title: Replicating the EnhanceFitness physical activity program in Hawai`i's multicultural population, 2007-2010.
abstract: BACKGROUND
  Despite 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.
  
  
  OBJECTIVE
  EnhanceFitness 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]).
  
  
  METHODS
  Evaluation 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).
  
  
  RESULTS
  Between 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.
  
  
  CONCLUSIONS
  EnhanceFitness 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.
authors.affiliation: Office of Public Health Studies, John A. Burns School of Medicine, University of Hawai`i at Mānoa, 1960 East-West Rd, Biomed D-209, Honolulu, HI 96822, USA. mtomioka@hawaii.edu
authors.forename: Michiyo
authors.initials: M
authors.lastname: Tomioka
authors.forename: Naomi
authors.initials: N
authors.lastname: Sugihara
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Braun
mesh_terms: D000368:Aged; D000375:Aging; D001213:Asian; D002908:Chronic Disease / Q000517:prevention & control*; D003153:Community Health Services; D018864:Cultural Diversity; D015444:Exercise; D006254:Hawaii; D006801:Humans; D009043:Motor Activity; D044468:Native Hawaiian or Pacific Islander; D010809:Physical Fitness; D044465:White People