About Project Enhance

Developed by the University of Washington in partnership with Sound Generations in Seattle, WA (formerly known as Senior Services) and Group Health Cooperative (now Kaiser Permanente) in the mid-1990’s, Project Enhance provides research coordination, licensing, training, and support for two health promotion programs designed especially for older adults and people aging with disability:

Enhance®Fitness (EF) is a low-cost, adaptable exercise program offering levels that are challenging for active older adults and levels that are safe for older adults who are less fit and/or frail.

Enhance®Wellness (EW) is a motivational behavior change intervention specifically targeted to those with chronic conditions. EW encourages older adults to take on health challenges through a participant-centered approach.

Both programs have been implemented successfully and sustainably with diverse populations in facilities around the country, including senior centers, YMCAs, churches, parks and recreation sites, affordable housing and retirement communities. Most importantly, they result in measurable improvements in health outcomes for participants.

Innovation

We value our strong relationships with the researchers, health care providers, delivery organizations and funders that support Project Enhance in various settings and populations. We are equally committed to quality assurance and innovation.

Project Enhance’s innovation includes:

  • Development of quality assurance and program monitoring tools and activities
  • Development of robust data collection and reporting systems
  • Founding member of Evidence-Based Leadership Collaborative to leverage multiple evidence-based programs to measurably improve health outcomes for diverse adult populations
  • Promotion of EnhanceFitness as a benefit for Medicare-Advantage eligible members of payor organizations
  • National Partnership with YMCA of the USA
  • Ongoing research to test program adaptation efficacy in diverse environments
  • Development of data collection and reporting systems for EnhanceFitness (EF ODES) and EnhanceWellness (WellWare) as well as for two additional evidence-based programs, A Matter of Balance falls prevention program and the PEARLS depression management program

Expansion

Throughout Project Enhance’s history, crucial support from several directions has spurred and sustained its growth. National policymakers and funders have embraced the program, prompting significant uptake far beyond the program’s home region of western Washington. Both programs are eligible for use of Title III funds for evidence-based health promotion programs. In addition, these agencies have helped to fund our development of a comprehensive online data management platform that gives Project Enhance the ability to monitor program reach and fidelity, while the user-facing application allows program licensees to produce relevant reports both for their funders and their participants, and to monitor the success of their own implementation efforts.

Program participants themselves, not to mention their physicians, bolstered by subjective and objectively demonstrable changes in health and fitness, have been important champions for driving demand for program expansion at the community level.

Before COVID-19, each year over 25,000 older adults with multiple chronic conditions were participating in in-person EnhanceFitness classes and meeting with EnhanceWellness Coaches in their communities. Since March 2020, with the adoption of physical distancing and shelter-at-home guidelines, Project Enhance and other evidence-based program (EBP) administrators, community-based organizations, health care, and policymakers have come together to adapt EBPs to be delivered remotely. These behavior-change EBPs are well-suited for living in a pandemic as they teach important skills for creating a new normal. This essential program delivery model provides a continuum of care and connection for older adults in vulnerable communities through the existing network of safety-net providers.

EnhanceFitness can currently be found in 44 states and the District of Columbia and EnhanceWellness in 10 states. Together, they have reached over 114,000 unique participants and continue to grow.

Evaluation

Project Enhance programs are continually evaluated for effectiveness and reach.

There have been several formal evaluations of EnhanceFitness conducted by the University of Washington Health Promotion Research Center, a CDC-funded prevention research center. In 2007, the CDC designated EnhanceFitness as an Arthritis Appropriate Evidence-Based Intervention (AAEBI). In 2017, the Administration for Community Living (ACL) designated EnhanceFitness as an evidence-based Falls Prevention program, in addition to Physical Activity and Chronic Disease Self-Management Support program.

As an ongoing program that aims to become a long-term part of its participants’ lives, the sustainability of EnhanceFitness is an essential feature. Project Enhance participates in research and evaluation to ensure that the program’s content and its delivery support materials are continuously maintained and updated. EnhanceFitness is always seeking to expand its existing partnerships with MedicareAdvantage plans and supplemental insurance payors to create reimbursement opportunities for EF delivery sites.

EnhanceWellness is federally designated as a Chronic Disease Self-Management program and listed as a legacy program in in The Substance Abuse and Mental Health Services Administration (SAMHSA) National Registry of Evidence-based Programs and Practices (NREPP), a searchable online registry of interventions supporting mental health promotion, substance abuse prevention, and mental health and substance abuse treatment. EnhanceWellness is also on the US HHS Agency for Healthcare and Research Quality Health Care Innovations Exchange as an innovation that improves health quality and reduces health disparities. In 2021, the CDC and Osteoarthritis Action Alliance designated EnhanceWellness as an Arthritis Appropriate Evidence-Based Intervention (AAEBI).

As relevant new research emerges, appropriate revisions are made to program protocols. Review the citations of published studies and articles.

Recognition

Project Enhance is proud of the awards our programs and our affiliates have received from organizations across the U.S.: