Aging, Loneliness, Mobility Limitation, Physical Inactivity, Social Isolation
Conditions
Keywords
Older adults, Physical activity, Mobility, Social isolation, Loneliness, Social connectedness, Behavior change, Implementation, Adaptation, Scale-up, Health equity
Brief summary
Choose to Move (CTM) is a 3-month, choice-based health-promoting program for low active older adults being scaled-up across British Columbia (BC), Canada. In this project, the investigators will support community-based seniors' services (CBSS) organizations across BC through a readiness-building process so they can adapt CTM and deliver the program to more diverse groups of underserved older adults than have previously participated in CTM.
Detailed description
Choose to Move (CTM) a 3-month, choice-based health-promoting program for low active older adults being scaled-up in phases across British Columbia (BC), Canada. To date (Phases 1-4), CTM participants have included mostly white older women living in large urban centres. In this project, the investigators aim to expand the reach of CTM to more diverse populations of underserved older adults across BC. Within CTM (Phase 4), trained activity coaches support older adults in two ways. First, in a one-on-one consultation, activity coaches help participants to set goals and create action plans for physical activity tailored to each person's interests and abilities. Older adults can choose to participate in individual or group-based activities. Second, activity coaches facilitate 8 group meetings with small groups of participants. In this study, the central support unit (CSU) will work with community-based seniors' services (CBSS) organizations across BC to adapt the CTM Phase 4 program to 'best fit' the population of underserved older adults they serve, and build capacity in these organizations to deliver CTM. The investigators will then evaluate the implementation of the adapted programs, and the impact of the adapted programs on older adults' physical and social health. Objectives: 1. To assess whether CTM (adapted Phase 4) was implemented as planned (fidelity) and investigate factors that support or inhibit its implementation at scale across BC (Part I - Implementation Evaluation). 2. To assess the impact (effectiveness) of CTM (adapted Phase 4) on the physical activity, mobility, and social connectedness of older adult participants (Part II - Impact Evaluation). Study Design: The investigators use a hybrid type 2 effectiveness-implementation (Curran et al. 2012) pre-post study design to evaluate the adapted CTM Phase 4 program. The investigators use mixed methods (quantitative and qualitative) and collect data at 0 (baseline) and 3 (post-intervention) months to assess implementation and impact of CTM.
Interventions
BEHAVIORALChoose to Move
As described under study arm description
Sponsors
Public Health Agency of Canada (PHAC)
University of British Columbia
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
50 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Central support unit staff member * Activity coach hired by delivery partner organization (activity coaches must speak English to participate in the evaluation); * English-speaking older adults (aged \>=50 years) who participate in CTM (recruited by delivery partner organizations) will be invited to participate in the evaluation; * Punjabi-speaking older adults will also be invited to participate in the evaluation if they can read English or Punjabi and/or if the activity coach or a member of the research team has the necessary language skills to ensure effective communication of the Punjabi language translated consent form and surveys.
Exclusion criteria
* non-English speaking activity coaches * CTM participants \< 50 years * CTM participants who do not speak either English or Punjabi
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in physical activity | 0, 3 months | The single item physical activity questionnaire will be used to measure physical activity. Output variable is self-reported number of days/week ≥30 min physical activity in the past week (range 0-7). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in physical functioning | 0, 3 months | The Physical Functioning Subscale of the SF-36 will be used to assess the physical function aspect of mobility. The measure asks participants to rate if their health limits them in performing 10 different activities. The output variable is an average score (range 0-100) of physical functioning, where a higher score indicates a more favourable health state. |
| Change in loneliness | 0, 3 months | The three-item loneliness scale will be used to assess loneliness. Participants rate three aspects of loneliness. The output variable is loneliness score (range 3-9); lower scores indicate lower levels of loneliness. |
| Change in social isolation | 0, 3 months | A four-item questionnaire adapted from two questions on social contact frequency will be used to assess social isolation. The output variable is social isolation score (range 0-20); higher scores indicate lower levels of social isolation. |
| Change in capacity for mobility | 0, 3 months | Two items will assess participants' ability to walk a quarter of a mile and up 10 steps. The output variable is self- reported presence of mobility-disability (no/any difficulty walking 400m or climbing one flight of stairs). |
| Change in social connectedness | 0, 3 months | A single item will be used to assess sense of belonging as an indicator of social connectedness. The output variable is sense of belonging score (range 1-4) where lower scores indicate a stronger sense of belonging. |
| Change in bone- and/or muscle-strengthening physical activity | 0, 3 months | A single item will be used to assess frequency (days/week) of physical activity that strengthens bone and/or muscle. |
| Change in balance-enhancing physical activity | 0, 3 months | A single item will be used to assess frequency (days/week) of physical activity that improve balance. |
| Change in social network | 0, 3 months | A six-item questionnaire will be used to assess social network. The output variable is an equally weighted sum (range 0-30) where higher scores indicate more social engagement. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Reach-individual | 3 months | Number of organizations and older adults participating in adapted CTM programs will be obtained from program records. |
| Adaptation - CTM program (survey) | 3 months | Extent to which the adapted CTM program can be adapted, tailored, refined, or reinvented to meet local needs will be assessed by survey (4 items each on a 1-5 Likert scale with 1 being completely disagree and 5 being completely agree; developed in house). |
| Reach-regional | 0 months | The neighbourhood characteristics of the regions where CTM programs were delivered will be determined using the Canadian Social Environment Topology (CanSET) tool. |
| Adoption - CTM program | 3 months | Number of activity coaches trained to deliver the CTM program will be obtained from program records. |
| Dose delivered - CTM program (survey) | 3 months | Number of group meetings (0-8) delivered by activity coaches will be assessed by survey (developed in house). |
| Fidelity - CTM program (survey) | 3 months | Fidelity to planned delivery will be assessed via survey (designed in house) for activity coaches and older adult participants. Higher scores (1-5 Likert scale) indicate better adherence to planned delivery. |
| Fidelity - CTM program (interview) | 3 months | Fidelity to planned delivery will be assessed via interview with activity coaches and older adult participants. |
| Participant Responsiveness - CTM program (survey) | 3 months | Program satisfaction will be assessed via participant (older adults) survey (designed in house). Higher scores (1-5 Likert scale) indicate higher participant satisfaction with the intervention. |
| Participant Responsiveness - CTM program (interview) | 3 months | Program satisfaction will be assessed via interview with older adult CTM participants. |
| Cost | 0, 3 months | Program delivery costs will be recorded using a cost capture template developed in house. |
Countries
Canada
Outcome results
None listed