1. Evidence-Based Research to Support Community Action Canadian Centre for Activity and Aging Gareth R. Jones Ph.D. Director Canadian Centre for Activity and Aging Canadian Centre for Activity and Aging

2. Leaders in physical activity and aging: from research to action ResearchDivision Community Outreach Division Canadian Centre for Activity and Aging Canadian Centre for Activity and Aging TRANSLATION

3. Reduction in physical activity as one ages may be due to: Social attitudes – take it easy, rest Lack of knowledge regarding the ability to restore potential through exercise Lack of facilities and convenience of participation Lack of expertise and leadership to offer effective exercise programs Canadian Centre for Activity and Aging Canadian Centre for Activity and Aging

4. Factors related to increasing physical activity in community- dwelling seniors: Moderate intensity activities (to start) Moderate intensity activities (to start) Inexpensive Inexpensive Simple programs that support functional activities Simple programs that support functional activities Programs are conveniently located Programs are conveniently located Social support network Social support network Educational support for both exercise leaders and participants. Educational support for both exercise leaders and participants. Canadian Centre for Activity and Aging Canadian Centre for Activity and Aging

5. 20406080 Age Years 10 20 30 40 Aerobic Power (ml·kg -1 ·min -1 ) 25% 50% 75% 100% 75% 50% 25% % Aerobic Capacity Dressing Domestic Work (vacuum, mow lawn, make beds) Walk level 5km/hr (80m/min) Walk Staircase Aerobic capacity required for selected activities relative to the age associated decline of fitness Canadian Centre for Activity and Aging Canadian Centre for Activity and Aging

6. Contribution of cardiorespiratory fitness and muscular strength to functional limitations and Dependence M Cardiorespiratory Fitness Morphology Muscular Performance Pathology Functional Limitations (Morey et al., 1998) Components of Fitness Canadian Centre for Activity and Aging Canadian Centre for Activity and Aging

7. In-house exercise programs Community Exercise Physiologist Community Exercise Physiologist Program Coordinator Program Coordinator 27 Instructors 27 Instructors Living Laboratory Living Laboratory ~ 400 participants ~ 400 participants 16 exercise programs 16 exercise programs Cardiorespiratory Cardiorespiratory Power walking Power walking Weight training Weight training Combined (weights & cardio) Combined (weights & cardio) Get fit for Active Living Get fit for Active Living Osteoporosis COPD Functional fitness Hip Fracture Rehab Dynamic Balance Tracking Older Participants of Twelve Physical Activity Classes Over a Three Year Period. Ecclestone, Myers & Paterson. Journal of Aging and Physical Activity (1998) 6: 70-82 Canadian Centre for Activity and Aging Canadian Centre for Activity and Aging

8. Community Outreach Division Community Programs Urban and rural Urban and rural Get Fit For Active Living Get Fit For Active Living Cherryhill Seniors Community Cherryhill Seniors Community VON-HOMME VON-HOMME VON-SMART VON-SMART Canadian Centre for Activity and Aging Canadian Centre for Activity and Aging

9. Leadership Training Programs Education, Training and Programs Canadian Centre for Activity and Aging Canadian Centre for Activity and Aging Robust Restorable Frail Seniors Fitness Instructor Course (SFIC) Seniors Fitness Instructor Course (SFIC) Peer leadership Peer leadership Advanced version Advanced version Get Fit For Active Living (GFAL) Get Fit For Active Living (GFAL) Personal Trainers for Older Adults (PTOA) Personal Trainers for Older Adults (PTOA) First Step Program (FSP) Home Support Exercise Program (HSEP) Functional Fitness for Older Adults (FFOA) Restorative Care Education and Training (RCET) NEW

10. Get Fit For Active Living (GFAL) Introduction to exercise, fitness and health 8 week program 8 week program 2x per week cardiorespiratory class 2x per week cardiorespiratory class 1x per week weight training 1x per week weight training 1x per week lecture 1x per week lecture Lecture topics include Lecture topics include Benefits of Physical Activity Benefits of Physical Activity Exercise Adherence Exercise Adherence Cardiorespiratory Exercise Cardiorespiratory Exercise Muscle strengthening Muscle strengthening Flexibility & balance Flexibility & balance Healthy eating Healthy eating Exercise at home and Exercise at home and community options community options Canadian Centre for Activity and Aging Canadian Centre for Activity and Aging Preliminary results 80% adherence at one year 63% ex. program 63% ex. program 17% ex. at home 17% ex. at home(n=215)

11. 36 hours of in-class theory (advanced only 18hrs) 36 hours of in-class theory (advanced only 18hrs) Aging & physical activity -overview Aging & physical activity -overview Programming,includes screening and assessment Programming,includes screening and assessment Special health conditions Special health conditions Planning and evaluation Planning and evaluation 16 hours of practical experience required 16 hours of practical experience required Take-home & Field test exam Take-home & Field test exam Certification by the CCAA Certification by the CCAA 1,300 certified 1,300 certified Ref: Govindasamy, D (1994). Physical Activity and the older adult: A knowledge base for managing exercise programs. Stipes Publishing Company. Seniors Fitness Instructor Course (SFIC) Leaders trained to deliver safe and effective exercise programs for older adults Canadian Centre for Activity and Aging Canadian Centre for Activity and Aging

12. First Step Program (FSP) Is the FSP effective at increasing physical activity when delivered through diabetes education centres? Is the FSP effective at increasing physical activity when delivered through diabetes education centres? Sixty-one FSP facilitators across Canada Sixty-one FSP facilitators across Canada Include both professional diabetes educators and peer leaders Include both professional diabetes educators and peer leaders Pilot study (Diabetes Educator, 2002) Pilot study (Diabetes Educator, 2002) RCT (Int J Obesity, 2003) RCT (Int J Obesity, 2003) Implementation and dissemination project Implementation and dissemination project (completed March 2004) (completed March 2004) Prospective investigation of long-term adherence (2004-2005 recent 1-yr funding of $70,000) Prospective investigation of long-term adherence (2004-2005 recent 1-yr funding of $70,000) Canadian Centre for Activity and Aging Canadian Centre for Activity and Aging A pedometer-based physical activity, behaviour modification program for those living with Type-2 diabetes

13. Training for those working with the frail, homebound elderly 10 simple, progressive exercise 4 hour workshop Resources include training manual facilitator guide picture booklet video Hong Kong & recent USA collaborations Training for home care in SWO funded by MOH Home Support Exercise Program (HSEP) Tudor-Locke et al. (2000) J Aging and Physical Activity Johnson et al. (2003) J Aging and Physical Activity. Jones et al. (2003) Aging and Geriatrics Jones et al. (2003) Stride Magazine Canadian Centre for Activity and Aging Canadian Centre for Activity and Aging

14. Functional Fitness for Older Adults (FFOA) 16 hour workshop Long Term Care staff interested in providing Safe Effective Challenging Group-based program Lazowski, et al. (1999). Evidence-based Lazowski, et al. (1999). A randomized outcome evaluation of group of exercises programs in long-term care institutes. J Gerontol: Med Sci, 54(12), 621-628. A randomized outcome evaluation of group of exercises programs in long-term care institutes. J Gerontol: Med Sci, 54(12), 621-628. Canadian Centre for Activity and Aging Canadian Centre for Activity and Aging

15. Restorative Care Education and Training (RCET) 40 hour course (5 modules) Educate long term care staff to deliver; individual exercise and rehabilitation interventions positioning, mobility and transfer techniques Communication and feeding skills assessment and evaluation Evidence-based Johnson, et al. (In Press). Evaluation of restorative care education and training program for long term care residents. Can J Aging. Johnson, et al. (In Press). Evaluation of restorative care education and training program for long term care residents. Can J Aging. Canadian Centre for Activity and Aging Canadian Centre for Activity and Aging

16. Train the Trainer Experienced and educated exercise leaders 40 hour course Taught course facilitation and adult education skills Web-based training Required to lead 2 education course within the first year and a minimum of 2 course per year in subsequent years. Biannual review of facilitation skills Canadian Centre for Activity and Aging Canadian Centre for Activity and Aging

17. CCAA Certified Exercise Leaders and Program Facilitators Training ProgramNUMBER TRAINED (as of May, 2004) SFIC Leaders1508 GFAL Facilitators10 HSEP Leaders800+ HSEP Facilitators24 FSP Facilitators61 FSP Trainers15 FFOA Leaders661 RCET Leaders877 Total CCAA Course Trainers80

18. CCAA trainers and programs throughout Canada Canadian Centre for Activity and Aging Canadian Centre for Activity and Aging

19. www.uwo.ca/actage

20. National Leadership Training Initiative Improving the Quality of Physical Activity programs for Canadas Older Adults Canadian Centre for Activity and Aging Canadian Centre for Activity and Aging International Guidelines to be tabled and endorsed by the WHO at the 6 th World Congress on Aging an Physical Activity

21. Chair N Ecclestone SteeringCommittee W Chodzko-Zaijko P Markon D Paterson A Taylor G Jones N Ecclestone NationalScientificCommittee A Taylor P Chilibeck N Ecclestone G Gutman G Jones C Johnson P Markon A Myers S OBrien Cousins D Paterson R Petrella A Pipe M Porter C Powell B Taylor T Vandervoort International Scientific Committee W Chodzko-Zaijko USA G Gass Australia H Baumann Germany E Heikkinen Finland J Holloszy USA J Jones USA J Judge USA A Kalache WHO S Lord Australia V Matsudo Brazil K McCully USA M McMurdo Scotland M Palaez PAHO Z Radak Hungary R Rikkli USA F Schena Italy M Sagiv Israel D Seals USA A Stewart USA K Tanaka Japan C Tudor-Locke USA Canadian Centre for Activity and Aging Canadian Centre for Activity and Aging