Ethnocultural adaptation of an effective health-promoting intervention for Punjabi-speaking older adults: Choose to Move ਆਓ ਚੰਗੀ ਸਿਹਤ ਵੱਲ ਚਲੀਏ

Background South Asians are the largest and fastest-growing racialized group in Canada but are underrepresented in health research and underserved in health-promoting initiatives. In this paper we: 1) describe the systematic process by which we ethnoculturally adapted Choose to Move (CTM) – an effective health-promoting model for older adults – for South Asian Punjabi-speaking older adults and organizations that serve them, 2) describe the adapted CTM model, and 3) evaluate implementation of the adapted CTM model. Methods Using community-based participatory research methods, we followed a multi-step adaptation process: 0) review existing CTM Phase 4 data; 1) engage community partners and Punjabi-speaking older adults; 2) conduct needs assessment; 3) develop and 4) validate a prototype adapted CTM model; 5) finalize adapted model; and 6) pilot implementation. We coded adaptations using the FRAME and FRAME-IS frameworks. Four organizations piloted the adapted CTM model (4 coaches, 5 programs, 68 older adults). Following program delivery, we assessed implementation indicators and outcomes through questionnaires and semi-structured interviews with organizations, activity coaches and participants. Results We proposed 23 updates to the CTM model after Step 0 (e.g., modified activity coach training content) and 32 ethnocultural adaptations after Steps 1–3 (e.g., increased length of group meetings, translated promotion and recruitment materials). During the pilot, 72% of participants completed the CTM program and provided post-program feedback. Organizations and coaches rated the program as acceptable, appropriate and feasible. Dose delivered, dose received and participant responsiveness were high (> 84% for all). Fidelity to core functions ranged from 62–100%. Four themes emerged from qualitative data to support these findings: 1) provide structure and support, 2) foster cultural and linguistic resonance, 3) make goals matter and 4) facilitate engagement. Coaches were satisfied with strategies they used (usage ranged from 25% to 100% across available resources) and made few adaptations. Qualitative data supported these findings through three themes: 1) build relationship-centered partnerships, 2) provide tailored and culturally appropriate support, and 3) tailored training. Conclusions We integrated implementation science approaches with ethnogerontology to generate a blueprint for implementing an evidence-based and ethnoculturally grounded health-promoting for Punjabi-speaking older adults. Clinical Trials Registration NCT06252259; Registration date: February 1, 2024