A Community-based Program That Supports Physical Activity, Healthy Eating, Social Participation and System Navigation in Older Adults — EMBOLDEN  

Healthy Aging Clinical Trial

Official title: The Enhancing Physical and Community Mobility in Older Adults With Health Inequities Using Community Co-design of a Multifaceted Intervention Incorporating Physical Activity, Healthy Eating, Social Participation, and System Navigation (EMBOLDEN) Trial

Status Recruiting

Clinical Trial Summary

Physical mobility and social participation are needed to maintain independence and quality of life for adults over 55 years of age. Despite the known benefits of physical activity and dietary change programs for older adults, the best ways to deliver these interventions are not well understood. The goal of the EMBOLDEN study is to promote physical and community mobility in older adults who experience difficulties taking up community programs and reside in areas of high health inequity. Building on existing best practices, the investigators will implement and evaluate an innovative co-designed community-based program to promote physical activity, healthy eating, social participation, and system navigation. The potential for spreading this program throughout Hamilton and adapted to other Canadian communities will also be explored

Clinical Trial Description

This is a randomized controlled trial employing a type II hybrid implementation-effectiveness design. This will enable the investigators to evaluate both clinical outcomes and important processes that impact the implementation of the co-designed intervention. The intervention will consist of i) weekly interactive group-based health education sessions focused on: increasing knowledge, skills, and behaviours related to physical activity, healthy eating, and available community supports for older adults; this will include facilitated physical activity delivered by a certified exercise physiologist or certified personal trainer with experience and expertise working with older adults and interactive nutrition sessions; socialization to foster peer and community connections, co-learning, and decrease social isolation; and skill-building to support independence and quality of life; and ii) tailored system navigation support to increase access to and use of health and social services systems and address barriers or unmet needs The investigators will place equal weight on our primary effectiveness outcome (physical mobility) and implementation outcomes: 1. Effectiveness: quantitative, two-arm randomized controlled trial (RCT) using accelerometers and questionnaires completed by study participants at baseline, immediately following the program, and 6 months after baseline to measure primary and secondary effectiveness outcomes. Qualitative interviews will be conducted with interventionists and a subset of participants to explore perceived effectiveness. 2. Implementation: quantitative surveys, document analysis (e.g., meeting notes), and qualitative interviews will be conducted with participants, interventionists, and Community Advisory Board members to evaluate implementation outcomes, and understand implementation barriers and facilitators. This trial has a pragmatic design in the following ways: i) recruiting a population with broad inclusion criteria, reflective of the general population of older adults; ii) conducting the study in existing community settings (when in-person delivery is feasible) and virtually, in partnership with organizations already delivering virtual supports due to the pandemic; iii) leveraging existing resources, staff, and service delivery organizations in the intervention arm that are available in usual care; iv) supporting flexibility delivery of the intervention (e.g., tailoring to participant group needs), as would be done through other community programs in usual care; v) flexibility in adherence to the intervention, in ways that are consistent with usual care; vi) selecting primary and secondary outcomes that are participant-relevant; and vii) using intention to treat analyses based on all available data. Primary Effectiveness Question: Does the 3-month EMBOLDEN intervention increase physical mobility compared to usual care in community-dwelling older adults (55+ years) residing in areas of high health inequity? Primary Implementation Question: How is the EMBOLDEN intervention implemented and adapted across diverse neighbourhoods? The study will be delivered in community settings in nine urban neighbourhoods identified as areas of health inequities (using Statistics Canada census tract data, 2016) in the cities of Hamilton and Toronto, Ontario. ;

Related Conditions & MeSH terms

• Health Related Quality of Life
• Healthy Aging
• Mobility Limitation

• NCT number: NCT05008159
• Study type: Interventional
• Source: McMaster University
• Contact: Caroline J Moore, BSc(Hons)
• Phone: 905-525-9140
• Email: camoore@mcmaster.ca
• Status: Recruiting
• Phase: N/A
• Start date: May 27, 2022
• Completion date: March 2025