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The Centre for Activity and Ageing offers multiple physical activity programs for the general public of older adults. Using a database of 670 registrants, we tracked 541 individuals in 12 programs at the same location over a 3-year period (1992-1995). We found program differences in gender and age mix, attendance patterns, and long-term adherence. Overall, we found a 68% attendance rate and adherence rates of 59%, 51%, and 43% at 6 months, 12 months, and 36 months, respectively. About 21% of participants tried out or transferred between programs during the tracking period, and these individuals were significantly more likely to remain at the center over 3 years. Longitudinal tracking demonstrates that program adherence is not necessarily the same as exercise adherence: older adults leave, rejoin, and switch exercise classes as their commitments and interests change. We project that 50% or more of older adults joining community programs will be long-term adherents to exercise.

The Home Support Exercise Program (HSEP) was developed to reach frail community seniors through home support workers (HSWs) rather than more costly health care professionals such as visiting nurses or physical therapists. This article describes the development and formative evaluation of the HSEP prototype, including the training of case managers and HSWs. In the HSEP’s final form, each client is instructed on 10 simple, functional, and progressive exercises and given an illustrated booklet and a short video. Ongoing encouragement is provided by specifically trained HSWs during regular visits (at least once a week). Formative evaluation of the HSEP model was used to examine and resolve implementation and delivery issues. Qualitative data were collected through focus groups or interviews with each stakeholder group—administrators/coordinators, case managers, HSWs, agency supervisors, and clients themselves. Evaluation findings were used to modify training, instructional, and support materials and the exercises.

The Home Support Exercise Program (HSEP) targets frail older adults. After a 4-hr training workshop, home-support workers (HSWs) encourage clients to do a simple, progressive set of 10 exercises during regular visits. Exercise compliance and functional performance were examined in 60 clients who received the HSEP, compared with 38 clients whose HSWs had not received HSEP training. Both groups were primarily female, average age 82, and many of them used walking aids. The 40 HSEP clients who continued with the program over 4 months showed good compliance and significant improvement on several indicators: timed up-and-go, sit-to-stand, 6-min walk, balance confidence, and well-being. Conversely, the comparison group declined on several measures. The findings support the effectiveness of the HSEP, as well as the importance of regular and ongoing support from HSWs for this population.