Online Program

Empirically-derived “lessons learned” from a peer-led group exercise intervention for aging U.S. Veterans

Monday, November 2, 2015

Leslie Patterson, PhD, Family and Community Medicine, Medical College of Wisconsin, Milwaukee, WI
Kathlyn Fletcher, MD, MA, Clement J. Zablocki VA Medical Center, Milwaukee, WI
Kristyn Ertl, BA, Clement J Zablocki VAMC, Milwaukee, WI
LaTamba Harris, Clement J. Zablocki VA Medical Center, Milwaukee, WI
Jeff Whittle, MD, MPH, Clement J Zablocki VAMC, Milwaukee, WI

Our previous work demonstrated that Veterans’ Service Organizations (VSOs) can be important partners in efforts to encourage healthy lifestyles among aging Veterans. This study joined community medicine personnel and Veterans Health Administration (VHA) staff with local VSO units (referred to as posts) to establish a network of community-based, peer-led exercise groups.


We observed all exercise groups in our network at least once. Observers used a structured template to collect data regarding the fidelity of the group’s activities to those outlined in the training sessions for the peer leaders. We  developed a coding scheme by open-coding the data from the observation visits. Using an iterative process, we refined our coding scheme until we were confident that the coding scheme explained all of the relevant aspects of the observations. When we reached consensus on the codes and definitions, we  explored the text for facilitators and barriers to successful sessions.


We identified 15 codes to categorize factors that affected the quality of the group exercise sessions. Of these 15, we found that group leaders, group attributes, and group dynamics were most responsible for the success of a session. Aspects of the physical environment and the logistics of running a group emerged as barriers to participation and the overall success of the session.


Implementing and maintaining a successful community-based exercise program can be challenging. Observing how exercise groups function “in the real world” can provide valuable insight into the factors that encourage—and discourage—uptake of these programs by community members.

Learning Areas:

Administer health education strategies, interventions and programs
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Social and behavioral sciences

Learning Objectives:
Describe the study methods used to qualitatively assess intervention fidelity among a set of community-based exercise groups. List barriers and facilitators to implementing community-based, peer-led group exercise programs for Veterans. Discuss approaches for other organizations to consider when implementing group exercise programs in partnership with community organizations.

Keyword(s): Physical Activity, Chronic Disease Management and Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I served as the Educational Specialist on two VA HSRD-funded randomized controlled trials, one examining the efficacy of a peer-led educational intervention to reduce blood pressure in hypertensive veterans, and the other a study of an innovative community-based weight management program. My role in the qualitative aspects of the projects included: conducting structured observations, analyzing data using principles of grounded theory, developing qualitative models, authoring reports, presentations and manuscripts related to our qualitative findings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.