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Updated: Jun 4, 2025

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Does optimizing Choose to Move - a health-promoting program for older adults - enhance scalability, program

Lindsay Nettlefold1, Heather M Macdonald1,2, Joanie Sims Gould1,2

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|December 19, 2024
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Summary

This study adapted the Choose to Move (CTM) program for older adults, reducing delivery costs by 40% without compromising effectiveness. The optimized CTM program successfully improved physical activity, mobility, and social isolation in older adults.

Keywords:
AdaptationHealth promotionImplementationLonelinessOlder adultsOptimizationPhysical activityScale-upSocial isolation

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Area of Science:

  • Gerontology
  • Public Health
  • Health Promotion

Background:

  • Health-promoting programs face resource limitations, necessitating optimization for scalability and sustainability.
  • The Choose to Move (CTM) program, an evidence-based intervention for older adults, underwent phased adaptation from 2015-2024.
  • CTM Phase 4 specifically focused on data-driven adaptations to reduce resource utilization while maintaining program efficacy.

Purpose of the Study:

  • To describe the adapted CTM Phase 4 program.
  • To assess the implementation of CTM Phase 4.
  • To evaluate the effectiveness of CTM Phase 4 in improving health outcomes for older adults.

Main Methods:

  • A type 2 hybrid effectiveness-implementation study was conducted for CTM Phase 4.
  • Activity coach hours were reduced by 40% compared to Phase 3.
  • 137 programs involving 1126 older adults (aged 59+) were assessed for implementation indicators and health outcomes (physical activity, mobility, social isolation, loneliness) pre- and post-intervention.

Main Results:

  • Implementation indicators confirmed successful delivery of CTM Phase 4.
  • Significant improvements were observed in physical activity, mobility, social isolation, and loneliness across different age groups of older adults.
  • Participant-level benefits were comparable or superior to previous CTM phases, demonstrating sustained effectiveness despite reduced resource input.

Conclusions:

  • The flexible, co-designed CTM program was successfully adapted to reduce delivery hours without compromising implementation or health benefits.
  • Optimizing health-promoting programs enhances scalability and sustainability, crucial for improving population health.
  • Reduced resource use in effective health programs is a viable strategy for broader public health impact.