Scheduling also could improve adherence. Older adults are more likely to attend classes offered between 9:00 am and noon rather than later in the day.46 Translated programs need an appropriate infrastructure in order to be implemented effectively. This involves building capacity within the adopting organizations (e.g., Young Men’s Christian Association, retirement www.selleckchem.com/products/a-1210477.html community) to provide the Tai

Ji Quan programs as well as developing implementers, (i.e., training Tai Ji Quan instructors) to deliver the programs to the participants. Finally, these new programs have to fit into the existing structures of community and senior services organizations so that the programs can be accessed easily by older adults. A large number of qualified Tai Ji Quan instructors will be needed if Tai Ji Quan programs are to be implemented widely. There are many trained instructors now in community and senior services organizations that are implementing older adult exercise, health and wellness programs. With organizational encouragement and support, some of these teachers could receive additional training to deliver Tai Ji Quan fall prevention

programs. Practical short-term workshop programs have been developed to train Tai Ji Quan instructors with previous experience working with older adults and who have an allied health or medical background, or are qualified exercise instructors.25 and 45 Vemurafenib chemical structure To accommodate the needs and abilities of older adults in the community, it may be necessary to modify aspects of a Tai Ji Quan program, (e.g., reducing the number of movements and level of difficulty).44 However, reduced exercise intensity and low completion rates will lessen a program’s effectiveness.29 and 33 Older adults may find it difficult to attend even one class a week, let alone the two classes a week often recommended, for a total of 50 h.31 Possible solutions

include encouraging participants to practice Tai Ji Quan at home, thereby increasing the effective “dose”,45 and providing practice opportunities by scheduling frequent group classes. Although an evidence-based program may be modified, MTMR9 it must maintain fidelity to the original intervention to preserve effectiveness. The program must retain the key elements that made the intervention effective while at the same time being adapted to fit the requirements of the implementation setting such as a senior center or community center. To successfully implement evidence-based Tai Ji Quan programs that can be widely distributed and delivered in a consistent manner, organizations will need to develop effective and efficient implementation strategies. These would include providing resources for training instructors to deliver the program with fidelity, identifying program sites, and actively recruiting participants.