Faith-based interventions hold promise for increasing physical activity (PA) and thereby reducing health disparities. This paper examines the perceived influences on PA participation, the link between spirituality and health behaviors and the role of the church in promoting PA in African Americans. Participants (n = 44) were adult members of African American churches in South Carolina. In preparation for a faith-based intervention, eight focus groups were conducted with sedentary or underactive participants. Groups were stratified by age (<55 years versus >or=55 years), geography and gender. Four general categories were determined from the focus groups: spirituality, barriers, enablers and desired PA programs. Personal, social, community and environmental barriers and enablers were described by both men and women, with no apparent differences by age. Additionally, both men and women mentioned aerobics, walking programs, sports and classes specifically for older adults as PA programs they would like available at church. This study provides useful information for understanding the attitudes and experiences with exercise among African Americans, and provides a foundation for promoting PA through interventions with this population by incorporating spirituality, culturally specific activities and social support within the church.

Researchers across multiple fields have described the iterative and nonlinear phases of the translational research process from program development to dissemination. This process can be conceptualized within a "program life cycle" framework that includes overlapping and nonlinear phases: development, adoption, implementation, maintenance, sustainability or termination, and dissemination or diffusion, characterized by tensions between fidelity to the original plan and adaptation for the setting and population. In this article, we describe the life cycle (phases) for research-based health promotion programs, the key influences at each phase, and the issues related to the tug-of-war between fidelity and adaptation throughout the process using a fictionalized case study based on our previous research. This article suggests the importance of reconceptualizing intervention design, involving stakeholders, and monitoring fidelity and adaptation throughout all phases to maintain implementation fidelity and completeness. Intervention fidelity should be based on causal mechanisms to ensure effectiveness, while allowing for appropriate adaption to ensure maximum implementation and sustainability. Recommendations for future interventions include considering the determinants of implementation including contextual factors at each phase, the roles of stakeholders, and the importance of developing a rigorous, adaptive, and flexible definition of implementation fidelity and completeness.

Active for Life((R)) (AFL) was a large (n = 8159) translational initiative to increase physical activity (PA) in midlife and older adults. Translational research calls for a shift in emphasis from just understanding what works (efficacy) to also understanding how it works in more 'real world' settings. This article describes the process evaluation design and findings, discuss how these findings were used to better understand the translational process and provide a set of process evaluation recommendations with community-based translational research. AFL community organizations across the United States implemented one of two evidence-based PA programs (Active Living Every Day-The Cooper Institute; Human Kinetics Inc. or Active Choices-Stanford University). Both programs were based on the transtheoretical model and social cognitive theory. Overall, the process evaluation revealed high-dose delivery and implementation fidelity by quite varied community organizations serving diverse adult populations. Findings reveal most variation occurred for program elements requiring more participant engagement. Additionally, the results show how a collaborative process allowed the organizations to 'fit' the programs to their specific participant base while maintaining fidelity to essential program elements.

Program sustainability in community and healthcare settings is critical to realizing the translation of research into practice. The purpose of this study is to describe the implementation and assessment of an intervention to increase organizational maintenance of evidence-based physical activity programs and the factors that impede or facilitate sustainability. All organizations implemented a sustainability action plan that included identifying factors related to sustainability, examining resources available, identifying program modifications to enhance sustainability, and long-term action planning. A mixed methods approach was used. Organizational (n = 12 sites) ability to demonstrate program effectiveness, align priorities with the organizational mission, and integrate the program within the existing infrastructure were strengths related to sustainability. Sites were more optimistic about program sustainability when they had less reliance on internal financial, but more reliance on internal human resources to run the program post-funding. The study resulted in a number of tools that can help community organizations plan for sustainability of physical activity programs.

The present study was designed to develop an innovative motivational intervention (based on SelfDetermination Theory and Social Cognitive Theory) to increase physical activity (PA) in underserved adolescents. Sixty-four adolescents (35 females, 29 males; 50% minority; 65% on reduced lunch program; ages 11-13 yr) participated in either an 8-week motivational intervention after-school (n = 32) or a typical after-school program (n = 32). The conceptual framework for the intervention targeted the social environment (perceived autonomy, perceived social support, participation, fun), cognitive mediators (perceived choice, self-efficacy, and relatedness/belongingness), and motivational orientation (intrinsic motivation, commitment, positive self-concept). Formative evaluation data was collected by staff through daily forms throughout the 8-week program and through observational data completed by independent objective observers during 2 weeks of the program. The major themes that were identified addressed theoretical concepts regarding the intervention and logistical issues in delivering the intervention. The data revealed information regarding the importance of the cognitive appropriateness of the PA and motivational activities, the environmental climate for promoting nurturing relationships, developing specific strategies for increasing intrinsic rather than extrinsic reinforcement, and developing methods for preventing social "cliques" and gender conflicts to maintain an appropriate level of support in the social climate. Themes for training staff included focusing on team building, leadership, and nurturing. This formative evaluation is being used to formalize a randomized trial to test the effects of a studentcentered motivational intervention on increasing PA in underserved 6th graders.

Challenges were present for community organizations; however, with some level of adaptation, the community organizations were able to effectively deliver and maintain fidelity in two evidence-based physical activity programs to a large and diverse group of mid- to older-aged adults.

The purpose of this study was to assess barriers experienced by mid-older adults upon entering a homebased, telephone-delivered physical activity (PA) program and examine differences in barriers for subgroups. Methods: Three hundred eighty four participants recruited from Tennessee, California, and Illinois for the Active Choices program, which was part of Active for Life®, completed one face-to-face counseling session and received follow-up telephone counseling. Barriers were analyzed qualitatively and quantitatively for subgroups of mid-older adults. Results: Personal, social, and environmental themes emerged as barriers. Lack of motivation was most salient for men while health barriers were more prominent for women; however, no significant differences were found between men and women. Both whites and African Americans reported lack of motivation as the most frequent barrier to PA. Health and weather barriers were more prominent for the oldest group of older adults. Few differences were reported by PA or weight status. Conclusions: In a large sample of mid-older adults varying in age, race, gender, and health status, multiple barriers to PA were reported. Differences across subgroups may have implications for future PA interventions.

Although most adults who are trying to maintain or lose weight are participating in physical activity, public health efforts need to focus on encouraging these adults to increase their levels of physical activity to meet the minimum standards for health benefits. Health care providers have an opportunity to educate and encourage patients about the recommended levels of physical activity to obtain maximum health benefits.