Physical Literacy-based Intervention for Older Adults

The ageing population creates concerns and challenges worldwide. The large number of older adults (aged over 65) in Hong Kong continues to rise as people live longer. This may result in heavy burdens on public services and problems such as a shortage of medical resources.

The purpose of this study is to implement a physical literacy-based intervention (PLBI) among older adults in Hong Kong in order to achieve the goal of health promotion. A two-arm cluster randomized controlled trial will be employed in this proposed study. Ten daycare centers for the elderly in Hong Kong will be invited to participate in this study. The intervention group will receive functional fitness training and mastering physical literacy class twice a week with buddy peer support, and they will be asked to keep a reflective writing journal on a daily basis for 12 weeks in total. Participants will be evaluated at baseline (week 0), post-intervention (week 12), and at 6-week follow-up (week 18). This will consist of objective and self-reported measures covering elements within physical literacy (i.e. physical competence, motivation and confidence, knowledge and understanding) and also physical activity levels on an individual basis.

The study intends to introduce a conceptual framework of physical literacy for the elderly through an intervention that allows older people to develop daily behaviour habits, which should promote active ageing for the elderly and greater self-esteem in later life. After this study, participants may share their positive experiences, and encourage their peers in the community to become physically literate in the future. In the long run, due to the feasibility and sustainability of these potential programs, this proposed study has the potential to connect seniors through social engagement and contribute to healthy living.

Older adults who are physically literate can effectively adapt to physical challenges associated with injury, chronic disease, and aging, demonstrating a characteristic ability to maintain their independence for an extended period compared to those who engage in less physical activity. Older adults who are physically literate can adapt to challenges associated with injury, chronic disease, and aging, thereby maintaining their independence for a more extended period compared to those who engage in less physical activity. Viewed through the lens of physical literacy, successful agers adeptly adjust and modify their activities, employing age adaptation and physical competence. They achieve this by optimizing their choices in terms of motivation and enjoyment of movement, ultimately maximizing their success, boosting confidence, and sustaining higher levels of functioning across all dimensions. Thus, developing physical literacy aligns with the goal of promoting healthy ageing, enhancing the prospects for overall well-being across the lifespan. This is grounded in the understanding that initiating an active lifestyle from the outset contributes to preserving independence and positively impacting population health.

This study attempts to introduce a conceptual framework of physical literacy through a Physical Literacy Based Intervention (PLBI) that allows older adults to develop good exercise habits with the development of daily behavioral habits. Based on the unique physical literacy journey and lifestyle of each individual, the proposed study would offer the elderly a meaningful way to achieve active ageing and encourage them to realize their physical literacy journey in later life. Evidence has shown that exercise is associated with better physical and mental health in older adults, and exercising with others is more likely to lead to a sufficient amount of physical activity. After this study, it is expected that older people will also encourage their peers in the community to engage in physical activity.

The benefits of physical activity to health are widely acknowledged. The concept of physical literacy has been vaunted as a key component in the establishment of lifelong adherence to physical activity. McLennan and Thompson espouse that physical literacy is the foundation of quality physical education. The development of physical literacy is the most influential variable with respect to physical health improvement. The proposed research, therefore, aims to implement a PLBI including functional fitness training and mastering physical literacy class, buddy peer support, and reflective writing for the development of motivation, confidence, physical competence, knowledge and understanding under the concept of physical literacy to achieve the goal of health promotion. This will add an effective comprehensive assessment and charting of physical literacy for older adults. In the short term, this study will lead to a convenient and powerful program and assessment tool that can be used by elderly centers and elderly fitness trainers and assessors. In the long term, this research will benefit the general public, in particular, communities of older people by encouraging participation in physical activity. When framing the proposed model to chart physical literacy for older adults, the program and measurement system may be adopted in elderly and ageing studies.

The aims of this study are 1) to develop and implement a PLBI including functional fitness training, mastering physical literacy class, buddy peers support, and reflective writing for older adults in Hong Kong; 2) to explore physical literacy (physical competency, daily behavior, knowledge and understanding, and motivation and confidence) of the older adults in Hong Kong; 3) to examine the effectiveness of a PLBI in terms of changes in physical literacy development among older adults in Hong Kong; and 4) to add information to the literature of physical literacy, gerontology, and public health in the Asian context of Hong Kong.

Eligibility Criteria:
Inclusion Criteria:

* those aged 65 to 74 years old who are registered in a daycare center/unit for the elderly in Hong Kong.
* the ability to walk eight meters without assistance.
* able to read and write.

Exclusion Criteria:

* neurological disease which impairs mobility, cardiovascular disease which results in shortness of breath or angina on walking up one flight of stairs.
* cognitive impairment. Participants' cognitive function will be screened by the Chinese Mini-Mental State Examination and those who score below 24 will be excluded.