Calculating reach of evidence-based weight loss and memory improvement interventions among older adults attending Arkansas senior centers, 2008-2011.

INTRODUCTION

Older adults could benefit from public health interventions that address the health conditions they face. However, translation of evidence-based interventions into the community has been slow. We implemented 2 evidence-based interventions delivered by lay health educators in Arkansas senior centers from 2008 to 2011: a behavioral weight loss intervention and a memory improvement intervention. The objective of this study was to measure the ability of these programs to reach and serve the growing population of older Americans. We report on differences in program enrollment by age, sex, race, and ethnicity and suggest how our approach to calculating the reach of the 2 interventions can guide future research and program development.

METHODS

We defined the reach of the 2 interventions as the proportion of people who needed the intervention and responded to initial recruitment efforts but who did not enroll compared with the proportion of people who needed the intervention and actually enrolled in the program. To calculate these proportions, we used Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance framework formulas. We defined need as the prevalence of obesity (body mass index in kg/m2 ≥30) and the level of concern about memory problems among older adults aged 60 years or older. Our target population was 2,198 people aged 60 years or older who attend 15 senior centers in Arkansas.

RESULTS

More than half of our target population responded to recruitment efforts for the behavioral weight loss intervention (61.9%) and for the memory improvement intervention (58.1%), yielding an overall response rate of 59.7%. More than one-third (35.6%) of the target population enrolled in the behavioral weight loss intervention, and 22.8% enrolled in the memory improvement intervention, for an overall reach for the 2 programs of 27.9%.

CONCLUSION

The reach of 2 evidence-based interventions designed for older adults that targeted specific health conditions and that were delivered in senior centers by community members was high. Our approach to calculating reach in applied settings can guide future research and program development.