Changes in physical functioning in the Active Living Every Day program of the Active for Life Initiative®.

BACKGROUND: Physical activity can prevent or delay the onset of physical functional limitations in older adults. There are limited data that evidence-based physical activity interventions can be successfully translated into community programs and result in similar benefits for physical functioning. PURPOSE: The purpose of this study is to measure the effects of the Active Living Every Day program on physical functioning and physical functional limitations in a diverse sample of older adults. METHODS: As a part of the Active for Life initiative, the Council on Aging of Southwestern Ohio implemented Active Living Every Day (ALED), a group-based lifestyle behavior change program designed to increase physical activity. Performance-based physical functioning tests (30-s Chair Stand Test, eight Foot Up-and-Go Test, Chair Sit-and-Reach Test, 30-Foot Walk Test) were administered to participants at baseline and posttest. Baseline to post-program changes in physical functioning and impairment status were examined with repeated measures analysis of covariance. Interactions tested whether change over time differed according to race/ethnicity, body mass index (BMI), and baseline impairment status. RESULTS: Participants significantly increased their performance in all four physical functioning tests. The percentage of participants classified as "impaired" according to normative data significantly decreased over time. Physical functioning improved regardless of BMI, race/ethnicity, or baseline impairment status. CONCLUSIONS: ALED is an example of an evidenced-based physical activity program that can be successfully translated into community programs and result in significant and clinically meaningful improvements in performance-based measures of physical functioning.

Maintenance of change in the Active-for-Life initiative.

BACKGROUND: There is a notable gap in translating efficacious interventions to community-based organizations. Further, physical activity interventions have been less successful in promoting longer-term maintenance. PURPOSE: This study examined 6-month maintenance of improvements seen in Active for Life (AFL), a translational research initiative. METHODS: Participants from seven of 12 AFL sites enrolled in Years 3 and 4 were surveyed 6 months after completing the 6-month telephone-based Active Choices program (AC, one site) or the 20-week or 12-week group-based Active Living Every Day program (ALED, six sites). Repeated measures analyses controlled for site clustering and covariates. Programs were implemented from 2003 to 2007 and analysis was conducted in 2009. RESULTS: For the AC (n=368) and ALED (n=2151) programs, respectively, participants were aged 72.0 and 70.8 years on average, were 70% and 78% non-Hispanic white, and were 72% and 83% women; 46% and 50% returned 6-month follow-up surveys. For AC, improvements from pre- to post-test were maintained at follow-up for physical activity; satisfaction with body function (SBF); and BMI. For ALED Year 3, there was a decrease at follow-up for physical activity and SBF. Body mass index decreased from pretest to follow-up. For ALED Year 4, increases in physical activity and reductions in BMI were maintained at follow-up. Satisfaction with body function increased from pretest to 12 weeks post-test, declined at 20 weeks, and was maintained at follow-up. CONCLUSIONS: Improvements were generally maintained at the 6-month follow-up. When behavioral decay occurred, follow-up values remained more favorable than at pretest. Given the broad reach of this translational initiative, the results suggest the viability of evidence-based programming as an effective public health practice.

Active for life: final results from the translation of two physical activity programs.

BACKGROUND: Most evidence-based programs are never translated into community settings and thus never make a public health impact. DESIGN: Active for Life (AFL) was a 4-year translational initiative using a pre-post, quasi-experimental design. Data were collected from 2003 to 2007. Analyses were conducted in 2005 and 2008. SETTING/PARTICIPANTS: Nine lead organizations at 12 sites participated. Active Choices participants (n=2503) averaged 65.8 years (80% women, 41% non-Hispanic white). Active Living Every Day (ALED) participants (n=3388) averaged 70.6 years (83% women, 64% non-Hispanic white). INTERVENTION: In AFL, Active Choices was a 6-month telephone-based and ALED a 20-week group-based lifestyle behavior change program designed to increase physical activity, and both were grounded in social cognitive theory and the transtheoretical model. The interventions were evaluated in Years 1, 3, and 4. An adapted shortened ALED program was evaluated in Year 4. MAIN OUTCOME MEASURE: Moderate- to vigorous-intensity physical activity, assessed with the CHAMPS self-reported measure. RESULTS: Posttest survey response rates were 61% for Active Choices and 70% for ALED. Significant increases in moderate- to vigorous-intensity physical activity, total physical activity, and satisfaction with body appearance and function, and decreases in BMI were seen for both programs. Depressive symptoms and perceived stress, both low at pretest, also decreased over time in ALED. Results were generally consistent across years and sites. CONCLUSIONS: Active Choices and ALED were successfully translated across a range of real-world settings. Study samples were substantially larger, more ethnically and economically diverse, and more representative of older adult's health conditions than in efficacy studies, yet the magnitude of effect sizes were comparable.