“It makes me feel not so alone”: features of the Choose to Move physical activity intervention that reduce loneliness in older adults

Abstract

Background Despite the well-known health benefits of physical activity (PA), older adults are the least active citizens. Older adults are also at risk for loneliness. Given that lonely individuals are at risk for accelerated loss of physical functioning and health with age, PA interventions that aim to enhance social connectedness may decrease loneliness and increase long-term PA participation. The objectives of this mixed-method study are to: (1) evaluate whether an evidence-based PA intervention (Choose to Move; CTM) influenced PA and loneliness differently among self-identified ‘lonely’ versus ‘not lonely’ older adults and (2) to describe factors within CTM components most likely to promote social connectedness/reduce loneliness. Methods CTM is a flexible, scalable, community-based health promoting physical activity intervention for older adults. Two community delivery partner organizations delivered 56 CTM programs in 26 urban locations across British Columbia. We collected survey data from participants (n = 458 at baseline) at 0 (baseline), 3 (mid-intervention) and 6 (post-intervention) months. We conducted in depth interviews with a subset of older adults to understand how CTM facilitated or impeded their PA and social connectedness. Results PA increased significantly from baseline to 3 months in lonely and not lonely participants. PA decreased significantly from 3 to 6 months in lonely participants; however, PA at 6 months remained significantly above baseline levels in both groups. Loneliness decreased significantly from baseline to 3 and 6 months in participants identifying as lonely at baseline. Factors within CTM components that promote social connectedness/reduce loneliness include: Activity coach characteristics/personality traits and approaches; opportunity to share information and experiences and learn from others; engagement with others who share similar/familiar experiences; increased opportunity for meaningful interaction; and accountability. Conclusion Health promoting interventions that focus on PA and social connectedness through group-based activities can effectively reduce social isolation and loneliness of older adults. Given the ‘epidemic of loneliness’ that plagues many countries currently, these kinds of interventions are timely and important. Research that further delineates mechanisms (e.g., sharing experiences vs. lectures), that modify the effect of an intervention on social connectedness outcomes for older adults engaged in community-based PA programs would be a welcome addition to the literature.

Rapidly adapting an effective health promoting intervention for older adults—choose to move—for virtual delivery during the COVID-19 pandemic

“…Choose to Move (CTM; described in Methods) is an effective health promoting intervention that was scaled up in phases (2016–21) across British Columbia (BC), engaging > 2000 older adult participants. CTM effectively enhanced social connectedness, mobility, and physical activity and reduced loneliness [ 41 , 42 ]. Prior to COVID, CTM was an in-person program.…”

Resistance Training With Partial Blood Flow Restriction in a 99-Year-Old Individual: A Case Report

“…In the WHOQOL-bref analysis, the score for the “Social relationships” domain presented a 40% increase from Pre to Post values. This may be partly due to the care and attention from researchers and the time spent with training instructors (Dickens et al, 2011 ; Franke et al, 2021 ). Unpublished data from Cook et al indicates that older adults that have participated in research interventions listed the researchers as people in their social support system.…”

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?

“…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. However, the amount or quality of interaction afforded through participation in CTM may have been insufficient to counter feelings of social isolation in our oldest participants.…”

“…Participants self-reported PA (number of days per week ≥30 min) using a valid and reliable singleitem questionnaire 31,32 and capacity for mobility as no/any difficulty walking 400 m and/or climbing one flight of stairs. 33 We assessed loneliness using a 3-item questionnaire (loneliness score; range 3-9, where higher scores indicate greater loneliness) that shows good internal consistency, discriminant validity, and convergent validity, 34 and social isolation using a 3-item questionnaire 35 adapted from 2 questions on social contact frequency 36 (social isolation score; range 0-15, where higher scores indicate less social isolation).…”