The article describes the dissemination and implementation of the Aging Well and Healthily (AWH) program in the Netherlands. In the period 1997–1999 this process was monitored by means of telephone interviews with 263 participants, 28 peer educators, and 13 organizers. The program participants were mainly physically active and relatively healthy people in their mid 70s. The peer educators were in their late 50s. The overall satisfaction with the content and delivery of the AWH program was good; 13% of the participants enrolled in related local sports activities. In total, the AWH program was run 57 times, which did not meet the target of 50 times a year. Different factors could have negatively influenced dissemination. In the first place, the organization of the program was perceived to be complex and not compatible with the values of the organizations that were to implement the program. Also, 3 national implementation partners had organizational problems of their own. The results were used to design a new social marketing strategy, which appears to be successful.
Marja H. Westhoff and Marijke Hopman-Rock
Marijke Hopman-Rock and Marja H. Westhoff
Edited by Wojtek J. Chodzko-Zajko
The Aging Well and Healthily (AWH) program consists of health education by peers and low-intensity exercise. It was evaluated via a small randomized controlled trial and a community intervention trial involving older adults in the Netherlands. Reasons stated for participation were to exercise (35%), to acquire information about health (28%), and for social reasons (12%). The program was rated 8.2 on a 10-point scale. Twenty-five percent of participants joined exercise groups after the program ended, and 28% intended to do so. The mean physical activity score improved from 2.6 to 4.6 at follow-up (F = 16.9, p = .00) and was for the least active participants significantly different from that of the control group (F = 22.9, p = .02). Four to 6 months later, 60% of respondents reported still doing the exercises regularly at home. It is concluded that AWH is a potentially effective program for older adults.
Marja H. Westhoff, Lysander Stemmerik, and Hendriek C. Boshuizen
This study’s purpose was to investigate whether a 10-week low-intensity strength-training program could improve strength of the knee extensors and functional ability. Participants 65 years and older with low knee-extensor muscle strength were randomized into an exercise (n = 11) and a control group (n = 10). Knee-extensor strength and functional ability were measured before and after the program and again 6 months later. Knee-extensor strength (Nm) increased by 54% (13% in the control) by the end of the training program (F = 13.02, p = .01), and most of this improvement was still present 6 months later. The program had a beneficial effect on functional tasks, especially the time taken to rise from a chair in combination with a 3-m walk (F = 3.99, p = .03) and self-reported ability related to lower extremity performance (F = 6.97, p = .02). It seems that this program could contribute to improving functional ability in frail older people.
Hendriek C. Boshuizen, Lysander Stemmerik, Marja H. Westhoff, and Marijke Hopman-Rock
Elderly participants experiencing difficulty in chair rising and with a maximum knee-extensor torque below 87.5 N · m were randomized to different versions of a strength-training program for the knee-extensors: to a high-guidance group (HG; two group sessions supervised by a physical therapist and one unsupervised home session per week, n = 17), a medium-guidance group (MG; one supervised group session and two unsupervised home sessions per week, n = 16), or a control group (C; no exercise, n = 16). Maximal isometric knee strength increased more in HG than in C (p = .03) and with increasing guidance (p = .03). The effect was mainly the result of participants with low initial strength. Walking speed increased more for HG than for C (p = .02) and than for MG (p = .06). No statistically significant improvements were seen on other functional tests. In summary, the study shows a trend toward better results with more supervision, but more and larger studies are needed to confirm this.