title: National dissemination of multiple evidence-based disease prevention programs: reach to vulnerable older adults.
abstract: Older adults, who are racial/ethnic minorities, report multiple chronic conditions, reside in medically underserved rural areas, or have low incomes carry a high burden of chronic illness but traditionally lack access to disease prevention programs. The Chronic Disease Self-Management Program (CDSMP), A Matter of Balance/Volunteer Lay Leader (AMOB/VLL), and EnhanceFitness (EF) are widely disseminated evidence-based programs (EBP), but the extent to which they are simultaneously delivered in communities to reach vulnerable populations has not been documented. We conducted cross-sectional analyses of three EBP disseminated within 27 states throughout the United States (US) (2006-2009) as part of the Administration on Aging (AoA) Evidence-Based Disease and Disability Prevention Initiative, which received co-funding from the Atlantic Philanthropies. This study measures the extent to which CDSMP, AMOB/VLL, and EF reached vulnerable older adults. It also examines characteristics of communities offering one of these programs relative to those simultaneously offering two or all three programs. Minority/ethnic participants represented 38% for CDSMP, 26% for AMOB/VLL, and 43% for EF. Rural participation was 18% for CDSMP, 17% for AMOB/VLL, and 25% for EF. Those with comorbidities included 63.2% for CDSMP, 58.7% for AMOB/VLL, and 63.6% for EF while approximately one-quarter of participants had incomes under $15,000 for all programs. Rural areas and health professional shortage areas (HPSA) tended to deliver fewer EBP relative to urban areas and non-HPSA. These EBP attract diverse older adult participants. Findings highlight the capability of communities to serve potentially vulnerable older adults by offering multiple EBP. Because each program addresses unique issues facing this older population, further research is needed to better understand how communities can introduce, embed, and sustain multiple EBP to ensure widespread access and utilization, especially to traditionally underserved subgroups.
authors.affiliation: Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center School of Public Health , College Station, TX , USA.
authors.forename: Samuel D
authors.initials: SD
authors.lastname: Towne
authors.affiliation: Department of Health Promotion and Behavior, College of Public Health, The University of Georgia , Athens, GA , USA.
authors.forename: Matthew Lee
authors.initials: ML
authors.lastname: Smith
authors.affiliation: Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center School of Public Health , College Station, TX , USA ; Division of Health Systems Management and Policy, School of Public Health, The University of Memphis , Memphis, TN , USA.
authors.forename: SangNam
authors.initials: S
authors.lastname: Ahn
authors.affiliation: University of North Carolina at Chapel Hill , Chapel Hill, NC , USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Altpeter
authors.affiliation: Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington , Seattle, WA , USA.
authors.forename: Basia
authors.initials: B
authors.lastname: Belza
authors.affiliation: National Council on Aging , Washington, DC , USA.
authors.forename: Kristie Patton
authors.initials: KP
authors.lastname: Kulinski
authors.affiliation: Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center School of Public Health , College Station, TX , USA.
authors.forename: Marcia G
authors.initials: MG
authors.lastname: Ory
keywords: aging health; community intervention; evidence-based programs; minority adults; older adults