Innovation: Enhance Fitness
USA
AAI Domain: Independent, healthy and secure living (promoting physical activity)
Enhance Fitness is a physical activity programme aimed at older people that was first piloted in the state of Washington in 1993 and now operates in over 500 locations involving more than 40,000 older people in nearly every state across the USA. It was developed by Senior Services, a state-wide non-profit agency that promotes positive ageing through senior centres and intervention programmes, and the University of Washington’s Health Promotion Research Centre who have been the primary research evaluators of the initiative.
Enhanced Fitness classes typically run for one hours three times a week in a variety of settings including senior centres, assisted living facilities, hospitals and continuing care retirement communities. They are guided by a certified instructor in organisations that have signed up and paid for a licence to operate the programme, receive training as well as benefit from guidance and support to successfully operate classes in a variety of settings. The sessions typically cater for groups of around 25 older people and involve appropriate aerobic exercise to increase cardio-vascular health, strength, balance and flexibility training that is delivered in a fun and positive fashion by instructors of all ages.
Research evaluations have shown improvements in social functions through participating in group activities with 99% of participants reporting that they would recommend Enhance Fitness to a friend, marked reductions in reported levels of depression and improvements in physical functioning. There is also evidence from the Centres for Medicare and Medicaid Services (CMS) to suggest that Enhance Fitness reduces the number of falls among older people who participate in the programme leading to reduced levels of unplanned hospitalisation and consequently to lower health care costs.
Studies have shown a 72% decrease in hospital days, a 35% decrease in the use of psychoactive drugs, an 11% decrease in depressive symptoms and a lower mortality rate (1.4%) among participants compared to controls (2.9%). It has been operating for more than twenty years and a strong evidence base has been developed to demonstrate the efficacy of the intervention in terms of improved health and well-being alongside reduced health care use and costs.
Enhance Fitness is a socially innovative programme that primarily relates to the increasing levels of physical activity domain of the Active Ageing Index. However, there is also an important social dimension to the programme that is likely to contribute to social connectedness among participants while increasing levels of physical activity is also highly likely to contribute to increasing healthy life expectancy.