Understanding the Challenges Encountered and Adaptations Made by Community Organizations in Translation of Evidence-Based Behavior Change Physical Activity Interventions: A Qualitative Study

Lattimore, Diana; Griffin, Sarah; Wilcox, Sara; Rheaume, Carol; Dowdy, Diane; Leviton, Laura C.; Ory, Marcia G.

doi:10.4278/ajhp.081024-qual-252

Cited by 23 publications

(14 citation statements)

References 21 publications

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“…Evidence-based physical activity programs are available, but the challenges in translating them to community practice are documented (6,17). EnhanceFitness has expanded in various places with diverse groups, yet few studies have been published about its effectiveness (11-13).…”

Section: Discussionmentioning

confidence: 99%

Replicating the EnhanceFitness Physical Activity Program in Hawai<i's Multicultural Population, 2007-2010

Tomioka

Sugihara²,

Braun³

2012

Prev. Chronic. Dis.

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BackgroundDespite evidence of the benefits of regular physical activity, many older adults are not physically active. Health professionals are challenged to replicate evidence-based programs to address low levels of physical activity among members of their communities.Community ContextEnhanceFitness is an evidence-based group exercise program developed in Seattle to increase the strength, flexibility, and balance of older adults. Hawai`i's Healthy Aging Partnership supported the rural island of Kaua`i to select, adapt, implement, and evaluate EnhanceFitness to increase physical activity among older adult residents (75% Asian/Pacific Islander [API]).MethodsEvaluation measures of the replication of EnhanceFitness included fidelity of EnhanceFitness delivery and participants' attendance, satisfaction with the program, confidence to exercise regularly, and pre-post fitness check measures of physical performance (chair stands, arm curls, and the up-and-go test).OutcomesBetween July 2007 and December 2010, 223 Kaua`i residents enrolled in EnhanceFitness; 178 (80%) participated at least 4 months and completed the 4-month fitness checks. EnhanceFitness classes were offered with a high degree of fidelity, and both API and white participants significantly improved their physical performance (chair stands, t = −11.06, P < .001; arm curls, t = −6.66, P < .001; and up-and-go test, t = 6.56, P < .001). Participants reported high satisfaction with the program and instructors and high confidence to continue to exercise regularly.InterpretationEnhanceFitness is replicable in Hawai`i and increased physical performance among API and white older adults. This case study outlines a replication process that other communities can follow.

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Section: Discussionmentioning

confidence: 99%

Replicating the EnhanceFitness Physical Activity Program in Hawai<i's Multicultural Population, 2007-2010

Tomioka

Sugihara²,

Braun³

2012

Prev. Chronic. Dis.

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“…Similar to other dissemination studies, one of the main challenges faced during the conduct of the OHP dissemination was the systematic collection and tracking of outcomes for evaluation [7,30]. This ORIGINAL RESEARCH may have been due to the service delivery orientation of community primary health care staff (which often does not emphasize evaluation).…”

Section: Supporting Program Implementationmentioning

confidence: 99%

“…The program is currently the most expensive of those offered by the Medicare Local, and ways to streamline program delivery to reduce costs and increase the number of participants successfully completing the program have become priorities. Examples from other dissemination studies show that adopting organizations are likely to change programs to make them more viable [30][31][32][33], including shortening their duration [8]. Similarly, the Medicare Local is considering offering the OHP as a 6-month (rather than 12-month) service.…”

Section: Supporting Program Implementationmentioning

confidence: 99%

Dissemination of an evidence-based telephone-delivered lifestyle intervention: factors associated with successful implementation and evaluation

Goode

Eakin

2013

Behav. Med. Pract. Policy Res.

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To inform wider-scale dissemination efforts of health behavior change interventions, we need to better understand factors associated with successful implementation and evaluation in nonresearch settings. Using the experience of the Optimal Health Program dissemination (OHP), a 12-month evidencebased telephone-delivered intervention for physical activity, healthy eating, and weight loss, we provide a detailed account according to the reach, efficacy/ effectiveness, adoption, implementation, and maintenance (RE-AIM) framework of the supports that were needed to facilitate the delivery and evaluation of the program in an applied community-based primary health care setting. Substantial initial research support including development of data collection procedures, staff training in intervention protocols, and ongoing support for fidelity of data collection and intervention delivery, as well as evaluation and reporting of outcomes was required. The RE-AIM framework can highlight common elements that will require attention from researchers to promote success of programs in applied settings.

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“…Only three papers were found that dealt with physical activity: an analysis of general assumptions about using pedometers for activity enhancement [9], a paper on the development of a daily activity program for individuals with type 2 diabetes [10], and a qualitative study of adaptations made on the institutional level during a transfer of successfully proved programs into real-world settings [6]. By now, even this small number of studies shows the broad range of opportunities to utilize program theory and theorydriven evaluation in physical activity and exercise programs.…”

Section: Searching For Theory-driven Evaluation Of Exercise Programsmentioning

confidence: 99%

Theory-driven evaluation of exercise programs: often recommended but still only a few hits in literature databases

Brach¹

2011

Eur Rev Aging Phys Act

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Understanding the Challenges Encountered and Adaptations Made by Community Organizations in Translation of Evidence-Based Behavior Change Physical Activity Interventions: A Qualitative Study

Abstract: 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.

Cited by 23 publications

References 21 publications

Replicating the EnhanceFitness Physical Activity Program in Hawai<i's Multicultural Population, 2007-2010

Replicating the EnhanceFitness Physical Activity Program in Hawai<i's Multicultural Population, 2007-2010

Dissemination of an evidence-based telephone-delivered lifestyle intervention: factors associated with successful implementation and evaluation

Theory-driven evaluation of exercise programs: often recommended but still only a few hits in literature databases

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