A digitally supported outdoor exercise facility-based integrative physical activity self-management intervention for mildly frail older adults living in community: a hybrid effectiveness-implementation study (OUTDOOR-FIT)

Objectives: This project aims to evaluate the real-world effectiveness and implementation of a digitally supported outdoor exercise facility-based integrative physical activity self-management intervention for mildly frail community-dwelling older adults. Hypothesis to be tested: The intervention group is more effective in improving long-term physical activity behavioral change, and other health outcomes than the active control group. Design and subjects: The hybrid effectiveness-implementation trial will evaluate the effectiveness by a two-arm cluster randomized controlled trial and evaluate the reach, adoption, implementation, and maintenance by administrative records, fidelity checklist and semi-structured interviews with stakeholders. Two hundred and forty older adults aged 60 years or above, obtaining a frailty score of 1 to 3, with inadequate physical activity level, will be recruited from community. Interventions: Older adults mildly frail will receive four weekly one-hour physical activity self-management workshops with outdoor exercise facilities visits. The intervention is also supported by app and trained volunteers. Outcomes measures: Physical activity level, mental well-being, social loneliness, exercise self-efficacy, pain, and information on reach, adoption, implementation, and maintenance will be collected. Data analysis: Differential changes in the effectiveness outcomes will be assessed using a generalized estimating equation model, and quantitative and qualitative implementation data will be analyzed using descriptive statistics and qualitative content analysis, respectively. Expected results: The collected effectiveness and implementation data are expected to inform the potential for integrating the project model with existing elderly services for mildly frail older adults in Hong Kong.