Table 1 10-step program

FUTURE WORKSHOP I

Step 1 – Collecting potential actions & discussing in small groups

Following a brainstorming session about potential PA-promoting offers with all participants, small groups discussed favoured actions together with researchers to consider different perspectives.

Step 2 – Cataloguing actions

Actions were catalogued and organised by opportunities, resources, commitments, and goals for promoting PA.

Step 3 – Favouring & considering actions in detail

As homework, participants collected actions they wanted to implement in daily home routine and considered actions in detail to present to the expert team.

FUTURE WORKSHOP II

Step 4 – Planning actions

Actions prioritised were systematically planned following the SMART concept [37] – including specification, measurability, acceptance, realisability and timing (further details below).

Step 5 – Creating goal attainment scaling 1.0

To assess success later, each action was assessed according to GAS [36]. Therefore, participants set expected goals by phrasing action success in 1 sentence (GAS = 0). The expert team determined positive and negative gradations (GAS = -2, -1, + 1, +2) retrospectively using field notes from workshops, then submitted them to homes for confirmation. Additionally, participants decided whether individual counselling for residents should be offered by a team of experts in their homes within the next weeks.

INDIVIDUAL COUNSELLING I + II

Step 6 – Developing individual activity schedules

Individual counselling I was structured according to the 5 A concept [38] (further details below) and aimed to integrate PA opportunities, including actions developed in future workshops, into individual daily resident lives based on individual PA motives and goals [39]. Relatives supported cognitively impaired residents during individual counselling and in implementing the activity schedule.

Step 7 – Handling barriers

After 6 weeks, individual counselling II was scheduled with residents and relatives to handle possibly arising barriers and to reflect activities scheduled together.

EVALUATION WORKSHOP

Step 8 – Implementing-supervising

Implementing actions into everyday life was supervised by the project team over 6 months between future workshops I + II by providing support when problems arose. Within 6 months, homes integrated actions into organisational structures and daily routines [40]. Responsible persons sent implementation protocols regularly. Evaluation questionnaires were surveyed after 3 and 6 months.

Step 9 – Revising goal attainment scaling 2.0

In the evaluation workshop, actions developed during future workshop I + II were evaluated according to a 5-level GAS. Actions were rated in different areas (social, neighbourhood, green care, infrastructure, employees & caregivers, individual activity behaviour, and specifications of the nursing home) based on the GAS of future workshop II. To design the GAS lower threshold, rating scales were reformulated into statements (-2 = much worse than expected; -1 = worse than expected; 0 = as expected; +1 = better than expected; +2 = much better than expected).

Step 10– Goal Attainment Scaling 3.0

Individual counselling was rated according to GAS, as well evaluated the success of the 2 sessions. Success was not evaluated for each resident but for the counselling approach in the home.