The Role of Community
Partnerships in Testing Three
New Versions of Fit and
Strong!
Susan Hughes,PhD
Renae Smith-Ray, PhD
Yolanda Curry, MPA
Sue Vega
Colleen Lammel-Harmon, RD, LDN
Claudia Aquilina
Introductions
 Susan Hughes, PhD
(Professor, School of Public Health and Director, Center for Research
on Health & Aging, University of Illinois at Chicago)
 Renae Smith-Ray, PhD
(Research Scientist for Center for Research on Health and Aging, UIC)
 Yolanda Curry, MPA
(Chicago Department of Family and Support Services-Area Agency on
Aging)
 Sue Vega
(Senior Programs Manager at Alivio Medical Center)
 Colleen Lammel-Harmon, RD, LDN
(Wellness Manager at Chicago Park District)
 Claudia Aquilina
(Activity Director, Senior Services Associates, Inc.)
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Today’s Objectives
 Brief overview of Fit & Strong!
 Describe three examples of how Fit & Strong! has been adapted :
 Inclusion of weight management / dietary change strategies
 For Spanish-speaking participants
 Bundling with other evidence-based programs such as Matter of
Balance
 Describe initiatives for system-level dissemination of Fit & Strong!
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Fit and Strong!
4
F&S!- An Evidence-Based
Program
An 8-week multiple component physical activity / behaviorchange program for older adults with lower-extremity pain
and stiffness
 3 sessions per week, 90 minutes per session
 First 60 minutes = physical activity
 Last 30 minutes = group discussion / problem solving
 Implemented and evaluated in community-based settings, tested
through efficacy, effectiveness, and dissemination trials, and has
achieved significant outcomes
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Adapting Evidence-Based Programs for
Community-Based Practice
• Core Components of the program
should not be changed!
• These components are critical to
achieving significant improvements
Program
Reinvention
or Adaption
Program
Fidelity
• A good program will be somewhat
adaptable to enhance dissemination
within a variety of settings and
contexts
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Dissemination of Fit & Strong!
Essential
Elements
Defined
Program support
available from
Fit & Strong!
team
Fidelity
monitored
Good participant
retention
Program
manuals for
participants and
instructors
Ease of
Implementation
Standardized
Training for Fit &
Strong!
Instructors
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Adaptation Example 1:
Fit and Strong! Plus
 Comparative effectiveness trial examining whether Fit & Strong! is
more effective with an added weight management/dietary change
component
 Osteoarthritis symptoms exacerbated by obesity
 Weight loss of 5.1 kg over a 10-year period decreases the odds of
developing knee OA by more than 50% (Felson 1992)
 Currently, no evidence-based program exists that combines physical
activity with weight loss for overweight/obese older adults with
osteoarthritis
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Adaptation Example 2:
Hispanic Version of Fit and Strong!
• Need for more evidencebased programming for
Hispanic older adults
• All Fit & Strong! materials
translated into Spanish
Meeting Physical Activity Guidelines
• Hispanic version tested in
Chicago and Phoenix
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20
• Significant improvements
in physical activity, selfefficacy, and OA symptoms
15
10
5
0
White
Black
Hispanic
Sources: : US Administration on Aging
http://www.aoa.gov/AoARoot/Aging_Statistics/minority_aging/Facts-on-Hispanic-Elderly.aspx
and Centers for Disease Control and Prevention 2012
Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health
Promotion
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Adaptation Example 3:
The Importance of Bundling
Evidence-Based Programs
The Need
 No systematic way for older adults to graduate
from program A and move on to program B
The Potential of Bundling
 Provides a roadmap
 Provides a way for individuals to progress their exercise
intensity
 Boosts maintenance of positive health promotion behaviors
Example: Fit & Strong! and Matter of Balance
 MOB-An evidence-based program designed to reduce fear of
falling and increase activity levels among older adults
 Both Matter of Balance (MOB) and Fit and Strong (F&S) offered
over past year at multiple Senior Services Associates sites
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Chicago Department of Family &
Support Services, Senior Services
Yolanda Curry, MPA
Deputy Commissioner, DFSS
DFSS SENIOR CENTERS
WHERE ADULTS 60 OR BETTER*
“ENJOY MORE”
LAUGH MORE * MOVE MORE * EXPLORE MORE
*EXPRESS MORE * LEARN MORE * CARE MORE
*Satellite Centers currently have Boomer Clubs where participant eligibility begins at 55 or better.
6 Regional Senior Centers
15 Satellite Senior Centers
Fitness Classes* Wellness Talks*Medication Management * Health
Screenings*Social Work Consultations*Support Groups* Arts & Crafts * Benefits
Assistance *Computer Instruction*Lecture Series* Information and Assistance*
Wide Range of Learning Experiences*Drop-in Activities* Trips & Tours
*Flu Clinics
274,175 Visits to Regional Centers in 2012
264,316 Visits to Satellite Centers in 2012
538,491 Total Visits 2012
What is a Senior Center?
Recognized as the most diverse service available to older
adults nationally:
Senior Centers are designated
as community focal points (Older
American Act) or as places where
“older adults come together for
services and activities that reflect
their experience and skills, respond
to their diverse needs and interests,
enhance their dignity, support their
independence, and encourage their
involvement in and with the center
and the community.”
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The Importance of Senior Centers
Research has shown that people who regularly attend senior centers:
•
Are in need of a support system to help them
improve or maintain their health and quality of
life.
•
Have healthier behaviors in terms of the foods
they eat and their participation in exercise.
•
Have fewer mental health problems, such as
depression.
•
Have a more positive outlook on life.
•
Believe their attendance helps them to maintain
their independence and to keep them socially
connected.
•
Say they enjoy having somewhere to go every
day.
•
Often volunteer, which can help empower them
especially if they feel that life after retirement
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has diminished the meaning of their lives.
DFSS SENIOR CENTERS
Demographic Profile
Total unduplicated Count for Calendar year
2012:
20,673
(registered clients who participated at a regional
or satellite senior center)
%
Gender
Male:
Female:
Total:
7,207
13,466
20,673
34.86%
65.14%
100.00%
Age Group
50 - 59
60 - 69
70 - 79
80 - 89
90 and older
Total:
530
7,318
8,274
3,749
802
20,673
2.56%
35.40%
40.02%
18.13%
3.88%
100.00%
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Chicago Senior Centers and
Fit & Strong! : A Natural Fit
•
City of Chicago Senior Centers administers a nationally
recognized senior fitness program.
 Harvard University Innovations in Government Semi-Finalist.
 National Council on Aging 10 Best Practice Program.
•
•
•
•
•
City of Chicago Fitness Program provides group exercise and/or
personal training in 40+ locations. In 2012, there were 8,747
unduplicated clients served in City of Chicago’s Fitness
Program.
Chicago Senior Centers were early research sites for Fit &
Strong!
In 2012 renewed effort to begin offering Fit & Strong! broadly
throughout Chicago senior centers.
Fit & Strong is highly regarded by participants. We have
received positive feedback from both instructors and
participants.
Received an Aldermanic request for current Fit & Strong
participants to continue in the newer program offerings.
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Partnership Between Pilsen
Senior Center and UIC
Susan Vega
Pilsen Satellite Senior Center
at Casa Maravilla




Three public and private
organizations in
partnership
Programming designed to
meet specific needs of
older adults in the
community
Focus on getting people
what they need as
articulated by them
A very Latino / MexicanMexican American place
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Key Lessons Learned
It is not necessary to wait for optimal
conditions
 Focus on what you can do
 Find people in the community who share
and support your vision
 Keep a sharp eye on the mission
 When in doubt, check in with your
constituents

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¡Fuerte y en Forma! at the Center
Strong effort to recruit people in the
building and program participants
 Good participation from Center members;
building residents
 Rave reviews of program / instructor
 Big demand for program to continue
 Program of great benefit to community

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Participant Feedback
“Program seemed designed for me! Helped me
to know how to keep active”. Participant A.
 “Provided practical advice, clear messages and
opportunity to learn how to manage my
arthritis”. Participant B.
 “Introduced us to the Center. Helped us start on
a path to increased physical activity”. Mr. and
Mrs. Participants C.
 Another couple that was not included in the
intervention learned about the Center and
became regulars.

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Susan Vega
Senior Programs Manager
Alivio Medical Center
312-743-0493
svega@aliviomedicalcente
r.org
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Chicago Department of Family &
Support Services, Senior Services
Colleen Lammel-Harmon
Wellness Manager, Chicago Park District
Our Mission:
-To enhance the quality of life in Chicago by
becoming the leading provider of recreation
and leisure opportunities.
-To provide safe, inviting, and beautifully
maintained parks and facilities.
-To create a customer-focused and responsive
park system.
Chicago Park District

Every adult is a kid at heart. That’s why the Chicago Park District
provides adult programming for our big kids to stay fit and active.

The Chicago Park District operates many adult classes including
aerobics, kickboxing, swimming, aquatic exercise, basketball,
boxing, volleyball, yoga, and conditioning.

We are the leading provider of recreation, fitness, and leisure
activities.

Right now we offer numerous physical activities and programs for
all ages.

Family Focus is the goal of the Chicago Park District.

We want to offer a variety of programs for all Chicagoans at an
affordable cost.
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Senior Programs
 Over 380 senior programs , including senior club, games,
sewing, dance, and 200 focused on fitness style programs
including aquatic exercise, fitness, yoga, conditioning, and
even 1 power lifting.
 Encourage structured programs for those needing social
support and instruction.
 Offer unstructured programs for those desiring less
curriculum.
 Senior Games- Olympic Program
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Objectives of Chicago Park
District and Fit and Strong Plus:
 Increased physical activity for seniors;
 Develop healthier eating habits; and
 Build sustainable partnership to impact various levels of the
city;
 Sustain “joint” partner programs and increase level of fitness to
seniors to adopt better life satisfaction and skill.
 Refer non active seniors to a tremendous high level program
like Fit and Strong Plus.
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Fitness Classes and Centers (71)
We offer several fitness classes
for beginners to advanced, kids to seniors.
Many Flavors. All senior only classes Free.
All others- Seniors get 50% off prices ranging $12-20/session
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Testimonies- Fit and Strong! Plus
 “Thank you for making me more healthy”
 “I can move my arms better now and eating much healthier”
 “I have had 2 knee replacements and bad asthma and after taking
the Fit and Strong Plus program I feel so much better!”
 “This program is great, this program is great, this program is great
and I can move my BODY! Thank you!”
 “Since taking the program, my doctor is amazed at results, I have
stopped taking so much medication and have been told I can avoid
my check up and extra tests for 3 months”
 “This program was a God sent and I now read labels before I buy
and eat. I suffered from Arthritis from head to toe and I can now
move freely”
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Benefits of Fit and Strong!
Program Partnership with CPD
 Highly qualified program for non active seniors
 Nutrition aspect well received
 Introduces Seniors to other programs to build sustainability
 Have worked with UIC to engage seniors to resume and continue
exercise program
 Seniors have great retention in programs.
 Win – win for both Partners- Save rental fees and gain new participants.
 Joint Fitness Trainings to staff
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Other Options for Fit and Strong!
Plus- Fitness Prescription Waiver
 Prescription for Exercise
 Offers free fitness
sessions (3 months) to
patrons with doctor’s
prescription to exercise
for obesity related
disease and BMI >25
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 New ideas learned from F/S program:




Senior Fitness and Nutrition Classes
Team Seniors with Teens and Youth
Combine non-fitness with fitness class for hook and catch!
Develop more Active Senior Clubs
For more information: www.chicagoparkdistrict.com/
wellness
COLLEEN.LAMMEL@CHICAGOPARKDISTRICT.COM
you for attending!
For more information: www.chicagoparkdistrict.com
COLLEEN.LAMMEL@CHICAGOPARKDISTRICT.COM
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Bundling Two Evidence-Based
Disease Prevention Programs
From the
Facilitator/Instructor’s
Perspective
Senior Services Associates, Inc.
Presented By: Claudia Aquilina, Activity Director
Bundling Matter of Balance and
Fit & Strong!
 SSA started MOB 2 ½ years ago. We have had 5 sessions
since 2011.
 SSA started F & S! 2012 and have had 4 sessions.
 Both being evidence based programs have been
beneficial to our organization.


Programs supported with information and training to
lead/facilitate classes.
Fidelity.
Bundling Matter of Balance and
Fit & Strong!
 MOB participants goal is to graduate to F & S!
 A percentage of F & S! participants continue exercising
with a lay F & S! instructor all year around.


We are able to do this at our center.
Must have the room to accommodate.
 Senior Services is very honored to be able to offer MOB
and see the participants that graduate into F & S!
 YES! Bundle Matter of Balance and Fit & Strong!
Matter of Balance
72% of participants had
fallen in the past 6 months
before starting
91% of participants have
not fallen since finishing
MOB
MOB
Matter of Balance
 “Informative and very well run program. MOB has
definitely helped my issues.”
 “Enjoyed the class. I want to do the class again.”
 “MOB helped me walking as well as thinking.”
 “Awareness helps for prevention of my falling or
tripping.” “Sorry this class is over.”
 “Appreciated being able to exchange suggestions
with class members. The tips on footwear were
great. Coaches were really great!”
Matter of Balance
 “Everybody should join the
class. Thank you very much.”
 “I have learned many more ways
for keeping the right balance to
avoid falling. It’s a great help.”
 “Very good exercises; very
informative.”
 “Keep up the good work.”
Fit & Strong!
 “Great program; wish it was
permanent.”
 “I found the program suited me
perfectly.”
 “Needs to keep going through
the year.”
 “I really enjoyed it and look
forward to doing it again.”
Fit & Strong!
 “My bone density was higher
than my last visit.”
 “My cholesterol went from 225
down to 190 since starting Fit &
Strong!.
 “Great program; wish it was
permanent.”
• “I found the program suited me perfectly.”
• “Needs to keep going through the year.”
• “I really enjoyed it and look forward to doing it again.”
Testimonials From Participants Who
Completed Multiple Programs
 “Multiple classes gave us several different exercises for our
legs. It kept mine from getting stiff.”
 “Since I’ve been going to these classes, my limbs are stronger.
It motivates you all the way around. I have been educating
other seniors about what I have learned.”
 “The information helped us learn more about our own
medical conditions, and we learned about how our peers
coped with the same conditions.”
 “By taking these classes, I feel strong. I am motivated to
sign up for whatever they offer because I enjoy exercising
and learning with the group!”
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THANK YOU!
Claudia Aquilina
Activity Director and Office Coordinator
Senior Services Associates, Inc.
110 W Woodstock Street
Crystal Lake, IL 60012
815-356-7457
caquilina@seniorservicesassoc.org
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The Future of Fit & Strong!
 Initiatives for system-level dissemination of Fit & Strong!
 Implementation of evidence-based programs just makes sense
(read: cents ¢)
 CMS prospective evaluation of Fit & Strong!
 Expand program REACH
 Hoping to develop partnerships with Managed Care
Plans- natural partnership given common goal of
keeping older adults functioning for as long as
possible in their homes and communities.
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