Approximately 20 years ago, we developed a task-oriented motor learning exercise program to improve walking that was delivered one on one by a physical therapist. Recognizing the impact of this novel exercise program, we were approached by individuals from UPMC Senior Communities and encouraged to translate the PT program to a group exercise program that could be delivered in the community and reach a larger number of older adults. Walking is important for maintaining independence and is highly valued by older adults. Unfortunately, walking limitations affect up to 76% of older Americans, which accounts for $42 billion annually in healthcare costs. Evidence continues to accumulate on the positive impact of group exercise programs on the health of older adults; however, these group programs fail to address the quality of walking. 

Over the past 15 years we involved relevant stakeholders in planning, conducting, and disseminating research related to our group-based exercise program, On the Move (OTM). During the development of OTM, we held sample exercise classes followed by focus groups with the participants to get their input into the structure and format of the classes. Our cluster-randomized trial to establish the efficacy/effectiveness of the program was funded by PCORI and included stakeholders as co-investigators and two stakeholder advisory boards. One stakeholder co-investigator was instrumental in developing the research questions and study aims. The patient stakeholders identified important study outcomes and provided insight into recruitment and retention strategies which resulted in over 94% retention rate. When a significant safety concern arose which resulted in a change to the study design/methods, the stakeholder advisory boards were advocates for the change to the funders. Leveraging connections with stakeholders from these previous endeavors, we created two advisory boards for our dissemination efforts, one representing older adult participants and exercise instructors and one representing community-based and national organizations. We engaged our stakeholders through audience research, focus groups, in-depth interviews, and surveys in order to understand their needs and to define targeted dissemination activities. Our stakeholder informed dissemination plan included print/digital materials, updates to the On the Move website, a social media campaign, and creation of an informational video. 

Meaningful stakeholder engagement is not always easy, but it is well worth the effort. It is important to take the time to listen in order to develop genuine and lasting partnerships. It is important to demonstrate through your words and actions that you value their input and that you are willing to make changes even if it is not easy and means more work. Though we involved patient stakeholders early in the process (i.e., during the development of the program), it would have been beneficial to involve a wider range of stakeholders including those who would eventually be delivering and hosting the exercise program.  Stakeholder involvement is critical to success but may be difficult to support financially. We took advantage of internal pilot awards through our CTSI and Pittsburgh Pepper Center to initiate the process and then pursued funding through PCORI Eugene Washington initiatives to sustain our efforts.  With valuable input from our stakeholders, we have grown and disseminated the On the Move program exponentially.