Health Program Proposal: Reducing Morbidities in Canadian

Senior Citizens through Physical Activity

Emma Lewis (8729799)

Jordan Lavallee (8578487)

Victor Fahmy (8723740)

Nicholas MacLean (8769656)

Riya Gupta (8616768)

Development and Evaluation of Health Programs

HSS4101B Winter 2019

Dr. Pilutti

Monday, February 18th, 2019

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 A report from Statistics Canada (SC) examined the occurrence of high impact, high

prevalence chronic health conditions (HIHPC) in individuals between 61 and 70 years old. The

results showed that 34% had one HIHPC, 22% had two HIHPC’s, and 12% had three or more

HIHPC’s. Cumulatively, 68% of the selected population had at least one HIHPC [1]. HIHPC’s are

known to directly affect quality of life; this relationship was examined in a 2018 study of quality-

adjusted life years (QALY) for chronic conditions [2]. The authors define QALY as a measurement of

disease burden which estimates the amount of years remaining for an individual afflicted with a

specific health condition at a specific age—assuming, otherwise, perfect health [2]. The average

QALY for those over 65 years old with hypertension is 6.5 years, 4.5 years with diabetes, and 1.6

years with depression [2].

Nearly all HIHCP’s are manageable and preventable through meeting the minimum

suggested amount of physical activity [2, 3] as outlined by the World Health Organization [3].

Physical activity has been shown to reduce rates of all-cause mortality, cardiovascular disease, high

blood pressure, type II diabetes and also lowering the risk of falling and improving cognitive

function. Physical activity is a non-invasive intervention that tackles the myriad of health conditions

facing the ageing Canadian population [4].

It was determined that 60% of Canadians older than 65 years old are inactive and spend 69%

of their waking hours performing sedentary activities [5]. The reasons for inactivity in this population

are HIHCP’s that limit physical activity and social/physical barriers that prevent or discourage

physical activity. These barriers can include negative community opinions regarding elderly physical

activity and a lack of understanding or knowledge about where and how to be physically active. Our

program aims to overcome these barriers by targeting adults 60+ years old in the Ottawa region with

the goal to increase their QALY by increasing the amount of physical activity through educating,

providing opportunities and creating a supportive community framework.

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 The target population includes adults aged 60 years or older, in the Ottawa region. The

strategies that will be used are health communication, health education, and community mobilization.

There are various interventions that will be used such as handing out flyers and posters in churches

and grocery stores, putting out radio advertisements, designing informative programs to educate

seniors, and eventually having seniors lead community activities. The outcome of our program will

be to reduce incidence and prevalence of chronic health conditions in this population.

At least 68% of the target population are suffering from an HIHPC that is robbing them of

years of good quality health [1]. The most accessible and effective method to tackle these HIHPC’s is

prevention physical activity. Currently the the enormous lack of physical activity has been identified

as a factor that is detrimental to the health outcomes of this population.

There are a variety of factors that are contributing to this situation. These influencing factors

are: chronic health conditions that limit physical activity, not being educated or having the resources

on how to be physically active, barriers in communities and environments that prevent or discourage

safe and accessible physical activity, or not being aware of the benefits of being physically active.

There are many underlying for these influencing factors; social isolation, introduction of technology,

poor education, fewer and weaker ties with family members, and climate conditions [6].

Technology is a major threat to physical activity. Before technology became a central part of

daily life, adults older than 60 years old would fill their days socializing face to face, however, they

are now attempting to fulfill this need through interacting through online social networks. The

population is also living much longer while still depending on outdated beliefs about exercise and

nutrition—education on the negative effects of isolation and lack of physical activity is necessary.

Social programs that encourage them to get out of their homes and be social, would greatly

increase their quality of life. The slippery slope of social isolation results in decreased mobility and

the fulfillment of their needs coming from shallow interactions with technology. Involving a social

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 aspect with a program that is trying to promote physical activity, would prevent many of the diseases

that come from lack of physical activity and stimulation.

Encouraging families to have a strong relationship with their members that fall into the target

population would also be beneficial. These members are more isolated today due to the changing

working roles of the husband and wife. Nowadays, it is normal that both husband and wife are

working. Conversely, back in the day only one parent would work while the other would typically

stay home and take care of the house and family is a domestic role. This member of the relationship

that would fulfill this domestic role would They would often take any elder dependants with them on

their outing and errands, maintaining their social ties and activity.

The weather of a given climate can also inhibit levels of physical activity. Specific factors

associated with weather and climate that would prohibit physical activity would be snow, ice,

excessive heat, humidity, and cold. The winter season can be a large limiter of physical activity, as it

is more challenging to be mobile. Furthermore, ones geographical location can be a threat to the

course of action, if living in rural areas.

Environments that are not conducive to physical activity for individuals who may have

impairments or chronic health conditions. These can present themselves as the lack of existing health

promotion programs, poor policies, facilities that are inaccessible to an older population, or negative

attitudes towards the target population.

With organisations such as In Motion, with their Forever...In Motion program (http://www.in-

motion.ca/pages/content/older-adults), the University of Illinois at Chicago School of Public Health

Institute for Health Research and Policy, with their program Fit & Strong! [7], along with the

Partners in Care Foundation and their program Healthy Moves [8], there are a variety of programs

that target the senior population with the goal of increasing their physical activity. The Ministry for

Seniors and Accessibility with the province of Ontario have identified the lack of physical activity in

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 the senior population as a key determinant of health in this population. Due to this, they have

implemented resources and programs to facilitate and promote physical activity for this group. Their

recommendations align with those of the World Health Organization, as the province of Ontario

recommends adults ages 65+ to have a minimum of 150 minutes of moderate-intensity aerobic

physical activity or 75 minutes of vigorous-intensity aerobic physical activity each week, as outlined

in their tips and guidelines which can be found among their many resources that promote this goal

[3]. They also have programs and activities such as the Ontario 55+ Games, similar to the Canada

Games, and a plethora of Senior Active Living Centres throughout the province [9]. To evaluate this

activity, a simple questionnaire given to the participants at the start and then again at the end of the

program would suffice. With the results of this questionnaire representing the degree to which the

target population are meeting the recommended amount of physical activity, the activity could then

be evaluated. Physical activity has been proven to be a critical determinant of health that lowers rates

of all-cause mortality, cardiovascular disease, high blood pressure, colon and breast cancer, type 2

diabetes, along with lower risks of falling, better cognitive function, and reduced limitations of their

functionality and roles (WHO). With this evidence, any activity or program that can successfully

promote or aid this population in achieving the recommended amount of physical activity, should be

pursued as it will achieve the mentioned health outcomes that accompany a healthy and active

lifestyle. Promoting physical activity is the least invasive health intervention, it can be successfully

evaluate throughout the program, and it has an enormous span of health problems that it can

successfully combat.

Goal is to target individuals, 60 years or older, in the Ottawa region and increase their QALY

through physical activity as a preventive mechanism for HIHPC’s.

Primary audience includes Canadians 60+ suffering from HIHPC’s. Secondary audience

includes Canadians not currently suffering from HIHPC’s but are at-risk of developing them.

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 Short-term outcome objectives: inform 10-15% of seniors aged 60+ in the Ottawa region by

January 2020, that light to moderate physical activity in a social setting can improve overall health

and increase QALY, to get 5-10% of seniors aged 60+ in the Ottawa region by January 2020 to get

out and do light to moderate physical activity in a social setting.

Medium-term outcome objectives are: to increase by 5-10% of seniors aged 60+ in the

Ottawa region with cognitive impairments, osteoarthritis, and poor cardiovascular health to develop a

habit and adopt a lifestyle through social group activity that improves overall QALY by January

2022; To increase by 5-10% of individuals in the Ottawa region to change lifestyle habits that disable

disease development and enable a healthy lifestyle by January 2022.

Long-term outcome objectives are: to reduce the prevalence (number of healthy to a number

with the disease) of cognitive impairments, osteoarthritis, and poor cardiovascular health by 3-5% in

the Ottawa region by January 2030; To reduce the incidence (number of new cases to total cases) of

cognitive impairments, osteoarthritis and poor cardiovascular health by 3-5% in the Ottawa region by

January 2030.

Strategy Activity Process Objective

Health Flyers and posters in churches, grocery 100 posted flyers, 500 distributed
communication stores, retirement communities, and flyers, 10 radio advertisements, and
community centres. 10 social media posts, From starting
Radio advertising on physical activity date January 2020 to May 2020.
reducing illness for seniors that can be
listened to in the car for children of
seniors to share with their parents.
Social media to attract grandchildren to
gain knowledge to share with their
grandparents

Health education Informative programs designed to A 4-week informative program for

educate seniors on the importance of seniors, to be delivered 3 times per
physical activity and a healthy active year, by January 2022.
lifestyles. (walk & talk).

Community Peer (senior) led community activities to 1 training session (with a maximum
mobilization encourage participatory decision making of # participants), for peer (senior)

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 and increase ability, capability, and exercise leaders/volunteers, by May
confidence to affect community change 2022.
toward a more active lifestyle.

References

[1] Sanmartin C. Research Highlights on Health and Aging. Statistics Canada

https://www150.statcan.gc.ca/n1/pub/11-631-x/11-631-x2016001-eng.htm (2016, accessed
February 17, 2019).

[2] Jia H, Lubetkin EI, Barile JP, et al. Quality-adjusted Life Years (QALY) for 15 Chronic
Conditions and Combinations of Conditions Among US Adults Aged 65 and Older. Medical Care;
56: 740–746.

[3] World Health Organization. Global Physical Activity: Fact Sheet. World Health Organization
https://www.who.int/news-room/fact-sheets/detail/physical-activity (2018, accessed February 17,
2019).

[4] World Health Organization. Global Strategy on Diet, Physical Activity and Health: Physical
Activity and Older Adults. World Health Organization
https://www.who.int/dietphysicalactivity/factsheet_olderadults/en/ (2015, accessed February 17,
2019).

[5] Government of Ontario, Stathokostas L. Physical Activity Promotion for Older Adults.
Government of Ontario http://www.seniorscouncil.net/uploads/files/PARC_Best Practices
Guide.pdf?fbclid=IwAR1pXyRVrsAIps5yWCuCqBiB7YQ1xNckXyNxsCdCr1wpvp1tiYk-
z_CGAG8 (2013, accessed February 17, 2019).

[6] Watson KB, Carlson SA, Gunn JP, et al. Physical Inactivity Among Adults Aged 50 Years and
Older — United States, 2014. MMWR Morbidity and Mortality Weekly Report; 65: 954–958.

[7] Fit & Strong! An award-winning, evidence-based physical activity program for older adults. Fit
& Strong! https://www.fitandstrong.org/ (accessed February 19, 2019).

[8] Healthy Moves. Fit & Strong! | Evidence Based Leadership Council
http://www.eblcprograms.org/evidence-based/recommended-programs/healthy-moves (2018,
accessed February 17, 2019).

[9] Seniors: stay healthy and active. Government of Ontario https://www.ontario.ca/page/seniors-

stay-healthy-and-active (2017, accessed February 17, 2019).

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