Maintenance of Change in the Active-for-Life Initiative

Background: There is a notable gap in translating efficacious interventions to community-based organizations. Further, physical activity interventions have been less successful in promoting longer-term maintenance. Purpose: This study examined 6-month maintenance of improvements seen in Active for Life (AFL), a translational research initiative. Methods: Participants from seven of 12 AFL sites enrolled in Years 3 and 4 were surveyed 6 months after completing the 6-month telephone-based Active Choices program (AC, one site) or the 20-week or 12-week group-based Active Living Every Day program (ALED, six sites). Repeated measures analyses controlled for site clustering and covariates. Programs were implemented from 2003 to 2007 and analysis was conducted in 2009. Results: For the AC (n=368) and ALED (n=2151) programs, respectively, participants were aged 72.0 and 70.8 years on average, were 70% and 78% non-Hispanic white, and were 72% and 83% women; 46% and 50% returned 6-month follow-up surveys. For AC, improvements from pre- to post-test were maintained at follow-up for physical activity; satisfaction with body function (SBF); and BMI. For ALED Year 3, there was a decrease at follow-up for physical activity and SBF. Body mass index decreased from pretest to follow-up. For ALED Year 4, increases in physical activity and reductions in BMI were maintained at follow-up. Satisfaction with body function increased from pretest to 12 weeks post-test, declined at 20 weeks, and was maintained at follow-up. Conclusions: Improvements were generally maintained at the 6-month follow-up. When behavioral decay occurred, follow-up values remained more favorable than at pretest. Given the broad reach of this translational initiative, the results suggest the viability of evidence-based programming as an effective public health practice.