Community health promotion programs for older adults: What helps and hinders implementation

Abstract

Background and Aims Despite the many known health benefits of physical activity (PA), older adults are the least active citizens in many countries. Regular PA significantly decreases the odds of functional limitation and social disengagement. However, there is a dearth of publicly funded support services for older adults. The primary objective of this study is to conduct a formative evaluation to examine the implementation of community‐driven health promotion programs for older adults in British Columbia, Canada. Methods The Active Aging Grant (AAG) initiative funded 30 community‐based organizations in British Columbia to design and deliver community‐driven health promotion programs for older adults, with an explicit focus on PA and social connectedness. Guided by the Framework for Successful Implementation, we recruited program coordinators and participants and used semistructured interview guides to focus on design, delivery, and experience within the program. Framework analysis was used with NVivo 11. Results Thirty‐six in‐depth, semistructured interviews were conducted in 2017, after program completion. Data saturation was achieved after interviewing 10 coordinators and 26 program participants from seven of the organizations. Eighteen were female; nine were male; 68% fell in the age range of 65‐84. We detail the innovation characteristics, provider characteristics, and contextual factors that facilitate and impede program implementation. Aspects that facilitate implementation include that they promote PA, foster social connectedness, and address isolation and loneliness; personal accountability; affordability; program design; providers' appropriate skills; community collaborations; and transportation support. Aspects that hinder implementation include lack of resources for marketing and communications, lack of volunteers and dedicated staff, and access to transportation. We also highlight two themes that emerged outside the theoretical framework, the roles of gender and funding in program implementation. Conclusions As part of a formative evaluation, the information will help adapt and enhance implementation of a larger scale‐out intervention aimed to increase PA and social connectedness amongst older adults in British Columbia, Canada.

Social isolation and health-promoting behaviors among older adults living with different health statuses: A cross-sectional study

“…Existing studies have demonstrated that social isolation could diminish participation in recreational physical activity as well as induce anxious-depressive-related behaviors [ 9 ]. In addition, older adults who were at risk of social isolation did not seem to make full use of medical services or seek help from others [ 10 ]. A vicious circle can be created between social isolation and a low level of health-promoting behaviors, which may finally lead to adverse health outcomes.…”

Primary care-based interventions addressing social isolation and loneliness in older people: a scoping review

“…88 92 In addition, we found that facilitating access to interventions in the form of transportation or affordability is a crucial component, as found by other reports. 93 We also found that participants' and professionals' poor understanding of referral pathways, lack of fit between intervention components and participant interest, age-related limitations and the fear of joining new groups, were barriers that affected overall intervention uptake and acceptability. Interventions should be adapted to participants' age-related physical and mental health conditions and social needs.…”

Status Quo or Drop-Off: Do Older Adults Maintain Benefits From Choose to Move—A Scaled-Up Physical Activity Program—12 Months After Withdrawing the Intervention?

“…46 The participants' positive relationship with their activity coach and interactions with other participants influenced feelings of social connectedness during CTM. 47,48 Sharing information and experiences, learning from their peers, and engaging with others who share familiar experiences also contributed to feelings of social connection. 35 It seems imperative to maintain social and mental health benefits; to do so, programs that support these outcomes must be ongoing.…”