EngAGE Community: A Student-led Telehealth Exercise Strategy Aiming to Improve Social, Psychological and Physical Wellbeing of Older Adults

EngAGE Community is a 15-week group-based telehealth program delivered by Zoom (Version 6.0.4) which utilises a student-led delivery model. 3-5 student practitioners will be allocated to each program, supervised by an Accredited Exercise Physiologist (AEP). Each program is delivered on a single day each week for a 15-week period and consists of two key phases: a 3-week preparation phase and a 12-week program delivery phase. Preparation phase During the 3-week preparation phase, the AEP facilitates a 20minute Zoom pre-exercise health screening with each participant using the Adult Pre-exercise Screening System (APSS). The APSS is a standardized questionnaire that be used to identify individuals who may be at risk of experiencing health issues during exercise and assists to determine what level a person can safely begin an exercise program or if they need medical clearance first. During this phase, student practitioners complete a structured and supervised 12-hour training program (3 weeks x 4 hours) with an Accredited Exercise Physiologist via Zoom to familiarise them with the EngAGE framework and prepare for the individual needs of the older adult participants. Students must attend the virtual training which also covers topics such as communicating effectively with older people, telehealth best practice, primary healthcare systems, program assessment and delivery components, and consultative time with AEPs for specific program design. Program delivery phase The 12-week program delivery phase consists of three 4-week modules. The modules conceptually progress participants through initiating new social networks and learning new exercise skills, towards solidifying social networks and applying new exercise skills independently. During this 12-week phase, weekly 2-hour EngAGE classes consist of exercise, sharing, creative, and educational activities designed to be fun, socially engaging, and build a sense of community. These activities are performed either as a whole group (whole program rotation ~20-25 older adults & 4-5 student practitioners & supervising AEP) or in small groups (4-5 older adults & 1 student practitioner) as required using breakout rooms to maximise engagement based on the specific activity. Exercise activities are always completed in small groups and consist of whole-body exercises that target mobility, strength, and balance with the complexity and intensity of the exercises being tailored to the individual needs of each participant and progressing over the program. General recommendations for program design are completing flexibility and mobility work that targets the whole body with a minimum of 1 set per body region (i.e. Cervical, thoracic, lumbar/hip, lower limb, shoulder) and 2-3 sets of 8-12 repetitions of strength and balance targeting the whole body. The individualisation of the exercise program will be initially based on the outcomes from the pre-exercise health screening, mainly the participants starting physical activity levels, any participant goals, and health concerns or limitations. Participants will be grouped into their small groups with other participants of similar physical capacity and social interests as decided by the Accredited Exercise Physiologist in consultation with the Student Practitioners. As such, participants in each small group can be prescribed similar exercise activities which can be progressed or regressed each week based on participant presentation and progression each week. This individualisation is preferred as there is diverse presentation of participants at the start of the program, and there is no one size fits all exercise prescription. Sharing activities generally look to build and strengthen social bonds between participants and can include ice breaker games, sharing of personal items such as photo albums, cookbooks, health goals etc. Creative activities are developed to be a group shared experience with examples being drawing/painting, collage, virtual museum tours etc. Education activities are a series of prescribed presentations about specific health aspects relevant to older adults and non-prescribed presentations that are developed based on the common interests of the group. Student practitioners lead their group activities each week with supervisory guidance from the AEP. Student practitioners and the supervising AEP mark attendance of older adult participants each session. Student practitioners are also provided 1 hour of guided preparation and reflection on either side of the 2-hour class to ensure program quality and student progression.