Physical Activity Initiatives with Older Adults A Canadian Perspective Whistler, B.C. December 10, 2001
Our Challenges • “It is surely a great criticism of our profession that we have not organized a critical summary, by specialty of sub-specialty, adapted periodically, of all relevant randomized controlled trials.” • Archie Cochrane
Our Challenges • Clear Lake Agreement by Federal, Provincial, & Territorial Ministers responsible for fitness, active living, recreation set a joint target to reduce physical inactivity in Canadians by 10% from 1998-2003
Active Old Age • Director General of the World Health Organization described gains in life expectancy as one of humanity’s greatest achievements • Living a full life to reach a healthy, happy and active old age is our aspiration
Not Aging but Saging …Wise Beyond Your Years • It might not affect you now, but it will. • Growing older is inevitable.
Dignity, Respect, Independence and Control • The importance of older people being able to maintain control and autonomy in their lives must not be lost
Definition of Older Adult • Self-defining (Active Living Coalition for Older Adults) • Varies depending upon initiative • 50-55+ for many initiatives (Physical Activity Guide)
Aging Population - Facts • Being physically active reduces the risk of heart disease, fall and injuries, obesity, high blood pressure, adult-onset diabetes, osteoporosis, stroke, depression, colon cancer and premature death • One-third of older adults face an increased risk of loss of mobility and functional capacity, thereby decreasing their functional independence
Aging Population Facts • 1 in 10 Canadians is an older adult • This number will double by 2021 • The greatest health risk for older adults is sedentary living (WHO, 1997) • Among adults 55 + only 34% of men and 29% of women are physically active • Among adults 74+ only 29% of men and 19% of women are physically active
The Older Adult Audience • 50% of seniors report physical activity of 15 min. or more at least 12/month • Almost 2/3 of those aged 80+report needing no help with daily tasks • Only 16% of older adults use the Internet • Once online Canadian seniors use the Internet on average 12 hours weekly
The Older Adult Audience • 1/3 of Canadian seniors live in rural areas and small towns, the rest in urban areas • 93% of seniors live in private households • 20% of Canadians 65+ have post-secondary diploma or degree • 60% did not finish high school • Considerable number have difficulty with reading
By 2041…. • 46% have a disability but for most part continue to enjoy and active lifestyle in their communities • For those born in 1998 life expectancy increased to 92 for men and 100 for women • By 2041 number of Canadians over 80 will quadruple
Why Older Adults are not as Physically Active • Accessibility • Safety • Security • Support • Motivational issues • Must be addressed to encourage, support and ensure that opportunities exist that facilitate involvement in Active Living
Aging and Communication • Visual acuity • Hearing acuity • Agility & Mobility • Social/emotional changes
Barriers to Reaching Older Adults • Physical changes of aging • Stereotypes, outdated assumptions about older adults lifestyles, interests, capabilities • Communication materials and media not suited to audience
Initiatives • Physical Activity Guide for Older Adults • -individuals & leaders, practitioners • Moving through the Years – A Blueprint for Action for Active Living and Older Adults • Policy, decision makers • Evidence Based Clinical Guidelines for Osteoporosis • Physicians (Specialists/ GP,FP), Other Allied Health Professionals
Canada’s Physical Activity Guide for Older Adults • The Guide and the accompanying handbook are the Canadian standard for physical activity and older adults • Based on prototype of Physical Activity Guide for Canadians and Canada’s Food Guide • Bilingual (French & English)
Canada’s Physical Activity Guide for Older Adults • Developed over 3 years • Done in partnership with the Active Living Coalition for Older Adults (ALCOA), Canadian Society for Exercise Physiology and Health Canada • Launched in May 1999 • Multi-disciplinary national advisory committee which included older adults • Focus testing with both older adults and health professionals in urban and rural settings
Canada’s Physical Activity Guide for Older Adults • Guide and Handbook underwent numerous reviews by a group of scientific experts • Guide and handbook used by leaders, health providers and program delivers • Guide includes tips to getting started, how much activity is enough, health benefits, and examples of endurance, flexibility, strength and balance activities to choose from • Launched in conjunction with the “Blueprint for Action”
Canada’s Physical Activity Guide for Older Adults Challenges • Retain scientific validity • Retaining balance between consumer wants & needs and what science says • Marketing of message had to be simple, realistic, believeable, and inspiring • Attaining the outcomes & benefits while making goal attractive & attainable • Carry a message to audience that was clear and user friendly
Canada’s Physical Activity Guide for Older Adults Challenges • Simple Messages: Age is no barrier • Be Active, Your Way, Every Day for Life • Every little bit helps, but more is better • Add it up principle • Moderate physical activity most days for 30-60 minutes • Choice of activities from each of three activity groups: • Endurance, Flexibility, Strength & Balance
Canada’s Physical Activity Guide for older adults • Science based facts (benefits/risks) • Why do this and what is in it for you • Variety & Safety concerns (start where you can) • Overcoming barriers • Pull out Guide to put on refrigerator • Sample calendar/planning sheet • Stories/Real people (not cartoons) • Next steps planner
Canada’s Physical Activity Guide for older adults - Barriers • I feel too tired to get started • I don’t want to exercise? I’ve worked hard all my life, not its time to relax • I have arthritis or stiff joints? • I have osteoporosis? • I have concerns about my heart? I’m afraid that physical activity will do more harm than good
Canada’s Physical Activity Guide for older adults - Barriers • I don’t have much time…so which activity is best? • I am unsteady on my feet? • I am afraid to go out in winter?
What’s Different • Size of print • Benefits right up front • Real people • Practical user friendly suggestions • Talk about barriers (tell it like it is) • Safety • Refers individuals to their physician or health professional
What’s Different • Lots of white space • Bold headings • Clear Language • Stories of real people
Key Learning from the Guide • Senior friendliness is an attitude based on considering seniors’ needs and respecting seniors’ contributions • Physicians are credible influencers of individual’s health behaviours for older adults • Design communication with your clients not for them.
Canada’s Physical Activity Guide for Older Adults • An excellent example of how consensus statements and research can be translated into simple clear messaging for the target audience
Canada’s Physical Activity Guide for Older Adults • Outcomes • Over 50 National organizations endorsed the Guide • Over 2 million copies have been printed and distributed
College of Family PhysiciansKey Influencers • Adopted a Physical Activity and Health Strategy • Developed a unique video on active ageing • Physicians learn more about barriers to PA • Describes new counseling & training tools • New Practice-based Small Group Learning Module on PA & older adults • For info email email@example.com
Moving Through The Years:A Blueprint for Action Goal to update 1991 original Blueprint • Fondation en Adaptation Motrice, ALCOA and Health Canada conducted survey in 22 communities across Canada and over 20 NGO’s • Over 450 individuals consulted (over half of whom were older adults) • Launched in 1999 in International Year of Older Persons
Moving Through The Years:A Blueprint for Action • A national framework for plan of action • Provides a collective direction for current and future initiatives • A tool for planned change • ALCOA asked to serve as the keeper of the Blueprint to ensure its uptake • Serves as a base for ALCOA’s goals and objectives
Active Living Coalition for Older Adults • In 1993 three older adult national bodies came together (National Walking Campaign, Secretariat for Fitness for the Third Age, The Older Adult Active Living Association) • Became Active Living Coalition for Older Adults (ALCOA) • Mandate to bring together national organizations & researchers working with older Canadians in Active Living
Moving Through The Years:A Blueprint for Action • Nine Guiding Principles based on the vision of : • An active society where all older Canadians are leading active lifestyles thereby contributing to their physical and overall well-being.
Moving Through The Years:A Blueprint for Action • Principle 1 • It is recognized that active living is essential for daily living and a cornerstone of health and a quality of life.
Moving Through The Years:A Blueprint for Action • Principle 2: • There is a need for more positive attitudes toward aging, with realistic images that depict older adults as respected, valued, and physically active members of society.
Moving Through The Years:A Blueprint for Action • Principle 3: • Older adults should be encouraged to participate in decision-making and leadership positions, in all phases of program/service development and delivery.
Moving Through The Years:A Blueprint for Action • Principle 5: • Issues, needs and interests of older adults in their community need to be identified, and accessible, affordable active living activities and programs designed to meet these needs.
Moving Through The Years:A Blueprint for Action • Principle 6: • While it is recognized that both aging and learning are a life-long process, it is appreciated that for some, pre-retirement years may be a key time to re-focus on active living and well-being.
Moving Through The Years:A Blueprint for Action • Principle 7: • Canada is a society for all ages: Programs and services should be developed which accommodate older adults’ choice to be with others.
Moving Through The Years:A Blueprint for Action • Principle 8: • There is a need to identify, support, and share research priorities that apply to active living and aging.
Moving Through The Years:A Blueprint for Action • Principle 9: • There is a need for education and promotion of the health benefits of active living as a way of life for older adults
Areas of emphasis for active living and older adults • Increase public awareness about the benefits of active living • Develop competent leaders in active living who can meet the needs & interests of older adults • Ensure resources and social supports needed to be active are in place • Strengthen delivery systems and improve levels of cooperation, coordination, and communication among organizations
Areas of emphasis for active living and older adults • Encourage and enable older adults to advocate for the right to a quality of life that includes physical activity • Identify, support, and share research priorities and results on aging and active living • Continually monitor and evaluate programs, services and outcomes to ensure that active living needs, interests, and concerns of older adults are met
Blueprint Implementation Summit • In 1999 Blueprint implementation Summit held • Over 50 national and provincial organizations attended along with other stakeholders • Resulted in five priority areas: • Leadership Development • Shared Research in Plain Language • Marketing and Communications • Influencing Policy • Coordination and Capacity Building
Leadership Development • ALCOA providing strategic leadership • Develop a network of community presenters to conduct workshops with older adults • Develop strong delivery system at the community level through the members of ALCOA • Presenting to seniors groups and organizations to promote the Guide and the Blueprint and to highlight local opportunities in each community to be active
Communicating Research in Plain Language • ALCOA Research Update Launched May 2001 • Goal to interpret current leading edge research into user friendly, plan language format • Included in Research Update is a special Active Living Tips sheet for older adults • Copies available
Marketing & Communications • Includes ALCOA’s website, newsletter, electronic listserv, national spokesperson and a framework for affecting change • Provides an opportunity to share information, network, learn and reach older adults with consistent active living messages
Influencing Policy • ALCOA partners with key member groups and stakeholders • ALCOA to develop information to members of parliament/policy and decision makers to influence and promote the priority of active living opportunities for older adults