Oral Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2025

Adapting an Effective Mobility Program for Different Clinical Contexts: A Stakeholder-Driven Approach (119666)

Melody Cheuk Yin Leung 1 2 , Cathie Sherrington 1 2 , Abby Haynes 1 2 , Peter Youssef 1 2 3 , Daniel Treacy 4 , Leanne Hassett 1 2 , Stephen Gilbert 1 2 , Rhuta Gole 5 , Braydon Finnerty 5 , Tony Youssef 5 , Joshua Wakefield 4 , Lucy Haver 6 , Whitney Harris 6 , Ying Wang 6 , Karlee Mueller 6 , Jenny Rayner 7 , Pamela Charlton 7 , Alexandra Edmondson 1 2 , Charlotte McLennan 1 2 , Raaj Kishore Biswas 3 , Marina B Pinheiro 1 2
  1. Institute for Musculoskeletal Health, University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
  2. School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
  3. Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
  4. Prince of Wales Hospital, Sydney, New South Wales, Australia
  5. St George Private Hospital, Sydney, New South Wales, Australia
  6. South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
  7. No current organisational affiliation, Sydney, New South Wales

Aims: Evidence shows that a 2-week program of 1-hour standing balance circuit classes, three times a week, in addition to usual therapy, is cost-saving and effective at improving mobility. However, multiple contextual challenges arise when applying it in different clinical settings. This project aims to adapt and implement a proven mobility program in both a private (St George Private Hospital) and public (Prince of Wales Hospital) setting, addressing system-level constraints (staffing, logistics) while optimizing patient outcomes and sustainability in diverse clinical environments.

 

Methods: The project plan, designed in collaboration with stakeholders, includes three stages (Figure 1): stakeholders’ collaboration, step wedge trial (sites progressively transition from usual care to the adapted program at different timepoints over 22 months), and dissemination and translation into clinical practice.

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Figure 1

 

Results: Collaboration with various stakeholders impacted by the program is essential for adapting the program to their unique settings. Key lessons included understanding factors such as ward logistics, staff-to-patient ratios, staff confidence and patient types, to facilitate adaptation. Identifying program’s core components, such as exercise type, dosage/intensity and staff/patient expectations for maintaining effectiveness while making modifications. This helps address barriers/facilitators for a successful change in practice. This project will provide a roadmap for scaling mobility programs in other hospitals.

 

Conclusions: This project provides a structured adaptation framework to help clinicians implement effective mobility interventions in varied clinical settings. By balancing fidelity to core program elements with local adaptation, this approach maximizes relevance, feasibility, and sustainability, enhancing its potential for broader implementation in geriatric rehabilitation.