title: Strength training in community settings: impact of lay leaders on program access and sustainability for rural older adults.
abstract: BACKGROUND
  The effect of volunteer lay leaders on availability and sustainability of strength-training programs for older adults has not been well explored. We describe implementation of the StrongWomen strength training program by the Arkansas Cooperative Extension Service, and report on the relationship between delivery approach (agent-led, lay-led, or combination of agent- and lay-led) and program access and sustainability.
  
  
  METHODS
  All state Extension agents (n = 66) were surveyed on program implementation, continuance, and use of lay leaders. Program records were used to identify the number of trained lay leaders. Regression models were used to examine the relationship between delivery approach and group availability.
  
  
  RESULTS
  Counties using lay leaders had twice as many groups as counties using only agents. There was a significant, positive relationship between the number of lay leaders and the number of groups. Counties using lay leaders were 8.3 times more likely to have continuing groups compared with counties not using lay leaders.
  
  
  CONCLUSIONS
  Program continuance was significantly and positively associated with lay leader use. Lay delivery expanded access to strength training programs and increased the likelihood that programs would continue. This approach can be used to increase access to and sustainability of strength training programs, particularly in resource-constrained areas.
authors.affiliation: Cooperative Extension Service, University of Arkansas Division of Agriculture, Little Rock, AR.
authors.forename: Lisa T
authors.initials: LT
authors.lastname: Washburn
authors.forename: Carol E
authors.initials: CE
authors.lastname: Cornell
authors.forename: Martha
authors.initials: M
authors.lastname: Phillips
authors.forename: Holly
authors.initials: H
authors.lastname: Felix
authors.forename: LaVona
authors.initials: L
authors.lastname: Traywick
mesh_terms: D000328:Adult; D000368:Aged; D001131:Arkansas; D005260:Female; D058015:Health Communication / Q000379:methods*; D006295:Health Resources; D006801:Humans; D007857:Leadership; D008297:Male; D055070:Resistance Training / Q000379:methods*; D012423:Rural Health / Q000193:education*; D012424:Rural Population; D014838:Volunteers