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.

[1]  Jacob Cohen Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[2]  Sarah Bowen,et al.  Demystifying knowledge translation: learning from the community , 2005, Journal of health services research & policy.

[3]  P. Williams,et al.  Physical activity and public health. , 1995, JAMA.

[4]  Patricia J. Jordan,et al.  Screening, safety, and adverse events in physical activity interventions: Collaborative experiences from the behavior change consortium , 2005, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[5]  K. Emmons,et al.  How can we increase translation of research into practice? Types of evidence needed. , 2007, Annual review of public health.

[6]  Paul A. Estabrooks,et al.  Evaluating the impact of behavioral interventions that target physical activity: issues of generalizability and public health. , 2003 .

[7]  L. Radloff The CES-D Scale , 1977 .

[8]  A. Stewart,et al.  The California active aging community grant program: Translating science Into practice to promote physical activity in older adults , 2005, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[9]  A. King,et al.  Moderate-Intensity Exercise and Self-rated Quality of Sleep in Older Adults: A Randomized Controlled Trial , 1997 .

[10]  W L Haskell,et al.  Comparative effects of two physical activity programs on measured and perceived physical functioning and other health-related quality of life outcomes in older adults. , 2000, The journals of gerontology. Series A, Biological sciences and medical sciences.

[11]  Ross C Brownson,et al.  Evidence-based interventions to promote physical activity: what contributes to dissemination by state health departments. , 2007, American journal of preventive medicine.

[12]  James F. Sallis,et al.  Correlates of satisfaction with body function and body appearance in middle- and older aged adults: The activity counseling trial (ACT) , 2000 .

[13]  Carol J. Verboncoeur,et al.  Physical activity outcomes of CHAMPS II: a physical activity promotion program for older adults. , 2001, The journals of gerontology. Series A, Biological sciences and medical sciences.

[14]  J. Kampert,et al.  Comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness: a randomized trial. , 1999, JAMA.

[15]  M. Irwin,et al.  Screening for depression in the older adult: criterion validity of the 10-item Center for Epidemiological Studies Depression Scale (CES-D) , 1999, Archives of internal medicine.

[16]  J. Prochaska,et al.  In Search of How People Change: Applications to Addictive Behaviors , 1992, The American psychologist.

[17]  A. King,et al.  Effects of moderate-intensity exercise on physiological, behavioral, and emotional responses to family caregiving: a randomized controlled trial. , 2002, The journals of gerontology. Series A, Biological sciences and medical sciences.

[18]  Patricia J. Jordan,et al.  The Behavior Change Consortium: setting the stage for a new century of health behavior-change research. , 2002, Health education research.

[19]  R. Glasgow,et al.  Why don't we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. , 2003, American journal of public health.

[20]  Corneel Vandelanotte,et al.  Telephone interventions for physical activity and dietary behavior change: a systematic review. , 2007, American journal of preventive medicine.

[21]  L W Green,et al.  From research to "best practices" in other settings and populations. , 2001, American journal of health behavior.

[22]  Nora Jacobson,et al.  Development of a framework for knowledge translation: understanding user context , 2003, Journal of health services research & policy.

[23]  A. Stewart,et al.  CHAMPS physical activity questionnaire for older adults: outcomes for interventions. , 2001, Medicine and science in sports and exercise.

[24]  L. Pbert,et al.  An evaluation of the perceived stress scale in two clinical populations , 1992 .

[25]  Paul A Estabrooks,et al.  Translating effective clinic-based physical activity interventions into practice. , 2006, American journal of preventive medicine.

[26]  S. Blair,et al.  Work Ability, Physical Activity, and Cardiorespiratory Fitness: 2-year Results From Project Active , 2000, Journal of occupational and environmental medicine.

[27]  A. Stewart,et al.  Evaluation of champs, a physical activity promotion program for older adults , 1997, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[28]  Task Force on Community Preventive Services Recommendations to increase physical activity in communities. , 2002, American journal of preventive medicine.

[29]  Robert Friedman,et al.  Ongoing physical activity advice by humans versus computers: the Community Health Advice by Telephone (CHAT) trial. , 2007, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[30]  A. King,et al.  Long-term effects of varying intensities and formats of physical activity on participation rates, fitness, and lipoproteins in men and women aged 50 to 65 years. , 1995, Circulation.

[31]  A. Steckler,et al.  The importance of external validity. , 2008, American journal of public health.

[32]  H. Kraemer,et al.  Group- vs home-based exercise training in healthy older men and women. A community-based clinical trial. , 1991, JAMA.

[33]  A. Stewart Community-Based Physical Activity Programs for Adults Age 50 and Older , 2001 .

[34]  Marsha Dowda,et al.  Results of the first year of active for life: translation of 2 evidence-based physical activity programs for older adults into community settings. , 2006, American journal of public health.

[35]  A. Yancey,et al.  Dissemination of physical activity promotion interventions in underserved populations. , 2006, American journal of preventive medicine.

[36]  A. Bandura Social Foundations of Thought and Action: A Social Cognitive Theory , 1985 .

[37]  A. Stewart,et al.  An evaluation of three self-report physical activity instruments for older adults. , 2001, Medicine and science in sports and exercise.

[38]  Obesity in Adults,et al.  Identification, Evaluation, and Treatment of Overweight and Obesity , 2021, Obesity Prevention and Treatment.

[39]  T. Kamarck,et al.  A global measure of perceived stress. , 1983, Journal of health and social behavior.

[40]  W L Haskell,et al.  Effects of differing intensities and formats of 12 months of exercise training on psychological outcomes in older adults. , 1993, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[41]  L. Berkman,et al.  Two Shorter Forms of the CES-D Depression Symptoms Index , 1993 .

[42]  R J Shephard,et al.  Revision of the Physical Activity Readiness Questionnaire (PAR-Q). , 1992, Canadian journal of sport sciences = Journal canadien des sciences du sport.

[43]  Ross C. Brownson,et al.  From the Schools of Public Health , 2002 .

[44]  S. Straus,et al.  Lost in knowledge translation: Time for a map? , 2006, The Journal of continuing education in the health professions.

[45]  A. Dunn,et al.  Diffusion and dissemination for increasing physical activity in world populations. , 2006, American journal of preventive medicine.

[46]  J. Kampert,et al.  Reduction in cardiovascular disease risk factors: 6-month results from Project Active. , 1997, Preventive medicine.

[47]  K. Patrick,et al.  Physical Activity and Public Health: A Recommendation From the Centers for Disease Control and Prevention and the American College of Sports Medicine , 1995 .