Ready to change - Promoting Community Readiness for Physical Activity among Older Adults
Unequal access is one important reason why preventive interventions may increase rather than reduce health inequalities between subpopulations. Community resources and networks (capacities) can play a key role in approaching diverse population groups. It has been demonstrated that tailoring physical activity (PA) interventions to stages of individual behaviour change may enhance intervention reach and effectiveness. The Community Readiness concept goes beyond the individual level and applies a stage model of change to the community level. According to this concept, a certain degree of problem awareness and preplanning in the community is needed for a health promotion intervention to be successfully implemented. It is therefore recommended to assess community readiness and, if necessary, increase it before starting an intervention.
Results of the first funding phase (2015-2018)
To analyze the community readiness we conducted a community readiness assessment in 23 communities in the Metropolitan Region Northwest. The interviews were carried out with n=118 local key persons with expertise in (the promotion of) physical activity in older adults, e.g. heads of the local office, chairpersons of sports clubs, seniors' councils, representatives of civic centers or neighborhood management. The community readiness scores ranged from 4.4 to 5.6, averaging 4.9. This means that 15 municipalities were in the pre-planning phase (stage 4), 8 municipalities in the preparation phase (stage 5). The results showed differences in an urban-rural comparison with higher CR scores in rural communities (see Gansefort et al., 2018).
- In a literature review about "community capacity building" in the area of PA promotion in old age, five groups of strategies emerged from the literature: (1) building community coalitions and networks, (2) training of professionals, (3) training of laypersons, (4) strengthening competence and awareness in the target population and (5) allocation of financial resources (see Ubert et al., 2017).
- According to the findings from the literature review, community capacity building measures were implemented in three municipalities. These included the formation of a working group on "PA in old age", the participative development of exercise programs for the elderly, the transfer of information to (older) citizens about PA in old age and the participation in municipal events (such as community feasts).
- The ActiStairs program has been implemented to investigate the role of technology to motivate stair climbing in public spaces. Therefore a motivation system was build up in a shopping mall in Bremen. Subsequent surveys of users showed that especially young, physically inactive people were attracted by the installation.
- In order to investigate the reasons for or against participating in PA promotion measures of older people, a qualitative survey was conducted among a total of 25 older (non-) participants of the physical activity program “Fit im Nordwesten” (see sub-project Promote). First results show four multidimensional types of participation behaviors: (1) complex health-designing types, (2) organized wellness types, (3) flexible function-oriented types, and (4) individual fun-oriented types.
Objectives of the second funding period (2018-2021)
The overall objective of the second phase is to examine the sustainability of CR capacity building a longitudinal perspective. For this purpose, cooperation with the intervention communities will be continued in order to achieve a high CR level.
Work programme of the second funding period (2018-2021)
- Community Readiness Assessment
Following to the first funding period the CR will be re-assessed in 4 municipalities (2 intervention, 2 control) at the beginning and towards the end of the second funding phase to analyze the long-term development of the local capacities for PA promotion.
- Community Readiness Intervention
Local stakeholders in two intervention communities will be supported to achieve stabilization, expansion and professionalization in their efforts towards PA promotion among older adults. Practical strategies include the development of a strategic plan for the community, reviews of existing PA programs and activities, implementation of PA programs on a permanent basis as well as the standardization and documentation of the PA programs.
- Development of a CR manual and dissemination
Based on the 6 year experience of applying the CR model to PA promotion among older adults, a CR manual for practitioners will be developed. For the manual a short version of the CR assessment instrument will be constructed.
Dr. Tilman Brand, Leibniz Institute for Prevention Research and Epidemiology – BIPS (Head of project)
Prof. Dr. Hajo Zeeb, Leibniz Institute for Prevention Research and Epidemiology – BIPS
Saskia Müllmann, Leibniz Institute for Prevention Research and Epidemiology – BIPS
Sabine Röseler, Gesundheitswirtschaft Nordwest e. V.
Tobias Ubert, Gesundheitswirtschaft Nordwest e. V.
Jochen Meyer, OFFIS – Institute for Information Technology
Prof. Susanne Boll, OFFIS – Institute for Information Technology
Elke Beck, OFFIS – Institute for Information Technology
Prof. Dr. Ingrid Darmann-Finck, Institute for Public Health and Nursing Research (IPP), University of Bremen
Prof. Dr. Heinz Rothgang, Research Center on Inequality and Social Policy, University of Bremen
Phone: +49 421 21856914