A new program offered at Nova Scotia YMCAs and developed with researchers from Dalhousie and Acadia Universities aims to help older adults use the proven benefits of exercise to manage chronic disease.
LiveWell is delivered by qualified exercise professionals who customize programming for a variety of participants across the spectrum of conditions and abilities, with the goal of building strength, balance, and overall fitness. Although self-referrals and walk-ins are permitted, health care professionals are encouraged to refer patients to the program.
With the aging of Nova Scotia’s population, the need for a community program for people managing chronic illnesses has become increasingly important. Having seen the success of a similar program developed in Ontario, the regional director of the YMCA advocated for the development of a similar program in Nova Scotia.
Dalhousie Kinesiology graduate and consultant Scott Logan leads the LiveWell team of researchers from the Dalhousie and Acadia Colleges of Health and Medicine. The program was designed using significant learnings from Acadia’s Active for Life initiative, a 10-week program that helps older adults improve their fitness, balance, coordination, flexibility, strength and power through style classes. of life and group exercises.
bridging the gap
Jonathan Fowles, a professor of kinesiology at Acadia, has been working to develop the Active for Life program in collaboration with Nova Scotia Health and various chronic disease programs for a decade. He says a key aspect of the program is providing solutions that ‘bridge the gap’ from acute medical care to community wellness programming. He also seeks to address safety concerns related to the medical condition of active older adults. He hopes the advanced training received by the staff running the program will encourage more referrals.
“Having a referral pathway for healthcare professionals to a community program for people with medical conditions taught by a qualified exercise professional is something I’m passionate about supporting. I am very pleased that the YMCA has adopted our ‘Active for Life’ program model,” says Dr. Fowles.
Under the Active for Life framework, a clinical exercise physiologist (CEP) who has specific training in assessing and prescribing exercise for people with chronic conditions acts as a “navigator” receiving referrals from healthcare providers and the community . The CEP evaluates the participants and then designs and delivers evidence-based, safe and effective exercise schedule.
This approach has been shown to build trust with healthcare providers and patients. Research by Dr. Fowles and his team shows that the model is effective and has received funding from the Department of Health and Welfare to promote its development in Nova Scotia.
From pilot to permanent programming
The LiveWell program kicked off at the Halifax and Bridgewater YMCAs in April and is nearing the end of a 12-week pilot program. With financial support from the Nova Scotia Department of Communities, Culture, Tourism and Heritage, Logan is eager to move beyond the Halifax/Bridgewater pilots and begin permanent LiveWell programming at additional YMCA locations in Pictou and Amherst this summer. . The Cape Breton YMCA will follow in the fall.
As the expansion and outreach continues, Logan hopes to earn the trust of healthcare providers and increase their referrals to the program.
“It’s important for healthcare providers to know that we’ve hired trained staff to assess and monitor patients to make sure they’re not at risk and are safely progressing to improved, functional health,” he says. “We need to demonstrate to health care providers that when they refer someone, they are sending them to a qualified exercise professional they can trust, who is insured and trained specifically in clinical conditions and how to treat them.”
Logan says knowing that exercise is a proven benefit in both preventing and managing chronic conditions is the easy part. His team is trying to look beyond that body of evidence to factors related to engagement and long-term retention.
“As someone like Dr. Robert Strang would tell me, Minimize hospital readmissions or minimize recurrence,” he says. “So that’s where we want to go. Exercise can do those things, but if we don’t have people in the right programs for long periods of time, we’re not going to achieve those broader goals.”
The team will study the program for three years with the goal of determining what makes people understand the benefits and commit to exercise when they have so many conflicting priorities.
Olga Theou, Canada Research Chair in Physical Activity, Mobility and Aging Health and Assistant Professor in Physiotherapy and Geriatric Medicine at Dal, recently received a grant from Research Nova Scotia to complete an in-depth evaluation of an exercise program with a format Similary. focused on older adults with some level of frailty.
Dr. Theou has been involved in the design of the LiveWell program and will continue to advise at all stages.
“We all need to be more active, but there is no one-size-fits-all solution,” he says. “The most effective physical activity program is the one that people stick to.”
Access and expansion
If all goes well, LiveWell will expand beyond the five Nova Scotia YMCA “hubs” and be offered in numerous YMCA outreach communities to ensure accessibility for all interested in participating. The program team is also eager to address health inequalities and the needs of marginalized groups, and will engage with Nova Scotian African, Indigenous, and LGBTQ+ communities, who typically do not access these types of services, and encourage their participation in this program and others. .
In the future, Logan envisions the program expanding even further, into what he calls prevention and ‘prehabilitation.’
“LiveWell focuses on managing chronic conditions or what’s called secondary prevention,” says Scott. “But as this grows, we are committed to looking at more primary prevention programs, so that later we help develop healthy exercise habits with children, young people, new mothers and other specific populations.”
For now, older adults and their health care providers are encouraged to participate. LiveWell’s physical activity programming can be tailored for just about anyone, regardless of prior experience, fitness level, or ability. And as Dr. Melanie Keats, Director of the Division of Kinesiology at the Dalhousie School of Health and Human Performance and consultant to the program, says: “Most of us can benefit from being more physically active or just moving more.”