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Download the program summary.

Visit the Project Enhance website.

Developed by: University of Washington
Program Administrator: Susan Snyder, susans@seniorservices.org
Year Program First Implemented: 1997


EnhanceFitness (formerly Lifetime Fitness Program), is a low-cost, highly adaptable exercise program offering levels that are challenging enough for active older adults and levels that are safe enough for the unfit or near frail. One-hour group classes include stretching, flexibility, balance, low-impact aerobics, and strength-training.

Supporting Evidence:

One hundred older adults were recruited for a six-month randomized, controlled trial. All members of the experimental group received an exercise intervention, nutrition counseling, and a home safety assessment. Smoking and alcohol interventions were delivered to at-risk subjects. Outcome variables included the Medical Outcomes Study Short Form (SF-36) health survey, the CES-Depression scale, bed days, and restricted-activity days. The exercise program was well received: 85% of intervention subjects completed the 6-month program and adherence was excellent, with over 90% attendance at exercise classes. After 6 months the intervention group had significantly better scores on 7 of 8 SF-36 subscales and fewer depressive symptoms than controls.

A second study was conducted this was a retrospective, matched cohort study to determine if changes in healthcare costs for Medicare-eligible adults who choose to participate in a community-based exercise program are different from similar individuals who do not participate.  Exercise program participants included 1114 adults greater than or equal to 65, who were continuously enrolled in Group Health Cooperative of Puget Sound (GHC) between 10/1/1997 and 12/31/2000 and participated in EnhanceFitness (EF) at least once; three GHC enrollees who never attended EF were randomly selected as controls for each participant by matching on age and gender.  Cost and utilization estimates from GHC administrative data for the time from EF enrollment to 12/31/2000 were compared using multivariable regression models. The average increase in annual total healthcare costs was less in participants compared to controls (+$642 vs. +$1175; p = 0.05). After adjusting for differences in age, sex, enrollment date, co-morbidity index, and pre-exposure cost and utilization levels, total healthcare costs for participants were 94.1% (95% Confidence Interval (CI), 85.6%-103.5%) of control costs. However, for participants who attended the exercise program at an average rate of ≥1 visit weekly, total adjusted follow-up costs were 79.3% (95% CI, 71.3%-88.2%) of controls.


Wallace JL, Buchner DM, Grothaus L, Leveille S, Tyll L, LaCroix AZ, Wagner EH. Implementation and Effectiveness of a Community-Based Health Promotion Program for Older Adults. J Gerontol A Biol Sci Med Sci. (1998) 53A (4): M301-M306. [Online]: http://biomedgerontology.oxfordjournals.org/content/53A/4/M301.abstract.

Ackermann RT, et al. (2008). Healthcare cost differences with participation in a community-based group physical activity benefit for medicare managed care health plan members. The Journal of The American Geriatrics Society, 56:1459-1465, 2008. [Online]: http://www.ncbi.nlm.nih.gov/pubmed/18637982.


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