Outcomes Associated With Translating Evidence-Based Research Into Practice: The Physical Activity for Lifelong Success Program.

BACKGROUND: Few programs assess for outcomes once translated into practice. The Physical Activity for Lifelong Success program was developed as a center-based public health intervention and shown to improve walking speed and distance among older adults with type 2 diabetes. We adapted the program for community-based delivery by lay leaders to physically inactive older adults. METHODS: We followed the Replicating Effective Programs framework to identify community stakeholders, adapt, implement, and evaluate fidelity of delivery in community settings, and plan for maintenance and evolution. Sixteen community sites enrolled 184 adults (mean age 73.5 y, 85% female, 93% White) in 21 workshops. Baseline and postworkshop measures assessed participants' health-related quality of life, physical function, and physical fitness. Data were analyzed using Fisher exact tests, Student t test, and paired linear regression with fixed effects. RESULTS: Fidelity testing indicated leader training was sufficient to maintain key elements with delivery. Data from 122 participants showed improvements in chair stands (P < .001), arm curls (P < .001), 2-minute step test (P < .001), sit-and-reach (P = .001), 8-foot up-and-go (P < .001), and 10-m walk (P < .001). CONCLUSIONS: Adaptation of Physical Activity for Lifelong Success for implementation by community organizations for physically inactive older adults demonstrates that fidelity and effectiveness can be maintained after program translation.

Essential elements to "design for dissemination" within a research network-a modified Delphi study of the Community-Academic Aging Research Network (CAARN).

BACKGROUND: The Community-Academic Aging Research Network (CAARN) was developed in 2010 to build partnerships, facilitate research, and ultimately accelerate the pace of development, testing, and dissemination of evidence-based programs related to healthy aging. CAARN has facilitated development and testing of 32 interventions, two of which are being packaged for scale-up, and three of which are being scaled up nationally by non-profit organizations. The purpose of this study is to describe CAARN's essential elements required to replicate its success in designing for dissemination. METHODS: We conducted a modified Delphi technique with 31 participants who represented CAARN's organization (staff and Executive Committee) and academic and community partners. Participants received three rounds of a web-based survey to rate and provide feedback about the importance of a list of potential key elements compiled by the authors. The criterion for establishing consensus was 80% of responses to consider the element to be extremely or very important. RESULTS: Response rate was 90% in Round 1, 82% in Round 2, and 87% in Round 3. A total of 115 items were included across rounds. Overall, consensus was achieved in 77 (67%) elements: 8 of 11 elements about academic partners, 8 of 11 about community partners, 29 of 49 about the role of the community research associate, 16 of 21 about the role of the director, 9 of 17 about the purveyor (i.e., the organization that scales up an intervention with fidelity), and 7 of 7 about the overall characteristics of the network. CONCLUSIONS: The development of evidence-based programs designed for dissemination requires the involvement of community partners, the presence of a liaison that facilitates communications among academic and community stakeholders and a purveyor, and the presence of a pathway to dissemination through a relationship with a purveyor. This study delineates essential elements that meet the priorities of adopters, implementers, and end-users and provide the necessary support to community and academic partners to develop and test interventions with those priorities in mind. Replication of these key elements of the CAARN model may facilitate quicker development, testing, and subsequent dissemination of evidence-based programs that are feasible to implement by community organizations.

The Community-Academic Aging Research Network: A Pipeline for Dissemination.

BACKGROUND/OBJECTIVES: The Community-Academic Aging Research Network (CAARN) was created to increase the capacity and effectiveness of Wisconsin's Aging Network and the University of Wisconsin to conduct community-based research related to aging. The purpose of this article is to describe CAARN's infrastructure, outcomes, and lessons learned. DESIGN: Using principles of community-based participatory research, CAARN engages stakeholders to participate in the design, development, and testing of older adult health interventions that address community needs, are sustainable, and improve health equity. SETTING: Academic healthcare and community organizations. PARTICIPANTS: Researchers, community members, and community organizations. INTERVENTION: CAARN matches academic and community partners to develop and test evidence-based programs to be distributed by a dissemination partner. MEASUREMENTS: Number of partnerships and funding received. RESULTS: CAARN has facilitated 33 projects since its inception in 2010 (30 including rural populations), involving 46 academic investigators, 52 Wisconsin counties, and 1 tribe. These projects have garnered 52 grants totaling $20 million in extramural and $3 million in intramural funding. Four proven interventions are being prepared for national dissemination by the Wisconsin Institute for Healthy Aging: one to improve physical activity; one to reduce bowel and bladder incontinence; one to reduce sedentary behavior; and one to reduce falls risk among Latinx older adults. Additionally, one intervention to improve balance using a modified tai chi program is being disseminated by another organization. CONCLUSION: CAARN's innovative structure creates a pipeline to dissemination by designing for real-world settings through inclusion of stakeholders in the early stages of design and by packaging community-based health interventions for older adults so they can be disseminated after the research has been completed. These interventions provide opportunities for clinicians to engage with community organizations to improve the health of their patients through self-management. J Am Geriatr Soc 68:1325-1333, 2020.

Use of a Model Wellness Policy May Not Increase the Strength and Comprehensiveness of Written School Wellness Policies.

BACKGROUND: Many state agencies have developed model wellness policies (MWPs) to serve as examples for schools when writing their own school wellness policy (SWP). The purpose of this study was to evaluate if a MWP aids schools in writing stronger, more comprehensive SWPs. METHODS: For this cross-sectional study, 91 school districts submitted their current SWP and completed a survey that classified districts into either districts that utilized the state MWP (N = 56; 61.5%) or those that did not (NMWP, N =35; 38.5%). The Wellness School Assessment Tool (WellSAT) was used to assess the strength, comprehensiveness, total overall score, and subsection scores of each policy. Dependent variables were compared between groups using t tests. Statistical significance was set at p ≤ .05. Data are presented as mean ±SD. RESULTS: No significant differences were found between groups in total overall (MWP 76.8 ± 37.9; NMWP 62.1 ± 34.3), strength (MWP 25.3 ± 17.6; NMWP 19.1 ± 12.8), or comprehensiveness scores (MWP 51.5 ± 21.2; NMWP 43.0 ± 22.1). The only subsection score difference identified between groups was the Nutrition Standards comprehension score (p = .02). CONCLUSIONS: These data suggest MWPs may not improve the quality of written SWPs. Further research is needed to better understand the needs of school districts in SWP development.