Published Studies

Schrodt, L., Sledge, R., Hergott, C., Rohrer, B., Sidelinker, J., Brach, J., Vincenzo, J., Shirley, K., Shubert, T. (2021). Clinical-Community Connections: Incorporating Evidence-Based Programs for Improved Patient Outcomes. Topics in Geriatric Rehabilitation • Volume 37, Number 3, 163-167,

Moser Mays, A., Kim, S., Rosales, K., Au, T., Rosen,S. (2020). The Leveraging Exercise to Age in Place (LEAP) Study: Engaging Older Adults in Community-Based Exercise Classes to Impact Loneliness and Social Isolation, The American Journal of Geriatric Psychiatry, 2020, ISSN 1064-7481,

Liu, M., Zhang, X., Xiao, J., Ge, F., Tang, S., & Belza, B. (2020). Community readiness assessment for disseminating evidence-based physical activity programs to older adults in Changsha, China: a case for Enhance(R)Fitness. Glob Health Promot, 27(1), 59-67. doi:10.1177/1757975918785144

Petrescu-Prahova, M., Kohn, M., Leroux, B., Steinman, L., Fishleder, S., Pike, M., Kava, C. M., Belza, B., Schrodt, L., Hannon, P. A., & Harris, J. R. (2019). Building community-clinical linkages to increase older adult physical activity: The PT-REFER trial protocol and participant baseline characteristics. Contemp Clin Trials Commun, 15, 100373. doi:10.1016/j.conctc.2019.100373

Kava, C. M., Fishleder, S., Steinman, L., Petrescu-Prahova, M., Schrodt, L., & Harris, J. R. (2019). Provider-Patient Communication and Involvement in Physical Activity Programs Among Patients Receiving Physical Therapy Services: A Qualitative Study. J Appl Gerontol, 733464819847402. doi:10.1177/0733464819847402

Fishleder, S., Petrescu-Prahova, M., Harris, J. R., Steinman, L., Kohn, M., Bennett, K., & Helfrich, C. D. (2018). Bridging the Gap After Physical Therapy: Clinical-Community Linkages With Older Adult Physical Activity Programs. Innov Aging, 2(1), igy006. doi:10.1093/geroni/igy006

Fishleder, S., Petrescu-Prahova, M., Harris, J. R., Leroux, B., Bennett, K., Helfrich, C. D., Kohn, M., & Hannon, P. (2018). Predictors of Improvement in Physical Function in Older Adults in an Evidence-Based Physical Activity Program (EnhanceFitness). J Geriatr Phys Ther. doi:10.1519/JPT.0000000000000202

Petrescu-Prahova, M. G., Eagen, T. J., Fishleder, S. L., & Belza, B. (2017). Enhance(R)Fitness Dissemination and Implementation: 2010-2015: A Scoping Review. Am J Prev Med, 52(3S3), S295-S299. doi:10.1016/j.amepre.2016.08.015

Miyawaki, C. E., Belza, B., Kohn, M. J., & Petrescu-Prahova, M. (2016). Champions of an Older Adult Exercise Program: Believers, Promoters, and Recruiters. J Appl Gerontol. doi:10.1177/0733464816645921

Smith, M. L., Belza, B., Braun, K. L., King, S., Palmer, R. C., Sugihara, N. S., Altpeter, M., Snyder, S., & Ory, M. G. (2015 (in press)). National reach and dissemination of EnhanceFitness. Health Behavior and Policy Review.

Petrescu-Prahova, M., Belza, B., Kohn, M., & Miyawaki, C. (2015). Implementation and Maintenance of a Community-Based Older Adult Physical Activity Program. Gerontologist. doi:10.1093/geront/gnv024

Liu, M., Belza, B., & Zhang, X. (2015). Considerations When Disseminating American-Developed, Evidence-Based Health Promotion Programs in China. J Gerontol Nurs, 41(6), 3-4. doi:10.3928/00989134-20150511-01

Kohn, M. J., Belza, B., Petrescu-Prahova, M., Miyawaki, C. E., & Hohman, K. H. (2015). Participant Variation by Delivery Site Type in an Evidence-Based Physical Activity Program. J Aging Phys Act, 23(3), 401-408. doi:10.1123/japa.2013-0252

Kohn, M., Belza, B., Petrescu-Prahova, M., & Miyawaki, C. E. (2015). Beyond Strength: Participant Perspectives on the Benefits of an Older Adult Exercise Program. Health Education & Behavior, 43(3), 305-312. doi:10.1177/1090198115599985

Greenwood-Hickman, M. A., Rosenberg, D. E., Phelan, E. A., & Fitzpatrick, A. L. (2015). Participation in Older Adult Physical Activity Programs and Risk for Falls Requiring Medical Care, Washington State, 2005-2011. Prev Chronic Dis, 12, E90. doi:10.5888/pcd12.140574

Gillette, D. B., Petrescu-Prahova, M. G., Herting, J. R., & Belza, B. L. (2015). A Pilot Study of Determinants of Ongoing Participation in EnhanceFitness: A Community-Based Group Exercise Program for Older Adults. J Geriatr Phys Ther. doi:10.1519/JPT.0000000000000041

Agmon, M., Kelly, V. E., Logsdon, R. G., Nguyen, H., & Belza, B. (2015). The Effects of EnhanceFitness (EF) Training on Dual-Task Walking in Older Adults. J Appl Gerontol, 34(3), NP128-142. doi:10.1177/0733464812465921

Snyder, S. J., Thompson, M., & Denison, P. (2014). EnhanceFitness: A 20-Year Dissemination History. Front Public Health, 2, 270. doi:10.3389/fpubh.2014.00270

Snyder, S. J., Thompson, M., & Denison, P. (2014). EnhanceFitness: A 20-Year Dissemination History. Front Public Health, 2, 270. doi:10.3389/fpubh.2014.00270

Rosenberg, D. E., Grothaus, L., & Arterburn, D. (2014). Characteristics of older adult physical activity program users. Am J Manag Care, 20(7), e245-249.

Page, T. F., Batra, A., Ghouse, M. M., & Palmer, R. C. (2014). Implementation cost analysis of a community-based exercise program for seniors in South Florida. Health Promot Pract, 15(4), 585-591. doi:10.1177/1524839913518221

Kohn, M. J., Belza, B., Petrescu-Prahova, M., Miyawaki, C. E., & Hohman, K. H. (2014). Participant Variation by Delivery Site Type in an Evidence-Based Physical Activity Program. J Aging Phys Act. doi:10.1123/japa.2013-0252

Biedenweg, K., Meischke, H., Bohl, A., Hammerback, K., Williams, B., Poe, P., & Phelan, E. A. (2014). Understanding older adults’ motivators and barriers to participating in organized programs supporting exercise behaviors. J Prim Prev, 35(1), 1-11. doi:10.1007/s10935-013-0331-2

Belza, B., Petrescu-Prahova, M., Kohn, M., Miyawaki, C. E., Farren, L., Kline, G., & Heston, A. H. (2014). Adoption of Evidence-Based Health Promotion Programs: Perspectives of Early Adopters of Enhance((R))Fitness in YMCA-Affiliated Sites. Front Public Health, 2, 164. doi:10.3389/fpubh.2014.00164

Tomioka, M., & Braun, K. L. (2013). Implementing evidence-based programs: a four-step protocol for assuring replication with fidelity. Health Promot Pract, 14(6), 850-858. doi:10.1177/1524839912469205

Snyder, S., & Denison, P. (2013). Building Strong Communities through Evidence-Based Health Improvement Programs. Generations: Journal of the American Society on Aging, 37(4), 77-78.

Tomioka, M., Sugihara, N., & Braun, K. L. (2012). Replicating the EnhanceFitness physical activity program in Hawai`i’s multicultural population, 2007-2010. Prev Chronic Dis, 9, E74.

Sugihara, N., Watanabe, M., Tomioka, M., Braun, K. L., & Pang, L. (2011). Cost-benefit estimates of an elderly exercise program on Kaua’i. Hawaii Med J, 70(6), 116-120.

Smith, M., Lorino, A., Wilson, A., Pollet, C., & Ory, M. (2011). Reaching At-Risk Populations to Improve Clinical Measures of Physical Activity: Delivery of EnhanceFitness to Low-Income African American Adults in Houston, Texas. Texas Public Health Journal, 63(1), 50-53.

Belza, B., Snyder, S., Thompson, M., & LoGerfo, J. (2010). From Research to Practice: EnhanceFitness, an Innovative Community-Based Senior Exercise Program. Topics in Geriatric Medicine, 26(4), 299-309.

Sin, M. K., Choe, M. A., Kim, J., Chae, Y. R., Jeon, M. Y., & Vezeau, T. (2009). Comparison of body composition, handgrip strength, functional capacity, and physical activity in elderly Koreans and Korean immigrants. Res Gerontol Nurs, 2(1), 20-29. doi:10.3928/19404921-20090101-11

Moore-Harrison, T. L., Johnson, M. A., Quinn, M. E., & Cress, M. E. (2009). An evidence-based exercise program implemented in congregate-meal sites. J Phys Act Health, 6(2), 247-251.

Nguyen, H. Q., Maciejewski, M. L., Gao, S., Lin, E., Williams, B., & Logerfo, J. P. (2008). Health care use and costs associated with use a health club membership benefit in older adults with diabetes. Diabetes Care

Nguyen, H. Q., Ackermann, R., Maciejewski, M., Berke, E., Patrick, M., Williams, B., & LoGerfo, J. (2008). Managed-Medicare Health Club Benefit and Reduced Health Care Costs Among Older Adults. Prev Chronic Dis, 5(1). Retrieved from

Frank, J., Coviak, C., Healy, T., Belza, B., & Casado, B. (2008). Addressing fidelity in evidence-based health promotion programs for older adults. Journal of Applied Gerontology, 27(4), 4-34.

Fitts, S., Won, C. W., Williams, B., Snyder, S., Yukawa, M., Legner, V., LoGerfo, J., & Phelan, E. (2008). What is the Optimal Duration of Participation in a Community-Based Health Promotion Program for Older Adults? J Appl Gerontol, 27(2), 201-214.

Chiang, K., Semen, L., Belza, B., & Tsai, J. (2008). “It’s our exercise family”: ethnic older adults’ experiences in a group-based exercise program. Prev Chronic Dis, 5(1). Retrieved from

Ackermann, R. T., Williams, B., Nguyen, H. Q., Berke, E. M., Maciejewski, M. L., & Logerfo, J. P. (2008). Healthcare Cost Differences with Participation in a Community-Based Group Physical Activity Benefit for Medicare Managed Care Health Plan Members. J Am Geriatr Soc, 56, 1459–1465.

Snyder, S., & Belza, B. (2007). Enhancing Healthy Aging. Northwest Public Health, (Fall/Winter) 24(2), 20-21.

Nguyen, H. Q., Ackermann, R. T., Berke, E. M., Cheadle, A., Williams, B., Lin, E., Maciejewski, M. L., & LoGerfo, J. P. (2007). Impact of a managed-Medicare physical activity benefit on health care utilization and costs in older adults with diabetes. Diabetes Care, 30(1), 43-48.

Walwick, J., Shiu-Thornton, S., Belza, B., Schwartz, S., & LoGerfo, J. (2006). Promoting physical activity in ethnic communities: perspectives from older adults. Journal on Active Aging(Jan/Feb), 28-34.

Berke, E. M., Ackermann, R. T., Lin, E. H., Diehr, P. H., Maciejewski, M. L., Williams, B., Patrick, M. B., & LoGerfo, J. P. (2006). Distance as a barrier to using a fitness-program benefit for managed Medicare enrollees. J Aging Phys Act, 14(3), 313-324.

Snyder, S., & Belza, B. (2005). Eliminating disparities in communities of color through the Lifetime Fitness Program [abstract]. Prev Chronic Dis [serial online]. Retrieved from

Sin, M. K., Belza, B., Logerfo, J., & Cunningham, S. (2005). Evaluation of a community-based exercise program for elderly Korean immigrants. Public Health Nurs, 22(5), 407-413. doi: PHN220505 10.1111/j.0737-1209.2005.220505.x

Sin, M. K., LoGerfo, J., Belza, B., & Cunningham, S. (2004). Factors influencing exercise participation and quality of life among elderly Korean Americans. J Cult Divers, 11(4), 139-145.

Phelan, E. A., Williams, B., Penninx, B. W., LoGerfo, J. P., & Leveille, S. G. (2004). Activities of daily living function and disability in older adults in a randomized trial of the Health Enhancement Program. J Gerontol A Biol Sci Med Sci, 59(8), M838-843.

Belza, B., Walwick, J., Shiu-Thornton, S., Schwartz, S., Taylor, M., & LoGerfo, J. (2004). Older adult perspectives on physical activity and exercise: voices from multiple cultures. Prev Chronic Dis, 1(4), A09. Retrieved from

Phelan, E. A., Cheadle, A., Schwartz, S. J., Snyder, S., Williams, B., Wagner, E. H., & LoGerfo, J. P. (2003). Promoting health and preventing disability in older adults: lessons from intervention studies carried out through an academic-community partnership. Fam Community Health, 26(3), 214-220.

Ackermann, R. T., Cheadle, A., Sandhu, N., Madsen, L., Wagner, E. H., & LoGerfo, J. P. (2003). Community exercise program use and changes in healthcare costs for older adults. Am J Prev Med, 25(3), 232-237.

Phelan, E. A., Williams, B., Leveille, S., Snyder, S., Wagner, E. H., & LoGerfo, J. P. (2002). Outcomes of a community-based dissemination of the health enhancement program. J Am Geriatr Soc, 50(9), 1519-1524.

Cheadle, A., Sullivan, M., Krieger, J., Ciske, S., Shaw, M., Schier, J. K., & Eisinger, A. (2002). Using a participatory approach to provide assistance to community-based organizations: the Seattle Partners Community Research Center. Health Educ Behav, 29(3), 383-394.

Kinne, S., Patrick, D. L., & Maher, E. J. (1999). Correlates of exercise maintenance among people with mobility impairments. Disabil Rehabil, 21(1), 15-22.

Cress, M. E., Buchner, D. M., Questad, K. A., Esselman, P. C., deLateur, B. J., & Schwartz, R. S. (1999). Exercise: effects on physical functional performance in independent older adults. J Gerontol A Biol Sci Med Sci, 54(5), M242-248.

Wallace, J. I., Buchner, D. M., Grothaus, L., Leveille, S., LaCroix, A. Z., & Wagner, E. H. (1998). Implementation and effectiveness of a community-based health promotion program for older adults. Journals of Gerontology, 53A(4), M301-306.

Leveille, S. G., Wagner, E. H., Davis, C., Grothaus, L., Wallace, J., LoGerfo, M., & Kent, D. (1998). 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, 46(10), 1191-1198.

King, A. C., Rejeski, W. J., & Buchner, D. M. (1998). Physical activity interventions targeting older adults. A critical review and recommendations. Am J Prev Med, 15(4), 316-333.

Cress, M. E., Buchner , D. M., Questad, K. A., & Esselman, P. C. (1997). Exercise training improves physical functional performance in independent older adults. Med Sci Sports Exercise, 29(5), S76.

Buchner, D. M., Nicola, R. M., Martin, M. L., & Patrick, D. L. (1997). Physical activity and health promotion for older adults in public housing. Am J Prev Med, 13(6 Suppl), 57-62.

Belza, B., Patrick, D., Ramsey, S., Maher, E., & Nerri, M. (1997). Will exercise reduce costs and improve quality of life for people with osteoarthritis? Arthritis and Rheumatism, 40(9), S326.

Cress, M. E., Conley, K. E., Schwartz, R. S., Questad, K. A., Esselman, P. C., & Buchner, D. M. (1996). Change in physical function with exercise in older adults. The Gerontologist, 36(1), 28.

Cress, M. E., Conley, K. E., Balding, S. L., Hansen-Smith, F., & Konczak, J. (1996). Functional training: muscle structure, function, and performance in older women. J Orthop Sports Phys Ther, 24(1), 4-10.

Novais, J., Wagner, E., Buchner, D., LaCroix, A., Patrick, D., Beresford, S., & Omenn, G. (1994). Effects, safety, and compliance with an exercise program in a senior center: A randomized trial. J Am Geriatr Soc.

Grembowski, D., Patrick, D., Diehr, P., Durham, M., Beresford, S., Kay, E., & Hecht, J. (1993). Self-efficacy and health behavior among older adults. J Health Soc Behav, 34(2), 89-104.

Koepsell, T. D., Wagner, E. H., Cheadle, A. C., Patrick, D. L., Martin, D. C., Diehr, P. H., Perrin, E. B., Kristal, A. R., Allan-Andrilla, C. H., & Dey, L. J. (1992). Selected methodological issues in evaluating community-based health promotion and disease prevention programs. Annual review of public health, 13, 31-57.

Elward, K. S., Wagner, E. H., & Larson, E. B. (1992). Participation by sedentary elderly persons in an exercise promotion session. Fam Med, 24(8), 607-612.

Elward, K., Larson, E., & Wagner, E. (1992). Factors associated with regular aerobic exercise in an elderly population. J Am Board Fam Pract, 5(5), 467-474.

Buchner, D. M., Beresford, S. A., Larson, E. B., LaCroix, A. Z., & Wagner, E. H. (1992). Effects of physical activity on health status in older adults. II. Intervention studies. Annual review of public health, 13, 469-488.

Koepsell, T. D., Martin, D. C., Diehr, P. H., Psaty, B. M., Wagner, E. H., Perrin, E. B., & Cheadle, A. (1991). Data analysis and sample size issues in evaluations of community-based health promotion and disease prevention programs: a mixed-model analysis of variance approach. J Clin Epidemiol, 44(7), 701-713.

Buchner, D. M., & Pearson, D. C. (1989). Factors associated with participation in a community senior health promotion program: a pilot study. Am J Public Health, 79(6), 775-777.



Published Studies

Hughes SL, Seymour RB, Campbell RT, Shaw JW, Fabiyi C, Sokas R. Comparison of two health-promotion programs for older workers. Am J Public Health. 2011 May;101(5):883-90. doi: 10.2105/AJPH.2010.300082. Epub 2011 Mar 18. PMID: 21421955; PMCID: PMC3076396.

Leveille SG, et al. (1998). Preventing disability and managing chronic illness in frail older adults: A randomized trial of a community-based partnership with primary care. Journal of American Geriatrics Society, 46:1-9.

Phelan EA, Williams B, Snyder SJ, Sizer Fitts S, LoGerfo JP. (2006). A five state dissemination of a community-based disability prevention program for older adults. Clinical Interventions in Aging, 1(3): 267-74.

The Substance Abuse and Mental Health Services Administration National Registry of Evidence-based Programs and Practices (NREPP) is a searchable online registry of more than 250 interventions supporting mental health promotion, substance abuse prevention, and mental health and substance abuse treatment. In order to learn how to implement EnhanceWellness in your community, visit The National Registry of Evidence-based Programs and Practices.

EnhanceWellness was reviewed and accepted to be on the US HHS Agency for Healthcare and Research Quality Health Care Innovations Exchange website as an innovation that improves quality and reduces disparities.

Health Mentor Program Published Study

Davis C, et al. (1998). The use of volunteers in a community-based health promotion and chronic illness self-management program for the elderly. Journal of Gerontological Nursing, October, 16-23. URL:


* Formerly known as the Lifetime Fitness Program (LFP)
† Formerly known as the Health Enhancement Program (HEP)



Project Enhance

Sound Generations

2208 2nd Ave, Ste 100

Seattle, WA 98121



Tel:   (206) 448 5725

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