California Agencies Promote Strength-Training Programs for Older Adults
Staff of the California Center for Physical Activity a joint program of the University of California, San Francisco, Institute for Health & Aging and the California Department of Health Services awarded grants to 19 community agencies to establish Active Aging Community Task Forces.
These task forces promoted and provided strength-training, balance and mobility classes to older adults in the 28 California counties with the highest levels of nonfatal injuries from falls among individuals age 50 and older.
The grant accomplished the following, according to staff of the California Center for Physical Activity and a program evaluation published in Evaluation and Program Planning:
- Drew more than 12,500 older adults from diverse community settings into strength-training, balance and mobility classes.
- Created 315 new strength-training, balance and mobility classes and incorporated strength training, balance and mobility into 157 existing exercise classes.
- Conducted 36 workshops to train 416 senior fitness class instructors.
- Documented participant gains in functional fitness, especially in low back/hip range of motion, aerobic endurance, agility/dynamic balance and lower and upper arm strength.
- Promoted institutional changes to foster a stronger focus on physical activity among older populations.
The Robert Wood Johnson Foundation (RWJF) provided $346,908 to the University of California, San Francisco, for this unsolicited project from April 1, 2001, to August 31, 2005.
Muscle strength declines an average of 15 percent to 20 percent per decade after age 50, according to staff at the California Center for Physical Activity, which is jointly supported by the California Department of Health Services and the University of California, San Francisco, Institute for Health & Aging. A substantial body of research has established the benefits of structured exercise routines to improve muscle strength, range of motion and endurance and to lessen the risk of falls.
In 1996, the Marin County (Calif.) Commission on Aging established a Task Force on Strength Training for Seniors. The task force helped educate seniors and nursing home and adult care center staff about the health benefits of strength training and developed new strength-training classes.
In 2000, the California Center for Physical Activity expanded the Marin County model by awarding small grants (from $4,000 to $8,000) to three Area Agencies on Aging and one county public health department. The grantees formed task forces that built local capacity to offer strength-training classes.
Area Agencies on Aging, established and funded under the federal Older Americans Act of 1973, are local agencies that provide an array of community-based and in-home services and information to older adults.
In April 2001, the Robert Wood Johnson Foundation (RWJF) awarded a $346,908 grant to the California Center for Physical Activity to expand this project. See Appendix 1 for additional funders.
Although the Foundation's 2007 focus on physical activity programming is on children, its original emphasis was on physical activity for all ages. RWJF funded Active for Life: Increasing Physical Activity Levels in Adults Age 50 and Older® in 2001; this program runs through the end of 2007. (For more information see Grant Results.)
RWJF also has funded a number of smaller projects focused on physical activity for older adults. They include:
- Development of an assessment tool for older adults called the Exercise/Physical Activity Assessment and Screening for You (EASY). See Grant Results on ID# 046841.
- An examination of communication between health care practitioners and their older adult patients on physical activity. See Grant Results on ID# 046648.
- An AARP social-marketing campaign to get older adults to be more physically active in two demonstration sites, Madison, Wis., and Richmond, Va. See Grant Results on ID# 046220.
- A test of a 12-week physical activity program that combined aerobics, resistance exercise and motivational activities in a group of 340 low-income, mostly African-American seniors in New York City. See Grant Results on ID# 045610.
Staff at the California Center for Physical Activity used RWJF funds to award 19 two-year grants of $16,000 ($8,000 each year) to county public health departments or Area Agencies on Aging to promote strength training, balance and mobility for Californians age 50 and older.
As a condition of these grants, Area Agencies on Aging and county public health departments were required to work together a unique requirement given that public health and aging service agencies in most communities rarely form partnerships.
These lead agencies created Active Aging Community Task Forces that worked in one or more of the 28 California counties with the highest rate of nonfatal injuries from falls among persons age 50 and older. Task force participants included public officials, older adults and representatives from hospitals, skilled nursing facilities, other health care entities, health clubs, senior advocacy groups, emergency services, colleges and universities, parks and recreation, faith-based organizations, and senior housing complexes.
Each Active Aging Community Task Force was charged with:
- Educating older adults and their service providers about the health benefits of physical activity, especially strength training.
- Increasing the number of exercise classes designed to improve muscle strength, bone health, balance and mobility in older adults and to enroll older adults in these classes.
- Increasing the number of senior fitness instructors available to provide safe and effective exercise classes to older adults in diverse community settings.
The California Center for Physical Activity staff provided ongoing technical assistance to each task force, including site visits and monthly teleconferences.
Task force members and staff at the California Center for Physical Activity and at the local lead agencies worked together to evaluate project accomplishments by:
- Collecting data from grantee progress reports, surveys, interviews and site visits at six and 12 months after each task force was established.
- Conducting functional fitness assessments of exercise class participants. The assessments were taken before participants attended strength-training, balance and mobility classes and after they had participated for three to six months.
Staff published evaluation results in Evaluation and Program Planning. (See the Bibliography for details.)
According to the Evaluation and Program Planning article and the project director, the task forces:
- Enrolled more than 12,500 older adults in strength-training, balance and mobility classes. These classes were offered at community and senior centers, assisted living and skilled nursing facilities, retirement communities, housing complexes, parks and recreation facilities, schools, churches, rehabilitation centers and other community settings.
- Developed 315 new strength-training, balance and mobility classes for older adults. They also incorporated strength training into 157 existing classes that had not previously offered it.
- Conducted 36 workshops to train 416 senior fitness instructors.
- Documented gains in functional fitness at four sites:
- Participants showed consistent improvements in low back/hip range of motion, agility/dynamic balance, aerobic endurance and lower and upper arm strength.
- More variable gains were noted across participants at the four sites in terms of cardiovascular fitness, shoulder range of motion and leg strength.
- Developed multilingual promotional and educational materials for older adults and class instructors, including:
- A standardized, evidence-based "Active Aging Train-the-Trainer" manual.
- Three strength-training, balance and mobility class videos (two for beginning and one for advanced fitness levels in English and Spanish) of cablecast quality.
- An evidence-based strength-training exercise brochure.
- Promoted institutional changes:
- Four Area Agencies on Aging persuaded their boards to use funds available through the Older Americans Act specifically for physical activity programs.
- Five grantee organizations established positions for active aging specialists.
- A physical activity section within Title III of the Older Americans Act should be established. This would make a discrete pot of money available to Area Agencies on Aging for older adult physical activity programs. (Project Director)
- Within Area Agencies on Aging and county public health departments, a staff person should be specifically charged with overseeing physical activity programs for older adults. (Project Director)
The Evaluation and Program Planning article offers these conclusions:
- Area Agencies on Aging can effectively serve as lead agencies for coalitions focused on promoting physical activity.
- Active Aging Community Task Forces are able to engage high-risk and frail older adults in physical activity classes safely.
- Many opportunities exist to draw on community assets for physical activity programs for older adults. For example, community organizations were willing to host classes without compensation and a substantial number of health care providers were willing to participate on task forces.
AFTER THE GRANT
As of December 2006:
- Some 18 Active Aging Community Task Forces continue to provide strength-training, balance and mobility classes to older adults in 25 California counties by leveraging existing resources or obtaining new funding.
- The County of San Mateo Health Services Agency, the lead agency for that county's Active Aging Community Task Force, has been awarded a $972,460 grant from RWJF under its national program, Active for Life: Increasing Physical Activity Levels in Adults Age 50 and Older.
- The California Center for Physical Activity staff is updating the "Active Aging Train-the-Trainer" manual. The National Council on Aging, a 14,000-member network of organizations serving older Americans, and the California Center for Physical Activity, a program of the California Department of Health Services, will disseminate the manual to the nation's state Departments on Aging and Departments of Public Health.
GRANT DETAILS & CONTACT INFORMATION
Developing Physical Activity Programs for Older Adults
University of California, San Francisco (San Francisco, CA)
Dates: April 2001 to August 2005
Lisa A. Cirill
- Centers for Disease Control and Prevention, Preventive Health and Health Services Block Grant, $354,000
- Archstone Foundation, $98,000
- The California Wellness Foundation, $75,000
- National Council on Aging, $25,000
- National Association of Chronic Disease Directors, $10,000
- Kaiser Permanente, $10,000
- Fifty-Plus Lifelong Fitness Association, $6,500
(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)
Hooker SP and Cirill LA. "Public Health Promoting Physical Activity for Healthier Communities." Abstract for the International Society for Aging and Physical Activity's 6th World Congress on Aging and Physical Activity: From Research to Action." Journal of Aging and Physical Activity, 12(3): 404405, 2004.
Hooker SP and Cirill LA. "Evaluation of Community Coalitions' Ability to Create Safe, Effective Exercise Classes for Older Adults." Evaluation and Program Planning, 29: 242250, 2006. Available online.
Report prepared by: Jordanka Lazarevic
Reviewed by: Karyn Feiden
Reviewed by: Molly McKaughan
Program Officer: Robin Mockenhaupt