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Download the program summary.

Visit the Project Enhance website.

Developed by: University of Washington
Program Administrator: Susan Snyder
Year Program First Implemented: 1997


EnhanceWellness (formerly the Health Enhancement Program) is an individualized, motivational self-care intervention that encourages older adults to take on health challenges and maintain control of their lives. A team of two professionals, typically a nurse and social worker, work with the individual to develop a plan and help that individual achieve his/her goals.

Supporting Evidence:

Initial research utilized a randomized, controlled trial design to evaluate program outcomes. Each of 101 intervention participants met with a geriatric nurse practitioner from one to eight times (median = three) during the study year. The intervention group showed fewer declines in function, as measured by disability days and lower scores on the Health Assessment Questionnaire. Other measures of function, including the SF-36 and a battery of physical performance tests, did not change with the intervention. The number of hospitalized participants increased by 69% among the controls and decreased by 38% in the intervention group (P = .083). The total number of inpatient hospital days during the study year was significantly less in the intervention group compared with controls (total days = 33 vs. 116, P = .049). The intervention led to significantly higher levels of physical activity and senior center participation and significant reductions in the use of psychoactive medications.

Subsequent evaluation used a within-group, pretest-posttest design to determine effectiveness in a community-based setting, with 304 community-dwelling men and women aged 65 and older participating. The percentage of participants found to be depressed decreased (28% at time of enrollment vs. 17% at 1-year follow-up, P = .005). The percentage of physically inactive participants decreased (56% vs. 38%, P = .001). Physical activity level and exercise readiness improved (Physician-based Assessment and Counseling for Exercise mean score 4.3 vs. 5.1, P = .001). At follow-up, 83% rated their health the same as or better than a year ago, compared with 73% at time of enrollment. The proportion with impaired functional status, as measured by bed days and restricted activity days, stayed the same. The proportion hospitalized remained stable (23% at enrollment and follow-up, P = 1.0).


Leveille SG, Wagner EH, Davis C, Grothaus L, Wallace J, LoGerfo M, Kent D. Preventing disability and managing chronic illness in frail older adults: a randomized trial of a community-based partnership with primary care. J Am Geriatr Soc. (Oct 1998) 46 (10):1191-8. [Online]: http://www.ncbi.nlm.nih.gov/pubmed/9777899.

Phelan EA, Williams B, Leveille S, Synder S, Wagner EH, LoGerfo JP. Outcomes of a Community-Based Dissemination of the Health Enhancement Program. J Am Geriatr Soc. (Sept 2002) 50 (9): 1519–1524. [Online]: http://onlinelibrary.wiley.com/doi/10.1046/j.1532-5415.2002.50407.x/full.



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