Enhancing adoption of EnhanceFitness at YMCA-Affiliated sites: Strategies for success

Purpose: To identify strategies used by YMCA-affiliated (Y) sites to improve adoption of EnhanceFitness (EF). EF is an evidence-based group exercise program for seniors. Adoption answers the question: How do we develop organizational support to deliver a program? Methods: This qualitative study used semi-structured individual phone interviews with 15 Y staff from different Y-affiliated sites. Interviews were digitally recorded, transcribed, and analyzed using content analysis informed by the RE-AIM framework.  Findings: Mean age of the Y staff was 48.7 years (SD 13.5). Mean length of time involved with EF was 5.2 years (SD 3.1). Findings revealed three key strategies to improve adoption. First, link the adoption of EF to the Y organizational mission such as targeting a demographic that had been previously underserved and selecting an evidence-based program that meets Y goals and standards. Second, provide resources and supports to facilitate offering EF, such as no or low registration fees; solicit grant funding to offer EF; offer fewer competing classes; partner with established networks in the community; identify and support champions; and hire and train instructors enthusiastic about EF. Third, address concerns about the adoption of EF such as differentiate EF from other physical activity classes; offer a few EF classes to start and build on positive experiences; and promote EF as an evidence-based program.  Implications:  These strategies dovetail with RE-AIM recommendations for ways to support adoption of evidence-based health promotion programs. Packaging and sharing these strategies could help community-based agencies to facilitate adoption of EF and other evidence-based programs.