Wellness 2 Age; Supporting rural older people to age well

Background<br/><br/>Ageing can be associated with reduced independence, mobility, and social isolation, which leads to an increased risk of becoming dependent on health and aged care services. With an increasing ageing Australian population and limited access to services within rural areas, we need innovative approaches to better support older rural people to age independently.<br/><br/>The Wellness 2 Age Program adopts a strengths-based, person-centred approach to simultaneously improve the mobility, cognition, and social wellbeing of older rural community members through activities that are aligned to individual participants’ goals. The program runs for 1 hour per week for 10 weeks and involves graded activities to support individual needs, which are explicitly linking to home-based activities so that learnt strategies can easily translate into the older person’s everyday environment. Initially delivered in one rural NSW location, the aim of this research was to determine whether the acceptability, feasibility and efficacy of the Wellness 2 Age program was maintained under different rural community-based services to inform scale-up more broadly across rural areas.<br/><br/>Methods<br/><br/>A prospective multi-site cohort study employing a mixed methods study design was used to evaluate the Wellness 2 Age program, with older people who participated in the program, and with allied health staff, allied health assistants, and aged care support staff who facilitated the program at each site. A range of online and paper-based surveys, standardised pre and post outcome measures, and semi-structured interviews were undertaken to evaluate the outcomes of implementing the program. Feasibility and acceptability surveys were analysed using descriptive statistics. Paired-samples t-tests were used to measure change on standardised outcome measures over the 10-week program. Thematic analysis was utilised to analyse the qualitative data from interviews.<br/><br/>Results<br/><br/>Eighteen staff were trained to deliver the program across four sites, with 29 older people completing the program during 2024. All staff indicated that the program was either completely feasible or feasible to some degree to deliver at their organisation. Most older people reported that all elements of the Wellness 2 Age program were completely acceptable, regardless of which site they participated at. Older participants across the sites demonstrated statistically significant positive improvement on self-rated occupational performance and satisfaction using the Canadian Occupational Performance Measure, with a large intervention effect. Older participants also demonstrated statistically significant improvement on mobility, cognition, and quality of life, with a medium to large intervention effect. Finally, three qualitative themes were identified from interviews with older participants; 1) The supported and adaptive program structure enabled engagement, 2) Skilled implementation balanced safety with encouragement and humour, 3) Opportunities existed to enhance clarity and connection.<br/><br/>Conclusion<br/><br/>The outcomes of this multisite study demonstrate that the Wellness 2 Age program can suit diverse rural settings while maintaining a structured foundation to ensure consistent outcomes. The ability to successfully implement the program across a range of health and aged care services suggests that it is adaptable to the local needs, while utilising the available rural workforce.