Health Promotion and Disease Prevention Research Center

简介(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。作为疾病预防控制中心于1986年资助的最初的三个预防研究中心之一，HPRC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、老年人的身心健康和工作场所健康促进。具体地说，我们将扩大三个旗舰健康老龄化计划的全国覆盖范围，这些计划由HPRC开发和测试，并由与HPRC合作的社区组织传播。首先是EnhanceFitness，这是一项面向老年人的集体锻炼计划。自1999年以来，总部设在西雅图的非营利性组织High Services为老年人提供服务，已在30多个州的500多个社区网站传播EnhanceFitness。它已经覆盖了25,000多名老年人，其中大多数是低收入者或少数族裔成员。第二个是珍珠，这是一个在社区环境中提供的抑郁症管理程序。自2003年以来，地区老龄化机构已经通过14个州的45个地点，向2000多名低收入、主要是脆弱的在家患有抑郁症的老年人送去了珍珠。第三是工作场所解决方案，这是一套基于证据的工作场所癌症预防实践。自2003年以来，美国癌症协会已经向42个州的1600多个工作场所和690万名员工分发了工作场所解决方案。扩大EnhanceFitness计划的规模，重点是减少关节炎患者中与种族/民族有关的差异，这将是我们核心研究项目的目标。2011年，高级服务将EnhanceFitness授权给美国基督教青年会(Y-USA)，后者是2700多名基督教青年会的全国性网络办公室。由于EnhanceFitness可以减轻关节炎患者的疼痛，增加他们的行动能力，Y-USA将把EnhanceFitness的实施重点放在一半患有关节炎的老年人身上。老年人更有可能参加像EnhanceFitness这样的社区计划，如果是由医疗保健提供者推荐的，因此Y-USA请求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理疗师进行形成性研究，以了解增加对EnhanceFitness等社区项目的推荐的最有效方法。其次，我们将开发一种改进的方法，以获得药剂师、物理治疗师和初级保健提供者对老年关节炎患者参加基督教青年会EnhanceFitness的建议。第三，我们将进行一项整群随机试验，以比较当前方法和改进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.