Bridging the scale-up to sustainment gap: Choose to Move-Next Steps
Abstract Overview
Background: Choose to Move (CTM) is an evidence-informed, 3-month program scaled-up across 9 years (2016-2024); CTM improved physical activity (PA), mobility, and loneliness in low active older adults. We designed a follow-up intervention (CTM-Next Steps; CTM-NS) comprised of ‘booster sessions’ to help participants maintain positive changes. We sought to identify whether a ‘minimum dose’ could sustain participant behaviours over 2 years.
Purpose: To use an integrated knowledge translation (iKT) approach to evaluate CTM-NS implementation.
Methods: From Fall 2020-2021 CTM programs, 576 participants were eligible for CTM-NS. We randomized interested participants into high (monthly; n=214) or low (quarterly; n=210) dose programs (n=19 each) delivered virtually by 5 activity coaches (ACs). We assessed implementation determinants (feasibility, acceptability) and outcomes (attendance, participant responsiveness) via survey and interviews with ACs and older adults 3, 12, and 24 months after CTM-NS program start. Using an iKT approach, we reviewed implementation data in January 2022, 12 months after the first program started.
Results: CTM-NS was feasible, but ACs noted challenges with attendance (52% vs. 68%), commitment (“come in with a different attitude”) and connection (“like I’m meeting a new group every three months”) for quarterly groups versus monthly. At 3 months fewer older adults were satisfied with the frequency of quarterly (54%) vs monthly (80%) group sessions. Therefore, we adapted the quarterly program to become a monthly program during year 2. This adaptation was well received (“a game-changer”) and fostered social connection among participants.
Conclusions: While both were feasible, ACs and older adults found monthly group meetings more acceptable. By evaluating implementation of CTM-NS early, we were able to address implementation challenges by adapting CTM-NS for the final year of the program.
Practical implications: Evaluating implementation during program delivery ensures the needs of participants and program providers are met.
Funding: Canadian Institutes of Health Research
Additional Authors
Name: Lindsay Nettlefold
Affiliation: Active Aging Research Team, University of British Columbia
Presenting Author: yes
Name: Heather Macdonald
Affiliation: Active Aging Research Team, University of British Columbia
Presenting Author: no
Name: Douglas Race
Affiliation: Active Aging Research Team, University of British Columbia
Presenting Author: no
Name: Thea Franke
Affiliation: Active Aging Research Team, University of British Columbia
Presenting Author: no
Name: Dawn Mackey
Affiliation: Aging and Population Health Lab, Simon Fraser University
Presenting Author: no
Name: Adrian Bauman
Affiliation: University of Sydney
Presenting Author: no
Name: Joanie Sims Gould
Affiliation: Active Aging Research Team, University of British Columbia
Presenting Author: no
Name: Heather McKay
Affiliation: Active Aging Research Team, University of British Columbia
Presenting Author: no
Information
Study Type: Intervention
Subtheme: Implementation science
Population Group: Older Adults
Setting: Community
Submitting Author
Lindsay Nettlefold
Senior Researcher
University of British Columbia
Canada