Perceived Versus Actual Factors Associated with Adoption and Maintenance of Evidence-Based Physical Activity Programs

Despite the need to increase the availability of evidence-based (EB) physical activity (PA) programs for people with arthritis (Brady et al., 2009), little is known about effective ways of translating and diffusing these programs. This study used qualitative methods to examine factors related to the adoption and maintenance of EB PA programs in two states. Fit and Strong! is a PA/ health behavior change program for older adults with osteoarthritis. We conducted focus groups (n=6) with decision makers who were potential adopters of Fit and Strong! prior to their offering the program. We then conducted in-depth interviews (n=18) with key informants from organizations that adopted the program. Both sets of participants were asked to identify barriers and facilitators to the adoption and maintenance of PA programs in general and Fit and Strong!, specifically. Four perceived and five actual generic factors were identified. Both contemplators and adopters identified client interest/need as the primary factor. Cost was also reported but ranked higher for contemplators than program adopters. Participants identified four perceived vs. two actual factors as associated with program-specific adoption. Space was identified by both groups. Actual generic factors associated with adoption included client interest, safety and effectiveness, evidence, cost, and appeal to multiple user groups. Actual generic factors associated with maintenance included client interest, enrollment, instructor satisfaction, instructor retention and cost. Differences found between respondent groups indicate that EB programs should craft different marketing messages to address barriers and facilitators perceived and experienced by providers engaged in specific stages of translation.