Factors Affecting Implementation and Sustainability of the Walk with Ease Program for Adults with Arthritis in Community Organizations Receiving Short-Term Grants
Creators: name: Vilen, Leigha
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2018

description: Background. The Arthritis Foundation’s evidence-based Walk with Ease (WWE) program improves symptoms, function, and psychosocial measures among adults with arthritis, and is feasible for widespread adoption and implementation in community organizations. This study examines barriers and facilitators to WWE implementation and sustainability among a subset of organizations receiving year-long grants to implement WWE. The research aims were: 1) identify factors affecting the implementation and plans for sustainability of WWE, 2) identify major barriers to implementation and sustainability, and solutions that grantees have employed to overcome these barriers, and 3) determine what minimum resources would improve grantees’ likelihood to sustain the program post-grant.Methods. Five grantees that had begun yearlong WWE grants in April 2017 were selected for interviews: three Early Success Cases (ESCs) (>30% of goal participants reached by 6-mo. progress report) and two Early Delay Cases (EDCs) (no participants reached by 6-mo. progress report). One interviewer conducted semi-structured interviews with program managers from these grantees. The interviewer then transcribed and coded for themes using an integrated approach based on the Planning for Sustainability Framework and the Consolidated Framework for Implementation Research. Grantees’ responses were grouped by reported likelihood to sustain the program (“definitely will” vs. “hope to”) and by ESC/EDC status to identify differences in barriers and facilitators between these groups.Results. Three grantees indicated they “hoped to sustain” the WWE program after funding ends, while two grantees indicated they “definitely will”. The strength of WWE’s evidence-base, it’s potential to supplement other programs, and strong, developed community partnerships facilitated implementation and confidence for sustainability. Rigid program design (3x/week instructor-led), difficulties recruiting and retaining volunteer leaders, and organizational upheaval impeded implementation; organizational upheaval especially was a a major reason for early delays experienced by EDCs. While all grantees experienced barriers to WWE implementation, most barriers that ESCs experienced had concrete solutions while some barriers experienced only by EDCs, like organizational upheaval and competing staff priorities, did not. Organizations reported a variety of resources that would improve likelihood of sustainability. Notably, many of these resources were non-financial and could be provided by an outside advocacy organization or through community partnerships.Implications. WWE is effective and relatively easy to implement in community organizations. Reducing the rigidity of WWE’s program design, improving its ability to supplement other programs for participants with diseases other than arthritis, and promoting development of sustainable community partnerships during a grant period can promote the program’s successful implementation and sustainability in communities.