title: Implementation and effectiveness of a community-based health promotion program for older adults.
abstract: BACKGROUND
  Because preventing functional decline in older adults is a national priority and senior centers have been identified as potentially important venues for health-promotion activities, a trial of a multicomponent disability prevention program was conducted at a senior center.
  
  
  METHODS
  One hundred older adults were recruited for a 6-month randomized clinical trial. All members of the experimental group received an exercise intervention, nutrition counseling, and a home safety assessment. Smoking and alcohol interventions were delivered to at-risk subjects. Outcome variables included the Medical Outcomes Study Short Form (SF-36) health survey, the CES-Depression scale, bed days, and restricted-activity days.
  
  
  RESULTS
  A single study announcement resulted in a response sufficient to recruit 100 subjects. The exercise program was well received: 85% of intervention subjects completed the 6-month program and adherence was excellent, with over 90% attendance at exercise classes. After 6 months the intervention group had significantly better scores on 7 of 8 SF-36 subscales and fewer depressive symptoms than controls.
  
  
  CONCLUSIONS
  Senior centers may be excellent sites for community-based health promotion interventions: participation and adherence rates may be acceptable, interventions can be designed that are feasible in this setting, and these interventions appear to affect health status positively. The study program improved physical and psychosocial functioning and is a promising model for preventing functional decline through activities based at senior centers.
authors.affiliation: Department of Medicine, University of Washington, Seattle, USA. irving@u.washington.edu
authors.forename: J I
authors.initials: JI
authors.lastname: Wallace
authors.forename: D M
authors.initials: DM
authors.lastname: Buchner
authors.forename: L
authors.initials: L
authors.lastname: Grothaus
authors.forename: S
authors.initials: S
authors.lastname: Leveille
authors.forename: L
authors.initials: L
authors.lastname: Tyll
authors.forename: A Z
authors.initials: AZ
authors.lastname: LaCroix
authors.forename: E H
authors.initials: EH
authors.lastname: Wagner
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003153:Community Health Services / Q000458:organization & administration*; D003159:Community-Institutional Relations; D003376:Counseling; D004185:Disability Evaluation; D015444:Exercise; D005260:Female; D015577:Geriatric Assessment; D006293:Health Promotion / Q000458:organization & administration*; D006299:Health Services for the Aged / Q000458:organization & administration*; D006801:Humans; D008297:Male; D015596:Nutrition Assessment; D010043:Outcome and Process Assessment, Health Care; D015397:Program Evaluation; D012044:Regression Analysis; D012307:Risk Factors; D012648:Self Care; D012919:Social Behavior