A Decade of Innovation: Lessons From Nationwide Dissemination of a Clinical Exercise Program for Older Adults

TL;DR

The Gerofit program, a clinical exercise initiative for older adults, expanded successfully across 33 VA centers with support from mentorship, telehealth, and standardized tools.

Contribution

This study provides insights into the nationwide dissemination of a clinical exercise program for older adults within the VA system.

Findings

Gerofit expanded 8-fold from 2013–2025, serving over 5,000 older adults annually.

Telehealth and on-demand videos increased rural access, with 58% of current enrollees using telehealth.

94% of sites sustained programming post-implementation due to institutional buy-in and leadership alignment.

Abstract

The Gerofit program, established in 1986 addresses functional decline in older Veterans through tailored exercise. Initially piloted at 4 sites in 2013, it now operates at 33 VA medical centers. This abstract traces its dissemination via VA’s Geriatrics and Extended Care (GEC) Mentoring Partnerships Program and Office of Rural Health (ORH) Enterprise Wide Initiative. Expansion strategies included phased funding (GEC/ORH partnerships), virtual adaptations, standardized implementation training curriculum and toolkit development, and clinical note templates. The Gerofit National Coordinating Center (NCC) provided mentorship, monthly Community of Practice forum, and data infrastructure. Sustainability metrics tracked post-funding retention and program growth. From 2013–2025, Gerofit expanded 8-fold, serving >5,000 older adults annually. Telehealth programming (58% of current enrollees) and on-demand videos (119K views) increased rural access. Post-implementation, 94% of sites sustained programming through institutional buy-in. Key facilitators included leadership alignment with VA’s Whole Health initiative, multi-disciplinary provider teams, automated workload capture, and consumer demand for the program. Barriers included staff turnover, loss of clinical space, and competing facility priorities. Gerofit’s success reflects VA’s commitment to scaling evidence-based geriatric care. Hybrid delivery models and NCC support enable long-term viability and continued innovation, offering a blueprint for national dissemination of clinical wellness programs for medically complex older adults.