Evidence-Based Research to Support Community Action Canadian Centre for Activity and Aging Gareth R....

Evidence-Based Research Evidence-Based Research toto

Support Community ActionSupport Community Action

Canadian Centre forCanadian Centre for

Activity and AgingActivity and Aging

Gareth R. Jones Ph.D. Gareth R. Jones Ph.D.

DirectorDirector Canadian Centre for Activity and AgingCanadian Centre for Activity and Aging

Leaders in physical Leaders in physical activity and aging: from activity and aging: from research to actionresearch to action

ResearchResearch

DivisionDivision

Community Community

Outreach DivisionOutreach Division

Canadian Centre for Activity and AgingCanadian Centre for Activity and Aging

TRANSLATIONTRANSLATION

Reduction in physical Reduction in physical activity as one ages may be activity as one ages may be due to: due to: Social attitudes – take it

easy, rest Lack of knowledge regarding

the ability to restore potential through exercise

Lack of facilities and convenience of participation

Lack of expertise and leadership to offer effective exercise programs


Factors related to increasing Factors related to increasing physical activity in physical activity in community-dwelling seniors: community-dwelling seniors: Moderate intensity activities (to Moderate intensity activities (to

start)start) InexpensiveInexpensive Simple programs that support Simple programs that support

functional activitiesfunctional activities Programs are conveniently Programs are conveniently

locatedlocated Social support networkSocial support network Educational support for both Educational support for both

exercise leaders and participants.exercise leaders and participants.


2020 4040 6060 8080Age YearsAge Years

1010

2020

3030

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25%

50%

75%

100%

100%

75%

50%

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% Aerobic Capacity% Aerobic Capacity

% A

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Dressing

Domestic Work (vacuum, mow lawn, make beds)

Walk level 5km/hr (80m/min)Walk Staircase

Aerobic capacity required for selected activitiesAerobic capacity required for selected activitiesrelative to the age associated decline of fitnessrelative to the age associated decline of fitness


Contribution of cardiorespiratory Contribution of cardiorespiratory fitness and muscular strength to fitness and muscular strength to functional limitations and functional limitations and DependenceDependence

M

Cardiorespiratory Fitness

Morphology

MuscularPerformance

PathologyFunctional Limitations

(Morey et al., 1998)(Morey et al., 1998)

Com

pon

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f Fit

ness

Com

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f Fit

ness


In-house exercise In-house exercise programsprograms

• Community Exercise PhysiologistCommunity Exercise Physiologist• Program CoordinatorProgram Coordinator• 27 Instructors27 Instructors• Living LaboratoryLiving Laboratory

• ~ 400 participants~ 400 participants• 16 exercise programs16 exercise programs

CardiorespiratoryCardiorespiratory Power walkingPower walking Weight trainingWeight training Combined (weights & Combined (weights &

cardio)cardio) Get fit for Active Get fit for Active

LivingLiving

Osteoporosis COPD Functional fitness Hip Fracture Rehab Dynamic BalanceDynamic Balance

Tracking Older Participants of Twelve Physical Activity Classes Over a Three Year Period.Tracking Older Participants of Twelve Physical Activity Classes Over a Three Year Period.Ecclestone, Myers & Paterson. Ecclestone, Myers & Paterson. Journal of Aging and Physical ActivityJournal of Aging and Physical Activity (1998) 6: 70-82 (1998) 6: 70-82


Community Outreach Community Outreach DivisionDivision

Community ProgramsCommunity Programs• Urban and ruralUrban and rural

Get Fit For Get Fit For Active LivingActive Living

Cherryhill Cherryhill Seniors Seniors CommunityCommunity

VON-HOMMEVON-HOMME VON-SMARTVON-SMART


Leadership Training ProgramsLeadership Training ProgramsEducation, Training and ProgramsEducation, Training and Programs


RobustRobust RestorableRestorable FrailFrail Seniors Fitness Seniors Fitness Instructor Course (SFIC)Instructor Course (SFIC)

Peer leadershipPeer leadership Advanced versionAdvanced version

Get Fit For Active Living Get Fit For Active Living (GFAL) (GFAL)

Personal Trainers Personal Trainers for Older Adults (PTOA)for Older Adults (PTOA)

First Step Program First Step Program (FSP)(FSP)

Home Support Home Support Exercise Program Exercise Program (HSEP)(HSEP)

Functional Fitness for Older Adults (FFOA)

Restorative Care Education and Training (RCET)

NEWNEW

Get Fit For Active Living (GFAL)Get Fit For Active Living (GFAL)

Introduction to exercise, fitness and healthIntroduction to exercise, fitness and health

8 week program8 week program 2x per week 2x per week

cardiorespiratory classcardiorespiratory class 1x per week weight training1x per week weight training 1x per week lecture1x per week lecture

Lecture topics includeLecture topics include Benefits of Physical ActivityBenefits of Physical Activity Exercise AdherenceExercise Adherence Cardiorespiratory ExerciseCardiorespiratory Exercise Muscle strengtheningMuscle strengthening Flexibility & balanceFlexibility & balance Healthy eatingHealthy eating Exercise at home andExercise at home and community optionscommunity options


Preliminary resultsPreliminary results80% adherence 80% adherence

at one yearat one year• 63% ex. program63% ex. program• 17% ex. at home17% ex. at home

(n=215)(n=215)

36 hours of in-class theory (advanced only 36 hours of in-class theory (advanced only 18hrs)18hrs)

Aging & physical activity -overviewAging & physical activity -overview Programming,includes screening and Programming,includes screening and

assessmentassessment Special health conditionsSpecial health conditions Planning and evaluationPlanning and evaluation

16 hours of practical experience required16 hours of practical experience required Take-home & Field test examTake-home & Field test exam Certification by the CCAACertification by the CCAA

1,300 certified1,300 certifiedRef: Govindasamy, D (1994). Physical Activity and the older adult: A knowledge base for managing exercise programs. Stipes

Publishing Company.

Seniors Fitness Instructor Course (SFIC)Seniors Fitness Instructor Course (SFIC)

Leaders trained to deliver safe and Leaders trained to deliver safe and effective exercise programs for effective exercise programs for older adultsolder adults


First Step Program (FSP)First Step Program (FSP)

Is the FSP effective at increasing physical Is the FSP effective at increasing physical activity when delivered through diabetes activity when delivered through diabetes education centres?education centres?

Sixty-one FSP facilitators across CanadaSixty-one FSP facilitators across Canada Include both professional diabetes educators Include both professional diabetes educators

and peer leadersand peer leaders Pilot study Pilot study (Diabetes Educator, 2002)(Diabetes Educator, 2002)

RCT RCT (Int J Obesity, 2003)(Int J Obesity, 2003)

Implementation and dissemination project Implementation and dissemination project (completed March 2004)(completed March 2004)

Prospective investigation of long-term Prospective investigation of long-term adherence adherence (2004-2005 recent 1-yr funding of $70,000)(2004-2005 recent 1-yr funding of $70,000)


A pedometer-based physical activity, behaviour modification program for those living with Type-2 diabetes

Training for those working with the frail, homebound elderly

10 simple, progressive exercise 4 hour workshop Resources include

training manual facilitator guide picture booklet video

Hong Kong & recent USA collaborations

Training for home care in SWO funded by MOH

Home Support Exercise Program Home Support Exercise Program (HSEP)(HSEP)

Tudor-Locke et al. (2000) Tudor-Locke et al. (2000) J Aging and Physical ActivityJ Aging and Physical ActivityJohnson et al. (2003) Johnson et al. (2003) J Aging and Physical ActivityJ Aging and Physical Activity..

Jones et al . (2003) Jones et al . (2003) Aging and GeriatricsAging and GeriatricsJones et al. (2003) Jones et al. (2003) Stride MagazineStride Magazine


Functional Fitness for Older Adults Functional Fitness for Older Adults (FFOA)(FFOA)

16 hour workshop Long Term Care staff interested

in providing Safe Effective Challenging

Group-based program Evidence-based Lazowski, et al. (1999). Lazowski, et al. (1999).

A randomized outcome evaluation of group of exercises A randomized outcome evaluation of group of exercises programs in long-term care institutes. J Gerontol: Med programs in long-term care institutes. J Gerontol: Med Sci, 54(12), 621-628.Sci, 54(12), 621-628.


Restorative Care Education and Restorative Care Education and Training (RCET)Training (RCET)

40 hour course (5 modules) Educate long term care staff

to deliver; individual exercise and

rehabilitation interventions positioning, mobility and

transfer techniques Communication and feeding

skills assessment and evaluation

Evidence-based JohnsonJohnson, et al. (In Press). Evaluation of , et al. (In Press). Evaluation of

restorative care education and training program restorative care education and training program for long term care residents. Can J Aging.for long term care residents. Can J Aging.


Train the TrainerTrain the Trainer Experienced and educated

exercise leaders 40 hour course Taught course facilitation

and adult education skills Web-based training Required to lead 2

education course within the first year and a minimum of 2 course per year in subsequent years.

Biannual review of facilitation skills


CCAA Certified Exercise Leaders and CCAA Certified Exercise Leaders and Program FacilitatorsProgram Facilitators

Training Program NUMBER TRAINED (as of May, 2004)

SFIC Leaders 1508

GFAL Facilitators 10

HSEP Leaders 800+

HSEP Facilitators 24

FSP Facilitators 61

FSP Trainers 15

FFOA Leaders 661

RCET Leaders 877

Total CCAA Course Trainers 80

CCAA trainers and programs throughout CanadaCCAA trainers and programs throughout Canada


www.uwo.ca/actagewww.uwo.ca/actage

National National Leadership Leadership Training InitiativeTraining InitiativeImproving the Quality of Physical Activity programs for Canada’s Older Adults


International Guidelines to be International Guidelines to be tabled and endorsed tabled and endorsed by the WHO at the 6by the WHO at the 6thth World World Congress on Aging an Physical Congress on Aging an Physical ActivityActivity

ChairChairN EcclestoneN Ecclestone

Steering Steering CommitteeCommitteeW Chodzko-ZaijkoW Chodzko-ZaijkoP MarkonP MarkonD PatersonD PatersonA TaylorA TaylorG JonesG JonesN EcclestoneN Ecclestone

NationalNationalScientificScientificCommitteeCommitteeA TaylorA TaylorP ChilibeckP ChilibeckN EcclestoneN EcclestoneG GutmanG GutmanG JonesG JonesC JohnsonC JohnsonP MarkonP MarkonA MyersA MyersS O’Brien CousinsS O’Brien CousinsD PatersonD PatersonR PetrellaR PetrellaA PipeA PipeM PorterM PorterC PowellC PowellB TaylorB TaylorT VandervoortT Vandervoort

InternationalInternationalScientific Scientific CommitteeCommitteeW Chodzko-Zaijko USAW Chodzko-Zaijko USAG Gass G Gass AustraliaAustraliaH Baumann H Baumann GermanyGermanyE Heikkinen FinlandE Heikkinen FinlandJ Holloszy J Holloszy USAUSAJ Jones J Jones USAUSAJ Judge J Judge USAUSAA Kalache A Kalache WHOWHOS Lord S Lord AustraliaAustraliaV Matsudo V Matsudo BrazilBrazilK McCully K McCully USAUSAM McMurdo ScotlandM McMurdo ScotlandM Palaez M Palaez PAHOPAHOZ Radak Z Radak HungaryHungaryR Rikkli R Rikkli USAUSAF Schena F Schena ItalyItalyM Sagiv M Sagiv IsraelIsraelD Seals D Seals USAUSAA Stewart USAA Stewart USAK Tanaka K Tanaka JapanJapanC Tudor-Locke USAC Tudor-Locke USA


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