title: Essential Resources for Implementation and Sustainability of Evidence-Based Health Promotion Programs: A Mixed Methods Multi-Site Case Study.
abstract: As of October 2016, use of federal Older Americans Act funds for health promotion and disease prevention will be restricted to the Administration on Aging's criteria for high-level evidence-based health promotion programs. Dissemination of these programs to rural communities remains limited. Therefore a strong need exists to identify strategies that facilitate program implementation and sustainability. The objective of this study was to compare organizational readiness and implementation strategies used by rural communities that achieved varying levels of success in sustaining evidence-based health promotion programs for older adults. We utilized a qualitative multi-site case study design to analyze the longitudinal experiences of eight rural sites working to implement evidence-based health promotion program over 3 years (8/2012-7/2015). Multiple sources of data (interviews, documents, reports, surveys) from each site informed the analysis. We used conventional content analysis to conduct a cross-case comparison to identify common features of rural counties that successfully implemented and sustained their target evidence-based health promotion program. Readiness to implement evidence-based programs as low at baseline as all site leaders described needing to secure additional resources for program implementation. Sites that successfully utilized six essential resources implemented and sustained greater numbers of workshops: (1) External Partnerships, (2) Agency Leadership Commitment, (3) Ongoing Source of Workshop Leaders, (4) Health Promotion Coordination Tasks Assigned to Specific Staff, (5) Organizational Stability, and (6) Change Team Engagement. The six essential resources described in this study can help rural communities assess their readiness to implement health promotion programs and work secure the resources necessary for successful implementation.
authors.affiliation: Geriatric Research Education and Clinical Center (GRECC), William S. Middleton Memorial VA Hospital, 2500 Overlook Terrace, 11G, Madison, WI, 53705, USA. mdattalo@uwhealth.org.|Division of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53705, USA. mdattalo@uwhealth.org.
authors.forename: M
authors.identifier: http://orcid.org/0000-0001-7769-5224
authors.initials: M
authors.lastname: Dattalo
authors.affiliation: Sonderegger Research Center, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, 53705, USA.
authors.forename: M
authors.initials: M
authors.lastname: Wise
authors.affiliation: Center for Health Systems Research and Analysis, College of Engineering, University of Wisconsin-Madison, Madison, WI, 53726, USA.
authors.forename: J H
authors.initials: JH
authors.lastname: Ford Ii
authors.affiliation: Wisconsin Institute for Healthy Aging, Madison, WI, 53714, USA.
authors.forename: B
authors.initials: B
authors.lastname: Abramson
authors.affiliation: Division of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53705, USA.|Wisconsin Institute for Healthy Aging, Madison, WI, 53714, USA.
authors.forename: J
authors.initials: J
authors.lastname: Mahoney
mesh_terms: D000368:Aged; D004493:Education; D055317:Evidence-Based Practice / Q000379:methods / Q000458:organization & administration; D006293:Health Promotion / Q000379:methods / Q000458:organization & administration*; D006801:Humans; D009111:Local Government; D008137:Longitudinal Studies; D019982:Organizational Case Studies; D016730:Program Development; D015397:Program Evaluation; D014922:Wisconsin
keywords: Aging service network; Fall prevention; Health promotion; Organizational readiness; Rural health; Sustainability