Abstract Background Physical inactivity among people with disabilities and older adults is a persistent public health concern, particularly those from racial minority groups living in underserved communities where structural barriers limit access to exercise opportunities. Technology-driven exercise programs offer scalable solutions, but the contextual factors that influence their uptake, fidelity, and sustainability remain underexplored. Objective This study applied the Consolidated Framework for Implementation Research (CFIR) to identify barriers, facilitators, and lessons learned during the implementation of 2 technology-driven group exercise programs—synchronous online fitness and active virtual reality gaming—delivered to predominantly African American older adults with disabilities and/or chronic health conditions in an underserved community. Methods Using a multimethod design, we conducted semistructured interviews and focus groups with program participants, staff, and administrators (n=15) and administered implementation surveys to program deliverers (n=9). Qualitative data were analyzed deductively using CFIR domains and constructs, while survey data provided descriptive context. Results Both programs achieved high acceptability and appropriateness scores, with feasibility rated slightly lower for virtual reality. Themes mapped to 4 CFIR domains (innovation, outer setting, inner setting, and individuals). Qualitative analysis identified adaptability, affordability, engaging design, and community support as key facilitators, while barriers included technology and space constraints, resistance to new technology, and sustainability challenges. Conclusions Technology-driven exercise programs can expand access to physical activity in underserved communities when they are adaptable, affordable, and socially engaging. Addressing multilevel barriers, including resource limitations, technology hesitancy, and long-term sustainability, is critical to scaling and sustaining these interventions.
Neal et al. (Tue,) studied this question.