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Evidence-based public health is defined as the development, implementation, and
evaluation of effective programs and policies in public health through
application of principles of scientific reasoning, including systematic uses of
data and information systems, and appropriate use of behavioral science theory
and program planning models.
For The State of Aging and Health in America reports, we selected
effective interventions and programs that had been described in published
peer-review literature at the time of the report's publication. Effectiveness
was based on whether researchers used sound research designs, controlled for
potential sources of biases, and the outcome measures were of statistical and
public health significance. Additionally, these programs were either identified
as part of the recommendations from The
Guide to Community Preventive Services reviews (e.g., physical
activity) or consistent with their approaches to reviewing the evidence.
Reference:
Brownson RC, Baker EA, Leet TL, Gillespie KN. (Eds). Evidence-based Public
Health. New York: Oxford University Press; 2003.
The State of Aging and Health in America online report highlights
evidence-based programs that are included in the "Spotlight" sections of the
hard copy reports.
Physical Activity
Falls Prevention
Enhance Fitness
This evidence-based physical activity program provides seniors with low-cost
fitness classes taught by certified fitness instructors. The one-hour classes
meet three times per week in ongoing, 5-week sessions. The classes include
strength training with wrist and ankle weights, as well as aerobics,
stretching, and balancing exercises. The program is designed to be safe and
effective for seniors with a wide range of physical abilities. This program
began as a partnership between Senior Services of Seattle/King County, Group
Health Cooperative of Puget Sound, and the University of Washington Health
Promotion Research Center. Studies have shown a marked improvement in
participants' physical and social functioning, as well as a decline in areas
such as pain, fatigue, and depression. To learn more, visit
Project Enhance.
Reference:
Wallace, J. I. et al. Implementation and effectiveness of a community-based
health promotion program for older adults. Journal of Gerontology: Medical
Sciences 1998;53a(4): M301-M306.
Arthritis Foundation Exercise Program
The Arthritis Foundation Exercise Program, formerly known as PACE (People with
Arthritis Can Exercise) is an evidence-based exercise program developed
specifically for people with arthritis. It uses gentle activities to help
increase joint flexibility and range of motion and maintain muscle strength.
Two program levels, basic and advanced, are available to address the varying
levels of fitness and limitation among those with arthritis. Participants have
experienced such benefits as increased functional ability, increased self-care
behaviors, decreased pain, and decreased depression.
Trained leaders are required to implement this course. For help in identifying
trained leaders in your area or for information on how to become a trained
leader, contact the Arthritis Program Director at the state health department
or the state/local Arthritis Foundation Chapter. (For a listing of directors by
state, visit
National Association of Chronic Disease Directors. For a listing of
chapters, visit The Arthritis Foundation.)
Reference:
Brady TJ, Kruger J, Helmick CG, Callahan LF, Boutaugh ML. Intervention programs
for arthritis and other rheumatic diseases. Health Education and Behavior
2003;30(1):44-63.
Exercise: A Guide from the National Institute on Aging
The National Institute on Aging has developed a manual and companion video that
guides older adults through safe and effective endurance, strength training,
balance, and flexibility exercises. The program can be completed on an
individual basis or in a group setting. The 80-page manual is available online
for free, or may be ordered along with the video for a cost of $7.00. The video
features Margaret Richard, star of PBS’ exercise show Body Electric. A Spanish
language version is also available. For more information, visit
National Institute on Aging.
Fear of Falling: A Matter of Balance
Fear of falling is a common occurrence among older adults, including those who
have not experienced a fall. Older people often restrict their activities
because they think it will reduce their risk of falling, but this can actually
lead to physical deconditioning and increased fall risk. The Boston University
Roybal Center Consortium developed this program, which uses cognitive
restructuring techniques and skills training to change perceptions and
behaviors in older adults whose activity levels have been limited by their
fears about falling. The program has been implemented successfully by senior
centers, senior housing sites, hospitals, and home health agencies. A low-cost
Facilitator's Manual and videotape provide a step-by-step implementation guide
for practitioners and providers in clinical and community settings. For more
information about the program, visit
The National Resource Center for Safe Aging or
Boston University.
Recently, the National Council on the Aging and the Administration on Aging
have been working with states to develop and test a “lay leader” model for A
Matter of Balance. Initial findings are very promising and published results
should be available in the future. For more information, visit the
Maine Department of Health site.
Reference:
Tennstedt S. Howland J. Lachman M. Peterson E. Kasten L. Jette A. A randomized,
controlled trial of a group intervention to reduce fear of falling and
associated activity restriction in older adults. Journals of Gerontology Series
B- Psychological Sciences & Social Sciences. 53(6):P384-92, 1998 Nov.
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