BACKGROUND: It is well-established that physical activity (PA) can reduce risks for numerous chronic diseases across the lifespan, especially for middle-aged and older adults. However, engagement in health-enhancing PA behaviors remains suboptimal globally especially in the United States. Thus, there is a need for dissemination and implementation of evidence-based interventions to increase adherence to PA guidelines among middle-aged and older adults. The objectives of this scoping review were to identify (a) effectiveness of Extension-delivered programs as measured by improving PA outcomes among middle-aged and older adults, (b) implementation outcomes of Extension-delivered PA program20s, and (c) implementation determinants (benefits and barriers) of Extension as a PA program delivery system. METHODS: A scoping review of papers published from 2008 to 2023 was conducted. One reviewer searched the online databases, including PubMed, MEDLINE, Web of Science (Web of Knowledge), ScienceDirect, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, AgeLine, Education Resources Information Center, and Cochrane Central Register of Controlled Trials using search terms related to Extension, PA, and dissemination and implementation science. The search yielded 937 papers. After a review of titles, abstracts, and full texts 25 papers describing 18 unique programs/interventions were included in the review. RESULTS: The PA outcomes reported in the included studies indicate improved PA levels among middle-aged and older adult participants of Extension programs. Implementation factors evaluated highlighted the high-reach and maintenance potential of Extension as a delivery system for evidence-based PA programs. CONCLUSIONS: Extension may offer a sustainable delivery system with large potential reach for implementation of evidence-based PA programs among middle-aged and older adults.

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