Walk with ease: The state-wide dissemination and implementation of an evidence-based arthritis self-management program

Arthritis is the leading cause of physical disability in the United States and affects over half of adults aged 65 years or older. Given the prevalence of arthritis and rapidly growing population of older adults, the need to expand the reach of arthritis interventions that improve health and functioning is particularly pressing. Walk with Ease (WWE), an evidence-based arthritis self-management program for older adults, is currently being disseminated throughout Oregon via University Extension Services with the goal to implement WWE in all 36 Oregon counties to reach 36,000 participants by 2017. Successful dissemination and subsequent implementation of health programs is predicated on the quality of implementation planning and capacity building, yet this area is understudied. This study evaluates and describes dissemination and implementation activities in the first year of this project. Multiple levels of dissemination activities were assessed through observation of stakeholder meetings and key informant interviews. Seven counties were recruited for implementation in year one. University Extension Service educators drew on existing relationships in their counties to recruit volunteer program leaders and exceeded recruiting goals. Program-specific barriers included identifying suitable delivery settings, recruiting participants, and accessing program materials. Capacity building at the administrative-level to provide technical assistance and sufficient funding impeded capacity building at the county-level and delayed the implementation timeline. Health program dissemination efforts require sufficient time and resources for capacity building prior to implementation. Using University Extension Services can be an effective strategy to recruit volunteer leaders and participants and disseminate health programming to older adults.