University of Washington PRC Intervention Wins National Award

February 2006

Instructor Charlesetta McDowell leads an EnhanceFitness class at Seattle's Central Area Senior Center. In the front row, from left to right, Ida M. Gray, Ed Browne, Julia P. Doyle, Diane Snell, and Eleanor Sundquist lift their left legs in exercise. In the back are Elias Schultz and Ella Pitre.

A proven intervention that originated in one of CDC’s Prevention Research Centers earned national recognition in October 2005 for improving health and physical performance in older adults.

U.S. Secretary of Health and Human Services Michael Leavitt granted one of the department’s 10 annual Innovation in Prevention awards to Senior Services of Seattle/King County for EnhanceFitness, a program of exercise classes for seniors. The agency is a longtime partner of the CDC-funded Health Promotion Research Center (HPRC) at the University of Washington.

“The EnhanceFitness program shows that people of all ages, including our seniors, can benefit greatly from improved fitness and nutrition,” said Secretary Leavitt, who referred to the intervention as “a model program.”

More than 100 applicants for the award were rated on their programs’ creativity, innovation, leadership, sustainability, replicability, and outcomes. All projects focused on obesity, physical inactivity, or poor nutrition—risk factors for chronic disease. EnhanceFitness was the only winner that targeted older adults.

EnhanceFitness began in the early 1990s when the HPRC worked with Senior Services of Seattle/King County to design the program, first tested at a Seattle senior center. HPRC is part of CDC’s Prevention Research Centers (PRC) Program, which supports academic-community partnerships to develop, test, and put into practice interventions that prevent chronic disease and disability.

Early trials showed that seniors who participated in the program gained strength and energy and felt their state of mind improve. In 1997, Senior Services of Seattle/King County, the research center, and other partners began to share EnhanceFitness, which is now offered at 92 sites in nine states and the District of Columbia, reaching 3,000 participants, according to the project’s director, Susan Snyder.

EnhanceFitness’s group classes for seniors focus on aerobic activity, strength conditioning, balance, and flexibility. Progress is measured on a number of factors including ‘get up and go,’ or the time it takes someone to rise from a chair.

“We’ve had excellent outcomes in physical functioning but also in socialization, decreased depression, decreased physical pain,” Ms. Snyder said.

Nowhere is the success of the program more apparent than in the stories of individual participants.

Mary Brown, 74, of Seattle, a retired Equal Opportunity administrator in the aviation industry and grandmother of nine, recalled how just a few years ago she had trouble climbing the 11 steps from her front door to her bedroom door.

“When I got to the landing my heart was beating fantastically, and I was out of breath,” she said.

A visit to the doctor showed high cholesterol and high blood pressure, which Ms. Brown learned could be improved by physical activity. She enrolled in EnhanceFitness, her first physical activity classes since junior high calisthenics.

After the first year, her cholesterol and blood pressure improved significantly. Brown, who has lost 35 pounds since beginning the program, now serves as an EnhanceFitness instructor, teaching five classes a week.

The HPRC continues to work closely with the program, providing evaluation support and recommending improvements. EnhanceFitness also partners with PRCs in other states, where researchers are interested in studying the intervention in new settings and for new applications, such as arthritis relief.

HPRC director James LoGerfo, M.D., said that CDC’s network of Prevention Research Centers helped make EnhanceFitness successful.

“The PRC Program’s unique emphasis on committed, long-term partnerships to develop, translate, and disseminate effective programs has been critical to the widespread adoption of EnhanceFitness,” Dr. LoGerfo said. “A long-term view that moves from efficacy trials to dissemination and continuous quality improvement in community settings does pay off.”

Dr. LoGerfo would like to see the program form partnerships with health insurers. In 1998, Group Health Cooperative, a Seattle nonprofit health care system, began offering the program as a free benefit to all its Medicare enrollees, and about 600 people take advantage of that benefit. The program gets most of its support from the federal Administration on Aging and nominal class fees. In 2004, the National Council on the Aging selected the intervention as a Best Practice in Health Promotion.

Ms. Brown said hearing about awards such as these motivates her to encourage more and more people to get involved. She also uses her personal story to inspire her students, who range in age from around 60 to 90.

“I tell them I’m a work in progress,” she said. “I tell my class I’m a reformed couch potato. You don’t realize when you’re in your 30s, 40s, 50s, but you are slowing down. You are involved in your job and your jobs are sedentary. All of a sudden you wake up one day like I did.”

In just a few years, she said, her life has changed dramatically, from her exercise routine to her daily diet and nutrition. And the stairs to her bedroom door?

“I can run those now. No sweat.”