Participation rates are compared between the study groups to evaluate the effects of the intervention. In addition, a cost-effectiveness analysis is carried out calculating recruitment costs per person reached in the two study groups. In the third module, qualitative interviews are conducted with participants and non-participants of the PA intervention exploring reasons for participation or non-participation.DiscussionThis study offers the potential to contribute to the evidence base of reaching vulnerable older adults for PA interventions and provide ideas on how to reduce participation barriers. Its findings will inform governmental authorities, professionals, academics, and NGOs with an estimate of resources necessary to achieve equitable access to physical activity programs for vulnerable older adults.Trial registrationGerman Clinical Trials Register DRKS00009564 (Date of registration 03-11-2015)
Highlights
Healthy ageing is an important concern for many societies facing the challenge of an ageing population
This study offers the potential to contribute to the evidence base of reaching vulnerable older adults for Physical activity (PA) interventions and provide ideas on how to reduce participation barriers
As reaching vulnerable groups is among the aims of community based strategies for health promotion, we investigate whether increasing community readiness leads to higher participation rates in traditionally hard-to-reach population groups
Summary
Healthy ageing is an important concern for many societies facing the challenge of an ageing population. PA is a key health resource for an ageing community In spite of these well-known beneficial effects, only one third of older adults in Germany are physically active; 25.4% of male and 15.5% of female persons over the age of 70 reach the WHO-recommended levels [9]. The concept of community readiness outlines an approach to increase a community’s readiness to participate in a health behaviour change intervention It applies a stage-based behaviour change model to the community level [18, 19]. According to this concept, a certain degree of problem awareness and pre-planning in the community is crucial for a health promotion intervention to be successfully implemented [18,19,20]. Its utility for reaching vulnerable populations for PA interventions and overall cost-effectiveness have not yet been systematically investigated
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