The National Cooperative Extension System offers walking programs, but impacts are underreported. One program offered in two state systems is FitEx, an 8-week, group-based behavior change intervention. The purpose of this work was to evaluate FitEx through the RE-AIM (reach, effect, adoption, implementation, maintenance) Framework, with a primary focus on reach and effectiveness (individual-level dimensions). Through a pragmatic, natural experiment, the impact of FitEx was assessed from 2015 to 2020. Reach was operationalized as the number and characteristics of eligible community members who participated. Effectiveness was operationalized as changes in physical activity levels. From 2015 to 2020, there were 1995 FitEx participants (274 ± 233 participants per year) who were 45.22 ± 14.13 years of age, predominantly female (83%) and White (78%). At the start of the program, 33% met physical activity guidelines and during the program 58% met guidelines (X2(1, 1648) = 1.6; P < .0). The reach and effectiveness of FitEx are comparable to-and in some cases, greater than-similar community-based walking programs. FitEx consistently reached middle-aged insufficiently active adults. Future work is needed to reach a more diverse population, establish objectively measured impacts, and establish a process to scale FitEx across the nation.
Keywords: Cooperative Extension System; RE-AIM; health promotion; physical activity; walking.
The National Cooperative Extension System offers walking programs, but impacts are not always reported. One program offered in two state systems is FitEx, an 8-week, group-based program to help people change their physical activity practice. The goal of this work was to evaluate FitEx through the RE-AIM (reach, effect, adoption, implementation, maintenance) Framework, with a focus on who is reached and if the program is effective. Through a real-world study, the impact of FitEx was assessed from 2015 to 2020. Reach outcomes were the number and traits of people who joined FitEx. Effectiveness outcomes were changes in participants’ physical activity levels. From 2015 to 2020, 1995 people took part in FitEx (an average of 274 per year). They were on average 45.22 years of age, mostly female (83%), mostly non-Hispanic White (78%). At the start of FitEx, 33% met physical activity guidelines. During the program, 58% met guidelines. The reach and effectiveness of FitEx are equal or better than other community-based walking programs. Over the years, FitEx enrolled middle-aged, less active adults. Future work is needed to reach a more diverse population, start measuring physical activity through objective tools, and begin a process of scaling FitEx across the nation.
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