Promoting Active Aging: Lessons Learned in an Implementation Pilot in Primary Care.

Publisher: Blackwell Science Country of Publication: United States NLM ID: 7503062 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-5415 (Electronic) Linking ISSN: 00028614 NLM ISO Abbreviation: J Am Geriatr Soc Subsets: MEDLINE

Publication: Malden, MA : Blackwell Science
Original Publication: New York [etc.]

Healthy Aging*/physiology ; Healthy Aging*/psychology ; Primary Health Care*/methods ; Primary Health Care*/statistics & numerical data; Health Promotion/*methods ; Preventive Health Services/*methods ; Remote Consultation/*methods ; Walk Test/*methods; Aged ; Exercise/physiology ; Exercise/psychology ; Feasibility Studies ; Female ; Health Services Accessibility ; Humans ; Implementation Science ; Male ; Mobility Limitation ; Outcome and Process Assessment, Health Care ; Pilot Projects

Background: Physical activity (PA) preserves mobility, but few practices screen older adults for mobility impairment or counsel on PA.
Design: "Promoting Active Aging" (PAA) was a mixed-methods randomized-controlled pilot, to test the feasibility and acceptability of a video-based PA counseling tool and implementation into practice of two mobility assessment tools.
Setting: Three primary care practices affiliated with Wake Forest Baptist Health.
Participants: Adults aged 65 years and older who presented for primary care follow-up and were willing and able to answer self-report questions and walk 4 meters (n = 59).
Intervention: Video-based PA counseling intervention versus control video, "Healthy Eating."
Measurements: Potential participants completed mobility assessments: self-report (Mobility Assessment Tool-short form (MAT-sf)) and performance based (4-meter walk test). We assessed PAA's implementation-feasibility, acceptability, and value-via interviews and surveys. Effectiveness was measured via participant attendance at a PA information session.
Results: Of 92 patients approached, 89 (96.7%) agreed to mobility assessment. Eighty-nine completed MAT-sf, and 97.8% (87/89) completed 4-meter walk test. Sixty-seven (75%) met eligibility criteria, and 59 (88%) consented to be randomized either to the PA counseling intervention (Video-PA) or to active control (Video-C). Most participants viewed the walk test positively (51/59; 86.4%). Staff reported that completion of patient surveys, MAT-sf, and videos required significant staff time and support (median = 26 minutes for all), resulting in low acceptability of MAT-sf and the videos. Attendance at a PA information session did not differ by randomization group (Video-PA = 11/29 (37.9%); Video-C = 12/30 (40%); 95% confidence interval for difference in proportion = -0.29 to 0.25).
Conclusions: Mobility assessment, particularly a 4-meter walk test, was feasible in primary care. Tablet-based assessment (MAT-sf) and video counseling tools, selected to reduce staff effort, instead required significant time to implement. Future work to promote PA should identify effective ways to facilitate adoption of PA in sedentary older adults that do not burden staff.
(© 2020 The American Geriatrics Society.)

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K76 AG059986 United States AG NIA NIH HHS; P30-AG021332 United States AG NIA NIH HHS; UL1 TR001420 United States TR NCATS NIH HHS; K76-AG059986 United States AG NIA NIH HHS; UL1-TR001420 United States TR NCATS NIH HHS; P30 AG021332 United States AG NIA NIH HHS; P30-CA012197 United States CA NCI NIH HHS; P30 CA012197 United States CA NCI NIH HHS

Keywords: implementation science; mobility assessment; physical activity

Date Created: 20201002 Date Completed: 20210917 Latest Revision: 20210917

20231215

PMC7902351

10.1111/jgs.16838

33006763