"HOPE-FIT" in Action: A Hybrid Effectiveness-Implementation Protocol for Thriving Wellness in Aging Communities.

Abstract

Background/Objectives: As global aging accelerates, there is a pressing and empirically substantiated demand for integrated and sustainable strategies, as evidenced by the rising prevalence rates of chronic conditions, social isolation, and digital exclusion among older adults worldwide. These factors underscore the urgent need for multidimensional interventions that simultaneously target physical, psychological, and social well-being. The HOPE-FIT (Hybrid Outreach Program for Exercise and Follow-up Integrated Training) model and the SAGE (Senior Active Guided Exercise) program were designed to address this need through a hybrid framework. These programs foster inclusive aging by explicitly bridging digitally underserved groups and mobility-restricted populations into mainstream health promotion systems through tailored exercise, psychosocial support, and smart-home technologies, thereby functioning as a scalable meta-model across healthcare, community, and policy domains. Methods: HOPE-FIT was developed through a formative, multi-phase process grounded in the RE-AIM framework and a Hybrid Type II effectiveness-implementation design. The program combines professional health coaching, home-based and digital exercise routines, Acceptance and Commitment Performance Training (ACPT)-based psychological strategies, and smart-home monitoring technologies. Empirical data from pilot studies, large-scale surveys (N = 1000), and in-depth user evaluations were incorporated to strengthen validity and contextual adaptation. Culturally tailored content and participatory feedback from older adults further informed ecological validity and program refinement. Implementation Strategy/Framework: The theoretical foundation integrates implementation science with behavioral and digital health. The RE-AIM framework guided reach, fidelity, and maintenance planning, while the Hybrid E-I design enabled the concurrent evaluation of effectiveness outcomes and contextual implementation strategies. Institutional partnerships with community centers, public health organizations, and welfare agencies further facilitated the translation of the model into real-world aging contexts. Dissemination Plan: The multi-pronged dissemination strategy includes international symposia, interdisciplinary academic networks, policy briefs, localized community deployment, and secure, authenticated data sharing for reproducibility. This design facilitates evidence-informed policy, empowers practitioners, and advances digital health equity. Ultimately, HOPE-FIT constitutes a scalable and inclusive model that concretely addresses health disparities and promotes active, dignified aging across systems and disciplines.