Co-creating an intergenerational intervention to enhance physical activity in the older adult population: A qualitative study of the engAGE project.

BACKGROUND: Older adults are the most sedentary population segment, and effective, sustainable interventions are needed to modify these behaviours. Intergenerational and participatory approaches may enhance adherence and support long-term engagement. This study reports on the co-creation of an intergenerational intervention to promote physical activity (PA) and social interaction among older adults. It also explores the potential of virtual reality (VR) to support uptake and adherence. METHODS: A mixed-methods design was applied, guided by the Health CASCADE framework and the Behaviour Change Wheel (BCW). The intervention was co-created with older adults, children, teachers, professionals, and policymakers. The qualitative components included expert interviews, workshops with older adults and children, and an advisory board workshop. An online survey with older adults explored willingness to participate, perceived acceptability and relevance, adaptation to their needs, and suggestions for improvement. RESULTS: Four themes informed the intervention: (1) building on prior experiences with technology; (2) designing with empathy to ensure safety, enjoyment, and adaptability; (3) valuing intergenerational engagement; and (4) aligning with older adults' priorities. Workshops with 26 older adults (84.1 ± 7.6 years) and nineteen children (11.5 ± 2.9 years) highlighted shared preference for outdoor activities. Findings were translated into an intervention proposal during the advisory board workshop. Survey results from 53 older adults showed that 67.9% were willing to participate. CONCLUSIONS: Co-creation is a feasible approach to developing inclusive intergenerational PA interventions. Outdoor activities were widely preferred, while VR may potentially support motivation when implemented with attention to accessibility, user acceptance, and gradual integration.