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A Longitudinal Implementation Evaluation of a Physical Activity Program for Cancer Survivors: LIVESTRONG® at the Y [post]

2020 unpublished
Purpose: Increased physical activity (PA) levels in cancer survivors are associated with decreased risk of recurrence and mortality as well as additional positive health outcomes. PA interventions have shown to be efficacious, though many lack translation to and sustainability in community settings. We used dimensions of the RE-AIM framework to evaluate LIVE STRONG® at the YMCA, a nation-wide community-based PA program for cancer survivors delivered at Ys. Methods: LIVE STRONG at the Y national
more » ... G at the Y national data compiled by YMCA of the USA and Y Association Program Managers between the years of 2010-2018 was examined. We assessed reach (number of participants), adoption (Associations offering the program), implementation (conducting 3 fidelity checks), setting-level maintenance (Associations recently offering program) and participant-level maintenance (membership conversion rate). We also examined relationships between organizational characteristics (years of program existence and Association area household income), and program implementation factors with member conversion. Results: As of 2018, LIVE STRONG at the Y has reached 62,044 survivors and 245 of the 840 (29.2%) of Y Associations have adopted the program. Among the adopters, 91% were aware of fidelity checks; implementation of Observational (62.3%), Goal-setting (49.9%), and Functional (64.6%) checklists varied. Most (95.1%) adopters reported offering ≥1 LIVE STRONG session per year (setting-level maintenance) and a facility-level mean membership conversion percentage of 46.9±31.2% (participant-level maintenance). Fewer years implementing the program and higher Association area household income were significantly associated with a greater membership conversion rate vs their comparison (all t-test p's <0.05). In a multiple regression model controlling for organizational characteristics, conducting the fidelity checks (Observational, β=8.41; β=9.70; and Functional, β=9.61; all p's <0.01) was positively associated with higher membership conversion rates. Conclusions: LIVE STRONG at the Y, in its early years, has shown promise for high reach, while adoption at more Associations could be facilitated. Implementing fidelity checks along with organizational characteristics were associated with higher participant-level maintenance. Identification of Association-level strategies to increase reach, adoption,
doi:10.21203/rs.2.21636/v1 fatcat:l7uj32ruz5hqnonvra2kh3czxi