Translating Strong for Life into the Community Care Program

Physical activity has substantial health benefits for older adults. Older adults receiving home and community-based services have functional limitations often hindering access to physical activity programs offered in the community. Thus, there is a need to develop and test delivery mechanisms to bring physical activity programming to this vulnerable population of older adults. In this dissertation, I provide results of a study investigating the feasibility of translating an evidence-based physical activity program, Strong for Life, into the Community Care Program through a randomized controlled trial. I enrolled 32 home care aides and their 42 older adult clients receiving home care aide services through the Community Care Program. I randomized the home care aides and clients into an intervention and usual care group or a usual care only control group. At baseline, older adult clients in both group had substantial levels of frailty and physical impairment underscoring the need for physical activity interventions to address these mobility and strength deficits. Fidelity check data showed that Strong for Life was implemented safely and with good fidelity. Program evaluation data demonstrated that home care aides and clients found Strong for Life to be acceptable and practical. Both parties also voiced the need for continued physical activity programming within the Community Care Program. Intervention group clients demonstrated greater median change in strength and mobility measures between baseline and post-test compared with the control group, with medium effect sizes for grip strength, global self-reported health, and mental health. Qualitatively, both home care aides and clients reported benefits of Strong for Life participation by enhancing client mobility and home care aide job satisfaction.