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J Am Geriatr Soc. 2002 Sep;50(9):1519-24.

Outcomes of a community-based dissemination of the health enhancement program.

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  • 1Department of Medicine, Division of Gerontology and Geriatric Medicine, School of Public Health and Community Medicine, Seatle, Washington 98104, USA.



We previously found in an efficacy trial that a health promotion program prevented functional decline and reduced hospitalizations in community-dwelling older people with chronic conditions. We sought to evaluate the effectiveness of the program in its dissemination phase.


Outcome evaluation using a within-group, pretest-posttest design.


Fourteen senior centers located throughout western Washington.


Three hundred four community-dwelling men and women aged 65 and older.


A disability-prevention, chronic disease-self-management program.


Participant characteristics, risk factors for disability, change in health and functional status, and healthcare use over 1 year of enrollment; participant satisfaction.


Participants were 71% female, had a mean age of 76, and reported three chronic health conditions on average. The percentage of participants found to be depressed decreased (28% at time of enrollment vs 17% at 1-year follow-up, P =.005). The percentage of physically inactive participants decreased (56% vs 38%, P =.001). Physical activity level and exercise readiness improved (Physician-based Assessment and Counseling for Exercise mean score 4.3 vs 5.1, P =.001). At follow-up, 83% rated their health the same as or better than a year ago, compared with 73% at time of enrollment. The proportion with impaired functional status, as measured by bed days and restricted activity days, stayed the same. The proportion hospitalized remained stable (23% at enrollment and follow-up, P = 1.0).


Under real world conditions, the Health Enhancement Program reaches older people at risk of functional decline. Those enrolled for 1 year experience a reduction in disability risk factors, improvement in health status, no decrements in functional status, and no increase in self-reported healthcare use.

[PubMed - indexed for MEDLINE]
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