Evaluation of a co-designed community-based physical activity program with immigrant South Asian older women: an intersectional RE-AIM/PRISM analysis of acceptability and feasibility.

内容摘要

To use the RE-AIM/PRISM Framework to evaluate a co-designed community-based physical activity program for immigrant South Asian older (ISAO) women. A qualitative-driven community based participatory research study that draws on intersectionality theory. The STRONG Program 'Seniors Thriving, Reaching Out, and Growing' is an eight-week hybrid intervention, combining virtual health education with in-person exercise sessions, that was co-designed with ISAO women in Edmonton, Canada. Data sources were participant observations, post-intervention interviews and conversation circles, facilitator debriefs and meeting minutes. Reflexive thematic analysis was used to examine RE-AIM/PRISM dimensions and intersectional influences shaping program acceptability and feasibility. Thirty-four ISAO women participated in the study. Reach was facilitated by relational safety, community champions, and family support. Perceived effectiveness was reflected in acceptance and satisfaction via high attendance (82%) and participant-reported improvements in physical function and social connectedness. Adoption and implementation were shaped by an intergenerational contract in which family members provided essential digital and transportation support, while South Asian facilitators bridged clinical expertise with holistic, strength-based care. Maintenance was challenged by structural inequities; however, organizational partnerships fostered continuity of program success. The STRONG program demonstrates that health promotion for ISAO women is acceptable and feasible when grounded in relational safety and family support. Long-term sustainability requires moving beyond individual-level interventions to address structural barriers related to transportation equity, digital literacy, and the integration of clinical expertise within community-based organizations. WHY IS THIS RESEARCH NEEDED?: Health inequities persist for immigrant older women, yet many health promotion interventions demonstrate limited reach, adoption, and sustainment due to insufficient attention to the lived experiences and structural barriers. This study explores how intersecting social identities, such as gender, migration, and culture, shape the acceptability and feasibility of a community-based health promotion program. WHAT ARE THE KEY FINDINGS?: Among ISAO women experiencing intersecting social exclusions, health promotion programs were more acceptable and feasible when strong intergenerational family contracts and organizational capacity to foster relational safety enabled family-mediated and relational mechanisms of engagement. HOW SHOULD THE FINDINGS BE USED TO INFLUENCE POLICY/PRACTICE/RESEARCH/EDUCATION?: Health promotion programs that are family-centered, use community champions and create relational spaces are more likely to be accepted by immigrant older women. Feasibility is hindered by structural deficits such as transportation inequity, low digital literacy, and lack of outreach of health experts in immigrant communities.