Twelve-Month Retention in and Impact of Enhance®Fitness on Older Adults in Hawai‘i

Abstract

Introduction. Enhance®Fitness is a low-cost group exercise program designed specifically for older adults (60+ years) to improve physical performance. The Hawai‘i Healthy Aging Partnership, a statewide health promotion initiative, has continuously offered Enhance®Fitness to Hawai‘i’s multicultural population since 2007. This study examined 12-month participation in and impact of Enhance®Fitness on physical performance among older adults in Hawai‘i. Method. Linear mixed-effects models were applied to analyze the physical performance measures (chair-stands, arm curls, and the up-and-go test) collected at baseline (month 0) and at 4, 8, and 12 months. We also compared the characteristics of participants who participated in the program for 12 months with those who dropped out in order to gain insights on participant retention. Results. Of 1,202 older adults with baseline data, 427 (35.5%) were continuously enrolled in Enhance®Fitness for 12 months and participated in follow-up data collection. On average, participants attended 63.7% of thrice-weekly classes each month. Participants’ physical performance measures improved after 4 months, continued to improve until 8 months, and were maintained thereafter. Besides continuous attendance, performance-measure improvements were associated with younger age, male gender, living with others (vs. alone), and fewer chronic conditions. Compared to those who completed 12 months of the program, the 775 who left the program over the course of the year were more likely to be younger, to be Caucasian (vs. Asian or Pacific Islander), to self-report depression as a chronic condition, and to have lower levels of fitness at baseline. Common reasons for dropping out were illness, relocation, time conflicts, lost interest, and transportation issues. Conclusions. Long-term participants in Enhance®Fitness initially improved and then maintained physical performance. Future research is needed to identify strategies to maintain enrollment of older adults in the exercise programs over time.

Remotely delivered exercise to older rural cancer survivors: a randomized controlled pilot trial

“…The median class attendance rate of 87% was higher than the 64-75% reported in previous studies of in-person exercise classes for older adults [44,45]. Attendance also exceeded the minimum recommendation of 75% attendance for cancer survivors [29,30].…”

Team members influence retention in a First Peoples’ community-based weight-loss program

“…Consistent with the majority of findings from the literature ( Leahey et al, 2010 , Jiandani et al, 2016 , Jiang et al, 2016 , Babatunde et al, 2017 , Burgess et al, 2017 , Leung et al, 2017 , Stoutenberg et al, 2017 , Alexander et al, 2018 , Tomioka et al, 2019 ), older (over 49 years of age) participants were more likely to complete their first the KHC participation than younger (under 29 years) participants. Obesity and chronic disease rates among Aboriginal Australians increase with age ( Australian Institute of Health and Welfare, 2015 ), with 80% of those 55 or more years old overweight or obese.…”

“…Poor retention is a problem because longer time spent in weight-loss programs is associated with better weight outcomes ( Jiandani et al, 2016 ); poor retention may distort study findings, likely biasing toward program effectiveness, and require better retention strategies ( Rae et al, 2013 ). Retention in weight-loss programs is generally associated with older age ( Leahey et al, 2010 , Jiandani et al, 2016 , Jiang et al, 2016 , Babatunde et al, 2017 , Burgess et al, 2017 , Leung et al, 2017 , Stoutenberg et al, 2017 , Alexander et al, 2018 , Tomioka et al, 2019 ), though some studies have found no such association ( Moroshko et al, 2011 , Latner and Ciao, 2014 ). Retention rates have been found to be higher among females ( Jiang et al, 2016 ), but also among males ( Burgess et al, 2017 ) or not associated with gender ( Moroshko et al, 2011 , Stoutenberg et al, 2017 ).…”

“…In a diabetes prevention program for Native American/Native Alaskans, age and gender predicted attrition in both program (4–6 month) and maintenance (12 months or longer) phases ( Jiang et al, 2016 ). Age and fitness level predicted attrition at 12 months from a culturally tailored community-setting fitness class for older Hawaiian adults ( Tomioka et al, 2019 ). In addition to targeting different Indigenous populations, these programs have different objectives from and are longer in duration than the KHC.…”