title: Translation of fit & strong! For middle-aged and older adults: examining implementation and effectiveness of a lay-led model in central Texas.
abstract: The Fit & Strong! program is an evidence-based, multi-component program promoting physical activity among older adults, particularly those suffering from lower-extremity osteoarthritis. The primary purpose of the study is to examine if the Fit & Strong! program translated into a lay-leader model can produce comparable outcomes to the original program taught by physical therapists and/or certified exercise instructors. A single-group, pre-post study design was employed, and data were collected at the baseline (n = 136 participants) and the intervention conclusion (n = 71) with both baseline and post-intervention data. The measurements included socio-demographic information, health- and behavior-related information, and health-related quality of life. Various statistical tests were used for the program impact analysis and examination of the association between participant characteristics and program completion. As in the original study, there were statistically significant (p < 0.05) improvements in self-efficacy for exercise, aerobic capacity, joint stiffness, level of energy, and amount and intensity of physical activities. The odds of completing the program were significantly lower for the participants from rural areas and those having multiple chronic conditions. Successful adaptation of the Fit & Strong! program to a lay-leader model can increase the likelihood of program dissemination by broadening the selection pool of instructors and, hence, reducing the potential issue of resource limitation. However, high program attrition rates (54.1%) emphasize the importance of adopting evidence-based strategies for improving the retention of the participants from rural areas and those with multiple chronic conditions.
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
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: Shinduk
authors.initials: S
authors.lastname: Lee
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: Alyson
authors.initials: A
authors.lastname: Zollinger
authors.affiliation: Office of Surveillance, Evaluation, and Research, Texas Department of State Health Services , Austin, TX , USA.
authors.forename: Kiran
authors.initials: K
authors.lastname: Bhurtyal
authors.affiliation: Department of Epidemiology and Biostatistics, Texas A&M Health Science Center, School of Public Health , College Station, TX , USA.
authors.forename: Luohua
authors.initials: L
authors.lastname: Jiang
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
keywords: aging; evidence-based program; exercise; implementation research