Objectives: This study examines the national dissemination of EnhanceFitness, a senior group-based exercise program, and describes lessons learned about participant and delivery site recruitment and retention. Methods: Program data for EnhanceFitness in 10 states were
analyzed. Quantitative findings were augmented with state-specific cases pertaining to infrastructure development, recruitment, and retention. Results: Between 2006 and 2009, 5719 unique participants were enrolled in EnhanceFitness. Nearly 50% of participants were from racial/ethnic
minority backgrounds and were more complex patients with multiple pre-existing conditions at the time of enrollment. Case studies illustrate the importance of broad-based technical assistance, infrastructure development, creative funding, and recruitment and retention strategies salient to
local communities. Conclusions: Growing and sustaining evidence-based programming require policies that allow for flexibility when applying resources and tailoring recruitment and retention strategies.