Fit and Strong!: Translating an Evidence-Based Multi-component Exercise Program f

描述（由申请人提供）： 摘要骨关节炎（OA）是老年人最常见的慢性病，是他们参与体育活动的主要障碍，也是残疾和机构化的已知风险因素。 健康和强壮！是一个以证据为基础的身体活动/行为改变计划，针对这一高风险群体。 它解决了记录的力量和有氧赤字在这一人群中，是廉价和简单的复制。 一项随机试验的结果表明，适合和强大！显著降低了参与者的下肢关节疼痛和僵硬，同时增加了他们锻炼的自我效能和他们随时间的锻炼维持（Hughes等人，2004和Hughes等人，2006年）。健康和强壮！目前正在芝加哥、北卡罗来纳州夏洛特和西弗吉尼亚州推广。 由于目前对翻译和传播老年人体育活动计划的最有效方法知之甚少，这项研究将检查与两个州现有的老龄问题地区机构合作的有效性（IL和NC）将该计划翻译并传播到每个州两个AAA集水区内的高级中心。 本翻译研究将使用格拉斯哥的重新瞄准模型和格林等人。的工作评价（格拉斯哥，沃格特和鲍尔斯，1999年;绿色和格拉斯哥，2006年），以确定促进者和障碍的范围，有效性，采用，实施和维护的健康和强大！ 我们将培训一名T培训师和一名主培训师，并将与他们合作，培训经过认证的运动教练，在4个AAA集水区的老年中心进行健身和强壮（目标N = 1名T培训师，2名主培训师，30个地点，30名经过认证的教练和至少1，200名参与者）。 该研究将使用混合方法，包括对人口普查和BRFS数据（范围）的二次分析，（有效性），对每个集水区的所有老年人中心进行调查（收养），对所有参与中心进行现场访问，以制定和完善保真度/适应检查表和程序（实施），并在Fit and Strong的每次迭代结束时与高层高级中心经理进行深入访谈！（维护）评估这一传播过程的有效性沿着在两个国家内部和之间遇到的促进者和障碍。 学习资金还将用于培养健康而坚强的人！此外，还设立了一个网站和一个互动式网络支助热线，以最后确定培训材料，为培训费用提供支助，并为首批报名参加的地点提供财政奖励。研究活动将促进健康和强壮的发展，作为一个高质量的，交钥匙的证据为基础的计划，也获得新的数据的因素，促进采用，实施和维护PA计划的老年人。

DESCRIPTION (provided by applicant): Abstract Osteoarthritis (OA) is the most common chronic condition among older adults, is a major barrier to their participation in physical activity, and is a known risk factor for disability and institutionalization. Fit and Strong! is an evidence-based physical activity/behavior change program that targets this high risk group. It addresses documented strength and aerobic deficits in this population and is inexpensive and simple to replicate. Results from a randomized trial show that Fit and Strong! has significantly decreased participants' lower extremity joint pain and stiffness while increasing their self efficacy for exercise and their maintenance of exercise over time (Hughes et al, 2004 and Hughes et al., 2006). Fit and Strong! is currently being replicated in Chicago, in Charlotte, NC and in WVA. It is ready for broad, community-based diffusion to persons who can benefit from it. Because little is currently known about the most effective ways of translating and diffusing physical activity programs for older adults, this study will examine the effectiveness of partnering with existing Area Agencies on Aging (AAAs) in two states (IL and NC) to translate and diffuse the program to senior centers within two AAA catchment areas per state. This translation study will use Glasgow's Re-Aim model and Greene et al.'s work on evaluation (Glasgow, Vogt and Bowles, 1999; Green and Glasgow, 2006) to identify facilitators and barriers to the reach, effectiveness, adoption, implementation and maintenance of Fit and Strong!. We will train a T Trainer and Master Trainers and will work with them to train certified exercise instructors to conduct Fit and Strong at senior centers in 4 AAA catchment areas (target Ns = 1 T trainer, 2 master trainers, 30 sites, 30 certified instructors and a minimum of 1,200 participants). The study will use mixed methods including secondary analyses of census and BRFS data (reach), pre-postest participant outcome measures (effectiveness), surveys of all senior centers in each catchment area (adoption), site visits to all participating Centers to develop and refine fidelity/adaptation checklists and procedures (implementation), and in-depth interviews with upper level senior center managers at the conclusion of each iteration of Fit and Strong! (maintenance) to evaluate the effectiveness of this diffusion process along with facilitators and barriers experienced within and across the two states. Study funds will also be used to develop a Fit and Strong! website and an interactive web-based support hotline, to finalize training materials, to support the cost of the trainings and to provide financial incentives for participation among the first sites that sign up to participate. Study activities will both advance the development of Fit and Strong as a high quality, turnkey evidence based program and also obtain new data on factors that facilitate the adoption, implementation, and maintenance of PA programs for older adults.