Christopher Ball

UNC DPT c/o 2015

- 4. At one-year post implementation of community gardening and walking/hiking groups, older-adult participants of Mills-River will demonstrate increased balance capability and functional mobility status with decreased incidence of falls annually (50% less than previous year), will be indicated as a “low falls risk” by performance on falls-assessments [BERG balance scale, and will require an assistance level of “supervision” based on functional independence measure performance [Timed- up and go (TUG); Timed 10 repetitions of sit to stand).
- 5. At one-year post implementation of the Mills River community gardening and walking/hiking groups, older-adult participants will demonstrate significant improvement in overall HRQoL as indicated by a minimum increase of 5 points on the SF-36 measure.

Methods Mills-River NC is a small rural, industrial/agriculturally based community outside of Asheville NC with access to a multitude of state/national forests that harbor many forms of outdoor recreation.. A large population of late- middle aged to elderly-adults (Female and Male; >/= 50 years old) reside in Mills-River and reported to have higher rates of obesity (29%), DM (10-12%) and levels of inactivity (31%) compared to other NC counties.1,2,3 As such this will be the prospective location and patient population targeted. Older-adults of Mills-River (>/= 60yo) will be the targeted demographic of the proposed health promotion programs. As such, to best achieve successful implementation and meet program objectives, the environment and interventions associated with community gardening as well as hiking groups will be tailored to promote maximal participation and optimal safety for the older-adult. Environmental characteristics and possible intervention modifications suited to the older-adult are outlined below in program methods. The optimal location for implementing the community gardening initiative for seniors would be at the existing community center located in Mills-River. Being an extension of the community center along with other forms of marketing would divulge a more accurate estimation of potential interest, increased exposure of a greater breadth within the population targeted. The community center also provides a consistent location for implementing both task- based and educational components to facilitate program adherence. Finally, utilizing the community center will provide older-adults and more importantly, their potential ride/driver, convenient access to alternate forms of health & wellness based programs provided at the community center. The coordination between health and wellness professionals and the community center allows input and participation of local public service members/officials and further ensure successful, quality and cost-efficient implementation of the program interventions themselves and best suited to the community of Mills- River. Finally, adding to the community centers existing infrastructure will drastically lower the initial and overall start-up cost and thus, provide cost-effective service of greater value for the individuals who participate. Funds can be redirected and investments focused on marketing, construction of program facilities, purchasing a larger quantity of quality equipment and providing adequate materials and recourses for education most suited to the older-adult.

### Methods: Community Gardening Initiative and Hiking Groups for Seniors

***This program proposal takes all necessary measures to insure maximal participation and safety of its participants. However, all participants will be required sign a consent form acknowledging they have been informed of the inherent risks with activity participation within the outdoor environment and those volunteering with the program (in the absence of direct negligence) are not held liable with the incidence of unforeseen injury or health complication.

## Duration:

This health promotion program is a one-year pilot program consisting of dual-task therapeutic activity interventions in conjunction with periodic educational components to reinforce active understanding and independent maintenance of positive health behavior change.

- • Gardening component will operate during the NC high-country growing season; March-November • Gardening component will operate during the NC high-country growing season; March-November