title: Implementation and Maintenance of a Community-Based Older Adult Physical Activity Program.
abstract: We examine facilitators and barriers to the implementation and maintenance of Enhance®Fitness (EF), a group exercise program for older adults, at early-adopter YMCA-affiliated sites, and summarize strategies employed by EF instructors and staff to overcome challenges.
  
  
  
  This qualitative study used semi-structured phone interviews with 32 instructors, staff members, and master trainers from 24 different YMCA-affiliated sites. Interviews were digitally recorded, transcribed, and analyzed with a focus on the implementation and maintenance components of the RE-AIM framework.
  
  
  
  We identified a series of factors affecting the implementation and maintenance of EF at YMCA-affiliated sites, which can be categorized into program-specific (such as instructor training, the structure of the program, reporting requirements, and insurance coverage), and organizational (such as organizational support and infrastructure for program delivery, champions, and funding to cover the costs of program delivery). Strategies used to overcome challenges associated with these factors include identifying parts of the program that can be adapted, hiring staff and instructors that understand and support the program, and educating staff and instructors about the importance of evidence-based programs and of data collection for program evaluation.
  
  
  
  Assessing the readiness of organizations for program delivery and the match between program goals and the needs of organizations and participants would help facilitate the successful implementation and maintenance of physical activity programs in community settings.
authors.affiliation: Health Promotion Research Center, University of Washington, Seattle. mirunapp@uw.edu.
authors.forename: Miruna
authors.initials: M
authors.lastname: Petrescu-Prahova
authors.affiliation: Health Promotion Research Center, University of Washington, Seattle.
authors.forename: Basia
authors.initials: B
authors.lastname: Belza
authors.affiliation: Health Promotion Research Center, University of Washington, Seattle.
authors.forename: Marlana
authors.initials: M
authors.lastname: Kohn
authors.affiliation: Health Promotion Research Center, University of Washington, Seattle.
authors.forename: Christina
authors.initials: C
authors.lastname: Miyawaki
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003153:Community Health Services; D055317:Evidence-Based Practice; D015444:Exercise; D005260:Female; D006801:Humans; D019458:Insurance Coverage; D008297:Male; D008875:Middle Aged; D010560:Personnel Selection; D016730:Program Development; D015397:Program Evaluation; D036301:Qualitative Research
keywords: Dissemination; Evidence-based practice; Healthy aging; Physical activity; RE-AIM