Maintenance of Change in the Active-for-Life Initiative Sara Wilcox, PhD, Marsha Dowda, DrPH, Stacy Wegley, MS, Marcia G. Ory, PhD Background: There is a notable gap in translating efficacious interventions to community-based organizations. Further, physical activity interventions have been less successful in promot- ing longer-term maintenance. Purpose: This study examined 6-month maintenance of improvements seen in Active for Life (AFL), a translational research initiative. Methods: Participants from seven of 12 AFL sites enrolled in Years 3 and 4 were surveyed 6 months after completing the 6-month telephone-based Active Choices program (AC, one site) or the 20-week or 12-week group-based Active Living Every Day program (ALED, six sites). Repeated measures analyses controlled for site clustering and covariates. Programs were implemented from 2003 to 2007 and analysis was conducted in 2009. Results: For the AC (n=368) and ALED (n=2151) programs, respectively, participants were aged 72.0 and 70.8 years on average, were 70% and 78% non-Hispanic white, and were 72% and 83% women; 46% and 50% returned 6-month follow-up surveys. For AC, improvements from pre- to post-test were maintained at follow-up for physical activity; satisfaction with body function (SBF); and BMI. For ALED Year 3, there was a decrease at follow-up for physical activity and SBF. Body mass index decreased from pretest to follow-up. For ALED Year 4, increases in physical activity and reductions in BMI were maintained at follow-up. Satisfaction with body function increased from pretest to 12 weeks post-test, declined at 20 weeks, and was maintained at follow-up. Conclusions: Improvements were generally maintained at the 6-month follow-up. When behavioral decay occurred, follow-up values remained more favorable than at pretest. Given the broad reach of this translational initiative, the results suggest the viability of evidence-based programming as an effective public health practice. (Am J Prev Med 2009;37(6):501–504) © 2009 Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine. Introduction A lthough substantial progress has been made in testing behaviorally based interventions to pro- mote physical activity, two major issues plague the field. First, the public health impact of most empirically validated interventions is never known because efficacious interventions are rarely adapted for widespread transla- tion to community-based organizations. 1,2 Second, inter- ventions have been less successful in promoting longer- term maintenance of behavior change. 3–5 Interventions that are integrated into community-based programs could promote maintenance of physical activity behavior change because they are accessible to large numbers of community residents. Active for Life (AFL) was a translational research initiative that successfully increased moderate-intensity physical activity in midlife and older adults. 6,7 This study examined whether these improvements were main- tained 6 months post-intervention. It was hypothesized that intervention effects would be greatest from pretest to immediate post-test but would be maintained, de- spite some decay, at follow-up. Methods Program and Sites The AFL methodology, outcomes, and participating organi- zations are presented in detail elsewhere. 6,7 In AFL, Active Choices (AC) was a 6-month physical activity program deliv- ered through one face-to-face meeting and up to eight brief telephone counseling calls. 8 –10 Active Living Every Day (ALED) was a 20-week physical activity program delivered From University of South Carolina (Wilcox, Dowda), Columbia, South Carolina; Hamilton County Public Health (Wegley), Cincin- nati, Ohio; and Texas A&M Health Science Center (Ory), College Station, Texas Address correspondence and reprint requests to: Sara Wilcox, PhD, University of South Carolina, Department of Exercise Science, Arnold School of Public Health, 921 Assembly Street, PHRC 2nd Floor, Columbia SC 29208. E-mail: swilcox@sc.edu. 501 Am J Prev Med 2009;37(6) 0749-3797/09/$–see front matter © 2009 Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine doi:10.1016/j.amepre.2009.07.016