A Realist Review Protocol of Community Group-Based Programs to Promote Physical Activity in Immigrant Older Adults.

Abstract

\n Background: Immigrants constitute 30% of Canada’s older adult population. Immigrant older adults have low levels of physical activity coupled with higher risks for cardiovascular disease and obesity in some sub-populations. Community group-based physical activity programs combine both physical and social benefits and are well received by older adults. These programs often lack sensitivity to the needs of equity-deserving groups, such as immigrants, who continue to experience lower levels of participation. Local, accessible, and culturally informed approaches are required to remedy these well documented inequities in who has access to and benefits from such programs. There is a gap, however, in our understanding of the characteristics and conditions for effective program design and delivery when the target population is immigrant older adults.Methods: The aim of this equity-focused realist review is to develop a programme theory that explains how, why, for whom, and under which circumstances community group-based physical activity programs work when delivered to older immigrants. We will first articulate an initial programme theory that explains tentatively how, why and for whom such programs work and then test and refine the programme theory using a systematic realist review process. The initial programme theory will draw from existing theories that inform group-based physical activity programs for older adults, intersectional theory, and stakeholder insights. PROGRESS-Plus factors will be explored in relation to relevance and impact for physical activity interventions. Stakeholders will include service providers, community volunteers and leaders who have extensive knowledge and interactions with immigrant communities. The initial programme theory will then be tested and refined using a systematic process of searching, retrieving, and reviewing literature on physical activity in immigrant populations. The final programme theory will be validated using stakeholder input and the research team’s expertise in aging, health equity, and physical activity. Discussion: Physical activity improves the wellbeing of older adults, decreases frailty, and supports aging in place. Ensuring that all older adults can participate in such programs entails understanding what works for whom, when and under which circumstances. This review will provide recommendations on best practices to support immigrant older adults’ participation in group-based physical activity programs.Systematic review registration: The protocol has been submitted to PROSPERO for registration (ID#258179, Date submitted May 30th, 2021.