Active for Life®: Increasing Physical Activity Levels in Adults Age 50 and Older, a national program of the Robert Wood Johnson Foundation (RWJF), studied how to deliver and sustain research-based physical activity programs in real-world settings so that large numbers of older Americans could benefit from them. The program supported the overarching goal of increasing the number of adults age 50 and older who engage in regular physical activity.

The program featured:

• Nine community-based projects in which a variety of community organizations implemented one of two behavior change programs that research demonstrated to be effective in helping mature adults become more active:
  • Active Living Every Day, a 20-week program in which groups of between 12 and 20 people age 50 or older met for one hour each week with guidance from a trained facilitator. Weekly discussion topics were presented in the participant manual titled Active Living Every Day: 20 Weeks to Lifelong Vitality. Participants read the relevant chapter and completed written assignments between discussion sessions.
• Researchers at Cooper Institute in Dallas designed the program. See Appendix 1 for more information.
  • Active Choices, a six-month program delivered through an initial face-to-face meeting during which a health educator and the participant formulated a physical activity plan that addressed the participant's readiness to change, motivations and concerns. During about eight subsequent telephone consultations, they discussed health status, reviewed activity levels and progress toward goals.
• Researchers at Stanford Prevention Research Center in the Department of Medicine in Palo Alto, Calif., designed the program. See Appendix 2 for more information.
• A 2002–2004 marketing and policy initiative led by AARP and evaluated by Princeton Survey Research Associates International of Princeton, N.J., to help two communities, Richmond, Va., and Madison, Wis., promote more active lifestyles for their older residents. See Grant Results for more information, including evaluation findings.
• A resource center to serve as a clearinghouse for information and technical assistance.

Key Results
Researchers from the University of South Carolina Arnold School of Public Health conducted an evaluation to determine whether the community organizations were able to adapt — or "translate" — the models and whether the adapted programs achieved outcomes comparable to the original models. The evaluation did not report on the sites' results individually.

• Nonresearch organizations delivered research-based programs and significantly increased physical activity levels in sedentary adults age 50 and older:
  • Participating organizations included city and county health departments, social service organizations, a hospital and a health insurance provider.
  • Project sites met or exceeded recruitment goals of 900 participants per site.
  • Project staff and partners served people from various racial and socioeconomic backgrounds, who in contrast to participants in the research studies, were older, had more risk factors for chronic diseases, were more overweight and had lower incomes and education levels.
• Program developers and national program office and project staff identified and introduced adaptations that made Active Living Every Day and Active Choices more responsive to community needs. Key adaptations included:
  • Reducing the duration of Active Living Every Day from 20 to 12 weeks.
  • Increasing or decreasing the frequency of Active Choices telephone consultations to meet individual circumstances.
  • Changing marketing materials to reflect a wider age range of participants and more diverse racial groups.
• Seven of the nine sites sustained or expanded their Active for Life programs.
• National program office staff designed and launched the Learning Network for Active Aging, a forum that let community agencies and researchers learn from one another.

Key Findings

• Participants significantly increased their level of moderate-to-vigorous physical activity.
• Participants reported increases in satisfaction with body appearance and function, and decreases in weight (as measured by body mass index or BMI).
• Participants in Active Living Every Day, but not in Active Choices, reported modest reductions in symptoms of depression and perceived stress.
• Participants were more ethnically and economically diverse, and in poorer health than the older adults in the original research-based studies of the two programs. Nonetheless, the levels of improvement in Active for Life participants were comparable to those seen in the original studies.

Program Management
RWJF established a national program office at Texas A&M University to manage Active for Life. Marcia G. Ory, Ph.D., M.P.H., directed the program. Diane M. Dowdy, Ph.D., served as deputy director. The program management team included Cynthia M. Castro, Ph.D., from the Stanford Prevention Research Center and Ruth Ann Carpenter, M.S., R.D., L.D., of the Cooper Institute who provided technical assistance in adapting the two evidence-based program models.

The team also included Russell E. Glasgow, Ph.D., and Paul Estabrooks, Ph.D., who had developed RE-AIM (Reach, Efficacy/Effectiveness, Adoption, Implementation and Maintenance), a framework that helps researchers and community practitioners translate research-based programs into real-world settings and evaluate their impact on the health of the population.

Communications were directed by Brigid Sanner, B.S., a health communications and marketing consultant, who helped project staff develop and implement strategies to recruit participants and communicate results.

Funding
In April 2001, RWJF's Board of Trustees authorized Active for Life for up to $17 million for four years.