Effectiveness and Implementation of an Enhance®Fitness Physical Activity Intervention Specifically in Adults with Arthritis: A RE-AIM Evaluation

This study evaluated the effectiveness of the evidence-based, Enhance®Fitness (EF) physical activity (PA) intervention in improving arthritis symptoms, physical and mental function, and PA in adults with arthritis.This was a community-based, randomized, controlled effectiveness trial that switched to a non-randomized controlled trial. Participants were sedentary/low-active adults, aged ≥ 18 years, with self-reported physician-diagnosed arthritis, who were assigned to an immediate (IG) or delayed group (DG) (12-week, wait-list control group). Classes were held thrice weekly for 12 weeks at 17 community sites in four urban and five rural West Virginia counties. Data were collected at baseline, 12 weeks, and 24 weeks. The RE-AIM Framework evaluated EF's: 1) reach (enrollment); 2) effectiveness (outcomes); 3) adoption (proportion of sites/instructors that delivered EF); 4) implementation (attendance, fidelity, adverse events, satisfaction); and 5) maintenance (EF continuation). Outcomes were analyzed using linear mixed-effects regression.There were 323 adults with a mean age of 68.3 years (range 27-95). Reach was 74%; site and instructor adoption rates were 100% and 55%, respectively; attendance (1.8 sessions per week) and fidelity were good; injury rate was low (3.8%); participants were highly satisfied and experienced improvements in arthritis symptoms and physical function; and 27% of instructors and 18% of sites continued EF.Enhance®Fitness was safe and effective in improving arthritis symptoms and physical function in sedentary/low-active adults with arthritis, across the adult age spectrum, under real-world conditions, in both urban and rural communities.