Integrating exercise and bundled health promotion in a collaborative community-based program for older adults: A cluster randomized trial

Background: To promote healthy aging, the University of Pittsburgh Prevention Research Center (PRC) developed the “10 Keys”TM to Healthy Aging, a bundled health promotion program. The PRC partnered with the Arthritis Foundation (AF) to combine the “10 Keys”TM with the AF Exercise Program (AFEP). The program was designed for older adults with arthritis or joint pain because they are at higher risk for other chronic conditions. Methods: A cluster randomized trial was implemented to compare the combined “10 Keys” TM and AFEP program compared to AFEP alone, and to build sustainability of the program in the community. The collaboration involved combining content, training instructors, and recruiting host sites, instructors, and participants. Sites were matched on key characteristics for stratified randomization. Results: To date, 18 sites have been randomized to the integrated program (7 programs) or AFEP alone (11) with a goal of 40. Sessions have been held twice weekly for 10 weeks with 467 program participants. Of these, 122 consented to a detailed assessment of preventive health behaviors at baseline and follow-up. Research participants were on average 72.4 (± 9.2) years; 84.4% were women, and 98% Caucasian. Feedback was positive with 92% rating the program as excellent or very good. 50% of the sites continued to offer the program after the initial ten weeks. Conclusions: This program delivers bundled health promotion targeting multiple co-morbid conditions to at-risk older adults in the community. Program continuation suggests that it will be sustainable. Impact on preventive health behaviors remains to be tested.