Barriers and Facilitators to Adoption of a Lay-Delivered Community-Based Strength Training Program for Women in Rural Areas

Background: Limited access to fitness programs for rural older adults make lay or volunteer delivery approaches potentially desirable to extend reach. However, factors affecting adoption of such approaches are not well explored. Purpose: This study sought to identify barriers and facilitators affecting adoption of a volunteer lay delivery approach for the community-based StrongWomen strength training program conducted through rural county Extension offices. Methods: Educators implementing the program, identified as adopters (n = 6) and nonadopters (n = 13) of the lay delivery approach, participated in semistructured interviews, which were recorded, transcribed, and coded. The socialecological model (SEM) as an organizing framework revealed barriers and facilitators at the intrapersonal, interpersonal, institutional, and community levels. Results: Barriers included lack of appropriate facilities, limited time, passive leader recruitment approaches, volunteer training proximity, and perceived lack of confidence among potential volunteers. Retired or part-time employment status, education level, comfort in leadership positions, communication of need for volunteers, and active recruitment approach were facilitators. Discussion: Barriers and facilitators can be attributed to differences in educator approaches, participant characteristics, and institutional and community factors. Translation to Health Education Practice: Identification of modifiable factors promoting or inhibiting adoption of lay-led approaches may assist others seeking to implement similar delivery strategies to extend reach.