ࡱ> JLI abjbj 7DhhaKKKKK____s_90i VKKK<<< KK<<<<0UED_ < 09<aLa<aK<<2 9a : ReachChallenge 1Challenge 2Success 1Success 2 Definition: The absolute number, proportion, and representativeness of individuals who are willing to participate in a given initiative, intervention, or program What were issues leading to challenges or successes in meeting your reach goals in terms of numbers as well as representation of enrolled participants?? It has been challenging to meet reach goals primarily because we have had some difficulty hiring qualified instructors to meet the needs of opening classes at new sites.At some sites, consistently drawing the number of participants we hope to draw has been challenging. Through internship and recruiting efforts, we have been able to bring in some new instructors recently that have allowed us to open new EnhanceFitness classes.Promoting our program at conferences has allowed us to spread the word about our program and we have received interest from site managers regarding bringing our program to their sites.EffectivenessChallenge 1Challenge 2Success 1Success 2 Definition: The impact of an intervention on important outcomes, including potential negative effects, quality of life, and economic outcomes. What were issues leading to challenges or successes in achieving desired outcomes? In order for intervention outcomes to be reliable, it is important for participants to participate fully in the program (i.e., attendance, full participation, proper form, etc.). It can be challenging to ensure that participants adhere to this during the intervention.It is challenging to ensure that all instructors properly administer evaluative measurements in an identical fashion so that tests are conducted consistently from site to site.Based on early data, it appears that our participants have very similar data outcomes to published EnhanceFitness data. This is a success, as it suggests that classes and measurements are conducted properly and consistently.AdoptionChallenge 1Challenge 2Success 1Success 2 Definition: The absolute number, proportion, and representativeness of settings and intervention agents (people who deliver the program) who are willing to initiate a program. What were issues leading to challenges or successes in developing partnerships and recruiting host and delivery sites?In attempting to disseminate our EnhanceFitness classes, we have encountered many sites that are hesitant to adopt the program because they are unwilling to change the activities they may already hold.Many potential host sites and partners already have exercise classes for seniors and are disinterested in changing the program/adopting an EnhanceFitness program.Persistence and an explanation of the benefits of exercise, in addition to speaking directly to the seniors have been ways to convince site managers that an exercise class is a valuable addition to their activity list. An explanation of EnhanceFitness status as an evidence-based program has helped to convince a site manager that they should adopt EnhanceFitness in lieu of their current exercise class.ImplementationChallenge 1Challenge 2Success 1Success 2 Definition: At the setting level, implementation refers to the intervention agents' fidelity to the various elements of an intervention's protocol, including consistency of delivery as intended and the time and cost of the intervention. At the individual level, implementation refers to clients use of the intervention strategies. What were issues leading to challenges or successes or implementing the program with fidelity? Making certain that all instructors consistently lead classes according to EnhanceFitness protocols in each and every class (3 days/week) is challenging.Making certain that the program is delivered 3 days/week consistently is challenging, as instructor attrition can complicate program delivery.Comprehensive instructor training that is specific to EnhanceFitness helps to ensure that classes are led according to EnhanceFitness protocols. In addition, periodic site visits allow for an outsiders input and perspective as to the manner in which the classes are conducted.We have been fortunate in maintaining most of our instructors, thus giving us an experienced group. The EnhanceFitness program allows for some creativity that fits into established protocols, and our instructors have successfully been able to deliver the program accurately.MaintenanceChallenge 1Challenge 2Success 1Success 2Definition: The extent to which a program or policy becomes institutionalized or part of the routine organizational practices and policies. Within the RE-AIM framework, maintenance also applies at the individual level. At the individual level, maintenance has been defined as the long-term effects of a program on outcomes after 6 or more months after the most recent intervention contact. What were issues leading to challenges or successes or in maintaining gains at the individual level and sustaining program capacity? EnhanceFitness classes can be a bit repetitive in nature; thus, it can be challenging to keep participants interested in the class after a while. Instructor creativity, while still maintaining fidelity to EnhanceFitness, can be a challenging balance.Some centers are accustomed to short-term programs and it can be challenging to discuss long-term sustainability ideas with them. The EnhanceFitness program lends itself well to becoming an institutionalized activity within senior sites, as it is held so frequently. We have observed this at our host sites.Encouragement and reminders to our senior participants regarding the benefits of regular physical activity helps to keep them motivated and interested in the class. 23@q r   # $   '  lmHIBCDP/붲ввЭ먶ФРРЭèРРh7@h~6h hF h~6 h6h\h7@hqm6 h Z6 h7@6h7@h7@6 h7@h7@h7@h7@5hKh7@h3<6 hqm6 h7@h3<h7@h3<5<(2d$Ifgd7@23kd$$IflrV C0) 3      t2044 lap2yt34q r  $ d$Ifgdqmd$Ifgd7@    H:::::d$Ifgd7@kd\$$IflrV C0) 3     t044 layt  kdE$$IflrV C0) 3      t2044 lap2yt   d$Ifgdqmd$Ifgd7@ H:::::d$Ifgd7@kd$$IflrV C0) 3     t044 laytkd$$IflrV C0) 3      t2044 lap2ytmId$Ifgd7@".8BH:::::d$Ifgd7@kd$$Ifl\rV C0) 3     t044 laytBCkd$$IflrV C0) 3      t2044 lap2ytCD0Cd$Ifgd7@/0BD|}^`ah,hh\h7@h~6 h7@6h7@h7@6 h~6h7@h7@5hu h7@h7@CDP\hr|H:::::d$Ifgd7@kd+$$Ifl rV C0) 3     t044 layt|}kd $$IflrV C0) 3      t2044 lap2yt}_d$Ifgd7@_`aHFkdp $$IflrV C0) 3     t044 layt51h0:p7@= /!"#$% Z$$If!vh5 5 5 5 5 #v #v #v :V l  t205 5 5 / / / p2yt$$If!vh5 5 5 5 5 #v #v #v :V l t05 5 5 / / / ytZ$$If!vh5 5 5 5 5 #v #v #v :V l  t205 5 5 / / / p2yt$$If!vh5 5 5 5 5 #v #v #v :V l t05 5 5 / / / ytZ$$If!vh5 5 5 5 5 #v #v #v :V l  t205 5 5 / / / p2yt$$If!vh5 5 5 5 5 #v #v #v :V l\ t05 5 5 / / / ytZ$$If!vh5 5 5 5 5 #v #v #v :V l  t205 5 5 / / / p2yt$$If!vh5 5 5 5 5 #v #v #v :V l t05 5 5 / / / ytZ$$If!vh5 5 5 5 5 #v #v #v :V l  t205 5 5 / / / p2yt$$If!vh5 5 5 5 5 #v #v #v :V l t05 5 5 / / / ytj 666666666vvvvvvvvv666666>6666666666666666666666666666666666666666666666666hH6666666666666666666666666666666666666666666666666666666666666666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ OJPJQJ_HmH nH sH tH J`J ,Normal dCJ_HaJmH sH tH DA D Default Paragraph FontRi@R 0 Table Normal4 l4a (k ( 0No List tt 3< Table Grid7:V0 dPK![Content_Types].xmlj0Eжr(΢Iw},-j4 wP-t#bΙ{UTU^hd}㨫)*1P' ^W0)T9<l#$yi};~@(Hu* Dנz/0ǰ $ X3aZ,D0j~3߶b~i>3\`?/[G\!-Rk.sԻ..a濭?PK!֧6 _rels/.relsj0 }Q%v/C/}(h"O = C?hv=Ʌ%[xp{۵_Pѣ<1H0ORBdJE4b$q_6LR7`0̞O,En7Lib/SeеPK!kytheme/theme/themeManager.xml M @}w7c(EbˮCAǠҟ7՛K Y, e.|,H,lxɴIsQ}#Ր ֵ+!,^$j=GW)E+& 8PK!Ptheme/theme/theme1.xmlYOo6w toc'vuر-MniP@I}úama[إ4:lЯGRX^6؊>$ !)O^rC$y@/yH*񄴽)޵߻UDb`}"qۋJחX^)I`nEp)liV[]1M<OP6r=zgbIguSebORD۫qu gZo~ٺlAplxpT0+[}`jzAV2Fi@qv֬5\|ʜ̭NleXdsjcs7f W+Ն7`g ȘJj|h(KD- dXiJ؇(x$( :;˹! I_TS 1?E??ZBΪmU/?~xY'y5g&΋/ɋ>GMGeD3Vq%'#q$8K)fw9:ĵ x}rxwr:\TZaG*y8IjbRc|XŻǿI u3KGnD1NIBs RuK>V.EL+M2#'fi ~V vl{u8zH *:(W☕ ~JTe\O*tHGHY}KNP*ݾ˦TѼ9/#A7qZ$*c?qUnwN%Oi4 =3ڗP 1Pm \\9Mؓ2aD];Yt\[x]}Wr|]g- eW )6-rCSj id DЇAΜIqbJ#x꺃 6k#ASh&ʌt(Q%p%m&]caSl=X\P1Mh9MVdDAaVB[݈fJíP|8 քAV^f Hn- "d>znNJ ة>b&2vKyϼD:,AGm\nziÙ.uχYC6OMf3or$5NHT[XF64T,ќM0E)`#5XY`פ;%1U٥m;R>QD DcpU'&LE/pm%]8firS4d 7y\`JnίI R3U~7+׸#m qBiDi*L69mY&iHE=(K&N!V.KeLDĕ{D vEꦚdeNƟe(MN9ߜR6&3(a/DUz<{ˊYȳV)9Z[4^n5!J?Q3eBoCM m<.vpIYfZY_p[=al-Y}Nc͙ŋ4vfavl'SA8|*u{-ߟ0%M07%<ҍPK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 +_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!Ptheme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] aD/a23   BCC|}_a !8@0(  B S  ?cc2 C D}cciuX(Q'o-E77@LX Z\sKF3< ,nZuqmUR `Ej7q~ac@a@@UnknownG* Times New Roman5Symbol3. * Arial7.{ @CalibriACambria Math"hRf[FW  (W  (!nr4VV2HP)$P3<2!xxReach jdprochaskaanwadeOh+'0t  0 < HT\dlReach jdprochaska Normal.dotmanwade5Microsoft Office Word@0@>'j@EDW ՜.+,0 hp  TAMHSC( V Reach Title  !"$%&'()*,-./012345678:;<=>?@BCDEFGHKRoot Entry FuEDMData #1Table+aWordDocument7DSummaryInformation(9DocumentSummaryInformation8ACompObjy  F'Microsoft Office Word 97-2003 Document MSWordDocWord.Document.89q