Evaluating Implementation and Impact of the Adapted Choose to Move (CTM) Program

N/AEnrolling By InvitationNCT06252259

University of British Columbia336 enrolled

Overview

Choose to Move (CTM) is a 3-month, choice-based health-promoting program for low active older adults being scaled-up across British Columbia (BC), Canada. In Phase 5, the goal of CTM is to enhance physical activity, mobility and social connectedness in three target populations: South Asian older adults, older men, and older adults living in Northern BC. To do so, the investigators will support community-based seniors' services (CBSS) organizations through a readiness-building process so they can adapt CTM and deliver the program to these populations. This study has two main research questions: 1. How are adapted CTM programs delivered ('implementation outcomes') and what factors influence delivery ('implementation determinants')? 2. What is the impact of the adapted CTM programs on health outcomes of older adults?

Choose to Move (CTM) a 3-month, choice-based health-promoting program for low active older adults being scaled-up in phases across British Columbia (BC), Canada. To date (Phases 1-4), CTM participants have included mostly white older women living in large urban centres. In Phase 5, the investigators aim to expand the reach of CTM to three target populations: South Asian older adults, older men, and older adults living in Northern BC. Within CTM (Phase 5), trained activity coaches support older adults in two ways. First, in a one-on-one consultation, activity coaches help participants to set goals and create action plans for physical activity tailored to each person's interests and abilities. Older adults can choose to participate in individual or group-based activities. Second, activity coaches facilitate 8 group meetings with small groups of participants. In this study, the central support unit (CSU) will work with community-based seniors' services (CBSS) organizations to adapt CTM to 'best fit' these target populations of older adults, and build capacity in these organizations to deliver CTM. The investigators will then evaluate the implementation of the adapted programs, and the impact of the adapted programs on older adults' physical and social health. Objectives: 1. To assess whether CTM (Phase 5) was implemented as planned (fidelity) and investigate factors that support or inhibit its implementation at scale (Part I - Implementation Evaluation). 2. To assess the impact (effectiveness) of CTM (Phase 5) on the physical activity, mobility, and social connectedness of older adult participants (Part II - Impact Evaluation). 3. To assess whether participant-level benefits of CTM (Phase 5) are maintained 12 months after participants complete the CTM program. Study Design: The investigators use a hybrid type 2 effectiveness-implementation (Curran et al. 2012) pre-post study design to evaluate CTM Phase 5. The investigators use mixed methods (quantitative and qualitative) and collect data at 0 (baseline), 3 (post-intervention) and 15 (12-months post intervention) months to assess implementation and impact of CTM.

Eligibility

Sex: ALLMin age: 50 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion criteria: * Central support unit staff member; * Delivery partner organization staff member; * Activity coach hired by delivery partner organization (activity coaches must speak English to participate in the evaluation); * English-speaking older adults (aged \>=50 years) who participate in CTM (recruited by delivery partner organizations) will be invited to participate in the evaluation; * Punjabi-speaking older adults will also be invited to participate in the evaluation if they can read English or Punjabi and/or if the activity coach or a member of the research team has the necessary language skills to ensure effective communication of the Punjabi language translated consent form and surveys. Exclusion criteria: * non-English speaking delivery partner staff member * non-English speaking activity coach

Outcomes

Primary Outcomes

Change in physical activity

The single item physical activity questionnaire will be used to measure physical activity. Output variable is self-reported number of days/week ≥30 min physical activity in the past week (range 0-7).

Time frame: 0, 3, 15 months

Secondary Outcomes

Change in capacity for mobility

Two items will assess participants' ability to walk a quarter of a mile and up 10 steps. The output variable is self- reported presence of mobility-disability (no/any difficulty walking 400m or climbing one flight of stairs).

Time frame: 0, 3, 15 months

Change in physical functioning

The Physical Functioning Subscale of the SF-36 will be used to assess the physical function aspect of mobility. The measure asks participants to rate if their health limits them in performing 10 different activities. The output variable is an average score (range 0-100) of physical functioning, where a higher score indicates a more favourable health state.

Time frame: 0, 3, 15 months

Change in loneliness

The three-item loneliness scale will be used to assess loneliness. Participants rate three aspects of loneliness. The output variable is loneliness score (range 3-9); lower scores indicate lower levels of loneliness.

Time frame: 0, 3, 15 months

Change in social isolation

A four-item questionnaire adapted from two questions on social contact frequency will be used to assess social isolation. The output variable is social isolation score (range 0-20); higher scores indicate lower levels of social isolation.

Time frame: 0, 3, 15 months

Change in social network

A six-item questionnaire will be used to assess social network. The output variable is an equally weighted sum (range 0-30) where higher scores indicate more social engagement.

Time frame: 0, 3, 15 months

Change in social connectedness

A single item will be used to assess sense of belonging as an indicator of social connectedness. The output variable is sense of belonging score (range 1-4) where lower scores indicate a stronger sense of belonging.

Time frame: 0, 3, 15 months

Change in health-related quality of life (EQ-5D-5L Profile)

The EQ-5D-5L consists of five dimensions (mobility, self-care, usual activities, pain/discomfort and anxiety/depression). Participants are asked to indicate their level of functioning (from 1 "no problems" to 5 "extreme problems") on each of the five dimensions of the EQ-5D-5L. The EQ-5D-5 L describes 3125 distinct health states, with 11111 representing the best and 55555 the worst possible health states. The investigators apply the Canadian EQ-5D-5 L scoring algorithm to generate index scores, which ranged from - 0.148 for the worst (55555) to 0.949 for the best (11111) health states.

Time frame: 0, 3, 15 months

Change in health-related quality of life (EQ-5D-5L Visual Analogue Scale)

Health status will be assessed with the EQ-5D-5L visual analogue scale. Participants report on their health on a visual analogue scale from 0 (worst health) to 100 (best health).

Time frame: 0, 3, 15 months

Change in physical activity (objective)

Physical activity will be assessed by accelerometers (worn for 7 days) in a subset of participants in the Men on the Move study arm. The output variables are minutes per day of light, moderate and vigorous physical activity.

Time frame: 0, 3, 15 months

Evaluating Implementation and Impact of the Adapted Choose to Move (CTM) Program

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes