Beginning With the End in Mind: Contextual Considerations for Scaling-Out a Community-Based Intervention

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dc.contributor.authorBalis, Laura E.en
dc.contributor.authorStrayer, Thomas E., IIIen
dc.contributor.authorRamalingam, NithyaPriya S.en
dc.contributor.authorHarden, Samantha M.en
dc.contributor.departmentHuman Nutrition, Foods, and Exerciseen
dc.date.accessioned2019-10-28T13:14:36Zen
dc.date.available2019-10-28T13:14:36Zen
dc.date.issued2018-12-10en
dc.description.abstractIntroduction: A number of effective physical activity programs for older adults exist, but are not widely delivered within community settings, such as the Cooperative Extension System. The purpose of this paper was to determine if an evidence-based intervention (EBI) developed in one state Extension system could be scaled-out to a new state system. Methods and results: The RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework was used to guide an iterative evaluation of three translational stages. Stage 1: Before program adoption, Extension health educators were surveyed and interviewed to assess physical activity programming perceptions and factors that may influence their decision to attend training or deliver the program in practice. Results indicated that a virtual, scalable training protocol would be necessary and that training needed to include hands-on instruction and be catered to those who were less confident in physical activity program delivery. Stage 2: Training attendees were surveyed pre- and post-training on factors related to the adoption-decision making process and contacted post-training to assess program delivery status. Training did not influence perceptions of the program, intent to deliver, or confidence in delivering the program. Stage 3: During program implementation, the program was evaluated through the RE-AIM framework by surveying across three key stakeholder groups: (1) program participants, (2) potential delivery personnel, and (3) Extension administrators. Findings indicate that the program has the potential to reach a large and representative proportion of the target audience, especially in rural areas. However, adoption and implementation rates among Extension health educators and community partners were low and data collection for effectiveness, implementation, and maintenance was a challenge. Conclusion: Overall, the results indicate initial struggles to translating and evaluating the program in a large, rural state. Implications for practice include making system-level changes to increase physical activity program adoption rates among Extension health educators and improve data collection and program evaluation through this community-based organization. More work is needed to identify infrastructure support and capacity to scale-out EBIs.en
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.3389/fpubh.2018.00357en
dc.identifier.issn2296-2565en
dc.identifier.other357en
dc.identifier.pmid30619802en
dc.identifier.urihttp://hdl.handle.net/10919/95184en
dc.identifier.volume6en
dc.language.isoenen
dc.publisherFrontiersen
dc.rightsCreative Commons Attribution 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectRE-AIMen
dc.subjectphysical activityen
dc.subjectcooperative Extension systemen
dc.subjectimplementation scienceen
dc.subjecttranslationen
dc.titleBeginning With the End in Mind: Contextual Considerations for Scaling-Out a Community-Based Interventionen
dc.title.serialFrontiers in Public Healthen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
dc.type.dcmitypeStillImageen

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