Implementation and Dissemination of Evidence-based Programs for the Prevention and Management of Chronic Conditions in Older Adults: Theoretical Perspectives and Case Examples from the United States

Abstract

More than 50 million Americans are currently 65 and older, with current projections estimating that there will be nearly 100 million by 2060. While there is great variability among the older population, many older adults will be disproportionately affected by negative health and well-being consequences associated with chronic diseases, increased fall risk, and physical inactivity. The implementation and dissemination of evidence-based programs can play a major role in the prevention and management of these conditions, thus improving quality of life for the growing number of older adults worldwide. These goals are consistent with the World Health Organization Declaration of the Decade of Healthy Ageing. Research and practice around evidence-based programs for chronic illness management and related conditions in older adults have spearheaded many new opportunities to promote healthy aging as well as revealing challenges in getting effective programs and policies implemented and widely disseminated. For example, most evidence-based programs are not readily scalable or sustainable. Reasons for this may include delay in implementing programs as a result of contextual barriers or the lack of infrastructure for dissemination. These challenges emphasize the need for strategies to ensure the successful implementation and dissemination of evidence-based programs for older adults. Dissemination and implementation science (DIS) provides a broad framework to design interventions and identify implementation strategies that work in diverse real-world clinical and community settings to meet the need of diverse populations. Advancements in research and practice require a basic understanding of (a) principles of DIS; (b) relevant theories, frameworks, and conceptual models; (c) awareness of national and international case examples of chronic disease, falls, and physical activity initiatives for better management of health and functioning in older adults; and (d) shared lessons from research and practice. This lens helps underscore the importance of the evidence-based program movement to the aging services network.