Mathieu de Greef PhD Ger Kroes MSc

Groningen Active Living Model (GALM) A health enhancing physical activity program for sedentary

older adults in the Netherlands

www.galm.nl

focus sedentary older adults

aim to enhance physical activity to meet ACSM guidelines

age group 55-85 year

theory driven behavioral change as a multidimensional dynamic proces

orientation community based, recreational sportsprogram

Fit weekly 60 minutes, 30 months, moderate intensity

Features of the GALM program

-Social Cognitive Theory-Evolutionary play Theory-Toronto Model

Stage

Behavioral change mechanisms

Theoretical concepts

Campaign activities

Recruitment

Motivational climate

Adoption Behavioral change

Active Ageing

EnjoymentEnhancing

fitness, skills & connectedness

Adherence and Social participation

Selfmanagement training

-Transtheroretical Model - Self-Determination Theory - Nudge Theory - Active living concept

(2 months) (4 months)

Group tailored exercise class

(12 months) (12 months)

-Schema theory -Health Literacy framework -Relapse Prevention Theory

Home visits Exercise introduction program

GALM conceptual model

- Goalsetting Theory - Social connected- ness theory

1 2 3 4

+ + +

motivation

PA status

Fysical fitness

enjoyment

compliance

Health education

nudging engagementadherence

Social connectedness

Theoretical framework GALM

Self determination theory

Transtheoretical Model

Health Literacy theory

Relapse Prevention Model

Social supportSocial Cognitieve theory

Self-efficacy

Community based

Active Living Model

Social Cognitieve theoryToronto Model; Play theoryMarketing mix

Social Marketing Theory

empowermentSchema theory

Nudge Theory

Behavioral changeRecruitment and adoption Active Ageing

Social Capacity Theory

Expected pleasure theory

Self determination theory

Resilience theory

social participation

Social capital theory

Linkage theoretical framework GALM to the Socio-ecological model

Health literacy framework

Social Capital Theory

Social Marketing Theory

Resilience Theory

Social cognitive Theory

Transtheoretical Model

Active living Model

Self Determination Theory

Totonto model

Scheme theory

participati 14.0

Interested fittest intro program after 18 mo after 30 mo

20% 18%

Popkema & de Greef 2000,

16% 14%

24%

The effect on behavioral change

flex schoulder

reaction time

flex hip

endurance

leg strength

0

10

20

30

40

50

60

man

women

total

percentage of fitness scores below average

Development and dissimination GALM

1995

GALMSedentary elderly

SCALASendentary elderly wiih chronic conditions

1999

SMALLDPA program sedentary elderly

Social VitalityHealthy Ageing program sedentary and lonely elderly in deprived neighbourhoods

GALM-ADLADL campaign frail elderly in nursing homes

FLASH PA CampaignNetherlands on the move

Differentiation

dissemination

National Health enhancing PA campaigns

2 local projects

2003 2007

National Actionplan Sportsimpuls

902 local projects

European Health Promotion Award 2001

matrix organization structure GALM

National level Regional level Local level

- GALM foundation- University Groningen

- National Institute for Recreational Sports and Physical Activity (NISB)

- Ministry of Health, Welfare and Sport - Netherlands Organization for Health

Research and Development (ZonMW)

- Vocational Education Institutions- Regional Sports Councils - Provincial boards - Regional Health Services (GGD)

MethodFundingMonitoringR&D

Localproject

TrainingFundingFitness testSelection targetgroup

-Municipality- Local sports and welfare organisations- Local care institutions- Member organisations for seniors

Network formationRun GALM programFundingContinuity

Theory

Program

Implementation

Evidence

summaryGALM is theory driven health enhancing physical activity strategy

Recruitment: 18% of sedentary older adults

Increase physical fitness (stength, endurance)

Feasible for euopean implementation

GALM-ECO model enhancement physical activity

NUDGING

Energy expenditure

Intrinsic motivation

resilience

MINDSETTING

Social marketing

active living

Health information