Community Healthy Activities Model Program for Seniors (CHAMPS)

Regular physical activity contributes substantially to the health, functioning, and quality of life of older adults. Many chronic conditions and illnesses can be prevented and managed through regular physical activity. Regular exercise to improve strength and endurance among older adults can also lower health care and nursing home utilization. Unfortunately, many older adults are not achieving the national guidelines for regular physical activity; only about 25% of men and 20% of women older than 65 years meet these guidelines. Older Americans can still benefit from regular physical activity, even if they have led a sedentary life.

This individually tailored, choice-based physical activity program promotes increased long-term physical activity levels in older adults. The Community Healthy Activities Model Program for Seniors (CHAMPS II) encourages participants to create a physical activity regimen based on their preferences, health, ability, and resources (such as availability of community classes and financial status). Based on social-cognitive theory, the program includes principles of self-efficacy enhancement and readiness to change as well as motivational techniques. Participants receive information on ways to exercise safely, motivate themselves, and overcome barriers. Information and support resources include an informational meeting, one individual planning session, regular staff initiated telephone calls from a counselor, monthly group workshops, physical activity diaries, monthly newsletters, and functional fitness assessments.

The initial informational meeting and the individual planning session require approximately 50 minutes each. Each of the 10 recommended monthly group workshops requires 60 to 90 minutes. Telephone calls (approximately 16 over the 1-year period) average 15 minutes depending on the needs and interests of the participant.

Participants were sedentary adults, 65 years or older in two Medicare health maintenance organizations (HMOs) through a large multispecialty medical group in California. The average age of participants was 74.4 years; 66% were female; and 9% were ethnic-racial minority group members in which 1.2% were Black; 4.3% were Asian or Pacific Islander; 2.4% were Hispanic; and 1% were classified as "Other".

This intervention is suitable for community-based settings.

The program's material includes the Community Healthy Activities Model Program for Seniors II (CHAMPS II) Program Manual.

After medical screenings and personal enrollment meetings, 173 eligible adults from two participating HMOs were randomly assigned to the 1-year CHAMPS II intervention or to a wait-list control group. CHAMPS participants were encouraged to gradually develop a program for themselves that would include strength training, endurance, flexibility, balance and coordination. Participants in the CHAMPS II group met individually with trained program staff to discuss readiness to increase physical activity, safety, precautions, and motivation to develop a practical and realistic physical activity regimen. In general, the long-term goal was for participants to achieve at least 30 minutes of moderate-intensity activity on most days of the week; additional recommendations were provided related to the different types of exercise. Participants then had the opportunity to attend any or all of 10 group workshops that included both lectures and practical movement instruction over the one-year intervention period; attendance at the initial exercise safety workshops was strongly encouraged. Participants received monthly telephone calls from program staff who provided encouragement and support, information on relapse prevention, and goal setting; staff also inquired about changes in participant's health and pain associated with exercise. Participants completed several functional fitness tests. They received monthly newsletters. Finally, participants were asked to complete a physical activity diary for two weeks out of each month.

Physical activity was measured by self-report at baseline and 1 year.

Results indicated:

• Participants in the intervention group increased their estimated caloric expenditure (+487 calories) in moderate-intensity (or greater) activities compared to participants in the control group (+5 calories).
• Participants in the intervention group also increased their estimated caloric expenditure (+687) in physical activity at any intensity compared to participants in the control group, whose caloric expenditure did not change.
• Participants in the intervention group lost an average of 3 pounds over the one-year intervention, based on a reduction of their body mass index (BMI), compared to control group participants who had no change in BMI.