Scaling out: Implementation of a health promotion model for older adults from marginalized, rural and remote communities across BC

A large proportion of Canadians are approaching older age. Those older than 65 will comprise more than 30 percent of Canada’s population by 2050. An increasing number of older adults are unable to sustain their health and are negatively affected by chronic disease, social isolation or mobility issues.

Despite the inextricable link between physical activity and chronic disease prevention, older adults are the least active Canadians. Thus, strategies that effectively enhance physical activity are key for preserving older adults’ health and independence.

In partnership with the BC Ministry of Health, the team developed an effective health promotion intervention for older adults called Choose to Move (CTM) that was scaled-up across BC. In CTM, older adults work with an activity coach to choose physical activities they like and are able to do. The scale-up study demonstrated that CTM increased older adults’ physical activity, mobility and social connectedness.

For this project, the team will focus on a part of implementation science called the “scale-out” which is defined as an extension of “scale-up”; it refers to the use of strategies to implement an evidence-based intervention to new populations and/or through new delivery systems. Simply speaking, the team will adapt CTM so that it can be implemented by different community organizations (delivery partners) in 16 rural and remote communities across BC, as well as with older adults of low income in Vancouver. With delivery partners, the team will monitor changes that enable a “best fit” for CTM in older adults who live in different communities across BC. The team is guided by the Framework for Successful Implementation.

The project’s specific research objectives are to:

1. Describe implementation strategies that support CTM at scale-out.
2. Describe how CTM is adapted for scale-out.
3. Assess the impact of CTM on older adults’ physical activity, mobility, social connectedness and loneliness.

The guideline document that will be created through this project will be able to be used to direct processes, strategies and evaluation of health promotion initiatives for other programs and practices within public health and health services sectors.