Grant: Travel Awards - Institute Community Support

By 2050, 30% of Canadians will be older adults. Thus healthy aging is a public health priority. Health promoting physical activity programs contribute to healthy aging by decreasing prevalence of chronic disease and preserving mobility and independence. Still, older adults are among the most sedentary Canadians; 85% fail to meet physical activity guidelines. To improve population health, programs need to be scaled-up to reach more people and adapted across diverse settings to meet the needs of diverse populations. In 2015 the British Columbia (BC) Ministry of Health released a physical activity strategy; older adults were identified as a priority. Thus, we engaged government and community stakeholders to co-design and deliver a physical activity program (Choose to Move, CTM) for older adults. CTM increased physical activity and mobility among older adults at small scale (2016-17; 56 programs). It will be scaled-up across BC in 2018-20, providing an opportunity to study how best to adapt CTM for scale-up. The purpose of my research is to describe the adaptation process and resultant adaptations to CTM prior to its scale-up across BC. We adopted a 9-step adaptation process: 1) identify stakeholders; 2) conduct needs assessment; 3) develop prototype of recommended adaptations; 4) validate prototype with stakeholders, 5) create adapted program; 6) pilot test adaptations, 7) modify adapted program, 8) implement adapted program; and 9) evaluate effectiveness of adapted program. Here we describe steps 1-6 and organize the data with an adaptation coding tool. The adapted program includes content, context and training adaptations. To address the need for more 'opportunities to socially connect' among CTM participants we: added more group meetings, reduced phone check-ins and adapted provider training to integrate social connections for older adults. Flexible, adaptable programs are more likely to be successfully delivered at scale and have equal impact as smaller trials.