Health Promotion and Disease Prevention Research Center

描述（由申请人提供）：我们在此提出华盛顿大学健康促进研究中心（HPRC）未来五年的总体规划。HPRC是1986年由美国疾病控制与预防中心资助的最初三个预防研究中心之一，专注于促进健康老龄化和减少50岁及以上成年人的健康差距。基于我们15年来开展旨在扩大有效干预措施的传播和实施研究的经验，我们计划将工作重点放在三个领域：癌症预防和控制、老年人身心健康以及工作场所健康促进。具体而言，我们将扩大由HPRC开发和测试并由与HPRC合作的社区组织传播的三个旗舰健康老龄化项目的全国覆盖面。首先是EnhanceFitness，这是一个针对老年人的团体锻炼项目。自1999年以来，总部位于西雅图的为老年人服务的非营利组织“老年服务”已将“增强健身”推广到30多个州的500多个社区站点。它已经覆盖了2.5万多名老年人，其中大多数是低收入者或少数族裔。第二个是PEARLS，这是一个在社区环境中实施的抑郁症管理项目。自2003年以来，老龄问题地区机构通过14个州的45个地点，向2000多名低收入、身体脆弱、居家的抑郁症老年人发放了“珍珠”。第三是工作场所解决方案，这是一套针对工作场所的循证癌症预防措施。自2003年以来，美国癌症协会向42个州的1600多个工作场所、690万名员工分发了“工作场所解决方案”。我们核心研究项目的目标是扩大“增强健身”项目的规模，重点是减少与种族/民族有关的关节炎痛苦差异。2011年，Senior Services将增强健身授权给美国基督教青年会（Y-USA），这是一个拥有2700多名基督教青年会会员的全国网络办事处。因为EnhanceFitness减轻了关节炎患者的疼痛，增加了他们的活动能力，Y-USA将把重点放在一半患有关节炎的老年人身上。如果医疗保健提供者推荐，老年人更有可能参加像EnhanceFitness这样的社区项目，因此Y-USA要求HPRC帮助加强其目前有限的方法，以增加提供者对EnhanceFitness参与的推荐。为此，我们将首先与药剂师和物理治疗师进行形成性研究，以了解最有效的方法来增加对像EnhanceFitness这样的社区项目的推荐。其次，我们将开发一种增强的方法，以获得药剂师、物理治疗师和初级保健提供者的建议，让老年关节炎患者参与基督教青年会的增强健身。第三，我们将进行一项集群随机试验，比较当前和增强方法的有效性和成本。

DESCRIPTION (provided by applicant): We propose here our overall plan for the Health Promotion Research Center (HPRC) at the University of Washington for the next five years. One of the original three Prevention Research Centers funded by CDC in 1986, HPRC focuses on promoting healthy aging and reducing health disparities among adults aged 50 and older. Building on our 15 years of experience conducting dissemination and implementation research aimed at scale-up of effective interventions, we plan to focus our work in three areas: cancer prevention and control, mental and physical health of older adults, and workplace health promotion. Specifically, we will expand the national reach of three flagship healthy-aging programs that were developed and tested by HPRC and disseminated by community organizations partnering with HPRC. First is EnhanceFitness, a group-exercise program for older adults. Since 1999, Senior Services, a Seattle-based non- profit organization serving older adults, has disseminated EnhanceFitness to more than 500 community sites in more than 30 states. It has reached more than 25,000 older adults, most of whom are low-income or members of racial and ethnic minorities. Second is PEARLS, a depression-management program delivered in community settings. Since 2003, Area Agencies on Aging have delivered PEARLS to more than 2,000 low-income, largely fragile and home-bound older adults with depression, through 45 sites in 14 states. Third is Workplace Solutions, a package of evidence-based cancer prevention practices for the workplace. Since 2003, the American Cancer Society has disseminated Workplace Solutions to more than 1,600 workplaces with 6.9 million employees in 42 states. Scale-up of the EnhanceFitness program, with a focus on reducing race/ethnicity-related disparities in arthritis suffering, will be the objective of our Core Researh Project. In 2011, Senior Services licensed EnhanceFitness to YMCA of the USA (Y-USA), the national-network office for more than 2,700 YMCAs. Because EnhanceFitness decreases pain and increases mobility for persons with arthritis, Y-USA will focus its EnhanceFitness implementation on the half of older adults who suffer from arthritis. Older adults are much more likely to participate in a community-based program like EnhanceFitness if it is recommended by a health care provider, so Y-USA has asked for HPRC's help in enhancing its current, limited approach to increasing provider recommendations for EnhanceFitness participation. To do so, we will first conduct formative research with pharmacists and physical therapists to learn the most effective means of increasing recommendations to a community-based program like EnhanceFitness. Second, we will develop an enhanced approach tailored to obtaining recommendations by pharmacists, physical therapists, and primary-care providers for participation of older-adult arthritis patients in EnhanceFitness at YMCAs. Third, we will conduct a cluster-randomized trial to compare the effectiveness and the cost of the current and enhanced approaches.