Informed Adaptations of a Strength-Training Program through a Researcha??Practice Partnership

摘要

Efficacy and effectiveness data for strength-training programs targeting older adults have been well established, but it is evident that they are not translated within practice-based settings to have a public health impact, as most (~90%) older adults are not meeting strength-training recommendations. Strength-training interventions developed, delivered, and evaluated in highly controlled settings (e.g., eligibility requirements, certified instructor, etc.) may not reflect real-world needs. One strategy to improve these outcomes is to work through an integrated research–practice partnership (IRPP) to plan and evaluate an intervention to better fit within the intended delivery system. The purpose of this study was to describe the IRPP method by which academic and practice representatives can partner to select and adapt a best-fit strength-training program for older adults. This work was planned and evaluated using the reach, effectiveness, adoption, implementation, and maintenance framework, applying the AIM dimensions to complement the methodology of the partnership. In this pragmatic work, members of the IRPP adapted the evidence-based program, Stay Strong, Stay Healthy (SSSH) into a new program, Lifelong Improvements through Fitness Together (LIFT). Of the health educators who agreed to be randomized to deliver LIFT or SSSH (N = 9), five were randomized to SSSH and four were randomized to deliver LIFT. Fifty percent of educators randomized to SSSH delivered the program, whereas 80% of the health educators randomized to LIFT delivered the program. The health educators deemed LIFT more suitable for delivery than SSSH, self-reported high rates of fidelity in program delivery, and intended on delivering the program in the following year. In conclusion, this study provides transparent methods for using an IRPP to adapt an intervention as well as preliminary outcomes related to adoption, implementation, and maintenance.