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The Social Context of Sedentary Behaviors and Their Relationships With Health in Later Life. J Aging Phys Act 2019; 27:797-806. [PMID: 30859891 DOI: 10.1123/japa.2018-0109] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study examined sedentary behaviors among older adults and explored associations with social context and health measures using cross-sectional data from the National Health and Aging Trends Study (N = 1,687). Multivariate models were estimated to explore associations of time in six sedentary behaviors (i.e., television watching, sitting and talking, hobbies, computer use, driving, and resting) with sociodemographic characteristics and level of social engagement and with health status. Results indicated substantial variability in sedentary behaviors, with television watching being the most frequent and resting the least frequent activities. Sedentary behaviors varied by sociodemographic characteristics, including age, race/ethnicity, and education, as well as by level of social engagement. Television watching and resting, but not other behaviors, were associated with poorer health. These findings help to unpack the role of social context in sedentary behaviors and could inform public health interventions aimed at reducing time spent in behaviors that are adversely associated with health.
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Tully MA, Cunningham C, Wright A, McMullan I, Doherty J, Collins D, Tudor-Locke C, Morgan J, Phair G, Laventure B, Simpson EEA, McDonough SM, Gardner E, Kee F, Murphy MH, Agus A, Hunter RF, Hardeman W, Cupples ME. Peer-led walking programme to increase physical activity in inactive 60- to 70-year-olds: Walk with Me pilot RCT. PUBLIC HEALTH RESEARCH 2019. [DOI: 10.3310/phr07100] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background
Levels of physical activity decline with age. Some of the most disadvantaged individuals in society, such as those with a lower rather than a higher socioeconomic position, are also the most inactive. Peer-led physical activity interventions may offer a model to increase physical activity in these older adults and thus help reduce associated health inequalities. This study aims to develop and test the feasibility of a peer-led, multicomponent physical activity intervention in socioeconomically disadvantaged community-dwelling older adults.
Objectives
The study aimed to develop a peer-led intervention through a rapid review of previous peer-led interventions and interviews with members of the target population. A proposed protocol to evaluate its effectiveness was tested in a pilot randomised controlled trial (RCT).
Design
A rapid review of the literature and the pilot study informed the intervention design; a pilot RCT included a process evaluation of intervention delivery.
Setting
Socioeconomically disadvantaged communities in the South Eastern Health and Social Care Trust and the Northern Health and Social Care Trust in Northern Ireland.
Participants
Fifty adults aged 60–70 years, with low levels of physical activity, living in socioeconomically disadvantaged communities, recruited though community organisations and general practices.
Interventions
‘Walk with Me’ is a 12-week peer-led walking intervention based on social cognitive theory. Participants met weekly with peer mentors. During the initial period (weeks 1–4), each intervention group participant wore a pedometer and set weekly step goals with their mentor’s support. During weeks 5–8 participants and mentors met regularly to walk and discuss step goals and barriers to increasing physical activity. In the final phase (weeks 9–12), participants and mentors continued to set step goals and planned activities to maintain their activity levels beyond the intervention period. The control group received only an information booklet on active ageing.
Main outcome measures
Rates of recruitment, retention of participants and completeness of the primary outcome [moderate- and vigorous-intensity physical activity measured using an ActiGraph GT3X+ accelerometer (ActiGraph, LLC, Pensacola, FL, USA) at baseline, 12 weeks (post intervention) and 6 months]; acceptability assessed through interviews with participants and mentors.
Results
The study planned to recruit 60 participants. In fact, 50 eligible individuals participated, of whom 66% (33/50) were female and 80% (40/50) were recruited from general practices. At 6 months, 86% (43/50) attended for review, 93% (40/43) of whom returned valid accelerometer data. Intervention fidelity was assessed by using weekly step diaries, which were completed by both mentors and participants for all 12 weeks, and checklists for the level of delivery of intervention components, which was high for the first 3 weeks (range 49–83%). However, the rate of return of checklists by both mentors and participants diminished thereafter. Outcome data indicate that a sample size of 214 is required for a definitive trial.
Limitations
The sample was predominantly female and somewhat active.
Conclusions
The ‘Walk with Me’ intervention is acceptable to a socioeconomically disadvantaged community of older adults and a definitive RCT to evaluate its effectiveness is feasible. Some modifications are required to ensure fidelity of intervention delivery is optimised. Future research needs to identify methods to recruit males and less active older adults into physical activity interventions.
Trial registration
Current Controlled Trials ISRCTN23051918.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 10. See the NIHR Journals Library website for further project information. Funding for the intervention was gratefully received from the Health Improvement Division of the Public Health Agency.
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Affiliation(s)
- Mark A Tully
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
- UK Clinical Research Collaboration, Centre of Excellence for Public Health Northern Ireland, Belfast, UK
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey, UK
- Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health, School of Health Sciences, Ulster University, Newtownabbey, UK
| | - Conor Cunningham
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
- UK Clinical Research Collaboration, Centre of Excellence for Public Health Northern Ireland, Belfast, UK
| | - Ashlene Wright
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
- UK Clinical Research Collaboration, Centre of Excellence for Public Health Northern Ireland, Belfast, UK
| | - Ilona McMullan
- UK Clinical Research Collaboration, Centre of Excellence for Public Health Northern Ireland, Belfast, UK
- Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health, School of Health Sciences, Ulster University, Newtownabbey, UK
| | - Julie Doherty
- Psychology Research Institute, Ulster University, Coleraine, UK
| | - Debbie Collins
- Department of General Practice, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Catrine Tudor-Locke
- Department of Kinesiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Joanne Morgan
- UK Clinical Research Collaboration, Centre of Excellence for Public Health Northern Ireland, Belfast, UK
- Community Development and Health Network, Newry, UK
| | - Glenn Phair
- Northern Ireland Clinical Trials Unit, The Royal Hospitals, Belfast, UK
| | | | | | - Suzanne M McDonough
- UK Clinical Research Collaboration, Centre of Excellence for Public Health Northern Ireland, Belfast, UK
- Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health, School of Health Sciences, Ulster University, Newtownabbey, UK
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Evie Gardner
- Northern Ireland Clinical Trials Unit, The Royal Hospitals, Belfast, UK
| | - Frank Kee
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
- UK Clinical Research Collaboration, Centre of Excellence for Public Health Northern Ireland, Belfast, UK
| | - Marie H Murphy
- Centre for Physical Activity and Health Research, Ulster University, Newtownabbey, UK
| | - Ashley Agus
- Northern Ireland Clinical Trials Unit, The Royal Hospitals, Belfast, UK
| | - Ruth F Hunter
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
- UK Clinical Research Collaboration, Centre of Excellence for Public Health Northern Ireland, Belfast, UK
| | - Wendy Hardeman
- Health Promotion Research Group, School of Health Sciences, University of East Anglia, Norwich, UK
| | - Margaret E Cupples
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
- UK Clinical Research Collaboration, Centre of Excellence for Public Health Northern Ireland, Belfast, UK
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Petrescu-Prahova M, Kohn M, Leroux B, Steinman L, Fishleder S, Pike M, Kava CM, Belza B, Schrodt L, Hannon PA, Harris JR. Building community-clinical linkages to increase older adult physical activity: The PT-REFER trial protocol and participant baseline characteristics. Contemp Clin Trials Commun 2019; 15:100373. [PMID: 31111115 PMCID: PMC6512749 DOI: 10.1016/j.conctc.2019.100373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 04/17/2019] [Accepted: 04/26/2019] [Indexed: 11/19/2022] Open
Abstract
Background Physical activity is important for maintaining older adult health, but a majority of older adults are not meeting recommended physical activity levels. This paper describes the protocol and participant baseline characteristics for a trial (named "PT-REFER") to test an intervention focused on developing community-clinical linkages to increase older adult referrals from physical therapy clinics to an evidence-based group exercise program (Enhance®Fitness) (EF) offered by YMCA associations. Methods We designed a two-arm cluster-randomized controlled trial with YMCA associations. We conducted formative research with YMCA staff and physical therapists to inform intervention format and content. The primary outcome is the number of new participants enrolled in EF over the course of 30 months. We also collect process information on cost and implementation though structured surveys and semi-structured qualitative interviews. Results The PT-REFER intervention creates a learning collaborative for YMCA associations, which are tasked with implementing a number of capacity- and partnership-building activities over the course of seven months, and participating in monthly group technical assistance calls. We recruited 20 YMCA associations from 13 states. At baseline, the average number of EF sites per association was 3.9 and the monthly average number of new EF participants was 3.7. Conclusions This study will test an approach to increasing the capacity of YMCAs for conducting outreach to physical therapy clinics, and evaluate the factors that may influence its implementation. As a result, it has the potential to contribute to our understanding of how to develop viable and sustainable community-clinical linkages for older adult health.
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Affiliation(s)
- Miruna Petrescu-Prahova
- Health Promotion Research Center, Department of Health Services, University of Washington, 1107 NE 45th St, Suite 400, Seattle, WA, 98105, USA
- Corresponding author. Health Promotion Research Center, University of Washington, Box 354804, 1107 NE 45th St, Suite 400, Seattle, WA, 98105, USA.
| | - Marlana Kohn
- Health Promotion Research Center, Department of Health Services, University of Washington, 1107 NE 45th St, Suite 400, Seattle, WA, 98105, USA
| | - Brian Leroux
- Health Promotion Research Center, Department of Health Services, University of Washington, 1107 NE 45th St, Suite 400, Seattle, WA, 98105, USA
| | - Lesley Steinman
- Health Promotion Research Center, Department of Health Services, University of Washington, 1107 NE 45th St, Suite 400, Seattle, WA, 98105, USA
| | - Sarah Fishleder
- Health Promotion Research Center, Department of Health Services, University of Washington, 1107 NE 45th St, Suite 400, Seattle, WA, 98105, USA
| | - Maureen Pike
- YMCA of the USA, 101 N Wacker Dr, Chicago, IL, 60606, USA
| | - Christine M. Kava
- Health Promotion Research Center, Department of Health Services, University of Washington, 1107 NE 45th St, Suite 400, Seattle, WA, 98105, USA
| | - Basia Belza
- Health Promotion Research Center, Department of Health Services, University of Washington, 1107 NE 45th St, Suite 400, Seattle, WA, 98105, USA
| | - Lori Schrodt
- Department of Physical Therapy, Western Carolina University, Cullowhee, NC, 28723, USA
| | - Peggy A. Hannon
- Health Promotion Research Center, Department of Health Services, University of Washington, 1107 NE 45th St, Suite 400, Seattle, WA, 98105, USA
| | - Jeffrey R. Harris
- Health Promotion Research Center, Department of Health Services, University of Washington, 1107 NE 45th St, Suite 400, Seattle, WA, 98105, USA
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Dance for neuroplasticity: A descriptive systematic review. Neurosci Biobehav Rev 2019; 96:232-240. [DOI: 10.1016/j.neubiorev.2018.12.010] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/17/2018] [Accepted: 12/08/2018] [Indexed: 12/12/2022]
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Wong JD, Son JS, West ST, Naar JJ, Liechty T. A Life Course Examination of Women's Team Sport Participation in Late Adulthood. J Aging Phys Act 2018; 27:1-10. [PMID: 29722593 DOI: 10.1123/japa.2017-0193] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
This study contributes to the fields of aging and physical activity by applying the key principles of the life course perspective to investigate women's team sport participation experience in late adulthood. Through focus groups, data were collected from six competitive softball teams of women (N = 64) ranging from 55 to 79 years old. Data were audio recorded, transcribed verbatim, and analyzed for themes related to the life course principles of historical context and place, social embeddedness, agency, as well as trajectories and timing. A key study finding was that the women experienced cultural lag and age-related barriers to resources when playing competitive softball in late adulthood. In addition, the network of shared relationships occupied by these women had both positive and negative influences on their participation in competitive sports. Study findings can help inform services and programs at the local community level aimed at enhancing women's physical activity and health in late adulthood.
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Flórez KR, Richardson AS, Ghosh-Dastidar M(B, Troxel W, DeSantis A, Colabianchi N, Dubowitz T. The power of social networks and social support in promotion of physical activity and body mass index among African American adults. SSM Popul Health 2018; 4:327-333. [PMID: 29854917 PMCID: PMC5976839 DOI: 10.1016/j.ssmph.2018.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 12/26/2017] [Accepted: 03/10/2018] [Indexed: 11/17/2022] Open
Abstract
Social support and social networks can elucidate important structural and functional aspects of social relationships that are associated with health-promoting behaviors, including Physical Activity (PA) and weight. A growing number of studies have investigated the relationship between social support, social networks, PA and obesity specifically among African Americans; however, the evidence is mixed and many studies focus exclusively on African American women. Most studies have also focused on either functional or structural aspects of social relationships (but not both) and few have objectively measured moderate-to-vigorous physical activity (MVPA) and body mass index (BMI). Cross-sectional surveys of adult African American men and women living in two low-income predominantly African American neighborhoods in Pittsburgh, PA (N = 799) measured numerous structural features as well as functional aspects of social relationships. Specifically, structural features included social isolation, and social network size and diversity. Functional aspects included perceptions of social support for physical activity from the social network in general as well as from family and friends specifically. Height, weight, and PA were objectively measured. From these, we derived Body Mass Index (BMI) and moderate-to-vigorous physical activity (MVPA). All regression models were stratified by gender, and included age, income, education, employment, marital status, physical limitations, and a neighborhood indicator. Greater social isolation was a significant predictor of lower BMI among men only. Among women only, social isolation was significantly associated with increased MVPA whereas, network diversity was significantly associated with reduced MVPA. Future research would benefit from in-depth qualitative investigations to understand how social networks may act to influence different types of physical activity among African Americans, as well as understand how they can be possible levers for health promotion and prevention. Contributes to research on the social environment and physical activity among African Americans. Social isolation was associated with lower BMI among men. Social isolation was associated with more physical activity among women. More social network diversity was associated with less physical activity among women.
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Affiliation(s)
- Karen R. Flórez
- CUNY Graduate School of Public Health and Health Policy, 55 West 125th Street, New York, NY 10027, USA
- Corresponding author.
| | | | | | - Wendy Troxel
- RAND Corporation, 4570 Fifth Avenue, Pittsburgh, PA 15213, USA
| | - Amy DeSantis
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90407, USA
| | | | - Tamara Dubowitz
- RAND Corporation, 4570 Fifth Avenue, Pittsburgh, PA 15213, USA
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Tieland M, Trouwborst I, Clark BC. Skeletal muscle performance and ageing. J Cachexia Sarcopenia Muscle 2018; 9:3-19. [PMID: 29151281 PMCID: PMC5803609 DOI: 10.1002/jcsm.12238] [Citation(s) in RCA: 422] [Impact Index Per Article: 70.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 07/20/2017] [Accepted: 08/05/2017] [Indexed: 02/06/2023] Open
Abstract
The world population is ageing rapidly. As society ages, the incidence of physical limitations is dramatically increasing, which reduces the quality of life and increases healthcare expenditures. In western society, ~30% of the population over 55 years is confronted with moderate or severe physical limitations. These physical limitations increase the risk of falls, institutionalization, co-morbidity, and premature death. An important cause of physical limitations is the age-related loss of skeletal muscle mass, also referred to as sarcopenia. Emerging evidence, however, clearly shows that the decline in skeletal muscle mass is not the sole contributor to the decline in physical performance. For instance, the loss of muscle strength is also a strong contributor to reduced physical performance in the elderly. In addition, there is ample data to suggest that motor coordination, excitation-contraction coupling, skeletal integrity, and other factors related to the nervous, muscular, and skeletal systems are critically important for physical performance in the elderly. To better understand the loss of skeletal muscle performance with ageing, we aim to provide a broad overview on the underlying mechanisms associated with elderly skeletal muscle performance. We start with a system level discussion and continue with a discussion on the influence of lifestyle, biological, and psychosocial factors on elderly skeletal muscle performance. Developing a broad understanding of the many factors affecting elderly skeletal muscle performance has major implications for scientists, clinicians, and health professionals who are developing therapeutic interventions aiming to enhance muscle function and/or prevent mobility and physical limitations and, as such, support healthy ageing.
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Affiliation(s)
- Michael Tieland
- Faculty of Sports and NutritionAmsterdam University of Applied SciencesDr. Meurerlaan 81067 SMAmsterdamthe Netherlands
| | - Inez Trouwborst
- Faculty of Sports and NutritionAmsterdam University of Applied SciencesDr. Meurerlaan 81067 SMAmsterdamthe Netherlands
| | - Brian C. Clark
- Ohio Musculoskeletal and Neurological Institute (OMNI)Ohio University250 Irvine HallAthensOH 45701USA
- Department of Biomedical SciencesOhio UniversityAthensOH 45701USA
- Department of Geriatric MedicineOhio UniversityAthensOH 45701USA
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Boekhout JM, Peels DA, Berendsen BA, Bolman CA, Lechner L. An eHealth Intervention to Promote Physical Activity and Social Network of Single, Chronically Impaired Older Adults: Adaptation of an Existing Intervention Using Intervention Mapping. JMIR Res Protoc 2017; 6:e230. [PMID: 29170146 PMCID: PMC5721211 DOI: 10.2196/resprot.8093] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 09/29/2017] [Accepted: 10/30/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Especially for single older adults with chronic diseases, physical inactivity and a poor social network are regarded as serious threats to their health and independence. The Active Plus intervention is an automated computer-tailored eHealth intervention that has been proven effective to promote physical activity (PA) in the general population of adults older than 50 years. OBJECTIVE The aim of this study was to report on the methods and results of the systematic adaptation of Active Plus to the wishes and needs of the subgroup of single people older than 65 years who have one or more chronic diseases, as this specific target population may encounter specific challenges regarding PA and social network. METHODS The Intervention Mapping (IM) protocol was used to systematically adapt the existing intervention to optimally suit this specific target population. A literature study was performed, and quantitative as well as qualitative data were derived from health care professionals (by questionnaires, n=10) and the target population (by focus group interviews, n=14), which were then systematically integrated into the adapted intervention. RESULTS As the health problems and the targeted behavior are largely the same in the original and adapted intervention, the outcome of the needs assessment was that the performance objectives remained the same. As found in the literature study and in data derived from health professionals and focus groups, the relative importance and operationalization of the relevant psychosocial determinants related to these objectives are different from the original intervention, resulting in a refinement of the change objectives to optimally fit the specific target population. This refinement also resulted in changes in the practical applications, program components, intervention materials, and the evaluation and implementation strategy for the subgroup of single, chronically impaired older adults. CONCLUSIONS This study demonstrates that the adaptation of an existing intervention is an intensive process in which adopting the IM protocol is an invaluable tool. The study provides a broad insight in adapting interventions aimed at single older adults with a chronic disease. It is concluded that even when the new target population is a sizable segment of the original target population, the adapted intervention still needs considerable changes to optimally fit the needs and situational differences of the narrower target population.
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Affiliation(s)
- Janet M Boekhout
- Faculty of Psychology and Educational Science, Open University of the Netherlands, Heerlen, Netherlands
| | - Denise A Peels
- Faculty of Psychology and Educational Science, Open University of the Netherlands, Heerlen, Netherlands
| | - Brenda Aj Berendsen
- Faculty of Psychology and Educational Science, Open University of the Netherlands, Heerlen, Netherlands
| | - Catherine Aw Bolman
- Faculty of Psychology and Educational Science, Open University of the Netherlands, Heerlen, Netherlands
| | - Lilian Lechner
- Faculty of Psychology and Educational Science, Open University of the Netherlands, Heerlen, Netherlands
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Abstract
Regular exercise is essential for healthy aging and offers many health benefits, including reduced risk of all-cause mortality, chronic disease, and premature death. Because physical inactivity is prevalent, greater focus is needed on integrating exercise into care plans and counseling, and developing partnerships that support exercise opportunities. Older adults should be as physically active as their abilities and conditions allow. For substantial health benefits, older adults need to do aerobic, muscle-strengthening, and stretching exercises weekly, and balance activities as needed. Appropriate planning must take account of factors such as prescribed medications, nutrition, injuries, hip and knee arthroplasties, and chronic conditions.
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