Background

An inadequate level of health literacy (HL) and social isolation are risk factors especially for older adults. A community-based HL intervention aiming to counteract both risk factors was developed and pilot tested. For the intervention “GeWinn”, self-reliant working groups of older adults with peer-moderators were installed. The 53-week program resulted in improved HL and was well-accepted. In order to scale up the intervention, the concept of “GeWinn” was optimized and a cooperation as well as financial funding with a large German health insurance company, AOK Bayern, was achieved. To successfully implement and enlarge the intervention in Bavaria, a 5-step scaling up program was developed and tested.

Description of Methods

A webinar was performed to inform regional multipliers of the health insurance about the intervention as well as instruct them to reach out to communal stakeholders. A 5-step scaling up program was implemented with each participating municipality concerning consultation, information events, co-operative planning, networking and kick-off meetings for the target group. To substitute in-person meetings during the pandemic, virtual conferences were held to promote important planning steps.

Results

In total, 40 multipliers participated in the webinar. Eight of the 71 Bavarian districts were acquired and participated in the intervention with 2-4 municipalities each. The regional decision makers and stakeholders tended to need more time to implement the program. Frequent contacting to ensure general willingness for participation and creating a network of local stakeholders seem to be essential. The participating municipalities differ a lot in terms of structure and community readiness. Therefore, the scaling up methods were adapted in its design and frequency for each region.

Conclusions

Close cooperation with participating municipalities promotes an effective recruitment of local partners and program implementation. To support the districts in implementing the program, the scaling up methods should be provided in small steps. At the intervention’s end, there will be a meeting with municipal stakeholders to discuss tailored methods for sustainable actions to consolidate regional structures. Therefore, the implementation of the intervention will not only support individual’s HL but has the potential to promote communities in their municipal health promotion for older adults.