Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 W Markham St, Slot 820, Little Rock, AR 72205, USA.
Prev Chronic Dis. 2012;9:E63. Epub 2012 Feb 23.
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.
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.
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%.
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.
老年人可以从针对其面临的健康状况的公共卫生干预措施中受益。然而，将基于证据的干预措施转化为社区实践的速度一直很慢。我们于 2008 年至 2011 年在阿肯色州的老年人中心实施了由非专业健康教育员提供的两项基于证据的干预措施：行为体重管理干预和记忆改善干预。本研究的目的是衡量这些项目覆盖和服务不断增长的美国老年人人口的能力。我们报告了项目参与率在年龄、性别、种族和民族方面的差异，并提出了我们计算这两个干预措施覆盖范围的方法如何指导未来的研究和项目发展。
我们将这两个干预措施的覆盖面定义为需要干预措施且对初始招募工作有反应但未注册的人与需要干预措施且实际注册该项目的人之间的比例。为了计算这些比例，我们使用了“Reach、Efficacy/Effectiveness、Adoption、Implementation 和 Maintenance（Reach、疗效/效果、采用、实施和维持）”框架公式。我们将需求定义为 60 岁或以上老年人的肥胖患病率（体重指数（kg/m2）≥30）和对记忆问题的关注程度。我们的目标人群是 2198 名年龄在 60 岁或以上的人，他们参加阿肯色州的 15 个老年人中心。
超过一半的目标人群对行为体重管理干预措施（61.9%）和记忆改善干预措施（58.1%）的招募工作做出了回应，总体回应率为 59.7%。超过三分之一（35.6%）的目标人群参加了行为体重管理干预措施，22.8%的人参加了记忆改善干预措施，这两个项目的总覆盖率为 27.9%。
针对特定健康状况并由社区成员在老年人中心提供的两项针对老年人的基于证据的干预措施的覆盖面很高。我们在应用环境中计算覆盖范围的方法可以指导未来的研究和项目发展。
