Adapting and extending the impact of community-based physical activity programs

Background: Disseminating and implementing physical activity programs often includes local adaptations according to setting resources and priorities. Adaptations can be based on program form (e.g., program structure) or function (e.g., underlying principles of change). Our objective is to describe the same core functions across four different programs delivered within the U.S. Cooperative Extension System (CES), the dissemination and implementation (D&I) science framework used to collect comprehensive data, and the team-based approach to decision making.
Program Delivery or Policy Components: CES operates in every state and territory and represents an established D&I system to deliver health programs. In one state, the Physical Activity Leadership Team (PALT) consists of agents and researchers who select, adapt, and deliver physical activity programming. The PALT utilized core functioning behavior change principles including group-dynamics, social support, goal setting, self-monitoring, feedback, and education across four programs: (1) FitEx to improve physical activity and fruit/vegetable intake among adults; (2) Lifelong Improvements through Fitness Together to improve functional fitness for aging adults; (3) Flourishing in the Garden to improve fruit/vegetable intake, permaculture knowledge, and confidence in gardening among youth; and (4) Physical Activity in Cooperative Extension (PACE) to improve physical activity and public health competencies among agents. All of the programs are 8-9 weeks in duration and include varying levels of synchronous and asynchronous components. For example, PACE includes 9 1-hour live, virtual sessions and 9 hours of self-guided work to earn the microcredentialing.
Evaluation: Ongoing evaluation is based on the RE-AIM framework to determine who participates (Reach); the impacts (Effectiveness); how many agents are trained and their personal characteristics (Adoption); needed ongoing training, adaptations, and technical assistance (Implementation); and agent intent to deliver in the future (Maintenance).
Conclusions: D&I science can guide use of core program functions and adapt the delivery form to meet CES needs and priorities.