Choose to Move (Active Aging Research Team)

In March 2013, BC Ministry of Health entered into a partnership with the Active Aging Research Team (AART) at Centre for Hip Health and Mobility (CHHM) to develop a key prevention strategy in order to enhance mobility and health, and prevent injury due to falls in BC seniors. During the development phase of Active Aging BC (ABC), AART engaged stakeholders and community partners out of which grew its signature program: Choose to Move. The Choose to Move program is an adaptable, evidence-based physical activity model designed to promote physical activity and improve the health of seniors (65+ years) who are not regularly active (<150 minutes per week). Delivered in partnership with BC Recreation and Parks Association (BCRPA) and YMCA of Greater Vancouver (YMCA), Choose to Move has run programs in 28 communities across all 5 regional health authorities in BC.

There is one full-time ABC manager centred at CHHM to support the program and provide general oversight. The ABC manager works directly with community partners BCRPA and YMCA to ensure fidelity to the program model is maintained, while also working with partners to understand local conditions. The ABC manager is responsible for the development of program materials, training model and delivery, and overseeing program evaluation. Each partner organization has a part-time provincial coordinator who supports the hiring of trained activity coaches, coordinates Choose to Move sites and program dates, supports program marketing and promotion, and is the primary contact for recreation coordinators and activity coaches delivering the program. Both the YMCA and BCRPA independently hire their own activity coaches.

Over a six-month period, Choose to Move participants work with a trained activity coach to develop a personalized physical activity action plan customized to their individual needs, interests, goals, resources and abilities. Physical activities are up to the individual, allowing participants to choose something they enjoy and that fits into a schedule that works for them. Participants receive three forms of ongoing support over the six-month program span: Motivational Group Meetings: Participants receive encouragement and instruction during four in-person, educational sessions with other Choose to Move participants and an activity coach.

One-on-One Consultations: Participants receive one-on-one consultations with their activity coach after the first Motivational Group Meeting. Together they develop a personalized physical activity action plan that outlines enjoyable ways to increase physical activity and active travel.

Check-ins: Activity coaches check-in with participants regularly through ten 15-minute phone calls over the six months. Check-ins are a chance to discuss how participants are doing with their action plan and to address any challenges they may be experiencing.

The ABC manager works with Choose to Move community partners to support them in developing strategies for recruiting inactive seniors to participate in the programs province-wide. Participants come from a diverse range of cultural backgrounds and range in age from 60 years to 90+ years.

Impact: To date, over 1,200 inactive seniors currently are or have participated in 132 Choose to Move programs located in 28 communities across the province.

Since launching in spring 2016, Choose to Move has created a positive impact on the lives of older adults and in the communities where it is embedded. For example, early results show that 84% of seniors who participated in Choose to Move had one or more chronic conditions at the time of enrollment, but after only 3 months of participation there were significant improvements in physical and social determinants of health including:

Increased physical activity rates by 1.7 days per week

Increased feelings of social connectedness

Decreased feelings of loneliness1

Choose to Move has changed the lives of many participants across the province, helping to restore once-lost confidence, and provide encouragement and support to seniors looking to start moving again. The shared experience and ongoing support of Choose to Move proves to be empowering and motivating for seniors on their journey to become more physically active.Some comments from Chose to Move participants: "With the support of the Choose to Move...I started to believe in myself again. Choose to Move was such a gentle and nudging push, it helped me to re-build my confidence."

“[Choose to Move] inspired me to go from no exercise to daily stretches and taking yoga ...I can now go up and down stairs without worrying”

Strengths and Challenges: Provincial Reach and Capacity Building - The strength of Choose to Move is that it is provincial initiative led by AART, a team of community-based researchers committed to interdisciplinary research conducted in partnership with communities. The implementation of the Choose to Move program has increased the capacity of the delivery partners to organize and provide physical activity programming for seniors that is evidence-based and effective. Community organizations that are running the programs have been able to create a new model for personal planning and support, and have strengthened their relationships internally among staff, within their membership and with other community groups and organizations. An advisory committee comprised of representatives from all levels of program delivery provide general guidance and input for the implementation of Choose to Move. At a facility level, Choose to Move has broadened the scope of program offerings to attract inactive seniors, a traditionally hard to reach segment of the population.

Evidence-Based Programming: Choose to Move is evidence-based, adopting key elements of the Community Healthy Activities Model Program (CHAMPS) which has been studied extensively in the United States. CHAMPS increased physical activity among older adults, even when disseminated more broadly, which is important for healthy aging. However, when individualized program elements (e.g. one-on-one planning session, frequent telephone support) were eliminated due to lack of resources3these benefits were diminished.AART is evaluating the delivery and health impact of Choose to Move, as well as how contextual factors influence delivery and impact at the local level.

Partnerships and Collaboration: Partnerships are the foundation of Choose to Move. Choose to Move partners BCRPA and YMCA are firmly embedded in the community and have robust networks already in place for accessing local seniors. They have also expanded their networks as a result of Choose to Move to connect with local agencies such as non-profit organizations,