Stay Active Program

The Stay Active Program provides a structured approach to maintain and improve physical function across diverse adult populations through progressive, adaptable activity modules and supportive behavior-change strategies.

Program Purpose & Principles

The core mission is to reduce functional decline and increase safe, sustainable physical activity by combining exercise science with behavior-change methods rooted in current professional guidance ^[1].

• Safety: prioritize risk screening, graded progression, and clear stop/start criteria.
• Accessibility: design sessions for multiple settings and low-equipment delivery.
• Progression: apply gradual overload and objective level-setting.
• Inclusivity: offer adaptations for chronic conditions, mobility differences, language and cultural needs.

Target Audience & Personalization

Primary targets are adults with low-to-moderate baseline activity and older adults at risk of mobility loss; secondary targets include individuals with stable chronic conditions cleared for exercise and those returning from short-term inactivity.

Baseline screening should include a structured health-history questionnaire, current activity status, and symptom review; clinically, examples of objective contra-indicators such as unstable angina or uncontrolled arrhythmia require referral to medical care before starting moderate or higher intensity activity ^[2].

Level-setting pathways use simple functional tests: a timed 6-minute walk or 30-second sit-to-stand to categorize participants into beginner, intermediate, or advanced tracks for tailored progressions.

Goals & Assessment Framework

Set SMART objectives across time horizons: a short-term target might be to achieve an extra 60 minutes of moderate activity per week within 4 weeks, a medium-term objective to reach 150 minutes per week at 12 weeks, and a long-term aim to maintain or improve functional independence at 6–12 months ^[3].

Baseline fitness assessment should include resting heart rate and blood pressure, a cardio test (6-minute walk or submaximal step test), strength measures (handgrip or sit-to-stand count), and balance/mobility screens (single-leg stance, Timed Up and Go).

Outcome metrics to track: minutes of moderate aerobic activity per week, number of strength sessions per week, functional test scores, and self-reported activity confidence; reassessment is recommended at regular intervals such as every 4–12 weeks depending on risk and program phase ^[1].

Activity Modules & Curriculum

The curriculum contains four core modules: aerobic conditioning, resistance training, mobility/balance, and flexibility. Each module includes progressive templates that adjust duration, frequency, and intensity by track.

Intensity guidance for aerobic work uses perceived exertion and heart-rate ranges: moderate intensity generally corresponds to roughly 50–70% of maximum heart rate and vigorous to about 70–85% of maximum, which can be used to individualize targets when heart-rate monitoring is available ^[4].

Strength modules emphasize multi-joint movements with 1–3 sets of 8–15 repetitions per exercise for most participants, progressing load as tolerated and using bodyweight, bands, or light free weights in low-equipment settings.

Weekly Structure & Progression Plan

Sample weekly distribution for beginner to intermediate tracks

Module	Frequency/week	Session Length	Intensity
Aerobic	3	20–30 min	Moderate
Strength	2	20–40 min	Moderate (8–15 reps)
Balance/Mobility	3	10–20 min	Low to Moderate
Flexibility	3–7	5–15 min	Low

Recommended overall weekly targets align with national guidance: aim for about 150 minutes of moderate-intensity aerobic activity per week, plus at least 2 strength sessions weekly for general health and functional maintenance ^[2].

Progression rules use conservative overload: increase total weekly training volume by no more than roughly 10% each week for most participants while monitoring symptoms and recovery markers ^[1].

Behavior Change & Motivation Strategies

Incorporate evidence-based behavior techniques: collaborative goal-setting, implementation intentions (specific when/where plans), and habit-stacking to link new activity to existing routines. Use short-term measurable milestones and positive reinforcement to support adherence.

Coaching approaches include structured feedback, weekly action planning, and periodic motivational interviewing to resolve ambivalence; self-monitoring with simple logs or apps supports objective tracking and accountability.

Social strategies can include small-group classes, peer buddies, leaderboards, or attendance-based incentives; when deployed, ensure incentives respect equity and do not penalize those with barriers to participation.

Safety, Accessibility & Adaptations

Pre-participation screening should identify red flags; for example, uncontrolled hypertension, recent myocardial infarction, or unstable symptoms warrant medical evaluation before higher-intensity work ^[5].

For older adults and those with fall risk, prescribe balance-focused activities on at least 3 days per week and include progressive challenge (narrow base, reduced hand support, dynamic tasks) to meaningfully reduce fall probability ^[4].

Adaptations for chronic conditions (e.g., controlled diabetes, osteoarthritis) emphasize symptom-guided progression, pain monitoring, and low-impact aerobic choices; home-based options rely on bodyweight, bands, and stair or step substitutes with clear safety cues for space and surface.

Monitoring, Tracking & Evaluation

Core tracking tools include weekly activity logs (minutes and type), periodic functional test results, and optional wearable data. Key performance indicators should include weekly moderate minutes, number of resistance sessions, and change in functional test scores over time.

Collect baseline and follow-up data at intervals that match program phase; common practice is reassessment every 4–12 weeks to adjust plans and document progress ^[1].

Privacy and consent procedures must specify which data are collected, how long they are retained, and who has access; use secure platforms and obtain documented consent for any identifiable health data shared with partners or clinicians.

Community, Support & Engagement

Group classes, peer-support networks, and periodic community events strengthen adherence by providing social reinforcement, shared goals, and accountability; coach-led onboarding should cover safety, goal-setting, and simple self-monitoring tools.

Coach and leader training should include exercise prescription basics, risk recognition, culturally responsive communication, and protocols for escalation to clinical care when needed.

Partnerships with healthcare providers and local organizations enable referral pathways, shared measurement frameworks, and potential resource supports such as subsidized equipment or space.

Implementation & Staffing

A typical local rollout cohort is often planned for 20–50 participants per coach to allow individualized attention during the first 8–12 weeks and to maintain group cohesion ^[3].

Program staffing ratios for mixed-format delivery commonly use 1 coach per 10–20 participants for in-person classes and 1 coach per 50–100 participants for asynchronous, app-supported delivery with periodic live check-ins ^[1].

Training requirements for frontline leaders should include a minimum of 16–24 hours of program-specific instruction covering risk screening, basic exercise prescription, and culturally responsive communication, with annual refreshers of 4–8 hours recommended ^[1].

Sample Progression Case

For a beginner assigned to the aerobic beginner track, start with 10–20 minutes of moderate walking three times per week and increase total weekly aerobic time by no more than about 10% each week until reaching roughly 150 minutes per week over 8–12 weeks ^[2].

If strength training begins with bodyweight or band-resisted squats at 1 set of 8–10 reps twice weekly, progression can move to 2–3 sets and higher resistance or additional exercises over a 6–10 week period based on symptom tolerance and performance improvements ^[4].

When implementing deload periods, plan one lighter week (reducing volume or intensity by ~30–50%) every 4–8 weeks for most adult participants, adjusting timing for age, comorbidity burden, and training load ^[1].

Program Metrics and Targets

Adoption targets for initial pilots often set enrollment goals of 100–300 participants to generate sufficient outcome data while keeping program management feasible ^[3].

Key performance indicators can include achieving a 60% retention rate at 12 weeks and 40% continued participation at 6 months as pragmatic benchmarks for community-based programs ^[2].

Clinical outcome targets might include a 10% improvement in sit-to-stand repetitions or a 30-meter increase in 6-minute walk distance over a 12-week intervention for function-focused cohorts, with measurement protocols standardized across sites ^[4].

Data Collection and Reporting Cadence

Routine program monitoring typically captures weekly activity logs and monthly summary reports, with formal outcome reassessments at baseline, 12 weeks, and 6 months to align with clinical and funding cycles ^[1].

For wearable-derived metrics, agree on standardized epochs such as daily step counts and weekly moderate minutes, aggregated and reported in 1-week or 4-week windows to reduce day-to-day variability ^[3].

Data retention policies should specify minimal retention of personal health data for the period necessary to meet program evaluation needs, commonly 3–7 years for audit and research purposes, with more limited retention for anonymized summaries ^[5].

Privacy, Consent and Governance

Obtain written informed consent for collection of health-related data, with separate opt-in choices for sharing with healthcare partners; provide clear descriptions of data types collected and intended uses at enrollment ^[5].

Use role-based access controls so that personally identifiable health data are accessible only to authorized staff; limit exported identifiable records to clinical partners under data use agreements that specify retention and destruction timelines ^[5].

Scaling, Partnerships and Sustainability

When scaling to multiple sites, aim for a pilot-to-scale ratio where 1–2 demonstration sites run for 6–12 months before wider rollout, allowing refinement of protocols and training materials ^[3].

Partnership agreements with employers or healthcare organizations commonly use shared-cost models where partners subsidize 25%–75% of program fees depending on expected return-on-investment and population risk profiles ^[2].

Long-term sustainability often combines modest participant fees, partner contributions, and grant or public-health funding to cover coaching, technology, and evaluation costs for multi-year continuity ^[3].

Quality Assurance and Continuous Improvement

Implement routine fidelity checks such as quarterly audit of 10%–20% of sessions for adherence to safety protocols and curriculum elements, with feedback loops to coaches and program leads ^[1].

Use participant-reported outcome measures and satisfaction surveys at 4, 12, and 24 weeks to identify barriers; aim for a mean satisfaction score above 4 on a 5-point scale in well-functioning programs ^[4].

Implementation Resources and Tools

Provide participants with simple, standardized resources such as a one-page safety checklist, a 4-week starter schedule, and short instructional videos; keep core resource size under 5 pages or 10 minutes of video to maximize uptake ^[1].

Offer coaches templated progress plans with 4–6 week blocks for common tracks (e.g., deconditioned older adult, chronic-condition maintenance, return-to-activity) so adaptations can be made quickly and consistently ^[4].

Evaluation Examples

An implementation evaluation might report process metrics (enrollment, retention) monthly and outcome metrics at 12 weeks, with success defined as meeting pre-specified thresholds such as 150 minutes of moderate activity per week for at least 30% of active participants at 12 weeks ^[2].

For clinical partnerships, reporting to referring clinicians can include changes in functional measures and a brief summary of adherence over the prior 12 weeks to support shared decision-making and ongoing care coordination ^[3].

Sources

• acsm.org —
• health.gov —
• nih.gov —
• who.int —
• heart.org —