Petrescu-Prahova Miruna G, Eagen Thomas J, Fishleder Sarah L, Belza Basia
Health Promotion Research Center, University of Washington, Seattle, Washington.
Department of Rehabilitation Medicine, University of Washington, Seattle, Washington.
Am J Prev Med. 2017 Mar;52(3 Suppl 3):S295-S299. doi: 10.1016/j.amepre.2016.08.015.
Physical activity has many benefits for older adult physical and mental health. EnhanceFitness (EF) is an evidence-based group exercise program delivered by community-based organizations. The purpose of this study was to review recent evidence on the dissemination and implementation of EF.
A scoping review of qualitative and quantitative studies with EF as main focus was conducted. CINAHL, PubMed, PubMed Central, SCOPUS, Web of Science, PsycINFO, and Google Scholar were searched between October and November 2015 for data-based studies on EF published in 2010-2015. Two team members abstracted each paper independently using a data abstraction tool. Results were summarized using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework.
Seventeen publications met inclusion criteria. EF has reached and is effective across a broad population base, including individuals with low SES and diverse ethnic/racial backgrounds. EF participation may be associated with reduced risk for falls requiring medical care, and is associated with fewer hospital admissions. Analyses of medical cost savings from EF participation and program implementation costs suggest economic benefits of EF implementation for communities. Organization-level maintenance is facilitated by program-specific and organizational factors, such as instructor training and funding. Individual-level maintenance is facilitated by program structure, absence of pain, and increased quality of life.
More-rigorous evidence is needed about the association between participation in EF and conditions such as falls. Evaluation of program fidelity, adaptations, and sustainability is limited; more-systematic examination across population groups and types of organizations would help ensure older adults continue to benefit from EF participation.
体育活动对老年人的身心健康有诸多益处。增强体能(EnhanceFitness,简称EF)是一项由社区组织开展的、基于证据的团体锻炼项目。本研究的目的是回顾近期有关EF传播与实施的证据。
对以EF为主要关注点的定性和定量研究进行了范围综述。2015年10月至11月期间,检索了CINAHL、PubMed、PubMed Central、SCOPUS、Web of Science、PsycINFO和谷歌学术,以查找2010 - 2015年发表的关于EF的实证研究。两名团队成员使用数据提取工具独立提取每篇论文的信息。结果使用“覆盖、效果、采用、实施和维持”(RE - AIM)框架进行总结。
17篇出版物符合纳入标准。EF已覆盖并在广泛的人群基础上取得了成效,包括社会经济地位较低以及具有不同种族/民族背景的个体。参与EF可能与降低需要医疗护理的跌倒风险相关,并且与较少的住院次数有关。对参与EF节省的医疗成本和项目实施成本的分析表明,实施EF对社区具有经济效益。项目特定因素和组织因素,如教练培训和资金,有助于促进组织层面的维持。项目结构、无疼痛以及生活质量提高有助于促进个人层面的维持。
关于参与EF与跌倒等情况之间的关联,需要更严格的证据。对项目保真度、适应性和可持续性的评估有限;对不同人群组和组织类型进行更系统的检查将有助于确保老年人继续从参与EF中受益。