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Anita L. Stewart

The term “community-based” can refer to many types of physical activity interventions. The bulk of physical activity research in older adults focuses on changing individual behavior, sometimes in community settings. Addressing the nation’s goal of increasing the proportion of physically active older adults requires more programs to improve contextual factors that support individual behavior and calls for introducing into community settings successful individual-level programs based on solid research. The social ecology model provides an ideal multilevel framework for community-wide efforts. In conjunction with programs to increase the types and levels of physical activity of older adults, changes can be directed at social, cultural, environmental, institutional, and policy contexts for individual behavior change. Guidelines and evaluation methods, including cost analysis of developing, implementing, and sustaining programs, are needed. Recommendations are made to advance community-based strategies for promoting physical activity among adults age 50 and older.

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Kristin M. Mills, Anita L. Stewart, Peter G. Sepsis, and Abby C. King

Most community-based physical activity interventions for older adults prescribe class-based activities that may not appeal to everyone. This paper describes physical activity format preferences in a sample of 98 older adults (mean age = 76 ± 8 years) enrolled in an exercise promotion program encouraging participation in class-based activities offered by the community; the study explores how these preferences are related to activity adoption and maintenance. Thirty-four percent of respondents preferred to exercise individually. 28% preferred to exercise in a group, and 39% had no preference. Those who preferred exercising individually were less likely to adopt a new class than those who preferred to exercise in a group and those who had no preference (p < .01). Programs taking into account individual preferences may be more successful than those offering specific formats.

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Peter G. Sepsis, Anita L. Stewart, Barbara McLellan, Kris Mill, Abby C. King, and Wayne Shoumaker

This paper describes the support mechanisms of a 6-month program designed to increase the physical activity levels of older adults in congregate housing facilities and in the community at large. It also reports participant ratings of perceived helpfulness of the various mechanisms to determine the relative value of these mechanisms to enrollees attempting to change their behavior. In general, there was consistency with respect to the ratings of perceived helpfulness between those residing in the community and those from the congregate housing facilities. However, some differences were found. For example, those residing in the community generally rated the mechanisms as less helpful than did participants from congregate housing settings. Individualized attention was ranked among the most helpful features. Results should be useful to those who design and implement physical activity promotion programs for older adults.

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Dawn E. Gillis, Melanie D. Grossman, Barbara Y. McLellan, Abby C. King, and Anita L. Stewart

As new multifaceted programs are developed to facilitate increased physical activity in older adults, it is increasingly important to understand how useful various program components are in achieving program goals. On concluding a community-based physical-activity-promotion program. 80 older adults (M = 74 years) completed a helpfulness survey of 12 different aspects of the program. and 20 also attended focus groups for evaluation purposes. Results indicated that personal attention from staff, an informational meeting, and telephone calls from staff were most helpful. Ratings were similar across gender, age, and income groups, as well as between those who had previously been sedentary and underactive. Compared with more educated participants, those with less education reported higher ratings for 8 of 12 program components. Results contribute to a small literature on older adults' perceptions of physical activity programs and might be useful in planning future physical activity and other health-promotion programs relying on similar components.

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Kristin M. Mills, Anita L. Stewart, Barbara Y. McLellan, Carol J. Verboncoeur, Abby C. King, and Byron W. Brown

Health-promotion programs’ success depends on their ability to enroll representative samples of the target population, particularly those who are hard to reach and those who can benefit the most from such programs. This article evaluates enrollment bias in the recruitment process, examines the usefulness of a 2-phased recruitment strategy in enrolling representative proportions of eligible individuals in a physical-activity-promotion program for older adults, and explores predictors of enrollment. Of 1,381 randomly selected Medicare HMO members. 519 were eligible. Of these, 54% attended an informational meeting and 33% enrolled in the program. Relative to the target population, a representative proportion of women was enrolled, but those who enrolled were slightly younger. Of those who were eligible, a representative proportion of sedentary participants was recruited, those who were overweight were overrep-resented, and the oldest old, less educated, ethnic minorities, and precontem-plators of physical activity were underrepresented. Modifiable predictors of enrollment included interest in health, previous health-class attendance, and having had a physician recommend exercise.

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Anita L. Stewart, Melanie Grossman, Nathalie Bera, Dawn E. Gillis, Nina Sperber, Martha Castrillo, Leslie Pruitt, Barbara McLellan, Martha Milk, Kate Clayton, and Diana Cassady

Diffusing research-based physical activity programs in underserved communities could improve the health of ethnically diverse populations. We utilized a multilevel, community-based approach to determine attitudes, resources, needs, and barriers to physical activity and the potential diffusion of a physical activity promotion program to reach minority and lower-income older adults. Formative research using focus groups and individual interviews elicited feedback from multiple community sectors: community members, task force and coalition members, administrators, service implementers, health care providers, and physical activity instructors. Using qualitative data analysis, 47 transcripts (N = 197) were analyzed. Most sectors identified needs for culturally diverse resources, promotion of existing resources, demonstration of future cost savings, and culturally tailored, proactive outreach. The program was viewed favorably, especially if integrated into existing resources. Linking sectors to connect resources and expertise was considered essential. Complexities of such large-scale collaborations were identified. These results may guide communities interested in diffusing health promotion interventions.