The Purpose of the Older Americans Act (OAA) Title III-D Program (“Health Promotion”)
It is understood that disease prevention and health promotion programs reduce the need for more costly medical interventions. Title III-D of the OAA was established in 1987 to provide formula grants to State Units on Aging to support healthy lifestyles and promote healthy behaviors amongst older adults (age 60 and older). Priority is given to serving older adults living in medically underserved areas of the state and those who are of greatest economic need
Authorizing Legislation: Section 361 of the OAA of 1965, as amended.
Background on Definition of Evidence-Based Programs
States that receive OAA funds under Title III are required to spend those funds on evidence-based programs that have been proven to improve health and well-being and reduce disease and injury. Since 2003, the aging services network has been steadily moving towards wider implementation of disease prevention and health promotion programs that are based on scientific evidence and demonstrated to improve the health of older adults. The FY 2012 Congressional appropriations law included, for the first time, an evidence-based requirement related to Title III-D funds. In response to the new requirement, ACL developed an evidence-based definition to assist states in developing their own Title III-D guidance.
How to Determine If a Program Meets the OAA Title III-D Evidence-Based Requirements
There are two ways to assess whether Title III-D funds can be spent on a particular program (and as always, State Units on Aging may have additional state-specific Title III-D requirements):
- The program meets the requirements for ACL's Evidence-Based Definition (the ACL Definition is below)
- The program is considered to be an "evidence-based program" by any operating division of the U.S. Department of Health and Human Services (HHS) and is shown to be effective and appropriate for older adults.
ACL Definition of Evidence-Based Programs
- Demonstrated through evaluation to be effective for improving the health and well-being or reducing disease, disability and/or injury among older adults; and
- Proven effective with older adult population, using Experimental or Quasi-Experimental Design;* and
- Research results published in a peer-review journal; and
- Fully translated** in one or more community site(s); and
- Includes developed dissemination products that are available to the public.
*Experimental designs use random assignment and a control group. Quasi-experimental designs do not use random assignment.
**For purposes of the Title III-D definitions, being “fully translated in one or more community sites” means that the evidence-based program in question has been carried out at the community level (with fidelity to the published research) at least once before. Sites should only consider programs that have been shown to be effective within a real-world community setting.
November 2023 Update: Evidence-Based Program Review Process
For the last several years ACL has supported a formal Evidence-Based Program (EBP) Review Process to identify disease prevention and health promotion programs that are based on scientific evidence and demonstrated to improve the health of older adults. These evidence-based programs are essential tools for helping older adults maintain their independence in the community.
In 2022, ACL temporarily paused the facilitation of the EBP Review Process, and launched an evaluation study to examine the existing Review Process, explore whether any updates may be needed, and to learn more about current EBP review efforts employed across other federal offices and agencies. The study has now concluded and the report, Analysis of Evidence-Based Health Promotion and Disease Prevention Programs Review Process, was recently published. The report findings highlighted several opportunities to enhance the current process, as well as help inform any future ACL-supported EBP Review Processes. While some of the identified opportunities can be immediately adopted, several may require new processes that will take considerable time to implement.
To ensure that ACL continues to support the identification and scaling of effective EBPs that meet the health and wellness needs of older adults across the country, ACL will support a modified version of the EBP Review Process in FY2024.
More information about the EBP Review Process and a call for programs will be announced in the coming months. For further questions, please contact Lesha Spencer-Brown.
State Unit on Aging Learning Community
A learning community is available through the Chronic Disease Self-Management Education Resource Center for State Unit on Aging (SUA) staff a variety of resources, such as OAA Title III-D 101, frequently asked questions, SUA contact lists, etc.
SUA staff who would like to access the learning community should contact Lesha Spencer-Brown (Lesha.email@example.com).
Pre-Approved Evidence-Based Programs
The National Council on Aging and ACL’s Office of Performance and Evaluation maintain lists of programs that meet ACL’s Title IIID definition of evidence-based:
- National Council on Aging Listing
- Aging and Disability Evidence-Based Program Listing
These lists are not exhaustive and state units on aging have flexibility to implement programs that are not on these lists using Title IIID funds, provided they meet ACL's Title IIID evidence-based requirements.
Understanding and Finding Evidence-Based Programs
Toolkit on Evidence-Based Programming for Seniors (Community Research Center for Senior Health)
A comprehensive guide on finding and implementing evidence-based programs in a community setting.
This page includes a multitude of resources, such as webinars, tip sheets, how to guides, and reports related to implementing and sustaining evidence-based programs.
Evidence-Based Leadership Collaborative
This organization represents a small but notable group of evidence-based programs that are shown to improve older adult health.