Factors impacting the implementation of evidence-based wellness programs in Illinois senior centers

Background: Older adults from racial/ethnic minority backgrounds, living in rural areas, or with lower socioeconomic status are more vulnerable to experience chronic diseases and conditions than their counterparts. Physical activity and proper nutrition have been shown to help prevent and manage these conditions. While evidence-based programs have been developed to increase physical activity and enhance nutrition in older adults, there has also been limited research to determine to what extent evidence-based programs actually reach individuals in local communities, especially vulnerable populations. Purpose: To identify the factors that impact the implementation of evidence-based physical activity, nutrition and/or chronic disease management programs in community senior centers in Illinois. Methods: The study utilized an implementation framework supported by the diffusion of innovations theory. A mixed methods research design that involved three phases was employed. Phase I included interviews with Area Agency on Aging (AAA) directors (n=4) in four Illinois regions. Phase II included surveys sent to all senior centers within the four regions (n=72). Phase III involved in-depth, semi-structured interviews (n=12) with a subset of senior centers including those: 1) offering evidence-based nutrition, physical activity or chronic disease management programs, and 2) offering nutrition, physical activity, or chronic disease management programs that were not evidence-based. Results: A variety of individual and organizational factors were discovered to influence the implementation of evidence-based nutrition or physical activity programs including limited knowledge, clientele preferences, demographic concerns, funding and competitive market for senior participation. Discussion: Results of the study increase our understanding, and add to the literature, important information regarding factors influencing the dissemination and implementation of policies and practices related to evidence-based programs and preventive care by identifying gaps in the stages of the implementation process, and discovering barriers to senior center’s participation in evidence-based programs such as clientele preferences, demographic changes, local competition, and program inflexibility