Pandemic-Driven Rural Fitness Boom Benefits Seniors

“Virtually the whole industry recognizes that offering in-person and remote programming—a full spectrum of programming—is a terrific strategy to reach more older folks, to promote access and equity,” said Jennifer Tripken, associate director of the Center of Healthy Aging at the National Council on Aging. “We must move together.”
Pandemic-Driven Rural Fitness Boom Benefits Seniors
Eight women, all 73 or older, paced Malmo Evangelical Free Church's fellowship hall to Daniel O'Donnell's "Rivers of Babylon" before an hourlong fitness class.
Despite snow and icy roads, the women from Mille Lacs Lake's eastern coast came for several reasons. One came to treat osteoporosis, another to recover from a stroke.

Most brought hand and ankle weights for the Stay Active and Independent for Life (SAIL) fall prevention program. Malmo, a 300-person village, holds class twice a week. Juniper, a statewide health promotion class network, runs it.

A few years ago, older individuals who wanted to take an evidence-based class like SAIL—one proven by research to benefit health—had just one option: attend in person if one was provided nearby.

Then came the COVID-19 pandemic and physical separation. Remote job and workouts accompanied social isolation.

After March 2020 lockdowns, U.S. senior agencies added virtual health classes. Virtual classes have replaced isolation. Virtual sessions give supervised physical activity to rural elderly folks who have trouble traveling to gyms.

Advocates believe online classes will stay.

“Virtually the whole industry recognizes that offering in-person and remote programming—a full spectrum of programming—is a terrific strategy to reach more older folks, to promote access and equity,” said Jennifer Tripken, associate director of the Center of Healthy Aging at the National Council on Aging. “We must move together.”

Since April 2020, the National Council on Aging has held monthly conference calls for service providers to discuss improving or starting virtual services.

“We found that remote programming, particularly for rural areas, expanded the reach of programs, allowing opportunity for folks who have traditionally not participated in in-person programs to now be able to tune in, to harness technology to participate and reap the benefits,” Tripken said.

Juniper, a Minnesota Area Agency on Aging initiative, provided online fitness programs to 1,547 seniors in 2022. Over half were rural.

Grants cover participant costs
Fall-prevention program SAIL meets at Malmo Evangelical Free Church in Minnesota. (KHN)
SAIL reduces elders' fall risk by strengthening and stretching them. (KHN)

Juniper's virtual lessons are popular with folks who live far from class venues and those with medical issues. Before the pandemic, Carmen Nomann, 73, exercised in Rochester. She can't get boosters or socialize after an unusual covid vaccination response.

“Really a terrific lifeline for keeping me in shape and having interaction,” she added of virtual lessons.

“Now, we would never go away from our online classes,” said Juniper's vice president of communications Julie Roles. “We've learned from so many folks, particularly rural people, that that allows them to engage regularly—and they don't have to drive 50 miles to a class.”

“It's tougher to establish that sense of ‘I'm supported right here at home'” when elders commute far to attend classes with people from other areas, she said.

Roles said virtual and in-person fitness programs combat social isolation in rural older persons.

Dr. Yvonne Hanley has taught Juniper's online SAIL class from her Fergus Falls home since 2021. She retired from dentistry and wanted to assist people stay healthy and strong.

Hanley doubted her pupils would bond, but they did. “As they check in, I say ‘Good morning',” she added. “I make class fun.”

Virtual fitness programs have helped Illinois senior agency AgeOptions. Last year, agency officials stated their operations "may have changed forever" to include virtual and in-person classes.

That concept lets AgeOptions maintain fitness programs in Illinois' harsh winters. AgeOptions now uses remote classes instead of winter events to keep older individuals from traveling in snow and ice.

“If the pandemic didn't come, and we didn't shift these programs to virtual, we wouldn't be able to accomplish that,” said AgeOptions manager Kathryn Zahm. “We might spend months reducing our programming or sorts of content. We may now safely conduct fall-prevention activities year-round.

The new method has drawbacks.

For the next few years, AgeOptions will provide technology access to help elders sign up.
Beverly Swenson (right) encouraged her neighbor Mary Swanson to the fall-prevention program after Swanson said she was "feeling kind of unsteady" and needed a fitness class. (KHN)

The agency found that “folks in remote places it was a struggle not just for them to have the gadget but to have the bandwidth to be able to undertake video conference calls,” Zahm added.

Tripken said providers and students need help to access virtual classes.

She said elderly persons with vision loss, hearing loss, and inadequate English proficiency should be able to take virtual classes.

Some programs accommodate technology.

Bingocize, a fall-prevention program licensed by Western Kentucky University that mixes fitness and health education with bingo, users utilize AgeOptions' printed game card if they can't use the app. Video participation is essential.

Bingocize inventor and worldwide director Jason Crandall said the mail option came about after numerous elder service groups asked how to offer it remotely.

Crandall created Bingocize as a face-to-face program and later incorporated the online app for in-person seminars. Then covid.

All of a sudden, Area Agencies on Aging were scurrying to figure out, ‘How do we do these evidence-based programs remotely?'” Crandall.

Though it had never done so before, Bingocize was one of the few systems that could swiftly switch to remote programming.

“From the pandemic to now, we've come light-years on how it is done, and everybody's getting more comfortable with it,” he said.

The Bingocize program's creator's identity was corrected at 11 a.m. ET on Jan. 17, 2023.

@cnsaintlouis, christinas@kff.org
References

Rural health COVID-19 Illinois Kentucky
Minnesota

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