Volunteer-led online group exercise for community-dwelling older people: a feasibility and acceptability study.

BACKGROUND: Despite the clear benefits of physical activity in healthy ageing, engagement in regular physical activity among community-dwelling older adults remains low, with common barriers including exertional discomfort, concerns with falling, and access difficulties. The recent rise of the use of technology and the internet among older adults presents an opportunity to engage with older people online to promote increased physical activity. This study aims to determine the feasibility and acceptability of training volunteers to deliver online group exercises for older adults attending community social clubs. METHODS: This was a pre-post mixed-methods study. Older adults aged ≥ 65 years attending community social clubs who provided written consent and were not actively participating in exercise classes took part in the feasibility study. Older adults, volunteers, and staff were interviewed to determine the acceptability of the intervention. The intervention was a once weekly volunteer-led online group seated strength exercises using resistance bands. The duration of the intervention was 6 months. The primary outcome measures were the feasibility of the intervention (determined by the number of volunteers recruited, trained, and retained, participant recruitment and intervention adherence) and its acceptability to key stakeholders. Secondary outcome measures included physical activity levels (Community Health Model Activities Programme for Seniors (CHAMPS) questionnaire), modified Barthel Index, Health-related quality of life (EQ-5D-5L), frailty (PRISMA-7) and sarcopenia (SARC-F), at baseline and 6 months. RESULTS: Nineteen volunteers were recruited, 15 (78.9%) completed training and 9 (47.3%) were retained after 1 year (mean age 68 years). Thirty older adults (mean age 77 years, 27 female) participated, attending 54% (IQR 37-67) of exercise sessions. Participants had no significant changes in secondary outcome measures, with a trend towards improvement in physical activity levels (physical activity in minutes per week at baseline was 1770 min, and 1909 min at six months, p = 0.13). Twenty volunteers, older adults, and staff were interviewed and found the intervention acceptable. The seated exercises were perceived as safe, manageable, and enjoyable. CONCLUSIONS: Trained volunteers can safely deliver online group exercise for community-dwelling older adults which was acceptable to older adults, volunteers, and club staff. TRIALS REGISTRATION: NCT04672200.

IEC interventions for health: a 20 year retrospective on dichotomies and directions.

In January 1997, the World Health Organization's Family Planning and Population Unit (WHO/FPP) commissioned a retrospective qualitative study of 20 years of experience in information, education, and communication (IEC) as it had been applied to public health initiatives globally. The purpose of the study, which relied on a literature search, a field survey, and in-depth interviews, was to examine lessons learned from two decades of experience in applying IEC interventions in support of public health in order to improve the integration of reproductive health services through IEC initiatives. While the focus of the study was on ways in which IEC can support reproductive health strategies, the discourse surrounding this effort pointed to a number of generic issues of interest or concern to all health education, communication, and promotion practitioners. An analysis and synthesis of "best practices" as perceived by IEC program managers, field implementers, donors, and evaluators revealed significant dichotomies and differences of opinion that have emerged in the field of IEC in recent years and helped to identify several areas for future operations research. This article articulates those divergent opinions, cites major areas for further research, and highlights a strategic approach to partnerships aimed at improving the delivery of health and communication programs.

Redefining macho: men as partners in reproductive health.

PIP: Traditionally, family planning (FP) programs and reproductive health (RH) services have neglected the potential role that men can play in contributing to their family's well-being. Programs that promote male involvement, male responsibility, and men's participation in RH gained ground in the 1990s, however. Recent surveys have indicated that men are more interested in and supportive of FP than has been assumed and have their own unmet reproductive and sexual health needs. Understanding the larger gender dimensions of male involvement in these realms has led to new strategies for ensuring an environment in which women gain control over their lives with the support of men. Male-oriented FP programs have been instrumental in increasing men's participation in RH by providing an environment in which they can overcome their fears and receive informed answers to their questions. Experience suggests that male involvement in RH is increased when sexually transmitted disease programs are offered through maternal-child health or FP programs and when the couple, rather than the woman, is the unit of care. Educating young men before they become sexually active and social norms are ingrained is also important. As gender barriers break down, the opportunities for effective partner communication, shared decision-making, and equality will increase.^ieng

'Big sister' and critics.

Health care: Clinton is ready to negotiate, but Hillary continues her crusade for converts, hoping to silence opponents and avoid compromise. She is failing on both fronts.

Facing the powers that be.

Lobbyists, entrenched forces in congress and self-interested friends will try to stymie Clinton's efforts. A look at four key arenas of combat.

Social marketing and communication: changing health behavior in the third world.

Abstract Development communication, particularly within the health sector, is relatively new and still shrouded in mystique. Many health planners and policy-makers in developing countries and elsewhere do not yet fully appreciate the role communication plays in primary health care interventions. Nevertheless, communication theory, embracing diffusion of innovations and social marketing, can make a significant contribution in improving health status. This paper explores, through an examination of the literature and the experience of a worldwide research and development project, the synthesis of development communication, diffusion, social marketing, and primary health care. It attempts to demonstrate the value of integrating these paradigms within the context of a public health communication model. Focusing on the use of radio and interpersonal communication, the paper describes model projects in India and Honduras and reveals through their example the role of communication in changing health behavior in Third World settings.

Superwoman in the third world.

PIP: Women play crucial roles in both production and reproduction, but development planners have focused on women as childbearers and homemakers rather than as individuals with their own needs and problems. Women are vehicles to achieve a project's ends. As a result, many ambitious development programs have failed. Women's health, necessary for their participation in programs, and traditional women's tasks have been neglected. Planners frequently disregard the demands and inflexibility of women's existing responsibilities. Most rural women work 10 to 12 hours per week and can not set aside family survival tasks to participate in classes, clinic visits or demonstrations. The 1st step in designing successful programs is to recognize the realities of poor women's lives, and to focus on the women themselves, their basic needs, health and responsibilities. Women must participate in planning their own development. Women's voices must be heard for programs that depend on their participation to succeed.^ieng