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Characteristics of Older Adult Physical Activity Program Users
Dori E. Rosenberg, PhD, MPH; Lou Grothaus, MA; and David Arterburn, MD, MPH
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Characteristics of Older Adult Physical Activity Program Users

Dori E. Rosenberg, PhD, MPH; Lou Grothaus, MA; and David Arterburn, MD, MPH
Authors compared users and non-users of older adult physical activity programs (EnhanceFitness and Silver Sneakers) within a healthcare system on health conditions, utilization, and costs.
We also found that, while EF users had significantly lower overall comorbidity assessed by Charlson score, they did not differ from nonusers on most of the specific chronic health conditions we examined. On the other hand, SS users had lower likelihood of cardiometabolic conditions (eg, diabetes, cardiovascular diseases) and lower Charlson scores. Overall, the findings suggest that EF is more used by patients with chronic health limitations that tend to become more common as people age, and SS may be more appealing than EF to younger and generally healthier older adults. While EF may be used more among people with chronic conditions, it is less utilized than SS overall. Innovative methods for health systems to better promote use of EF, particularly for older adults with chronic conditions, should be examined since the current system, which relies mainly on passive methods (eg, benefits websites) and physician referrals, does not appear to be highly effective in isolation.20,21

Study limitations

There are several limitations to our study. We relied on medical diagnosis codes, which can be inaccurately entered into the health record. In addition, our EF user group was relatively small, which may have limited our ability to detect differences. Finally, we defined demographic and health characteristics prior to use of SS and EF, but users could have been using the program for several years prior, so essentially our data can be interpreted as cross-sectional.


Free and low-cost physical activity programs are vastly underused among older adults, who typically have very low levels of physical activity. Our study presented novel data on use patterns of older adult physical activity programs and a direct comparison of the characteristics of SS and EF users to nonusers. This data can inform future efforts to proactively target new user groups such as men, individuals with cardiometabolic conditions, and obese older adults.

Author Affiliations: Group Health Research Institute, Group Health Cooperative, Seattle, WA (DR, LG, DA).

Source of Funding: Group Health Research Institute.

Author Disclosures: The authors report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article.

Authorship Information: Concept and design (DR, LG, DA); acquisition of data (DR, DA); analysis and interpretation of data (DR, LG, DA); drafting of the manuscript (DR, LG, DA); critical revision of the manuscript for important intellectual content (DR, DA); statistical analysis (LG); obtaining funding (DR, DA); supervision (DA).

Address correspondence to: Dori E. Rosenberg, PhD, MPH. Address: 1730 Minor Avenue, Suite 1600, Seattle, WA 98101. E-mail: rosenberg.d@
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