The primary outcome measure was physical activity participation in the form of a daily step count measured by an ActivPAL (TM) accelerometer (PAL Technologies Ltd), which has been shown to be a valid and reliable device for monitoring physical activity in older adults and individuals with an altered walking gait. The ActivPAL (TM) was enclosed in a small flexible sleeve to cover the monitor and fitted to the front of the thigh using a Tegaderm (TM) film to allow participants to perform their usual daily activities (including showering or bathing) with the device in place. The ActivPAL (TM) was worn day and night for a 7-day period with a minimum of 5 days’ worth of valid data required for inclusion at each assessment time. Data files from the ActivPAL (TM) were downloaded from the devices, and event files were created using a proprietary software (ActivPAL3, version 7.2.38; PAL Technologies). Event files were analyzed using a custom software (National Instruments Labview 2017) to determine daily step counts and total nonstepping time. Only days with full recordings were considered. Daily step counts were averaged for each assessment time point. Nonstepping time was calculated by summing the time spent lying, sitting, and standing over a 24-hour period. Self-reported physical activity (total minutes of activity and metabolic equivalent [MET] per minute per week) were obtained using the Active Australia Survey (AAS) [18]. The AAS assesses leisure time physical activity and includes the number of sessions and total time spent in planned walking, vigorous-intensity gardening or housework, and planned moderate- or vigorous-intensity physical activity. The AAS has been demonstrated to be valid in community-dwelling older adults [19]. The secondary outcomes included health risk factors, functional measures, and quality of life. Health risk factors were measured using standardized protocols and included body weight, BMI, and systolic blood pressure (SBP) and diastolic blood pressure (DBP) [15]. Body fat percentage (BF%) and lean mass (LM) were assessed using bioimpedance analysis scales [20]. LM was reported in kilograms rather than percentage to provide an absolute measure of LM, which may change relative to other body composition factors. The 10-time sit-to-stand (TTSTS) test was used to measure functional lower body strength [21] and the timed up and go (TUAG) test was used to assess dynamic balance and mobility [22], both of which relate to the ability to perform activities of daily living. The 6-min walk test (6MWT) [23] was used to assess cardiorespiratory fitness for participants who had mobility issues, including walking with aids. This is a self-paced test, requiring participants to walk as many laps of a 10-meter course as they can in 6 min. The Modified Shuttle Walk Test (MSWT) is an externally paced incremental walking test requiring participants to walk, jog, or run laps of a 10-meter course, keeping pace with an audio recording until they are unable to maintain the required pace [24], and was used for the remainder of the participants. Quality of life was assessed using the Short-Form 36-Item Health Survey (SF-36) [25]. Participants’ health conditions were provided by the referring practitioner upon referral to the S2S program and checked with the participant during their initial assessment before commencing the S2S program. For ease of reporting, health conditions were categorized as follows: cardiovascular, metabolic, musculoskeletal, pulmonary, cancer, and mental health conditions. The wear time of the AT was calculated as the total number of days in which the tracker was worn divided by the total number of available days (365 days). Nonwear days were defined as days in which zero steps were recorded.

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