The Aging Well and Healthily (AWH) program consists of health education by peers and low-intensity exercise. It was evaluated via a small randomized controlled trial and a community intervention trial involving older adults in the Netherlands. Reasons stated for participation were to exercise (35%), to acquire information about health (28%), and for social reasons (12%). The program was rated 8.2 on a 10-point scale. Twenty-five percent of participants joined exercise groups after the program ended, and 28% intended to do so. The mean physical activity score improved from 2.6 to 4.6 at follow-up (F = 16.9, p = .00) and was for the least active participants significantly different from that of the control group (F = 22.9, p = .02). Four to 6 months later, 60% of respondents reported still doing the exercises regularly at home. It is concluded that AWH is a potentially effective program for older adults.
Marijke Hopman-Rock and Marja H. Westhoff
Edited by Wojtek J. Chodzko-Zajko
Edward M. Phillips, Jeffrey Katula, Michael E. Miller, Michael P. Walkup, Jennifer S. Brach, Abby C. King, W. Jack Rejeski, Tim Church and Roger A. Fielding
To examine baseline characteristics and change in gait speed and Short Physical Performance Battery (SPPB) scores in participants medically suspended (MS) from a physical activity intervention (PA).
Randomized controlled trial.
University and community centers.
Sedentary older adults (N = 213) randomized to PA in the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P).
MS was defined as missing 3 consecutive PA sessions in adoption and transition phases or 2 wk in maintenance phase because of a health event.
In all, 122 participants completed PA without MS (NMS subgroup), 48 participants underwent MS and resumed PA (SR subgroup), and 43 participants underwent MS and did not complete PA (SNR subgroup). At baseline, SNR walked slower (p = .03), took more prescribed medications (p = .02), and had lower SPPB scores than NMS and SR (p = .02). Changes from baseline to Month 12 SPPB scores were affected by suspension status, adjusted mean (SE) SPPB change: SNR 0.0957 (0.3184), SR 0.9413 (0.3063), NMS 1.0720 (0.1871); p = .03.
MS participants unable to return to complete the PA in a trial of mobility-limited sedentary older adults had slower walking speeds, lower SPPB scores, and a higher number of prescribed medications at baseline. Change in SPPB scores at 12 months was related to suspension status.
Harriet G. Williams and Gerhild Ullmann
Falls and fall-related injuries are critical issues for older adults; evidence indicates that multidimensional interventions that address modifiable risk factors can be successful in reducing falls. Few evidence-based fall prevention interventions exist due, in part, to complex issues associated with development and implementation. There is a need for a variety of such programs from which older adults may choose. We describe steps, outcomes, and issues involved in developing/implementing an evidenced-based fall prevention program in community settings.
The Stay In Balance program (SIB), developed by a team of professionals, local service providers and active older adults, was carried out with total of 135 older adults in several steps: developing objectives and program content, laboratory-based randomized controlled trial (RCT), pilot program in the community, community-based RCT, and implementation at 2 community sites.
Each step in development provided useful and different insights into needed changes in program content, equipment, support materials, training, and appropriate outcome measures.
Development of an evidenced-based fall prevention program requires a long term commitment on the part of all partners, University personnel, local service providers, and older adult participants; funding is also critical.
Dorothy Pekmezi, Shira Dunsiger, Ronnesia Gaskins, Brooke Barbera, Becky Marquez, Charles Neighbors and Bess Marcus
Due to high rates of inactivity and related chronic illnesses among Latinas,1 the current study examined the feasibility and acceptability of using pedometers as an intervention tool in this underserved population.
Data were taken from a larger randomized, controlled trial2 and focused on the subsample of participants (N = 43) who were randomly assigned to receive a physical activity intervention with pedometers and instructions to log pedometer use daily and mail completed logs back to the research center each month for 6 months.
Retention (90.7% at 6 months) and adherence to the pedometer protocol (68.89% returned ≥ 5 of the 6 monthly pedometer logs) were high. Overall, participants reported increased physical activity at 6 months and credited pedometer use for helping them achieve these gains (75.7%). Participants who completed a high proportion (≥ 5/6) of pedometer logs reported significantly greater increases in physical activity and related process variables (stages of change, self-efficacy, behavioral processes of change, social support from friends) than those who were less adherent (completed < 5 pedometer logs).
Pedometers constitute a low-cost, useful tool for encouraging self-monitoring of physical activity behavior in this at-risk group.
Jakob Tarp, Lars B. Andersen and Lars Østergaard
Cycling to and from school is an important source of physical activity (PA) in youth but it is not captured by the dominant objective method to quantify PA. The aim of this study was to quantify the underestimation of objectively assessed PA caused by cycling when using accelerometry.
Participants were 20 children aged 11 to 14 years from a randomized controlled trial performed in 2011. Physical activity was assessed by accelerometry with the addition of heart rate monitoring during cycling to school. Global positioning system (GPS) was used to identify periods of cycling to school.
Mean minutes of moderate-to-vigorous physical activity (MVPA) during round-trip commutes was 10.8 (95% CI: 7.1−16.6). Each kilometer of cycling meant an underestimation of 9314 (95% CI: 7719−11238) counts and 2.7 (95% CI: 2.1−3.5) minutes of MVPA. Adjusting for cycling to school increased estimates of MVPA/day by 6.0 (95% CI: 3.8−9.6) minutes.
Cycling to and from school contribute substantially to levels of MVPA and to mean counts/min in children. This was not collected by accelerometers. Using distance to school in conjunction with self-reported cycling to school may be a simple tool to improve the methodology.
Gary S. Goldfield
To compare liking and other attitudes toward physical activity (PA) and television (TV) viewing versus PA behavior and time viewing TV at baseline as predictors of response to lifestyle intervention in 30, 8 to 12 year old overweight/obese children.
Secondary analyses from a randomized controlled trial designed to increase PA and reduce sedentary behavior. PA was measured by accelerometers worn by participants every day for 8 weeks. TV viewing at baseline and during intervention was assessed by self-report.
Multiple regression analyses showed that base rates of PA and TV viewing significantly predicted changes in PA (Beta = .39, P < .05) and TV viewing (Beta = .37, P < .05) during the intervention, even after statistically controlling for child age, gender, body mass index, as well as baseline attitudes and liking of PA and TV viewing. However, self-reported liking of TV viewing and PA, perceived adequacy, and predilection were not predictive of response to intervention.
Baseline measure of PA and TV viewing behaviors may be better predictors of response to lifestyle intervention than measure of liking and other attitudinal variables of PA. The theoretical and clinical implications of these findings are discussed.
Colleen A. Cuthbert, Kathryn King-Shier, Dean Ruether, Dianne M. Tapp and S. Nicole Culos-Reed
Family caregivers are an important health care resource and represent a significant proportion of Canadian and US populations. Family caregivers suffer physical and psychological health problems because of being in the caregiver role. Interventions to support caregiver health, including physical activity (PA), are slow to be investigated and translated into practice.
To examine the evidence for PA interventions in caregivers and determine factors hampering the uptake of this evidence into practice.
A systematic review and evaluation of internal and external validity using the RE-AIM (Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance) framework was conducted. Randomized controlled trials or pretest/posttest studies of PA interventions were included.
Fourteen studies were published between 1997 and 2015. Methodological quality of studies and risk of bias was variable. External validity criteria were often not reported. Mean reporting levels were 1) reach, 53%; 2) efficacy/effectiveness, 73%; 3) adoption, 18%; 4) implementation, 48%; and 5) maintenance, 2%.
The lack of reporting of components of internal and external validity hinders the integration of caregiver PA interventions into clinical or community settings. Researchers should focus on standardized outcomes, accepted reporting criteria, and balancing factors of internal and external validity, to advance the state of the science.
Bruce A. Reeder, Karen E. Chad, Elizabeth L. Harrison, Nigel L. Ashworth, M. Suzanne Sheppard, Koren L. Fisher, Brenda G. Bruner, Brian G. Quinn, Punam Pahwa and M. Alomgir Hossain
The study aimed to compare the effectiveness of a class-based (CB) and home-based (HB) exercise program for older adults with chronic health conditions.
172 sedentary older adults with overweight or obesity, type 2 diabetes, hypertension, dyslipidemia, or osteoarthritis were enrolled in a randomized controlled trial with a 3-month follow-up.
A significant increase was seen in the CB group in the Physical Activity Scale for the Elderly (PASE) scores and SF-12 Physical and Mental Health scores. In both groups, significant increases were seen in 6-minute walk distance, Physical Performance Test (PPT), and Functional Fitness Test (FFT), and significant reductions were seen in systolic and diastolic blood pressure but not body mass index or waist circumference. Except for a greater increment in the FFT in the CB group, the degree of improvement was not significantly different between the 2 groups.
After a 3-month intervention, both the CB and HB program produced comparable significant improvements in outcome measures.
Rachel S. Mark and Ryan E. Rhodes
Interactive stationary bikes provide positive affective experiences and physiological benefits; however, research is limited.
This study compared usage of GameBikes to traditional stationary bikes among families in the home following a 6-week randomized, controlled trial design. Parents completed questionnaires featuring constructs of the theory of planned behavior (TPB). Usage was tracked by all family members and belief elicitation with GameBike families followed the trial.
Usage across the trial was significantly different for children in favor of the GameBike group (t 36 = 2.61, P = .01, d = .85). No differences were identified for parents. Significant time effects for parents’ (F 5,48 = 5.07, P < .01; η2 = .35) and children’s (F 5,32 = 8.24, P < .01; η2 = .56) usage were found with declines across 6 weeks. Affective attitude was the only significant TPB variable between groups at both time one (t 57 = 2.53, P = .01; d = .65) and follow-up (t 52 = 2.70, P = .01; d = .74) in favor of the GameBike group. Elicited beliefs were primarily affective- and control-based.
The results provide support for use of interactive video games to augment current PA initiatives. Larger-scale trials with longer durations are warranted.
Erja Portegijs, Sanna Read, Inka Pakkala, Mauri Kallinen, Ari Heinonen, Taina Rantanen, Markku Alen, Ilkka Kiviranta, Sanna Sihvonen and Sarianna Sipilä
Our aim was to study the effects of sense of coherence (SOC) on training adherence and interindividual changes in muscle strength, mobility, and balance after resistance training in older people with hip fracture history. These are secondary analyses of a 12-week randomized controlled trial of progressive resistance training in 60- to 85-year-old community-dwelling people 0.5–7 years after hip fracture (n = 45; ISRCTN34271567). Pre- and posttrial assessments included SOC, knee extension strength, walking speed, timed up-and-go (TUG), and Berg Balance Scale (BBS). Group-by-SOC interaction effects (repeated-measures ANOVA) were statistically significant for TUG (p = .005) and BBS (p = .040), but not for knee extension strength or walking speed. Weaker SOC was associated with poorer training adherence (mixed model; p = .009). Thus, more complicated physical tasks did not improve in those with weaker SOC, independently of training adherence. Older people with weaker SOC may need additional psychosocial support in physical rehabilitation programs to optimize training response.