Creating sustainable programs to support health and wellbeing for older adults in rural Australia

Introduction:
Implementation of programs in rural areas is often complicated by well-known challenges that impact ongoing sustainability. Ensuring that community-based programs are adaptable for the rural context is critical, but often lacking. This is primarily due to limited guidance on what implementation strategies are likely to succeed.
Methods:
The aim of this scoping review was to identify strategies that can support sustainable implementation of programs with older adults in rural Australia. The review used the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR). Seven databases were searched and a thematic analysis was applied to provide a comprehensive and contextualised understanding of the phenomenon of interest.
Results:
Of 1277 records screened, 15 studies were identified and included in the review. Five themes were identified as key enablers for rural implementation: 1) Co-designing for the local context; 2) Embedding local champions; 3) Leveraging existing local resources; 4) Maintaining impact beyond the end of the funded period; 5) Flexibility in funding modes.
Discussion:
This review brings together existing knowledge on strategies to overcome well-known barriers to program implementation in rural areas. It highlights that rural programs design and implementation must recognise the pivotal role of collaborative processes that integrate local expertise through methods such as local partnership and co-design.
Conclusion:
Further work needs to be undertaken to better support program implementers to develop practical and evidenced-based approaches that focus on delivering effective and sustainable community-based programs for older people that appropriately reflect the unique contextual needs and strengths of rural Australian communities.