Table 3 Barriers to implementation of aging-related EBPs in racial and ethnically minoritized serving organizations in under-resourced settings

Community characteristics

• Limited range of accessibility: hearing, seeing, mobility, cognitive impairment

• Varying levels of independence

• Emotional barriers related to lack of social support, loss of loved ones

• Difficulty with paperwork (privacy concerns and/or finding it hard to read)

• Social isolation and anxiety about going somewhere new if not aware of the EBP-providing organization

• Need for flexibility in participation requirements (i.e., doctors appointments, health, wellbeing)

• Range of literacy levels

• Language preference (including language heterogeneity) not depicted in EBP

• Competing responsibilities: home, caretaking, job responsibilities, basic needs, religion, etc.

• Affordability and accessibility of technology (phones, internet) affecting awareness or participation

• Access to safe, reliable transportation or lack of walkability in the community

• Low awareness of EBPs and prevention programs in the community

• Lack of aging related services in the area

Intra organizations characteristics

• The administrative burden of program management

• Variable leadership support and buy-in for implementing EBPs

• The administrative burden of data collection and submission for EBPs, including multiple required submissions and copies for EBP developers, funders, etc.

• Lack of ability and capacity building to do internal program improvement and data collection

• Opportunity to collaborate with other community agencies to distribute work and promote program sustainability

• Opportunity, need, and administrative time burden for building programs and EBP partnerships within trusted institutions (faith-based programs, programs within public housing)

• Leadership not understanding population needs, assets, values, culture(s)

Evidence-based program characteristics

• Need for data transparency from EBP developers or funders for feedback for CBO quality improvement Data restrictions (ability to add questions, submission requirements, etc.)

• Intrusive data gathering on participants

• Challenge of senior engagement in class length and time of day for classes (takes time to find the “right” timing for the population served)

• Eligibility is limiting to serving the community’s needs

• Lacking cultural relevance in language or materials and diverse representation of examples in the curriculum

• Tailor curriculum to lower literacy levels to increase accessibility

• Should address social determinants (food insecurity, poverty, etc.)

• Language heterogeneity beyond English or Spanish

Fidelity

• Need tools, training, or resources to ensure fidelity

• The tension between the need for cultural adaptations and maintaining fidelity

• Need for flexibility in attendance for elderly and high SES-burdened population

• There is a need to build trust in local organizations to establish programs which cater to the local population

Staffing and Training

• The administrative burden of staff management: staff or volunteer turnover, the hidden costs of volunteers, workforce development

• Training takes time and has a cost

• Capacity training to recruit, train, and deliver the program

• Lack of volunteer staff or pool of volunteers that looks like the population served

• Lack of program evaluation skills and perceived importance of collecting meaningful data

• Staff qualifications (limited professional, educational, or training experience)

Marketing, cost, payment sources

• Outreach and recruitment take time, and staff not typically covered

• Needs for referral sources

• Cost of training can be expensive and takes time

• Financial burden of EBP implementation: evaluation, training time and cost, teaching, fidelity

• Need consistent funding streams to promote uninterrupted program delivery

• Diverse representation in marketing materials

• Offer incentives