A scoping review on the implementation dynamics of scaling up a community-based health promotion and exercise program for older adults: opportunities and challenges

Abstract

Background: As the global population of older adults continues to rapidly increase, there is a pressing need to address diverse concerns related to their physical, cognitive, and psychosocial well-being. In this scoping review, we aimed to map the existing literature on opportunities and challenges inherent in the implementation dynamics of scaling up a community-based health promotion and exercise programs designed for older adults. The research question is ‘What are the opportunities and challenges of successfully scaling up a community-based health promotion and exercise program for older adults?’ Methods: Three databases (EBSCO Host Medline, The Cochrane Library, and Scopus) were searched for articles published between January 2013 to December 2023. Utilizing a three-step screening process, 17 articles describing the opportunities and challenges of implementing a community-based health promotion and exercise program for older adults at scale were selected for inclusion in this scoping review. Opportunities and challenges were categorized through the lens of the RE-AIM (reach, evaluation, adoption, implementation, maintenance) framework. Results: The multifaceted key opportunities and challenges identified on the implementation dynamics of scaling up a community-based health promotion and exercise program for older adults across the RE-AIM framework encompassed issues related to engagement, participation, recruitment, accessibility, awareness, inclusivity, evaluation, adherence, baseline predictors, complexity, motivation, responsiveness, partnership, planning, viability, adaptation, optimization, training, infrastructure, resources, stewardship, and retention. Conclusions: Addressing these opportunities and challenges comprehensively is imperative to ensure the successful implementation and enduring sustainability of scaled-up programs of this nature.