Mixed-methods process evaluation of "Take a Walk With Your Brain," a cognitively enriched walking program for...

Cognitively enriched physical activity (PA) interventions have shown promise for enhancing cognitive functioning in healthy older adults, yet their real-world implementation remains underexplored. A real-life cognitively enriched walking program, "Take a Walk With Your Brain," was co-designed with older adults and walking coaches and evaluated in a 6-month, three-arm randomized controlled trial. The mixed-method process evaluation described in this paper was embedded to examine how the program was implemented. Guided by the framework of a previous study, fidelity, dose delivered and received, recruitment, reach, and context were examined. Participants age 65 + (n = 85) and walking coaches who guided the program sessions (n = 8) contributed data through questionnaires, logbooks, and focus groups. Quantitative data were analyzed descriptively; qualitative data were analyzed using thematic analysis. The program was perceived as enjoyable and feasible, with strong adherence to group sessions and the social aspect as a key motivator. However, there were challenges in delivering the intervention at a moderate PA intensity and personalizing the cognitive tasks, and the coaches expressed a need for more intensive training and peer support. Adherence to unsupervised cognitively enriched walking sessions was low, and the sample was highly educated and physically active at baseline. This process evaluation provides insights that can inform future cognitively enriched PA interventions.