Getting Ready for Scale-Up of an Effective Older Adult Physical Activity Program: Characterizing the Adaptation Process.

To optimize public health impact, health interventions must be delivered widely to reach the population in need. Yet, few interventions are ever implemented at broad scale (scaled-up). Thus it is necessary to devise implementation strategies that support scale-up of effective interventions. Adapting an intervention and implementation strategies to the local context to improve "fit" at scale-up is critical to success. Therefore, our study responds to a call to build a database of systematic adaptations of evidence-based interventions across populations and contexts, including scaled-up designs. To do so, we focus on the process of adapting an effective physical activity program for older adults, called Choose to Move (CTM), for scale-up. Our objectives were to describe the systematic process of adapting CTM for scale-up across British Columbia (BC) and to report the actual changes made to CTM. We adopted a 6-step process: (1) identify stakeholders; (2) conduct needs assessment; (3) develop prototype of adaptations; (4) validate prototype with stakeholders; (5) create adapted program; and (6) pilot test adaptations. For the adaptation process, we described each step and organized data within an adaptation coding system. Results showed that adaptations to CTM span program content, program context, and the training modules. For example, to address the request by CTM participants for more opportunities to socially connect with others, we added more group meetings, reduced phone check-ins, and integrated aspects of training related to social cohesion. Our study extends the current literature by providing researchers a clear pathway toward adapting health promotion interventions for scale-up.

"The Social Side Is as Important as the Physical Side": Older Men's Experiences of Physical Activity.

North American "hegemonic masculinity" values strength, autonomy, independence, and resilience among its ideals. As men age, their capacity is increasingly challenged and demands that they adapt to new physical and social realities. Although some reports on effective health-promoting programs for men are emerging, there is a need to better understand older men's experiences with their mobility and physical activity. This is a photovoice study with men ( N = 14) who were enrolled in a choice-based activity program for low active men. Based on in-depth interviews and analysis of over 800 photographs, three key themes emerged: the importance of social connectedness, supportive environments, and positive attitude toward the future. Findings are presented via a theoretical view of masculinities as socially constructed through relational behaviors and norms. Analyses provide insight into older men's motivation to be physically active and highlight the need for programs and policies customized to promote physical activity of older men.