Findings from the Translation and Dissemination of Fit and Strong!, an Evidence-Based Intervention for Older Adults with Osteoarthritis

The translation of evidence-based programs for older adults is a major public health priority. Osteoarthritis (OA) is the most common condition affecting older people today. Lower extremity joint impairment caused by osteoarthritis (OA) has been shown to be a risk factor for future disability. Fit and Strong!, was developed to address this risk factor. It is an award winning, evidence-based, multiple-component exercise/behavior change program for older adults with OA. The program is currently being diffused in Illinois and North Carolina through partnerships with local Area Agencies on Aging with funding from the Centers for Disease Control and Prevention (R18DP001140). We are using the RE-AIM framework to guide our efforts. To date, we have partnered with 32 providers, trained 101 instructors, and enrolled over 430 participants. Analyses of participant outcomes indicate significant improvements on exercise participation (p=0.025), lower extremity joint pain (0.035), energy/fatigue (p=0.035) and self-efficacy for exercise (p=0.020), and a borderline significant difference on lower extremity joint stiffness (0.082). Factors which facilitate and impede program adoption, fidelity and adaptation and sustainability will be discussed. Practical issues involved in providing Fit and Strong! in the community will be discussed, including space, equipment, recruiting, training and monitoring exercise instructors, and methods for monitoring fidelity of Fit and Strong!. We will also describe our interactive website (www.fitandstrong.org) and the cadre of Master trainers that make it possible for us to more broadly disseminate Fit and Strong! to other communities that seek to adopt it.