Activity Programs For Older Adults Research Articles

Getting Ready for Scale-Up of an Effective Older Adult Physical Activity Program: Characterizing the Adaptation Process.

To optimize public health impact, health interventions must be delivered widely to reach the population in need. Yet, few interventions are ever implemented at broad scale (scaled-up). Thus it is necessary to devise implementation strategies that support scale-up of effective interventions. Adapting an intervention and implementation strategies to the local context to improve "fit" at scale-up is critical to success. Therefore, our study responds to a call to build a database of systematic adaptations of evidence-based interventions across populations and contexts, including scaled-up designs. To do so, we focus on the process of adapting an effective physical activity program for older adults, called Choose to Move (CTM), for scale-up. Our objectives were to describe the systematic process of adapting CTM for scale-up across British Columbia (BC) and to report the actual changes made to CTM. We adopted a 6-step process: (1) identify stakeholders; (2) conduct needs assessment; (3) develop prototype of adaptations; (4) validate prototype with stakeholders; (5) create adapted program; and (6) pilot test adaptations. For the adaptation process, we described each step and organized data within an adaptation coding system. Results showed that adaptations to CTM span program content, program context, and the training modules. For example, to address the request by CTM participants for more opportunities to socially connect with others, we added more group meetings, reduced phone check-ins, and integrated aspects of training related to social cohesion. Our study extends the current literature by providing researchers a clear pathway toward adapting health promotion interventions for scale-up.

Beginning With the End in Mind: Contextual Considerations for Scaling-Out a Community-Based Intervention.

Introduction: A number of effective physical activity programs for older adults exist, but are not widely delivered within community settings, such as the Cooperative Extension System. The purpose of this paper was to determine if an evidence-based intervention (EBI) developed in one state Extension system could be scaled-out to a new state system.Methods and results: The RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework was used to guide an iterative evaluation of three translational stages. Stage 1: Before program adoption, Extension health educators were surveyed and interviewed to assess physical activity programming perceptions and factors that may influence their decision to attend training or deliver the program in practice. Results indicated that a virtual, scalable training protocol would be necessary and that training needed to include hands-on instruction and be catered to those who were less confident in physical activity program delivery. Stage 2: Training attendees were surveyed pre- and post-training on factors related to the adoption-decision making process and contacted post-training to assess program delivery status. Training did not influence perceptions of the program, intent to deliver, or confidence in delivering the program. Stage 3: During program implementation, the program was evaluated through the RE-AIM framework by surveying across three key stakeholder groups: (1) program participants, (2) potential delivery personnel, and (3) Extension administrators. Findings indicate that the program has the potential to reach a large and representative proportion of the target audience, especially in rural areas. However, adoption and implementation rates among Extension health educators and community partners were low and data collection for effectiveness, implementation, and maintenance was a challenge.Conclusion: Overall, the results indicate initial struggles to translating and evaluating the program in a large, rural state. Implications for practice include making system-level changes to increase physical activity program adoption rates among Extension health educators and improve data collection and program evaluation through this community-based organization. More work is needed to identify infrastructure support and capacity to scale-out EBIs.

Implementation of a co-designed physical activity program for older adults: positive impact when delivered at scale

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.

Modes of physical activity reported by older adults living with osteoporosis in Canada

Background: Physical activity is recommended as an adjunct to treatment for persons living with osteoporosis. Results from numerous studies demonstrate the health benefits linked with physical activity for persons living with osteoporosis yet little is known about the types of leisure-time physical activities reported by adults living with osteoporosis in Canada. Purpose: The purpose of this study was to address two questions: (1) What is the most common mode of physical activity reported by older adults living with osteoporosis in Canada? and (2) Does the mode of physical activity reported by older adults living with osteoporosis in Canada differ between males and females? Methods: Participants were enrolled in Cycle 2.2 of the Canadian Community Health Survey (CCHS) who reported a diagnosis of osteoporosis. Males (n = 167) and females (n = 1371) responded to select demographic questions and a modified version of the Physical Activity Monitor (m-PAM). Results: Walking for exercise was the most common mode of physical activity reported by males (60.5%) and females (60.7%) followed by gardening/yard work (34.8% to 44.9%) then home-based exercise (21.6% to 23.8%). Chi-square analyses revealed sex-differences in mode of participation for 11 of 21 physical activities assessed with the m-PAM. Conclusions: Overall, the findings of this study imply consideration of sex and mode of physical activity may be key issues for health professionals and policy developers to consider in designing and implementing physical activity programs for older adults living with osteoporosis in Canada.

Regular group exercise contributes to balanced health in older adults in Japan: a qualitative study

BackgroundWhile community-wide interventions to promote physical activity have been encouraged in older adults, evidence of their effectiveness remains limited. We conducted a qualitative study among older adults participating in regular group exercise to understand their perceptions of the physical, mental, and social changes they underwent as a result of the physical activity.MethodsWe conducted a qualitative study with purposeful sampling to explore the experiences of older adults who participated in regular group exercise as part of a community-wide physical activity intervention. Four focus group interviews were conducted between April and June of 2016 at community halls in Fujisawa City. The participants in the focus group interviews were 26 older adults with a mean age of 74.69 years (range: 66–86). The interviews were analysed using the constant comparative method in the grounded theory approach. We used qualitative research software NVivo10® to track the coding and manage the data.ResultsThe finding ‘regular group exercise contributes to balanced health in older adults’ emerged as an overarching theme with seven categories (regular group exercise, functional health, active mind, enjoyment, social connectedness, mutual support, and expanding communities). Although the participants perceived that they were aging physically and cognitively, the regular group exercise helped them to improve or maintain their functional health and enjoy their lives. They felt socially connected and experienced a sense of security in the community through caring for others and supporting each other. As the older adults began to seek value beyond individuals, they gradually expanded their communities beyond geographical and generational boundaries.ConclusionsThe participants achieved balanced health in the physical, mental, and social domains through regular group exercise as part of a community-wide physical activity intervention and contributed to expanding communities through social connectedness and mutual support. Health promotion through physical activity is being increasingly emphasized. The study results can help to develop effective physical activity programs for older adults in the community.

Beyond Strength: Participant Perspectives on the Benefits of an Older Adult Exercise Program.

This study examines the expected and experienced benefits among participants in Enhance®Fitness (EF), an evidence-based group physical activity program for older adults. We also describe the implications for program dissemination (reach, implementation, and maintenance) within the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. Twenty semistructured interviews were conducted with EF participants enrolled from 2005 to 2012. Interviews were digitally recorded, professionally transcribed, and analyzed using a deductive approach. Participants were motivated to join EF for expected physical benefits and the social environment of a group-based class. Actualized benefits of participation included physical, social, functional, and improved self-image/sense of well-being. Participants valued the practical application of class exercises to daily activities that support independent living, such as lifting objects and completing household chores. Organizations looking to implement EF or improve existing EF classes can improve program reach, implementation, and maintenance by incorporating participants' expressed motivations and valued benefits in program marketing and by improving organizational support to meet participant needs. EF class instructors can tailor their classes to engage participants based on their motivations. Understanding participants' motivations and valued benefits can improve EF dissemination by meeting participant needs with tailored class offerings and organizational needs informed by participant insights that aid program sustainability.

Increasing the Availability of Physical Activity Programs for Older Adults: Lessons Learned From Texercise Stakeholders.

Many initiatives have been developed to facilitate older adults' engagement in physical activity (PA) and document its benefits. One example is Texercise, a 12-week program with a focus on increasing participants' self-efficacy. The goal of this paper is to augment the knowledgebase of PA program implementation and dissemination by elucidating the experience of Texercise implementation as perceived by multiple stakeholders. We conducted 28 semistructured stakeholder interviews and categorized the responses into four preset themes: (1) program delivery and advocacy; (2) value/merit of the program; (3) successes/challenges of offering and sustaining the program; and (4) recommendations for enhancing implementation and delivery. We identified emergent subthemes through further analysis. Many perceptions that are broadly applicable to community organizations emerged. Our findings highlight the importance of stakeholder support when embedding PA programs in communities. Furthermore, the findings are crucial to understanding underlying processes that support widespread program dissemination and sustainability.

Predictors of physical activity and fitness in a 6-month, home-based physical activity program for older adults: MOVES

Predictors of physical activity and fitness in a 6-month, home-based physical activity program for older adults: MOVES

Intergenerational Service Learning Program Improves Aging Knowledge and Expectations and Reduces Ageism in Younger Adults

This article discusses a study which evaluated the effects of an intergenerational service-learning exergaming program for older adults on younger adults’ aging knowledge, expectations, and perceptions. Eighteen college students (ages 19-26 years) served as trainers for an 8-week exergaming physical activity program for older adults (12 contact hours). Questionnaires assessing aging knowledge, ageist attitudes and aging expectations were completed at Weeks 1, 8, and 25 (follow-up); program evaluations were completed at Weeks 8 and 25. Significant improvement from Week 1 to Week 25 was found for: Aging knowledge scores (p

Participant Variation by Delivery Site Type in an Evidence-Based Physical Activity Program.

This study examined participant demographic and physical function characteristics from EnhanceFitness, an evidence-based physical activity program for older adults. The sample consisted of 19,964 older adults. Participant data included self-reported health and demographic variables, and results for three physical function tests: chair stand, arm curls, and timed up-and-go. Linear regression models compared physical function test results among eight program site types. Participants were, on average, 72 years old, predominantly female, and reported having one chronic condition. Residential site participants' physical function test results were significantly poorer on chair stand and timed up-and-go measures at baseline, and timed up-and-go at a four-month follow-up compared with the reference group (senior centers) after controlling for demographic variables and site clustering. Evidence-based health-promotion programs offered in community settings should assess demographic, health, and physical function characteristics to best serve participants' specific needs, and offer classes tailored to participant function and ability while maintaining program fidelity.

Determining the reach of a home-based physical activity program for older adults within the context of a randomized controlled trial.

Determining the reach of physical activity (PA) programs is challenging due to inconsistent reporting across studies. The purpose of this study was to document multiple indicators of program reach for a 6-month, Digital Versatile Disc (DVD)-delivered home-based PA program. Radio, newspaper and direct mailing advertisements were tracked to determine costs as well as the number and representativeness of older adults exposed and responding to recruitment. It was estimated that all older adults in the recruitment area (n = 105 515) may have been exposed to at least one of the recruitment strategies--563 responded and 383 were screened as eligible. Of those that enrolled (n = 307), the DVD reached between 81% and 97% of the participants over each month within the 6 month period. Newspaper advertisements were most effective (n = 222) at a cost of $78 per participant enrolled. Using multiple indicators of reach supports the accurate calculation and generalizability of recruiting older adults into PA programs.

Adherence to a Videogame-Based Physical Activity Program for Older Adults with Schizophrenia.

Adults with schizophrenia are a growing segment of the older adult population. Evidence suggests that they engage in limited physical activity. Interventions are needed that are tailored around their unique limitations. An active videogame-based physical activity program that can be offered at a treatment facility can overcome these barriers and increase motivation to engage in physical activity. The purpose of this report is to describe the adherence to a videogame-based physical activity program using the Kinect(®) for Xbox(®) 360 game system (Microsoft(®), Redmond, WA) in older adults with schizophrenia. This was a descriptive longitudinal study among 34 older adults with schizophrenia to establish the adherence to an active videogame-based physical activity program. In our ongoing program, once a week for 6 weeks, participants played an active videogame, using the Kinect for Xbox 360 game system, for 30 minutes. Adherence was measured with a count of sessions attended and with the total minutes attended out of the possible total minutes of attendance (180 minutes). Thirty-four adults with schizophrenia enrolled in the study. The mean number of groups attended was five out of six total (standard deviation=2), and the mean total minutes attended were 139 out of 180 possible (standard deviation=55). Fifty percent had perfect attendance. Older adults with schizophrenia need effective physical activity programs. Adherence to our program suggests that videogames that use the Kinect for Xbox 360 game system are an innovative way to make physical activity accessible to this population.

Evaluation of a Peer-Led, Low-Intensity Physical Activity Program for Older Adults

BackgroundPhysical inactivity is a primary contributor to decreasing functional physical fitness and increasing chronic disease in older adults.PurposeThis study assessed the health-related benefits of ExerStart for Lay Leaders, a 20-week, community based, peer-led, low-impact exercise program for older adults. ExerStart focuses on aerobic endurance, muscular strength, flexibility, and balance.MethodsUsing a pre/posttest evaluation design, researchers examined the effects of the program on 432 older adults in St. Louis, Missouri, and Houston, Texas. Participants completed self-report surveys as well as observed functional physical fitness assessments.ResultsParticipants in ExerStart for Lay Leaders significantly improved their perceived satisfaction with body function, functional physical fitness, perceived overall health, and body mass index.DiscussionThis study adds to the evidence that older adults benefit from structured, peer-led exercise programs. The increased physical fitness, if maintained, may lead to a decrease in falls, adult obesity, and nursing home placements.Translation to Health Education PracticeThe current research has important implications for implementing outcome-based and cost-effective health education programs for older adults, including using peer leaders as a cost reduction technique to implement and disseminate research informed programs into community settings.

Best Practice Physical Activity Programs for Older Adults and ADL/IADL Performance

Best practice physical activity guidelines for older adults recommend multicomponent physical activity programs that incorporate behavioral change strategies and a safe design. This review examined research implementing best practice interventions and their impact on activities of daily living (ADL) and instrumental activities of daily living (IADL) for community-dwelling older adults. Of the 15 studies identified, all reported gains in at least 1 outcome, but few incorporated all features of best practice. Only 1 study evaluated ADL/IADL performance. More research implementing best practice physical activity guidelines and targeting ADL/IADL performance is indicated to understand the impact of such programs on everyday living.

Validação do teste de flexibilidade da AAHPERD para idosos brasileiros. 10.5007/1980-0037.2011v13n6p455

Flexibility is an indispensable component of the ability to carry out activities of daily living. The flexibility test proposed by the American Alliance for Health, Physical Education, Recreation and Dance (AAHPERD) is easy to administer and requires little equipment. Thus, the present study sought to ascertain the validity of the flexibility component of the AAHPERD Functional Fitness Assessment in Brazilian older adults. The study sample comprised 330 subjects (278 women and 52 men), with a mean age of 69.45+6.19 years, who took part in a physical activity program for older adults. The Leighton Flexometer was chosen as a comparator instrument. The Pearson correlation coefficient (r), simple linear regression, and Bland-Altman plots were used for statistical analysis. The correlation between AAHPERD Functional Fitness Assessment and Leighton flexometer findings was r = 0.93 and r = 0.86 (p &lt;0.01) for males and females respectively. The AAHPERD Functional Fitness Assessment explained 74.3% of variance in Leighton flexometer findings in female participants and 86.6% in male participants. We conclude that the flexibility component of the AAHPERD Functional Fitness Assessment provides adequate estimation of lumbar and hip flexibility in Brazilian older adults.

Sustainability of evidence-based community-based physical activity programs for older adults: lessons from Active for Life

Program sustainability in community and healthcare settings is critical to realizing the translation of research into practice. The purpose of this study is to describe the implementation and assessment of an intervention to increase organizational maintenance of evidence-based physical activity programs and the factors that impede or facilitate sustainability. All organizations implemented a sustainability action plan that included identifying factors related to sustainability, examining resources available, identifying program modifications to enhance sustainability, and long-term action planning. A mixed methods approach was used. Organizational (n = 12 sites) ability to demonstrate program effectiveness, align priorities with the organizational mission, and integrate the program within the existing infrastructure were strengths related to sustainability. Sites were more optimistic about program sustainability when they had less reliance on internal financial, but more reliance on internal human resources to run the program post-funding. The study resulted in a number of tools that can help community organizations plan for sustainability of physical activity programs.

Arm-Curl Field Test for Older Women: Is it a Measure of Arm Strength?

The facilitative effect of physical activity on age-related decline is well documented. Specifically, it has been found to reduce the risk of dependency. However, physical activity programs for older adults should be carefully designed so that improvements in all aspects of movement and physical capacities are achieved. This means that efficient fitness measurements should be made available for coaches and trainers. The arm-curl test is a common field test known for measuring the strength of upper extremities in older age. The objective of the current study was to determine to what extent this test indeed assesses arm strength as well as other fitness aspects such as arm muscle endurance or general endurance. Scores of the arm-curl test were compared with strength and endurance of elbow flexors measured by an isokinetic dynamometer and general endurance measured by a stress test in 48 independently functioning women (age 72.04 ± 6.28 yr). Significant correlations were indicated between the arm-curl scores and both isokinetic endurance (r = 0.452) and general endurance (r = 0.437); however, a very low nonsignificant correlation was found between the arm-curl and isokinetic maximal strength scores. Coaches must be aware of the fact that the repetitive arm-curl exercise contains a significant aerobic component and thus may contribute to aerobic fitness and arm muscle endurance but not necessarily to arm strength.

Relationship Between the Change in Daily Step Count and Brachial-Ankle Wave Velocity During a Pedometer-Based Physical Activity Program for Older Adults

Objective: To study the relationship between the change in the number of steps taken and brachial-ankle pulse wave velocity (baPWV) during a long-term pedometer-based physical activity program in healthy older adults. Methods: Sixty older adults participated in this 17-week program. Each subject was provided with a pedometer and was given a goal to walk a set number of steps/day. After five subjects were excluded because of insufficient step data, data from 55 subjects (19 men and 36 women; age range: 65–79 years, mean age: 71.3±3.7 years; mean body mass index [BMI]: 24.1±8.8 kg/m 2 ) were analyzed. Subjects were checked before and after the study. Each subject was informed of his or her vascular age, calculated from baPWV, at the start of the study. Results: Subjects were divided into four groups based on the results of baPWV. The group in which baPWV improved above a selected cut-off value (1,700 cm/s) revealed the largest increase in steps/day among groups. This increase (4837.7±1868.7 steps) was larger than in groups in which baPWV remained low (1406.7±2402.1 steps, p=0.036) and high (1678.2±2871.4 steps, p=0.059). In any group, age or initial steps/day did not influence the change in steps. Subjects classified as having an older vascular age than the actual age on the basis of initial baPWV walked further. Conclusion: An increase in steps/day might improve baPWV. Although walking is a low intensity physical activity, it can have an anti-atherosclerosis effect.

Participants' Attitudes, Opinions, and Beliefs of a Physical Activity Program in West Virginia

The qualitative study reported here assessed participants' attitudes, opinions, and beliefs concerning the West Virginia University Extension Service Active for Life Program (AfLP). Three focus groups were conducted to elicit participants' perceptions of the AfLP. Key themes identified by 19 participants included motivating factors, inhibiting factors, and change recommendations. With the qualitative evaluation, we verified the positive influence of the AfLP on community-dwelling adults in West Virginia. Our findings were consistent with those of other studies on community-based exercise programs. Other Extension Services may use this information to adopt the AfLP and increase access to physical activity programs for older adults.

Fatores determinantes para a continuidade da participação de idosos em programas de atividade física: a experiência dos participantes do projeto "Sem Fronteiras"

Este trabalho discute os resultados de uma pesquisa qualitativa, cujo objetivo foi o de investigar os fatores que determinam a participação continuada de idosos no projeto "Sem Fronteiras: Atividades Corporais para Adultos Maduros e Idosos", desenvolvido na Universidade Federal do Paraná. Participaram do estudo 10 idosos que estavam regularmente frequentando o projeto há pelo menos dois anos. Os dados foram coletados através de uma entrevista semi-estruturada. O guia de entrevista teve como linha condutora as seguintes questões: O que o (a) motivou a dar início à participação no projeto "Sem Fronteiras"? O que o (a) motiva a continuar participando do projeto? Quais as principais dificuldades que o senhor (a senhora) encontra para permanecer no mesmo? O que o (a) motiva a superar estas dificuldades? A análise das entrevistas teve como foco os principais temas que emergiram da fala dos participantes. Primeiramente foram analisados os dados de cada entrevista individualmente. A seguir, os dados foram cruzados buscando-se por temas comuns e divergentes entre as falas dos entrevistados. A principal conclusão da pesquisa foi que os idosos permanecem no programa não somente por perceberem benefícios à sua saúde física, mental e emocional, mas também pelas oportunidades que este lhe oferece em termos de desenvolvimento pessoal, socialização, e troca de informações, experiências, suporte e afeto. As barreiras mais importantes encontradas pelos mesmos para dar continuidade à sua participação no projeto relacionam-se com problemas de saúde e compromissos familiares.