Understanding the challenges encountered and adaptations made by community organizations in translation of evidence-based behavior change physical activity interventions: a qualitative study.
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PURPOSE: Designing programs for mid-life to older adults whose sedentary behaviors are associated with increased health risks is crucial. The U.S. Task Force on Community Preventive Services strongly recommends individually adapted behavior change programs as one approach to increasing physical activity in communities. The purpose of this study is to report challenges organizations faced when translating two evidence-based programs in real-world settings, adaptations made, and whether or not fidelity was negatively impacted by these adaptations. DESIGN: A grounded theory approach to qualitative research was used. SETTING AND PARTICIPANTS: Nine community organizations across the country participated. Two organizations had more than one site participating, for a total of 12 sites from nine organizations. Within those organizations, 2796 participants were part of the program during the first 2 years. Participants were underactive (i.e., not meeting Centers for Disease Control and Prevention and American College of Sports Medicine recommendations) mid- to older-aged adults. METHODS: Community organizations participated in monthly conference calls, and program information was entered into an electronic database regularly. Data obtained from the calls and database were used for analyses. RESULTS: Challenges and adaptations emerged in three categories: (1) program logistics, (2) program theory, and (3) program philosophy. CONCLUSION: Challenges were present for community organizations; however, with some level of adaptation, the community organizations were able to effectively deliver and maintain fidelity in two evidence-based physical activity programs to a large and diverse group of mid- to older-aged adults.