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

描述(由申请人提供)： 摘要骨关节炎是老年人最常见的慢性疾病，是老年人参与体力活动的主要障碍，也是导致残疾和住院的危险因素。体格健壮！是一项以证据为基础的体力活动/行为改变计划，目标是这一高危群体。它解决了这一人群中有记录的力量和有氧缺陷，并且价格低廉，易于复制。一项随机试验的结果表明，适合和强大！它显著降低了参与者的下肢关节疼痛和僵硬，同时提高了他们的锻炼自我效能，并随着时间的推移保持锻炼(Hughes等人，2004和Hughes等人，2006)。体格健壮！目前正在芝加哥、北卡罗来纳州夏洛特和西弗吉尼亚州复制。它已经准备好广泛地、以社区为基础向能够从中受益的人传播。由于目前对为老年人翻译和传播体力活动计划的最有效方式知之甚少，本研究将研究与两个州(IL和NC)现有的地区老龄机构(AAAs)合作翻译并传播该计划到每个州两个AAA地区内的老年中心的有效性。这项翻译研究将使用格拉斯哥的REAIM模型和格林等人的S的评估工作(格拉斯哥，沃特和鲍尔斯，1999年；格林和格拉斯哥，2006年)来确定促进者和障碍，以达到FIT和STRONG！的覆盖范围、有效性、采用、实施和维护。我们将培训一名T培训师和大师级培训师，并将与他们合作，在4个AAA集水区的高级中心(目标NS=1名T培训师、2名大师级培训师、30个地点、30名认证教练和至少1,200名参与者)培训获得认证的运动教练，以进行Fit and Strong。这项研究将使用混合方法，包括人口普查和BRFS数据的二次分析(REACH)、考前参与者结果衡量(有效性)、对每个集水区所有高级中心的调查(采用)、对所有参与中心的现场访问以制定和完善保真度/适应检查表和程序(实施)，以及在Fit and Strong！每次迭代结束时对高层高级中心经理进行深入访谈！(维护)评估这一扩散进程的有效性，以及在两个州内和跨州经历的促进者和障碍。学习经费也将用来发展壮大！此外，还将设立一个网站和一条基于网络的互动支持热线，以最后确定培训材料，支付培训费用，并为首批报名参加的网站提供财政奖励。研究活动将促进Fit and Strong作为一项基于证据的高质量计划的发展，并获得有关促进老年人PA计划采用、实施和维护的因素的新数据。

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.