[Feedback on the implementation of a departmental physical activity project for the elderly]. / Retour d'expérience sur la mise en œuvre d'une action départementale d'activité physique pour les seniors.

INTRODUCTION: Regular physical activity is nowadays recognized as one of the keys for ageing well. A number of interventions are therefore developed for this target group. The goal of this study was to examine the establishment and impact of a structured physical activity program for subjects aged 60 or more on a departmental scale and according to the point of view of different actors engaged. METHODS: The PAS Project (Prévention Active Senior), coordinated by a resource and expertise center, consisted of conceiving and implementing a structured physical activity program for subjects aged 60 or more. In every municipality, the program was conducted by a local sports instructor in partnership with a municipal representative. It consisted of 3 weekly sessions of physical activity (2 supervised and 1 individual) over a period of 3 months. The data was collected thanks to the tools developed for the evaluation. RESULTS: The program was conducted in 27 municipalities. A total of 586 participants enrolled in the program and 439 completed the final evaluation. This project allowed for the improvement of three main physical capacities (endurance, muscular strength, and balance) for most of the participants. At the end of the program, more than 50% of municipalities created or supported a long term physical activity offer for elderly. DISCUSSION: This study highlights the need of adapting this kind of intervention to the local context. It confirmed the interest of a combined individual and more general approach, as well as a cross-sectorial work in order to create the conditions for sustainable daily physical activity for the target group.

Implementation and Core Components of a Multimodal Program including Exercise and Nutrition in Prevention and Treatment of Frailty in Community-Dwelling Older Adults: A Narrative Review.

Increasing disability-free life expectancy is a crucial issue to optimize active ageing and to reduce the burden of evitable medical costs. One of the main challenges is to develop pragmatic and personalized prevention strategies in order to prevent frailty, counteract adverse outcomes such as falls and mobility disability, and to improve quality of life. Strong evidence reports the effectiveness of exercise interventions to improve various physical parameters and muscle function that are cornerstones of frailty. Other findings also suggest that the interactions between nutrition and physical exercise with or without health behavior promotion prevent the development of frailty. Multimodal programs, including structured exercise, adequate dietary intervention and health behavior promotion, appear increasingly consensual. However, in order for implementation in real-life settings, some pitfalls need to be addressed. In this perspective, structuring and tailoring feasible, acceptable and sustainable interventions to optimize exercise training responses are essential conditions to warrant short, medium and long-term individual benefits. The different components of exercise programs appear to be fairly consensual and effective. However, specific composition of the programs proposed (frequency, intensity, type, time, volume and progressiveness) have to be tailored to individual characteristics and objectives in order to improve exercise responses. The intervention approaches, behavioral strategies and indications for these programs also need to be refined and framed. The main objective of this work is to guide the actions of healthcare professionals and enable them to widely and effectively implement multimodal programs including exercise, nutrition and behavioral strategies in real-life settings.

[Conducting a multimodal exercise program in primary and secondary prevention of mobility disabilty in older adults at risk: guidelines and practical applications]. / Conduite d'un programme d'exercice multimodal en prévention primaire et secondaire de la perte de mobilité chez le senior à risque : recommandations et applications pratiques.

The implementation of strategies to prevent mobility disability in seniors at-risk with a strong focus on exercise is a public health imperative. These strategies must follow a pragmatic, structured and personalized approach. In order to obtain short, medium and long-term benefits, it is essential to consider the coordination of adapted physical exercise programs and to harmonize good practices. In support of national policies for the prevention of loss of autonomy, it is important to define clear guidelines to conduct effective programs. These programs should have a strong emphasis on evidence-based literature and should be validated by a consensus of multi-professional experts. The aim of this consensus is to outline the steps implementing these programs, to present their constituent elements and their practical application. Conception and elaboration of these programs should include frequency, intensity, duration, type of work, volume and individual progressiveness. Programs should also be focused on a personalised approach to develop participant health education, self-efficacy and empowerment for physical activity to ensure long-term health related behaviours. Moreover, trained professionals must supervise these programs in order to assure participants safety and program effectiveness. These guidelines will support policies for the prevention of loss of autonomy and mobility, throughout their development over the national territory.

Analysis of the Local Health-Enhancing Physical Activity Policies on the French Riviera.

Policy is a lever for initiating the structural and environmental changes that foster health-enhancing physical activity (HEPA) promotion. However, little is known about the evidence in support of local governments regarding their HEPA-promoting policies. The aim of this study was to collect comprehensive information on municipal HEPA policies on the French Riviera (Alpes-Maritimes and Var counties) to provide an overview of the development of these policies in this territory. Mid-sized cities from the two counties constituting the French Riviera were targeted (n = 17). In each city, a local tool for HEPA policy analysis, CAPLA-Santé, was used to gain information from key informants heading the departments of sports, health services, and social services. Data were collected through semi-structured interviews and document analysis. Ten mid-sized cities volunteered to participate. Key informants from the sports (n = 10), health services (n = 5), and social services (n = 6) departments were interviewed. Written HEPA policy documents were formalized in six cities. These documents (n = 14) were mainly from the sports (n = 8) and health services (n = 4) sectors. The key informants reported that support from national policy, the commitment of elected officials, and large local stakeholder networks facilitated HEPA promotion, whereas the lack of intersectoral collaboration and limited resources were limitations. The results provide insight into the development of municipal HEPA policies, highlighting some of the barriers, facilitators, and perspectives. These findings could be valuable to scale up HEPA promotion at the local level.