Implementation of Enhance®Fitness: a scoping review using the RE-AIM framework.

Background and Objectives Enhance®Fitness (EF) is an evidence-based group exercise program shown to promote physical and mental health among older adults. The scoping review aims to systematically map and synthesize the literature on EF using the RE-AIM framework (Reach, Effectiveness, Adoption, Imp...

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Published in:Gerontologist Vol. 66; no. 7; pp. 1 - 13
Main Authors: Peng, Wenting, McKiddy, Sarah, Tomioka, Michiyo, Maruca, Dina L, Gell, Nancy M, Smith, Matthew L, Maloy, Caitlin, Belza, Basia
Format: Article
Published: Oxford University Press / USA Jul2026
Subjects:
Online Access:View this record in EBSCOhost
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        atl: Implementation of Enhance®Fitness: a scoping review using the RE-AIM framework.
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          Peng, Wenting
          McKiddy, Sarah
          Tomioka, Michiyo
          Maruca, Dina L
          Gell, Nancy M
          Smith, Matthew L
          Maloy, Caitlin
          Belza, Basia
        affil:
          School of Nursing, University of Washington, Seattle, Washington, United States
          Center on the Family, University of Hawaii, Honolulu, Hawaii, United States
          Department of Orthopaedics and Division of Physical Therapy, West Virginia University, Morgantown, West Virginia, United States
          Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, United States
          Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, Indiana, United StatesCenter for Health by Design, School of Public Health, Indiana University, Bloomington, Indiana, United States
          Health Sciences Library, University of Washington, Seattle, Washington, United States
      su:
        Competency assessment (Law)
        Elder care
        Corporate culture
        Exercise
        Evaluation of human services programs
        Physical fitness
        Technology
        Health promotion
        Social support
        Social participation
        Old age
        Medical information storage & retrieval systems
        Medical care use
        Research funding
        Independent living
        CINAHL database
        Systematic reviews
        MEDLINE
        Conceptual structures
        Medical databases
        Online information services
        Medical needs assessment
        Psychology information storage & retrieval systems
        Physical activity
      sug:
        subj:
          Competency assessment (Law)
          Elder care
          Corporate culture
          Exercise
          Evaluation of human services programs
          Physical fitness
          Technology
          Health promotion
          Social support
          Social participation
          Old age
          Continuing Care Retirement Communities
          Fitness and Recreational Sports Centers
          Offices of Mental Health Practitioners (except Physicians)
          Other Individual and Family Services
          Medical information storage & retrieval systems
          Medical care use
          Research funding
          Independent living
          CINAHL database
          Systematic reviews
          MEDLINE
          Conceptual structures
          Medical databases
          Online information services
          Medical needs assessment
          Psychology information storage & retrieval systems
          Physical activity
      keyword:
        aged
        community
        copyrightHolder:The Gerontological Society of America
        copyrightYear:2026
        embase
        equity
        evidence-based practice
        Evidence-based programs
        exercise
        follow-up
        health care use
        health outcomes
        healthy aging
        https://dx.doi.org/10.1093/geront/gnag102
        implementation science
        inLanguage:en
        mental health
        Older adults
        publisher:Oxford University Press
        RE-AIM
        sameAs:https://pubmed.ncbi.nlm.nih.gov/42108557/
        social engagement
        aged
        community
        copyrightHolder:The Gerontological Society of America
        copyrightYear:2026
        embase
        equity
        evidence-based practice
        Evidence-based programs
        exercise
        follow-up
        health care use
        health outcomes
        healthy aging
        https://dx.doi.org/10.1093/geront/gnag102
        implementation science
        inLanguage:en
        mental health
        Older adults
        publisher:Oxford University Press
        RE-AIM
        sameAs:https://pubmed.ncbi.nlm.nih.gov/42108557/
        social engagement
      ab: Background and Objectives Enhance®Fitness (EF) is an evidence-based group exercise program shown to promote physical and mental health among older adults. The scoping review aims to systematically map and synthesize the literature on EF using the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance). Research Design and Methods We conducted a scoping review of implementation studies focusing on EF or its predecessor, the Lifetime Fitness Program. Searches were conducted in 6 databases (PubMed, Embase, CINAHL, SCOPUS, Web of Science, and PsycINFO) and supplemented with EF-related publications listed on the program's official website. The search included all publications from January 1, 1980 through July 1, 2025. Results We included 33 publications. Reach showed EF primarily engaged community-dwelling older adults, typically female. Effectiveness outcomes were generally positive, including improved physical and mental health and reduced health care utilization. Adoption occurred across varied settings, supported by trained instructors and organizational alignment. Implementation typically followed the standard EF protocol of three 60-min sessions per week, delivered in person or remotely. Facilitators included instructor training, organizational support, and social engagement, while barriers included attendance challenges, resource needs, and technology issues. Maintenance was demonstrated through sustained program delivery across diverse community settings, and participant-level maintenance was reflected in follow-up assessments of health outcomes at common time points of 4, 6, or 12 months. Discussion and Implications EF is a widely adopted program with demonstrated benefits for older adults. Greater attention to equity and long-term sustainability is needed to strengthen future dissemination and support healthy aging.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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