Healthy Activity Improves Lives (HAIL)

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PROJECT SUMMARY Older adults (age ≥ 60 years) tend to be less physically active than younger adults, engaging in less than 11% of recommended physical activity (PA) levels[1-3]. These trends are even lower in older individuals from Black communities. Lack of PA in older adults is associated with increased risk of all-cause mortality, especially in the Black population[4]. Large population-based studies suggest that moderate levels of PA provide protection from chronic diseases in older adults[5]. Therefore, interventions aimed at improving PA in older Black adults could significantly improve health outcomes and help to reduce health disparities among this population. To increase PA in older, Black adults, we use the socioecological perspective[7] to examine the barriers and facilitators at each level of influence (i.e., intrapersonal, interpersonal, organizational/community, environmental/policy). A PA intervention developed for older, Black adults that targets multiple levels of the socioecological model is needed. The evidence-based Fit and Strong! (F&S!) program for older adults, funded by the National Institute of Aging, can be optimized to bypass these barriers and effectively engaged older Black adults in sustained PA. Although the F&S! program has been successfully implemented in multiple community-based, ethnically diverse settings, it is limited because it is only offered in-person (i.e., no online component) and ends at 8 weeks with very little ongoing support. These limitations not only increase the cost and reduce the accessibility of the program but also fail to optimize or support gains made as improvements in PA during F&S! diminish over the follow-up phase[8]. We will bypass these limitations and develop an adjunct, online platform to the F&S! program that is capable of syncing with wearable devices (e.g., fitbit). To create this platform as well as examine its feasibility and acceptability, we will partner with the Black Ministerial Alliance of Greater Boston (BMA), an organization of predominantly Black churches, and administer the program in these churches in Boston, MA. Consistent with this FOA “to provide support for up to two years (R21 phase) for research planning activities and feasibility studies” we will conduct: 1) focus groups in two BMA-affiliated churches to better understand the key barriers necessary to bypass at every level of the socioecological model and then build this adjunct, online program to create the F&S!-Online program and 2) an open pilot study (N=30) across these two churches to examine the feasibility and acceptability of the F&S!-Online program. Per the FOA, the R21 will be, “followed by a possible transition to expanded research support (R33 phase) for optimizing the intervention and conducting larger-scale feasibility studies”. Consistently, for the R33 phase, we will conduct a larger scale feasibility study by randomizing four BMA-affiliated churches to either F&S!-Online or the standard F&S! (N=120) to determine the feasibility and acceptability of the online adjunct platform as well as pilot its efficacy and sustainability.