In the past three decades, we have learned much about how to prevent and control chronic diseases including cancer and depression; yet stark disparities remain, particularly among low-income adults and adults of color. The Health Promotion Research Center (HPRC) at the University of Washington seeks to eliminate these disparities. Our work focuses on cancer prevention and control, mental health and physical activity of older adults, and workplace health promotion. HPRC's three evidence-based programs are collectively implemented in more than 45 states, in partnership with strategic translation partners who reach and serve populations experiencing health disparities. The three programs are EnhanceFitness, a group-based physical activity program for older adults that has been implemented in 46 states and reached more than 80,000 older adults; Workplace Solutions, a suite of workplace health promotion programs that has been delivered to employers in more than 40 states and reached more than 8,000,000 employees and dependents; and the Program to Encourage Active and Rewarding Lives (PEARLS), a depression management program for older adults and the focus of our Core Research Project, which has reached more than 6,200 older adults in 25 states. In this proposal, we address six interrelated specific aims, three for our Center and three for our Core Research Project. Our Center aims include reducing health disparities through translation of HPRC's evidence-based programs into practice in new settings reaching underserved populations; building local, state, and national capacity in applied prevention research; and conducting a community-engaged Core Research Project aimed at large-scale implementation of PEARLS in two states. The proposed Center aims will improve health equity among middle-aged and older adults through translating HPRC's programs with partners and settings that reach populations experiencing health disparities. Our Core Research Project aims are to develop a community-engaged PEARLS translation strategy that meets the needs of organizations that that serve older adults experiencing disparities related to race/ethnicity, socioeconomic status, rural area of residence, and lack of access to depression care; test the translation strategy in a stepped-wedge, cluster-randomized controlled trial in two states; and collaborate with CDC and the PRC Network to disseminate and translate our findings. If successful, our approaches have the potential to improve health equity for middle-aged and older adults experiencing health disparities, and to generate replicable implementation and translation strategies that public health practitioners and researchers can apply to other evidence-based programs.
HPRC's focus areas ? cancer prevention and control, mental health and physical activity of older adults, and workplace health promotion ? address many of the biggest health problems among middle-aged and older adults. Our community-engaged research is aimed at expanding HPRC's evidence-based healthy aging programs with partners and in settings that reach populations experiencing health disparities. Our proposed core research project will focus on substantially expanding the reach of PEARLS via new partnerships with community-based organizations that serve older adults experiencing disparities related to race/ethnicity, low income, limited mobility, and lack of access to treatment for their depression.
