A five state dissemination of a community-based disability prevention program for older adults.
OBJECTIVE
To describe challenges in disseminating the Health Enhancement Program (HEP), a community-based disability prevention program for community dwelling elders, and to examine program effectiveness in geographically dispersed sites.


METHODS
Within-group, pre-test-post-test comparisons of disability risk factors, health and functional status, and hospitalizations for 115 participants completing one year in HEP, and primary care provider awareness and perceptions of the program.


RESULTS
Most (77%) participants were women, with an average age of 73 years and an average of 3.5 chronic conditions. At one-year follow-up, compared with enrollment, fewer participants were depressed (8.8% vs 15.9%), physically inactive (15.8% vs 38.6%), at high nutritional risk (24.3% vs 44.1%), or experiencing restricted activity days (35% vs 48%). Severity scores on most measures also improved significantly. The proportion hospitalized was unchanged from the year prior to HEP, although risk factors predicted an increase in hospitalizations as for the control group in the randomized trial.


CONCLUSIONS
HEP reduced participants' disability risk factors. Sites varied on numbers enrolled and time to implement the program, likely due to differing referral bases, degree of physician awareness of HEP, and site readiness. However, the benefits of HEP participation were comparable with those reported previously.
Phelan
Elizabeth A
EA
Department of Medicine, Division of Gerontology and Geriatric Medicine, University of Washington, Seattle, WA 98104-2499, USA. phelane@u.washington.edu
Williams
Barbara
B
Snyder
Susan J
SJ
Fitts
Sally Sizer
SS
LoGerfo
James P
JP
D000368:Aged; D000369:Aged, 80 and over; D004059:Diffusion of Innovation; D004185:Disability Evaluation; D005260:Female; D006293:Health Promotion / Q000458:organization & administration*; D006707:Homes for the Aged; D006760:Hospitalization / Q000639:trends; D006801:Humans; D033181:Information Dissemination; D007407:Interviews as Topic; D008297:Male; D017063:Outcome Assessment, Health Care; D011314:Preventive Health Services; D015397:Program Evaluation; D012307:Risk Factors; D012648:Self Care; D014861:Washington