bluuebunny/crossref_metadata_2025_split huggingface dataset:
S4-3 Protocol for assessing implementation of physical activity policies by national governments using the Physical Activity Environment Policy Index (PA-EPI)
Authors: Volf Kevin , Woods Catherine B 
Published: September 2023

Abstract

Purpose
The implementation of physical activity policies has been slow and uneven. As a remedy, the World Health Organization has recommended that national policy implementation should be supported with practical tools and guidance. The Physical Activity Environment Policy Index (PA-EPI) is a tool that allows the extent of policy implementation to be assessed. It comprises a list of good practice policy indicators. These are categorized into eight policy domains targeting aspects of the physical activity environment and seven infrastructure support domains for strengthening physical activity policy systems. This protocol provides researchers with guidance on how to use this tool.

Project
Guided by a protocol developed by the International Network for Food and Obesity / Non-communicable Diseases (NCDs) Research, Monitoring and Action Support (INFORMAS), the PA-EPI protocol. The INFORMAS protocol was modified based on the research teams experience carrying out the first study utilising the PA-EPI tool.
A multi-step process is recommended. This process relies upon the identification of two groups of partners: national policymakers and independent stakeholders tasked with the promotion of physical activity directly and/or indirectly. During the early steps of the process the desk-based research is undertaken to identify information about and evidence of physical activity policy implementation- the PA-EPI Evidence Document. This mapped information is presented to the national policymakers to verify that it is valid and comprehensive. Subsequently, the evidence of implementation is presented to the stakeholders who, using a 5-point Likert scale (1-little or none to 5 high), individually rate the extent of policy implementation in practice. These individual ratings are aggregated and a implementation scorecard is generated displaying the extent of implementation of each of the good practice indicators Stakeholder then engage in an expert workshop to review implementation scores, and identify key policy implementation recommendations which are presented to government.

Conclusions
The process of conducting a policy implementation assessment using the PA-EPI requires the cooperation of several stakeholders as part of a national coalition. It is envisioned that PA-EPI assessments will enable international cross comparison. This will promote learning from international best practice.
S6-4 How to engage community-dwelling older adults in fall prevention programs? – a qualitative study into potential strategies
Authors: van Scherpenseel Meike , van Veenendaal Lidia , te Velde Saskia , Ronteltap Amber 
Published: September 2023

Abstract

Aim
Fall rates and fall-related injuries among community-dwelling older adults (≥65 years) will likely increase due to the rapidly aging population worldwide. Therefore, fall prevention has become an international priority. Fall prevention programs (FPPs), consisting of strength and balance exercises, have been proven effective in reducing the number of falls among older adults. However, in practice, professionals find it difficult to enroll participants for FPPs. Therefore, this study aims to identify effective strategies that promote engagement in FPPs among older adults.

Methods
Based on previously identified barriers and facilitators for participation in FPPs by older adults, six strategies were designed using Intervention Mapping: 1) reframing; 2) informing about benefits; 3) raising awareness of risks; 4) involving social environment; 5) offering tailored intervention; 6) arranging practicalities. Strategies were presented and validated during semi-structured interviews with older adults (n = 12) at risk of falling. Interviews were recorded, transcribed and analyzed following a hybrid qualitative thematic method.

Results
Analysis showed that reframing 'aging’ and 'fall prevention' is important. Within this strategy, themes emerged related to respondents’ preference to be approached differently, taking a ‘life course’ perspective about falls, and avoiding confronting terms. Furthermore, the strategy 'informing about benefits' (e.g. ‘living independently for longer') could contribute to understanding the relevance of participating in FPPs. Other strategies were considered important to take into account too, but were less emphasized.

Conclusion
This study provides insight into possible strategies to stimulate older adults to participate in FPPs. Reframing ‘aging’ and 'fall prevention' may facilitate the conversation about fall prevention, which can be achieved by communicating differently about the topic, for example ‘staying fit and healthy’, while focusing on the benefits of participating in an FPP. Developing practical recommendations about how to apply the strategies, is an area for future research, as this could help health and social care professionals to enhance older adults’ participation in FPPs. Currently, the strategies are further developed to be applied and evaluated for effectiveness in multiple field labs in a central Dutch region (Utrecht).

Funding source
This research was co-funded by Regieorgaan SIA, part of the Netherlands Organization for Scientific Research (NWO).
S6-5 Tool for supporting implementation of physical activity programs among older adults: from science to practice
Authors: Preller Liesbeth 
Published: September 2023

Abstract

Aim
Research shows that professionals in healthcare and social work are crucial for reaching older adults but often do not refer them to local PA programs. Multidisciplinary collaboration, including sports professionals, is challenging. In The Netherlands interlocal differences in collaboration are large due to influence of local policy. Our aim was to develop a tool which makes referral of older clients to PA groups efficient and effective.

Methods
For input on contents of the tool we used a sounding board group, with representatives of three groups of professionals: physician assistant of the general practitioner, geriatrics physical therapist, and neighbourhood sports coach (NSC; connecting sports sector with other sectors like healthcare). During meetings we discussed which type and contents would help to improve collaboration and referral. We subsequently built an online tool and asked feedback on design and contents.

Result
The professionals stated that not knowing each other, unfamiliarity with each other’s role and with suitable local PA programs, are barriers for referring to PA programs and facilities. The developed generic tool describes referral procedures for four different groups of community-dwelling older people, ranging from vital to vulnerable. Basically one starts with screening on quantitative PA behaviour, motives and barriers, and leads the person directly or through an intermediate professional to suitable PA. In addition it includes general information on health effects of PA, screening methods, general PA possibilities and roles of different professionals in the referral process. For use in the local setting the tool has to be tailored, generally by the NSC, but with involvement of local organisations. Tailoring means that contact information of local professionals and organisations, local PA groups, and specific local agreements on collaboration are added.

Conclusion
Healthcare and social workers generally don’t refer older inactive older adults to suitable PA groups because they lack insight into local PA programs, and don’t know the relevant professionals. Since the tool makes this information visible at the local level, this will lower the threshold to refer clients adequately to PA.
S8-5 INTERACT capacity building framework for sport for all among sports federations
Authors: Mothibi Game 
Published: September 2023

Abstract

Purpose
International Sports Organisations (ISOs) have increasing interest in investing on sport for all and have been called by policy-makers through different policies (e.g. WHO Global Action Plan for physical activity, UN Sustainable Development Goals) to leverage their health and physical activity potential towards the society. This presentation showcase a training (in-person, informal education workshop) that aims to empower the staff and volunteers of ISOs promote Sport for All and physical activity and act as multipliers to train their national federations and grassroot sport organisations.

Project
The INTERACT Capacity-Building Framework which was designed by INTERACT Erasmus+ project partners (TAFISA and 8 International Sports Organisation) through different meetings and a co-construction approach, addresses key elements, identified as part of the INTERACT project, to support ISOs and continental/national sport federations in developing their own Sport for All and physical activity initiatives and engage with their members in the field. It provides exchange of knowledge and training to empower ISOs, their staff and volunteers in Sport for All and place physical activity promotion at the core of their activities. This will in turn increase participation in sport and physical activity.
By using different sensory channels (e.g. visual, acoustic, tactile), our approach satisfies the participant’s different learning types and primary ways of absorbing and processing information. Composed of three steps (advocacy, diagnostic, training), it alternates theory and practice as well as tension and relaxation, movement and rest. Participant-oriented educational work includes the conscious handling of diversity and diversity of people (e.g. in relation to sex/gender, nationality, ethnicity, religious belief, disability, sexual orientation etc.). A first pilot has been launched among 12 ISOs, and evaluation framework will be created this spring, based on a litterature review.

Conclusion
The INTERACT Capacity-building programme is developed to become a full-fetched service that is offered in the coming years to any ISO willing to step up its promotion of Sport for All activity.
S9-1 How to stimulate active ageing? Cross-national insights to improve recruitment, participation, fall prevention and scalability
Authors:   Chair(s):, Borodulin Katja , van Uffelen Jannique 
Published: September 2023

Abstract
With increasing numbers of older persons in the world, new practices and programs are needed to support active aging. These new practices and programs should rely on research-based evidence, be tested in real-world settings, and also be both sustainable and scalable to the society.
In this symposium we aim to share practice-to-policy-related examples from four countries, where issues related to transition to retirement, recruitment challenges, and fall prevention are covered.
Cases rely on research-based knowledge, but concentrate on presenting results from practice, implementation and scaling up phases. Issues related to challenges and solutions in each case are shared and discussed.
S9-2 Dutch national falls prevention
program- implementation challenges
Authors: Preller Liesbeth 
Published: September 2023

Abstract

Purpose
In the Netherlands, a very ambitious falls prevention program is being implemented in 2023 and 2024. Falls among older adults lead to a high burden on healthcare and high societal costs. This program is therefore part of the current government coalition agreement. Each year one in seven persons over 65 should be screened on fall risk and should be stimulated to reduce fall risk. The whole program includes specific falls prevention programs (FPPs) as well as Physical activity (PA) programs outside these FPPs to keep fall risk restricted. Large responsibility is given to municipalities for implementation at the local level, and to regional public health services at a higher level.

Project description
At present there is no good organisation of falls prevention. A whole infrastructure has to be set up to be able to carry out the prevention program. This is coordinated by VeiligheidNL.
It involves a considerable number of stakeholders and different working packages on FFPs, implementation, and communication. Starting in 2022, a number of sessions have been held to inform municipalities, regional health services, and professionals. Funding frameworks are set up including refunding of FPP participation and support of coordination by municipalities.
As part of the process, we evaluated among scientists, PA professionals and municipalities what is needed to organise PA for maintenance after FPPs and for people without increased risk. This includes more available organised PA, increase in frequency and intensity of current group PA, and involving regular sports clubs to increase overall capacity.
Most municipalities need to take a much stronger coordinating role, including also a professional with ‘broker’ role, generally the so-called neighbourhood sports coach (NSC). This professional guides older people to suitable PA and is a connector between health, social care and PA professionals.

Conclusions
The ambitious falls prevention program, supported by considerable financial resources, has the potential to give a large boost to PA in older adults. There are still a lot of challenges at the national as well as local level before implementation is successful, but several locations have already managed to develop a good infrastructure.
S9-3 Keep up -groups support fall prevention
Authors: Starck Heli , Säpyskä-Nordberg Minna , Hokkanen Sari , Viskari Jaana , Borodulin Katja 
Published: September 2023

Abstract

Purpose
In Finland one third of home dwelling older adults 70+ fall at least once a year. Falling causes injuries and suffering. The cost of one hip fracture is about 30 000 € on the first treatment year.
Balance and functional training is effective in preventing falls. Half of hip fractures can be prevented by exercising.

Project or policy description
Development: Age Institute is a partner in Age-friendly South Karelia project coordinated by Wellbeing Services County of South Karelia. The project acts through a network with municipalities, NGO’s, congregations, and older people councils. Preventing falls became an important goal of project since the number of hip fractures was increasing and higher than the average in Finland. Several actions were developed: educating professionals, giving information to older people, and improving exercise groups.

Implementation
‘Keep up’ exercise group for older adults with increased risk of falling was implemented in every municipality (9) of the county. The risk of falling was assessed using a screening questionnaire in health care centers or in events, where participants with high scores were guided to the groups. Municipal sport sector organized the strength and balance training group once a week. The participants were encouraged to do home exercise weekly. The groups also included discussion and tasks about falls prevention. Themes were e.g. nutrition, fear of falling, medication and safe environment. Age Institute made the material for the group.

Evaluation
SPPB test was made in the beginning and in the end of the 10 weeks training period. Majority of participants improved their physical performance. According to a questionnaire the participants perceived mostly good or strong benefits. Especially mood, strength, and knowledge of preventing falls improved. After the training period the participants were guided to continue exercising.

Dissemination
The municipalities continue to organize Keep up groups. The good practice will be disseminated to other municipalities and counties involved in Strength in Old Age Programme.

Conclusions
With multisectoral co-operation you can find older adults with increased risk of falling and guide them to exercise group. Strength and balance training combined with getting more knowledge is a feasible good practice.
S9-5 From a successful RCT to community implementation: lessons learnt from the REtirement in ACTion (REACT) group-based active ageing intervention targeting older adults with mobility limitations
Authors: Stathi Afroditi , Withall Janet , Greaves Colin J , Thompson Janice L , Western Max , Ladlow Peter , Fox Kenneth R 
Published: September 2023

Abstract

Purpose
Mobility limitation in older age reduces quality of life, generates substantial health and social care costs, and increases mortality. The REtirement in ACTion (REACT) trial established that a community-based, active ageing intervention can prevent decline in physical functioning in older adults already at increased risk of mobility limitations documenting significant savings in health and social care costs.

Project description
Recruitment: We recruited 777 older adults (mean age 77.6 yrs (SD 6.8 yrs); 66% female; with reduced lower limb physical functioning (Short Physical Performance Battery [SPPB] mean score 7.37, (SD 1.56) from three sites (Bristol/Bath; Birmingham; Exeter) in England. In terms of ethnicity (95.11% white) and deprivation, the sample was representative of the UK population of people 65+.

Intervention
Participants were randomly assigned to receive three healthy ageing sessions (n = 367) or a 12-month, group-based, multimodal programme including 64x1hr exercise, 43x20 min social and 21x45-min behavioural maintenance sessions (n = 410) delivered by qualified exercise specialists.

Implementation
The intervention was funded and delivered by community organisations including city councils, third sector organisations/charities, leisure industry providers. Currently REACT is implemented as a community programme in Bristol, UK while a strategy for rolling-out nationally is developed.

Evaluation
A multicentre, pragmatic, randomised controlled trial with process and health economic evaluations at baseline, six, 12 and 24 months. At the 24-month follow-up, the SPPB score was significantly greater in the intervention arm than in the control arm. Difference in lower limb function between intervention and control participants was clinically meaningful at both 12 and 24 months. Attrition rates were low (19%). Engagement with the REACT intervention was associated with positive changes in exercise competence, relatedness, enjoyment and perceived well-being benefits.
The health economic analysis indicated substantial quality-of-life and health economic benefits within the 24-month trial window and across a lifetime horizon.

Conclusions
This study adds robust evidence that a relatively low-resource, 1-year multimodal exercise,social and behavioural maintenance intervention helps older adults to improve and retain physical functioning for at least 24 months. There are great opportunities and some challenges for a national and international roll-out of this evidence-based active ageing programme.
S10-1 Research on sub-national initiatives in HEPA policy making from Europe, Japan and the USA
Authors:   Chair(s):, Sandu Petru , Gelius Peter 
Published: September 2023

Abstract
The importance of local governments' engagement in physical activity promotion at local level has been acknowledged and advocated by the World Health organization in documents such as: “Promoting physical activity and active living in urban environments: the role of local governments” or “Global action plan on physical activity 2018–2030: more active people for a healthier world”. However, given the relative “youngness” of the physical activity policy research domain, the local level initiatives have been underrepresented in the scientific literature. The current symposium aims to present a number of diverse initiatives to promote health enhancing physical activity at sub-national level, each having a very unique context and approach.
The paper from Eastern Michigan University presents the actions taken to implement Active People, Healthy Nation (APHN) program in geographic areas in Michigan where the priority population (Asian Americans) lives and the outcomes of this initiative.
The contribution from Japan describes the process of developing and applying the L-PAT (local policy audit tool), an instrument comprising 11 items based on WHO’s HEPA Policy Audit Tool (HEPA PAT) and the results of this survey within 47 Japanese prefectures and the C-PAT (city policy audit tool), a 6 items tool, in a selection of 272 Japanese municipalities.
The EU study presented in this symposium comprises the results of evaluation, using the CAPLA- Santé, a validated instrument, of local HEPA policies in 4 selected municipalities, one from each of the following countries: Finland, France, Germany, Romania and from one municipality in Japan.
The responsibilities of local authorities in health promotion and protection are undeniable. The way the authorities manage to fulfil these responsibilities is gaining more and more interest from various stakeholders from local level activists to researchers and policymakers at national and international level. Local communities are increasingly stimulated to contribute to their own wellbeing, so data on the status quo and progress is needed more than ever.
The initial discussion points of the symposium will focus on strengths and weaknesses of the initiatives presented, as well as the potential for knowledge exchange and replication & scaling-up.
S10-2 U.S. CDC’s Active People Health Nation: Michigan’s Story for Promoting Physical Activity in Local Communities
Authors: Yang Xining , Wu Tsu-Yin 
Published: September 2023

Abstract

Purpose
Being physically active is one of the most important ways people of all ages and abilities can improve their health. Survey data show that 76 percent of Asian Americans in Michigan USA do not meet the federal physical activity minimum guidelines. Guided by Active People, Healthy Nation (APHN), a national initiative to help 27 million Americans become more physically active, the Eastern Michigan University (EMU) Racial and Ethnic Approaches to Community Health (REACH) initiative promotes physical activity through local partnerships in geographic areas where the priority population (Asian Americans) lives.

Methods
Working with the state department of transportation, local municipalities, public schools, faith-based organizations, local businesses, and community health partners, EMU REACH used the following strategies to increase physical activity: 1) implement policies and activities to connect pedestrian, bicycle, or transit transportation networks (i.e., activity-friendly routes) to everyday destinations. 2) launch safe routes to school programs to increase walking and bicycling to and from school and 3) promote equitable park programs and policies that make it safe and easy for residents to be physically active. The team adopted the action planning guide and assessment modules in the Active Communities Tool (ACT) to facilitate cross-sector collaborations in developing an action plan to improve the community built environments that promote physical activity.

Results
The EMU CHDIS has successfully reached 24,510 people impacted by new/improved policies and plans in 2018-22. In the process, our environment scan showed that people living in underserved areas and from racial and ethnic minority groups are less likely to have access to these places due to historical land use, housing, and transportation policies. Based on the results from project implementation, it is recommended that creating or modifying streets, parks, and trails to connect activity-friendly routes to everyday destinations and offer access to safe places for physical activity for people of all ages and abilities can promote active lifestyles and provide physical-active environment.

Conclusion
While celebrating wins through the APHN initiative in Michigan, we advocate for new supportive policies and engage with more community members to raise awareness about the new resources to maintain the active momentum.