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Mashhadi-Naser S, Sabet FP, Nasiri M, Vasli P. Benefits of a family-based care transition program for older adults after hip fracture surgery. Aging Clin Exp Res 2024; 36:142. [PMID: 39002096 PMCID: PMC11246294 DOI: 10.1007/s40520-024-02794-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 06/21/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND Hip fracture (HF) in older adults is strongly associated with a greater decline in their activities of daily living (ADLs) and health-related (HRQoL). The present study aimed to evaluate the effects of a family-based care transition program (FBCTP) on ADLs, HRQoL and social support in this age group after HF surgery. METHODS A quasi-experimental design was conducted on 100 older adults who had undergone HFS and were selected by convenience sampling and allocated to the IG (n = 50) and the CG (n = 50). Data were collected utilizing the Barthel Index, the 12-item Short Form Health Survey (SF-12), and the Multidimensional Scale of Perceived Social Support. The FBCTP was delivered in-hospital education sessions, home visit, and a follow-up and telephone counselling session. The data were collected at three stages, including the baseline, four weeks after discharge, and eight weeks later. The level of statistical significance was set at 0.05. RESULTS The results of the study indicated that the effects of time and group on the increase in ADLs were 15.2 and 36.69 (p < 0.000), respectively, following the completion of the FBCTP. Furthermore, time and group were found to have a positive effect on HRQoL, with an increase of 2.82 and 5.60 units, respectively (p < 0.000). In this context, time and group also interacted in the IG compared to the CG, with scores increasing by 1.86 units over time (p < 0.000). Although the study results indicated that social support improved by 1.98 units over time (p < 0.000), the effects of group alone and the time × group interaction were not statistically significant. This indicates that the program was not effective in accelerating social support. CONCLUSION Consequently, nurses, policymakers, and planners engaged in geriatric healthcare may utilize these results to enhance the health status of this age group following HFS.
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Affiliation(s)
- Sahar Mashhadi-Naser
- Student Research Committee, Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Pashaei Sabet
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Malihe Nasiri
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvaneh Vasli
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Steinhoff P, Reiner A. Physical activity and functional social support in community-dwelling older adults: a scoping review. BMC Public Health 2024; 24:1355. [PMID: 38769563 PMCID: PMC11103817 DOI: 10.1186/s12889-024-18863-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 05/15/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Globally, the population of older people is increasing and is estimated to reach nearly 2.1 billion by 2050. Physical activity (PA) is one of the key components for successful ageing. However, PA decreases with age and many older adults do not meet PA guidelines. Previous research has shown that social support (SOSU) is related to PA in older people. The aim of this scoping review is to identify and map all of the available evidence and to explore the association between functional SOSU and PA in older adults. Functional SOSU consists of emotional, informational, instrumental and companionship SOSU and social comparison. METHODS A scoping review was conducted using the Joanna-Briggs manual. Quantitative and qualitative studies investigating associations between functional SOSU and PA levels in older adults (mean age ≥ 60 years) were identified through a systematic search in seven electronic databases up to August 2023. After removing duplicates, 20,907 articles were screened for titles and abstracts. The results were analysed separately for different types of SOSU. RESULTS 116 articles met the inclusion criteria; 72% were quantitative studies and 28% were qualitative studies. Most studies used self-reported PA measures, only 23% of the studies used objective-reported PA measures. Most studies of SOSU for PA reported positive associations but the evidence is inconclusive when the source of support is considered. PA is positively associated with general, emotional, informational, and companionship SOSU, while instrumental support may occasionally be negatively associated. Companionship support is particularly influential on PA, especially in group settings, as it promotes social connectedness. Qualitative studies show that social comparison also supports PA. Different forms of SOSU generally show positive associations with PA. CONCLUSIONS While the evidence on the association between functional SOSU and PA is mixed, most studies show that there is a positive association. PA may also be a strategy for improving social contact and social integration. This study offers a comprehensive overview of measures for SOSU and PA and thereby informs future research and policy-making.
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Affiliation(s)
- Paula Steinhoff
- Institute of Sociology and Social Psychology, University of Cologne, Cologne, Germany.
| | - Amelie Reiner
- Institute of Sociology and Social Psychology, University of Cologne, Cologne, Germany
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Weiß M, Mende E, Schaller N, Krusemark H, Spanier B, Zelger O, Bischof J, Haller B, Halle M, Siegrist M. Adherence and potential factors of adherence to a resistance, coordination and endurance training in older retirement home residents over 6 months. Scand J Med Sci Sports 2024; 34:e14576. [PMID: 38339790 DOI: 10.1111/sms.14576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/19/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024]
Abstract
INTRODUCTION High exercise adherence is a key factor for effective exercise programmes. However, little is known about predictors of exercise adherence to a multimodal machine-based training in older retirement home residents. AIMS To assess exercise adherence and potential predictors of adherence. Furthermore, to evaluate user acceptance of the multimodal training and the change in exercise self-efficacy. METHODS In this sub-analysis of the bestform-F study, a total of 77 retirement home residents ≥65 years (mean age: 85.6 ± 6.6 years, 77.9% female) participated in a 6-month machine-based resistance, coordination and endurance training. Attendance to the training was documented for each training session. To identify potential predictors a multiple linear regression model was fitted to the data. Analyzed predictors included age, sex, body mass index (BMI), physical function, exercise self-efficacy, and physical activity history. Different domains of user acceptance (e.g. safety aspects, infrastructure) and exercise self-efficacy were assessed by a questionnaire and the exercise self-efficacy scale (ESES), respectively. RESULTS Mean exercise adherence was 67.2% (median: 74.4%). The regression model (R2 = 0.225, p = 0.033) revealed that the 6-minute walk test (6-MWT) at baseline significantly predicted exercise adherence (β: 0.074, 95% confidence interval (CI): 0.006-0.142, p = 0.033). Different user domains were rated at least as good by 83.9%-96.9% of participants, reflecting high acceptance. No statistically significant change was found for exercise self-efficacy over 6 months (mean change: 0.47 ± 3.08 points, p = 0.156). CONCLUSION Retirement home residents attended more than two thirds of offered training sessions and physical function at baseline was the key factor for predicting adherence. User acceptance of the training devices was highly rated. These findings indicate good potential for implementation of the exercise programme.
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Affiliation(s)
- Michael Weiß
- Department of Preventive Sports Medicine and Sports Cardiology, TUM School of Medicine and Health, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Esther Mende
- Department of Preventive Sports Medicine and Sports Cardiology, TUM School of Medicine and Health, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Nina Schaller
- Department of Preventive Sports Medicine and Sports Cardiology, TUM School of Medicine and Health, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Helge Krusemark
- Department of Preventive Sports Medicine and Sports Cardiology, TUM School of Medicine and Health, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Bianca Spanier
- Department of Preventive Sports Medicine and Sports Cardiology, TUM School of Medicine and Health, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Otto Zelger
- Department of Preventive Sports Medicine and Sports Cardiology, TUM School of Medicine and Health, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jan Bischof
- Department of Preventive Sports Medicine and Sports Cardiology, TUM School of Medicine and Health, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Bernhard Haller
- Institute of AI and Informatics in Medicine, TUM School of Medicine and Health, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Martin Halle
- Department of Preventive Sports Medicine and Sports Cardiology, TUM School of Medicine and Health, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- DZHK (German Center for Cardiovascular Research), Partner site Munich Heart Alliance, Munich, Germany
| | - Monika Siegrist
- Department of Preventive Sports Medicine and Sports Cardiology, TUM School of Medicine and Health, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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Zhang H, Wang J, Xi J, Xu J, Wang L. Functional fitness and risk factors of older patients with diabetes combined with sarcopenia and/or frailty: A cross-sectional study. Nurs Open 2024; 11:e2042. [PMID: 38214433 PMCID: PMC10697117 DOI: 10.1002/nop2.2042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 09/19/2023] [Accepted: 10/19/2023] [Indexed: 01/13/2024] Open
Abstract
AIM To learn the functional fitness levels in older adults with diabetes combined with sarcopenia and/or frailty. DESIGN A cross-sectional investigation study. METHODS A total of 205 participants with type 2 diabetes were recruited from September 2019 to August 2020. All patients underwent diagnostic screening for sarcopenia and frailty, and were divided into combined group (the patients who had sarcopenia and/or frailty) and non-combined group (the patient who had no sarcopenia and/or frailty). The diagnostic criteria for sarcopenia applied was proposed by the Asian Working Group on Sarcopenia in 2019 and frailty status was assessed using FRAIL Scale. Functional fitness was measured using the Senior Fitness Test and compared between combined and non-combined groups. Biochemical data of blood routine, glycolipid, and hepatorenal function tests were acquired from medical records. Logistic regression analysis was applied to explore the factors associated with the sarcopenia and/or frailty in the older adults with diabetes. RESULTS Compared with non-combined group, the participants in combined group exhibited shorter 6-min walk distance, fewer repetitions of arm curls and chair stands, smaller back scratch and chair sit-and-reach values, and longer time in the 8-ft up-and-go test. The patients in the combined group had significantly lower level of red blood cell, haemoglobin, haematocrit, and higher level of platelet and blood urea nitrogen. Apart from calf circumference, physical activity, and insulin injection treatment, 6-min walk distance was the factor associated with diabetes combined with sarcopenia and/or frailty.
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Affiliation(s)
- Hui Zhang
- School of NursingSuzhou Medical College of Soochow UniversitySuzhouChina
- School of NursingSuzhou Vocational Health CollegeSuzhouChina
| | - Jinping Wang
- School of NursingSuzhou Medical College of Soochow UniversitySuzhouChina
- Department of EndocrinologySubei People's Hospital of Jiangsu ProvinceYangzhouChina
| | - Jing Xi
- School of NursingSuzhou Medical College of Soochow UniversitySuzhouChina
| | - Jing Xu
- School of NursingSuzhou Medical College of Soochow UniversitySuzhouChina
| | - Li Wang
- School of NursingSuzhou Medical College of Soochow UniversitySuzhouChina
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Tang J, Wang T, Cottrell J, Jia F. Navigating Uncertainty: Experiences of Older Adults in Wuhan during the 76-Day COVID-19 Lockdown. Healthcare (Basel) 2023; 11:2970. [PMID: 37998461 PMCID: PMC10671022 DOI: 10.3390/healthcare11222970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 11/25/2023] Open
Abstract
The COVID-19 pandemic continues to affect the world. Wuhan, the epicenter of the outbreak, underwent a 76-day lockdown. Research has indicated that the lockdown negatively impacted the quality of life of older individuals, but little is known about their specific experiences during the confinement period. Qualitative interviews were conducted with 20 elderly residents of Wuhan, aged 65 to 85, who experienced mandatory isolation throughout the pandemic. The interviews centered around three stages of experiences: the Early Lockdown stage (the first week of lockdown after the government implemented the lockdown policy in January 2020), Infection During Lockdown stage (from February to April 2020 when participants were affected by the lockdown), and the Post-Lockdown stage (after April 2020 when the government lifted the lockdown policy). We found that older adults experienced different core themes during each lockdown stage. In the Early Lockdown stage, they felt nervousness and fear while searching for information. During the Lockdown and Infection Stage, they relied on reciprocal support and adjusted to new lifestyles. In the Post-Lockdown stage, they expressed cautions, trust, and gratitude. The finding highlights the evolving emotions and coping strategies of older adults throughout the lockdown phases. This study has yielded valuable insights into the adaptations of behavior and the importance of social interactions, specifically emphasizing the significance of healthcare among the elderly population.
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Affiliation(s)
- Jianing Tang
- School of Foreign Languages and Literature, Wuhan University, Wuhan 430072, China;
| | - Tangsheng Wang
- School of Marxism, Wuhan University of Technology, Wuhan 430070, China;
| | - Jessica Cottrell
- Department of Biology, Seton Hall University, South Orange, NJ 07079, USA;
| | - Fanli Jia
- Department of Psychology, Seton Hall University, South Orange, NJ 07079, USA
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van der Laag PJ, Dorhout BG, Heeren AA, Veenhof C, Barten DJJA, Schoonhoven L. Barriers and facilitators for implementation of a combined lifestyle intervention in community-dwelling older adults: a scoping review. Front Public Health 2023; 11:1253267. [PMID: 37900029 PMCID: PMC10602891 DOI: 10.3389/fpubh.2023.1253267] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 09/08/2023] [Indexed: 10/31/2023] Open
Abstract
Background Lifestyle interventions, combining nutrition and exercise, are effective in improving the physical functioning of community-dwelling older adults and preventing healthcare risks due to loss in muscle mass. However, the potential of these types of interventions is not being fully exploited due to insufficient implementation. Having insight into the determinants that could hinder or facilitate the implementation of a combined lifestyle intervention could improve the development of matching implementation strategies and enhance the implementation of such lifestyle interventions. The aim of this study was to identify barriers and facilitators for the successful implementation of a combined lifestyle intervention for community-dwelling older adults. Method A scoping review was conducted. A literature search was conducted in four electronic databases, and references were checked for additional inclusion. Studies were screened if they met the inclusion criteria. Barriers and facilitators were extracted from the included studies. To validate the results of the literature search, healthcare professionals and community-dwelling older adults were interviewed. Barriers and facilitators were categorized by two researchers according to the constructs of the Consolidated Framework for Implementation Research (CFIR). Results The search identified 12,364 studies, and 23 were found eligible for inclusion in the review. Barriers and facilitators for 26 of the 39 constructs of the CFIR were extracted. The interviews with healthcare professionals and older adults yielded six extra barriers and facilitators for implementation, resulting in determinants for 32 of the 39 CFIR constructs. According to literature and healthcare professionals, cosmopolitanism (network with external organizations), patient needs and resources, readiness for implementation, costs, knowledge and beliefs about the intervention, network and communication, and engaging were found to be the most important determinants for implementation of a combined lifestyle intervention. Conclusion A broad range of barriers and facilitators across all domains of the CFIR framework emerged in this study. The results of this review reflect on determinants that should be taken into account when planning for the implementation of a combined lifestyle intervention. A further step in the implementation process is the development of implementation strategies aiming at the identified determinants to enhance the implementation of a combined lifestyle intervention in community care.
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Affiliation(s)
- Patricia J. van der Laag
- Julius Center for Health Sciences and Primary Care, Nursing Science, University Medical Center Utrecht, University Utrecht, Utrecht, Netherlands
| | - Berber G. Dorhout
- Research Group Innovation of Human Movement Care, Research Centre for Healthy and Sustainable Living, Utrecht University of Applied Sciences, Utrecht, Netherlands
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Aaron A. Heeren
- Research Group Innovation of Human Movement Care, Research Centre for Healthy and Sustainable Living, Utrecht University of Applied Sciences, Utrecht, Netherlands
| | - Cindy Veenhof
- Research Group Innovation of Human Movement Care, Research Centre for Healthy and Sustainable Living, Utrecht University of Applied Sciences, Utrecht, Netherlands
- Department of Rehabilitation, Physical Therapy Science & Sports, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, Netherlands
| | - Di-Janne J. A. Barten
- Research Group Innovation of Human Movement Care, Research Centre for Healthy and Sustainable Living, Utrecht University of Applied Sciences, Utrecht, Netherlands
- Department of Rehabilitation, Physical Therapy Science & Sports, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Lisette Schoonhoven
- Julius Center for Health Sciences and Primary Care, Nursing Science, University Medical Center Utrecht, University Utrecht, Utrecht, Netherlands
- Faculty of Health Sciences, University of Southampton, Southampton, United Kingdom
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Alessy SA, Malkin JD, Finkelstein EA, AlAhmed R, Baattaiah BA, Evenson KR, Rakic S, Cetinkaya V, Herbst CH, Al-Hazzaa HM, Alqahtani SA. Effectiveness of Interventions Promoting Physical Activity and Reducing Sedentary Behavior in Community-Dwelling Older Adults: An Umbrella Review With Application to Saudi Arabia. J Epidemiol Glob Health 2023; 13:361-373. [PMID: 37199911 PMCID: PMC10193325 DOI: 10.1007/s44197-023-00111-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 04/28/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND As Saudi Arabia is expected to face population aging in the future, the burden of diseases arising from inadequate physical activity (PA) and excess sedentary behavior (SB) may subsequently increase without successful interventions. The present study critically reviews the global literature on the effectiveness of PA interventions targeting community-dwelling older adults to draw on lessons and applications for future interventions in Saudi Arabia. METHODS This umbrella review of systematic reviews included interventions designed to increase PA and/or reduce SB in community-dwelling older adults. We conducted searches in July 2022 in two electronic databases-PubMed and Embase-and identified relevant peer-reviewed systematic reviews in English. RESULTS Fifteen systematic reviews focusing on community-dwelling older adults were included. Several reviews reported that PA- or SB-based interventions, including eHealth interventions (such as automated advice, tele-counseling, digital PA coaching, automated PA tracking and feedback, online resources, online social support, and video demonstrations), mHealth interventions, and non-eHealth interventions (such as goal setting, individualized feedback, motivational sessions, phone calls, face-to-face education, counseling, supervised exercise sessions, sending educational materials to participants' homes, music, and social marketing programs), were effective in the short term (e.g., ≤ 3 months) but with wide heterogeneity in findings and methodologies. There were limited studies on PA- and SB-based interventions that could be effective for one year or more after the intervention. Most reviews were heavily skewed toward studies carried out in Western communities, limiting their generalizability to Saudi Arabia and other parts of the world. CONCLUSION There is evidence that some PA and SB interventions may be effective in the short term, but high-quality evidence regarding long-term effects is lacking. The cultural, climate, and environmental barriers related to PA and SB in Saudi Arabia require an innovative approach and research to evaluate such interventions in older individuals in the long term.
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Affiliation(s)
- Saleh A. Alessy
- Public Health Department, College of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia
- Centre for Cancer, Society and Public Health, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | | | - Eric A. Finkelstein
- Duke-NUS Medical School, Health Services and System Research Program, Singapore, Singapore
| | - Reem AlAhmed
- King Faisal Specialist Hospital & Research Center, Liver Transplant Center, Riyadh, Saudi Arabia
| | - Baian A. Baattaiah
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Kelly R. Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina USA
| | | | | | | | - Hazzaa M. Al-Hazzaa
- Lifestyle and Health Research Center, Health Sciences Research Center, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Saleh A. Alqahtani
- King Faisal Specialist Hospital & Research Center, Liver Transplant Center, Riyadh, Saudi Arabia
- Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD USA
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Do levels of self-efficacy affect urinary incontinence, falls, quality of life, sleep, and physical activity in elderly people with urinary incontinence? Ir J Med Sci 2022; 192:935-944. [PMID: 35711012 DOI: 10.1007/s11845-022-03053-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/05/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Our study aims to determine whether different self-efficacy (SE) levels affect urinary incontinence symptoms, falls, quality of life, sleep, and physical activity in elderly individuals with incontinence. Our secondary aim is to examine the relationship between SE levels and urinary incontinence severity, quality of life, sleep status, fear of falling, and physical activity level. METHODS One hundred twenty elderly individuals (median age: 71 years) with urinary incontinence participated in the cross-sectional study. Participants were divided into 3 groups as levels of low, moderate, and high according to their Geriatric SE Index for Urinary Incontinence (GSE-UI). Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire (IIQ-7), Incontinence Quality of Life Scale (I-QOL), Pittsburgh Sleep Quality Index (PSQI), Fall Efficacy Scale (FES), Rapid Assessment Physical Activity (RAPA), and International Physical Activity Questionnaire Short Form (IPAQ-SF) assessments associated with incontinence were performed. Data were analyzed using Mann-Whitney U, Kruskal-Wallis tests, and Spearman's correlation. RESULTS A significant difference was found in UDI-6, IIQ-7, I-QOL, and FES belonging to three groups according to GSE-UI levels (p ˂0.01, p ˂0.01, p ˂0.01). It was determined that the group with low GSE-UI level had the highest incontinence symptoms, fear of falling, and the lowest quality of life statistically significant. A negative moderate significant correlation was found between GSE-UI scores and UDI-6 (r: - .67, p ˂0.01), IIQ-7 (r: - .67, p ˂0.01), and FES (r: - .46, p ˂0.01). CONCLUSION In elderly individuals with urinary incontinence, the level of SE may affect incontinence symptoms, severity, fear of falling, and quality of life and may be an important factor for incontinence. An increased level of SE may lead to positive effects on the user interface. Further studies in this field are needed.
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Teggart K, Ganann R, Sihota D, Moore C, Keller H, Senson C, Phillips SM, Neil-Sztramko SE. Group-based nutrition interventions to promote healthy eating and mobility in community-dwelling older adults: a systematic review. Public Health Nutr 2022; 25:1-32. [PMID: 35570675 PMCID: PMC9991860 DOI: 10.1017/s136898002200115x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 02/28/2022] [Accepted: 05/03/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To identify the efficacy of group-based nutrition interventions to increase healthy eating, reduce nutrition risk, improve nutritional status and improve physical mobility among community-dwelling older adults. DESIGN Systematic review. Electronic databases MEDLINE, CINAHL, EMBASE, PsycINFO and Sociological Abstracts were searched on July 15, 2020 for studies published in English since January 2010. Study selection, critical appraisal (using the Joanna Briggs Institute's tools) and data extraction were performed in duplicate by two independent reviewers. SETTING Nutrition interventions delivered to groups in community-based settings were eligible. Studies delivered in acute or long-term care settings were excluded. PARTICIPANTS Community-dwelling older adults aged 55+ years. Studies targeting specific disease populations or promoting weight loss were excluded. RESULTS Thirty-one experimental and quasi-experimental studies with generally unclear to high risk of bias were included. Interventions included nutrition education with behaviour change techniques (BCT) (e.g. goal setting, interactive cooking demonstrations) (n 21), didactic nutrition education (n 4), interactive nutrition education (n 2), food access (n 2) and nutrition education with BCT and food access (n 2). Group-based nutrition education with BCT demonstrated the most promise in improving food and fluid intake, nutritional status and healthy eating knowledge compared with baseline or control. The impact on mobility outcomes was unclear. CONCLUSIONS Group-based nutrition education with BCT demonstrated the most promise for improving healthy eating among community-dwelling older adults. Our findings should be interpreted with caution related to generally low certainty, unclear to high risk of bias and high heterogeneity across interventions and outcomes. Higher quality research in group-based nutrition education for older adults is needed.
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Affiliation(s)
- Kylie Teggart
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Rebecca Ganann
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Davneet Sihota
- Global Health Graduate Program, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Caroline Moore
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Heather Keller
- Schlegel-UW Research Institute for Aging, Waterloo, ON, Canada
- Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, Waterloo, ON, Canada
| | - Christine Senson
- Healthy and Safe Communities Department, City of Hamilton Public Health Services, Hamilton, ON, Canada
| | - Stuart M Phillips
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON, Canada
| | - Sarah E Neil-Sztramko
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ONL8S 4L8, Canada
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Wong AKC, Bayuo J, Wong FKY. Investigating predictors of self-care behavior among homebound older adults: The role of self-efficacy, eHealth literacy, and perceived social support. J Nurs Scholarsh 2021; 54:278-285. [PMID: 34766694 DOI: 10.1111/jnu.12730] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/20/2021] [Indexed: 01/15/2023]
Abstract
PURPOSE This study aimed to investigate the predictors of self-care behavior among homebound older adults using the Health Empowerment theory as a framework. DESIGN This was a cross-sectional, predictive correlational study. METHODS Sixty-eight participants were randomly selected from five Hong Kong community centers from May 21, 2020 through July 20, 2020. Self-care behaviors were assessed using the Chinese version of Partners in Health. Self-efficacy, eHealth literacy, and perceived social support were assessed as potential predictors of self-care behaviors. A multiple linear regression analysis was adopted to examine the predictive effects. RESULTS The age of the sample ranged from 61 to 85 years (mean = 71.7, SD = 6.0). Participants who reported having sufficient or more than sufficient financial resources had better self-care behaviors than those who claimed to have insufficient financial resources (F = 5.08, p = 0.009). Statistically significant correlations were found between the participants' eHealth literacy (r = 0.54, p < 0.001), perceived social support (r = 0.60, p < 0.001), and self-care behaviors. eHealth literacy (β = 0.13, p = 0.007) and perceived social support (β = 0.13, p < 0.001) were significant predictors of self-care behaviors. Collectively, the three variables accounted for 41% of the variances in self-care behaviors. CONCLUSIONS The findings in this study suggest that eHealth literacy and perceived social support are two key factors that predicted the self-care behaviors of this vulnerable population. CLINICAL RELEVANCE In this technological era, the use of eHealth, together with enhanced social support, can lead to better self-care among older adults, particularly those who are homebound.
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Affiliation(s)
| | - Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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Yu CY, Wang JH, Wang LW, Wang TJ, Liang SY, Wu SF, Lu YY. The influence of opioid-taking self-efficacy and social support on pain management satisfaction in outpatients with cancer pain. Support Care Cancer 2021; 30:805-812. [PMID: 34389908 DOI: 10.1007/s00520-021-06330-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 05/30/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of this study was to explore the correlations between patients' opioid-taking self-efficacy, social support, and their pain management satisfaction, and to evaluate the effect of social support and opioid-taking self-efficacy in explaining the variance in pain management satisfaction. METHODS We used a cross-sectional and correlational research design and recruited 123 cancer patients via convenience sampling. We used the following instruments: the Opioid-Taking Self-Efficacy Scale, the Inventory of Socially Supportive Behavior, and the Chinese version of the Pain Treatment Satisfaction Scale. RESULTS There were significant and negative correlations between opioid-taking self-efficacy and pain management satisfaction (r = - .43, p < .001) and between social support and pain management satisfaction (r = - .47, p < .001). Using a hierarchical regression analysis, social support and opioid-taking self-efficacy explained 17.20% and 5.20%, respectively, of the variance in pain management satisfaction. CONCLUSIONS The results of this study confirm the importance of social support and opioid-taking self-efficacy in influencing pain management satisfaction. We recommend that professional care providers develop relevant intervention aimed at improving patients' pain management satisfaction.
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Affiliation(s)
- Chiung-Yao Yu
- Nursing Department, Cardinal Tien Hospital, 362, Zhongzheng Rd., Xindian Dist, New Taipei City, 23148, Taiwan
| | - Jia-Hua Wang
- Changhua Nursing Home, Ministry of Health and Welfare, No. 1 Hugang Rd., Changhua City, Changhua Country, 500040, Taiwan
| | - Ling-Wei Wang
- Department of Medicine, Taipei Veterans General Hospital, 201, Sec. 2, Shipai Road., Beitou, Taipei, 112, Taiwan
| | - Tsae-Jyy Wang
- College of Nursing, National Taipei University of Nursing and Health Sciences, 365 Ming Te Road, Beitou, Taipei, 112, Taiwan
| | - Shu-Yuan Liang
- College of Nursing, National Taipei University of Nursing and Health Sciences, 365 Ming Te Road, Beitou, Taipei, 112, Taiwan.
| | - Shu-Fang Wu
- College of Nursing, National Taipei University of Nursing and Health Sciences, 365 Ming Te Road, Beitou, Taipei, 112, Taiwan
| | - Yu-Ying Lu
- College of Nursing, National Taipei University of Nursing and Health Sciences, 365 Ming Te Road, Beitou, Taipei, 112, Taiwan
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12
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Viviano NA, Galik E, Resnick B. Racial differences in physical activity in nursing home residents with cognitive impairment. Appl Nurs Res 2021; 60:151445. [PMID: 34247786 DOI: 10.1016/j.apnr.2021.151445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/31/2021] [Accepted: 05/16/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Nursing home (NH) residents with moderate-to-severe cognitive impairment experience mostly sedentary lifestyles. AIM Previous research has examined racial differences in physical activity (PA) levels in community-dwelling older adults but not in NH residents with cognitive impairment, and the current study aimed to examine these differences. METHODS This was a secondary data analysis of baseline data from the Function and Behavior Focused Care Intervention (FBFC) study. The sample included 247 cognitively impaired residents from 12 NHs who wore an ActiGraph to measure PA. RESULTS The residents' mean age was 82.6 (SD = 10.1) and had an average MMSE score of 7.8 (SD = 5.0). The sample (N = 247) was 41% African American and 59% White. African American and White residents engaged in only 50.6 and 46.2 min of light- and 1.5 and 1.1 min of moderate-level PA, respectively. Based on a multivariate analysis of covariance (MANCOVA), there was not a statistically significant difference between African American and White residents on combined dependent PA measures [F (8, 237) = 1.067, p = .387, Wilks' Λ = 0.962]. There was a trend that direct care providers subjectively reported that White residents engaged in more PA than their African American counterparts [F(8, 237) = 2.741, p = .09]. CONCLUSIONS These findings are not consistent with prior research. However, these findings indicate severely low levels of PA in NH residents, regardless of racial group. Future research should prioritize PA interventions that make accommodations for all NH residents, and especially consider their underlying physical comorbidities and cognitive function.
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Affiliation(s)
- Nicole A Viviano
- University of Maryland School of Medicine, Department of Epidemiology and Public Health, Division of Gerontology, 660 W. Redwood Street, Howard Hall 222, Baltimore, MD 21201, United States of America.
| | - Elizabeth Galik
- University of Maryland School of Nursing, 655 West Lombard Street, Baltimore, MD 21210, United States of America
| | - Barbara Resnick
- University of Maryland School of Nursing, 655 West Lombard Street, Baltimore, MD 21210, United States of America
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Shimizu H, Hirakawa Y, Chiang C, Ngiralmau B, Tellei J, Rehuher-Marugg FK, Mita T, Yatsuya H, Aoyama A. Perceptions and behaviors related to noncommunicable diseases in Palau: a qualitative study. NAGOYA JOURNAL OF MEDICAL SCIENCE 2021; 83:287-298. [PMID: 34239177 PMCID: PMC8236684 DOI: 10.18999/nagjms.83.2.287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 10/28/2020] [Indexed: 12/03/2022]
Abstract
The increasing burden of noncommunicable diseases (NCDs) is a major public health concern in Palau. This study aims to identify social and psychological factors related to NCDs among Palauan people using a qualitative approach. We conducted eight key informant interviews and eight focus group discussions, which were audio-recorded, transcribed and translated into English. Ideas of the respondents were extracted and labeled, and the labels were analyzed using an inductive multistage approach referred to as qualitative content analysis. Three themes emerged: (1) home education, (2) traditional local community, and (3) modernization and westernization of lifestyle. Respondents believed that the influence of the family on lifestyle was significant, but that disciplining children at home had become difficult. They considered that the traditional lifestyle was mostly healthy, and were reluctant to abandon certain unhealthy customs, such as serving abundant food to guests as a sign of fraternity. They also thought that they overate because of their stressful modernized lifestyle. This is the first qualitative study to analyze perception and behavior of the Palauan people in relation to NCDs. We found that the increase in NCDs was related to two concurrent trends: preserving certain traditional customs unfavorable to good health, and abandoning time-consuming healthy traditional lifestyle to adopt a modernized one. We also found that Palauan people were not confident in their ability to prevent NCDs. Therefore, health promotion activities should be designed to empower people to make positive changes.
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Affiliation(s)
- Hiroko Shimizu
- Department of Public Health and Health Systems, Nagoya University School of Medicine, Nagoya, Japan
- Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan
| | - Yoshihisa Hirakawa
- Department of Public Health and Health Systems, Nagoya University School of Medicine, Nagoya, Japan
| | - Chifa Chiang
- Department of Public Health and Health Systems, Nagoya University School of Medicine, Nagoya, Japan
| | | | | | | | - Takashi Mita
- Faculty of International Relations, Kyoto Sangyo University, Kyoto, Japan
| | - Hiroshi Yatsuya
- Department of Public Health and Health Systems, Nagoya University School of Medicine, Nagoya, Japan
- Department of Public Health, Fujita Health University School of Medicine, Toyoake, Japan
| | - Atsuko Aoyama
- Department of Public Health and Health Systems, Nagoya University School of Medicine, Nagoya, Japan
- Nagoya University of Arts and Sciences, Nisshin, Japan
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14
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Koren Y, Leveille S, You T. Tai Chi Interventions Promoting Social Support and Interaction Among Older Adults: A Systematic Review. Res Gerontol Nurs 2021; 14:126-137. [PMID: 34039148 PMCID: PMC9836824 DOI: 10.3928/19404921-20210325-02] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Tai chi is known to improve balance and reduce falls in older adults. Yet, little is known about the impact of group tai chi on perceived social support and its relationship with participant self-efficacy and adherence. The current systematic review, guided by Social Cognitive Theory and Successful Aging, includes an overview of tai chi interventions with and without enhancements (e.g., music, mentorship, group practice) that evaluated social support among their outcomes (N = 10). PubMed, CINAHL, and PsycINFO databases were searched for studies eligible under the inclusion criteria: sample population aged ≥60 years and published between 1999 and 2019. Four articles reported on tai chi interventions with specific enhancements to promote social interaction and reported increased perceived social support (p < 0.05). Six studies evaluated social support outcomes of tai chi programs without specific modifications to promote social engagement. Four of the six traditional tai chi intervention studies reported improved social support (p < 0.05). Group tai chi interventions for older adults may increase social support and therefore further increase health benefits of tai chi exercise among this population. [Research in Gerontological Nursing, 14(3), 126-137.].
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Affiliation(s)
- Yael Koren
- Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts
| | - Suzanne Leveille
- Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts
| | - Tongjian You
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts
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15
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Yoshikawa A, Smith ML, Lee S, Towne SD, Ory MG. The role of improved social support for healthy eating in a lifestyle intervention: Texercise Select. Public Health Nutr 2021; 24:146-156. [PMID: 32830625 PMCID: PMC10195600 DOI: 10.1017/s1368980020002700] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 06/24/2020] [Accepted: 07/06/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVE We examined the measurement and mediating role of social support in dietary intake among participants in Texercise Select, an intervention for improving lifestyle behaviours. DESIGN Quasi-experimental study. Participants reported their dietary intake, level of social support measured by the new Social Support for Healthy Eating scale, sociodemographics and disease profile. We conducted exploratory factor analysis for scale evaluation and structural equation modelling for mediation analysis to test if changes in dietary-specific social support mediate the relationship between the intervention and changes in dietary intake. SETTING Texas. PARTICIPANTS Community-dwelling middle-aged and older adults completed a self-reported survey at baseline and 3-month follow-up (intervention group n 211, comparison group n 175). RESULTS The majority of the sample was aged ≥70 years (mean 74·30, sd 8·54), female (82·1 %) and had at least two chronic conditions (63·5 %). The acceptable levels of reliability and validity of the dietary-specific social support scale were confirmed. Compared with the comparison group, the intervention group reported improved intake of fruit/vegetables and water, and improved dietary-specific social support. Improved dietary-specific social support mediated the association between intervention and change in fruit/vegetable intake, controlling for sociodemographics, number of chronic conditions and geographic residence. About 12 % of intervention effect was mediated by social support. CONCLUSIONS The current study confirms positive intervention effects on healthy eating, and highlights social support relating to dietary behaviours that may be helpful for healthy eating. Future research should investigate additional social support for developing healthy eating behavioural skills.
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Affiliation(s)
- Aya Yoshikawa
- Center for Population Health and Aging, School of Public Health, Texas A&M University, 212 Adriance Lab Road, 1266 TAMU, Suite 360, College Station, TX77843-1266, USA
| | - Matthew Lee Smith
- Center for Population Health and Aging, School of Public Health, Texas A&M University, 212 Adriance Lab Road, 1266 TAMU, Suite 360, College Station, TX77843-1266, USA
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA
- Deptartment of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA, USA
| | - Shinduk Lee
- Center for Population Health and Aging, School of Public Health, Texas A&M University, 212 Adriance Lab Road, 1266 TAMU, Suite 360, College Station, TX77843-1266, USA
| | - Samuel D Towne
- Center for Population Health and Aging, School of Public Health, Texas A&M University, 212 Adriance Lab Road, 1266 TAMU, Suite 360, College Station, TX77843-1266, USA
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA
- Department of Health Management & Informatics, College of Community Innovation and Education, University of Central Florida, Orlando, FL, USA
- Disability, Aging & Technology Faculty Cluster Initiative, University of Central Florida, Orlando, FL, USA
- Southwest Rural Health Research Center, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Marcia G Ory
- Center for Population Health and Aging, School of Public Health, Texas A&M University, 212 Adriance Lab Road, 1266 TAMU, Suite 360, College Station, TX77843-1266, USA
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA
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16
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Asiamah N, Petersen C, Kouveliotis K, Eduafo R. The Built Environment and Socio-Demographic Correlates of Partial and Absolute Sedentary Behaviours in Community-Dwelling Older Adults in Accra, Ghana. J Cross Cult Gerontol 2020; 36:21-42. [PMID: 33141375 DOI: 10.1007/s10823-020-09417-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2020] [Indexed: 11/25/2022]
Abstract
This study examined built environmental and socio-demographic variables as correlates of sedentary behaviour in a population of older adults, and attempted to introduce the idea of measuring sedentary behaviour with two domains, namely 'partial sedentary behaviour' and 'absolute sedentary behaviour'. The study's population was community-dwelling older adults aged 60 years or more in Accra, Ghana. A self-reported questionnaire was used to gather data from 504 older people. Multiple linear regression analysis was used to present findings, with all nominal categorical variables incorporated in this analysis dummy-coded. The overall (third) regression model accounted for a variance of 55.9% and a significant F-test [F (25,454) = 22.99; p < 0.001)]. Gender was positively associated with sedentary behaviour - the sedentary behaviour of women was 28 min in excess of that of men. Sedentary behaviour decreased as the social network size and supporting social network of older people increased. Sedentary behaviour decreased as availability of spacious road pavements, secure social recreational centres for older people, and health services in the community increased. The improvement of road safety conditions at the community level and design of the built environment to support social integration of older people are major recommendations of this study.
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Affiliation(s)
- Nestor Asiamah
- Department of Gerontology and Geriatrics, Africa Centre for Epidemiology, P.O. Box AN 18462, Accra North, Ghana.
| | - Carl Petersen
- Department of Health Sciences, University of Canterbury, Christchurch, New Zealand
| | - Kyriakos Kouveliotis
- Department of Health Management, International Telematic University Uninettuno, Rome, Italy
| | - Richard Eduafo
- Department of Gerontology and Geriatrics, Africa Centre for Epidemiology, Accra, Ghana
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17
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Chase JAD, Otmanowski J, Rowland S, Cooper PS. A systematic review and meta-analysis of interventions to reduce sedentary behavior among older adults. Transl Behav Med 2020; 10:1078-1085. [DOI: 10.1093/tbm/ibz189] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Abstract
Sedentary behavior (SB) is associated with numerous negative health outcomes, independent of physical activity behavior. Older adults are the most sedentary population in the United States. Understanding the effects and characteristics of existing interventions to reduce SB can inform practice, future research, and public health initiatives to improve older adults’ health. We conducted a systematic review and meta-analysis to examine existing SB intervention research among older adults and quantitatively synthesize intervention effects. Comprehensive searches were conducted to identify studies testing interventions to reduce SB time among adults at least 60 years old. Data on study design, intervention content and delivery, and participant characteristics were extracted from eligible studies. Standardized mean difference effect sizes (Cohen’s d) were synthesized using a random-effects model for two-group pretest–posttest design studies. Twenty-two reports describing 17 distinct studies were included in the narrative synthesis, with eight studies included in the meta-analysis (k = 8; n = 1,024). Most interventions were theory-driven and employed multiple strategies, including education, self-monitoring, and goal setting. Although SB interventions significantly reduced total sedentary time, the overall effect was small (d = −0.25, 95% confidence interval [−0.50, 0.00], p = .05). Studies were significantly heterogeneous (Q = 22.34, p < .01); however, the small number of comparisons prevented moderator analyses. Practitioners should employ diverse SB-specific strategies to encourage older adults to reduce time spent sedentary. To develop public health programs targeting SB in older adults, future research should include measures of time spent in specific SB and duration/number of breaks in sedentary time and investigate SB intervention effects on health outcomes.
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Affiliation(s)
- Jo-Ana D Chase
- Sinclair School of Nursing, University of Missouri, Columbia, MO, USA
| | | | - Sheri Rowland
- College of Nursing – Lincoln Division, University of Nebraska, Lincoln, NE, USA
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18
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Smith ML, Lee S, Towne SD, Han G, Quinn C, Peña-Purcell NC, Ory MG. Impact of a Behavioral Intervention on Diet, Eating Patterns, Self-Efficacy, and Social Support. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:180-186. [PMID: 31540863 DOI: 10.1016/j.jneb.2019.06.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 06/06/2019] [Accepted: 06/07/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To examine the effectiveness of a structured multimodal behavioral intervention to change dietary behaviors, as well as self-efficacy and social support for engaging in healthier diets. METHODS A quasi-experimental design was used to assign sites into intervention and comparison groups. Data were collected at baseline, 3 months, and 6 months. The intervention group participated in Texercise Select, a 12-week lifestyle enhancement program. Multiple mixed-effects models were used to examine nutrition-related changes over time. RESULTS For the intervention group, significant improvements were observed for fast food consumption (P = .011), fruit/vegetable consumption (P = .008), water consumption (P = .009), and social support (P < .001) from baseline to 3 months. The magnitude of these improvements was significantly greater than changes in the comparison group. CONCLUSIONS AND IMPLICATIONS Findings suggest the intervention's ability to improve diet-related outcomes among older adults; however, additional efforts are needed to maintain changes over longer periods.
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Affiliation(s)
- Matthew Lee Smith
- Center for Population Health and Aging, Texas A&M University, College Station, TX; Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX; Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA.
| | - Shinduk Lee
- Center for Population Health and Aging, Texas A&M University, College Station, TX
| | - Samuel D Towne
- Center for Population Health and Aging, Texas A&M University, College Station, TX; Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX; Department of Health Management & Informatics, University of Central Florida, Orlando, FL; Aging & Technology Faculty Cluster Initiative, University of Central Florida, Orlando, FL
| | - Gang Han
- Department of Epidemiology & Biostatistics, School of Public Health, Texas A&M University, College Station, TX
| | - Cindy Quinn
- Center for Population Health and Aging, Texas A&M University, College Station, TX
| | - Ninfa C Peña-Purcell
- Center for Population Health and Aging, Texas A&M University, College Station, TX; Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX; Family and Community Health, AgriLife Extension Service, Texas A&M University, College Station, TX
| | - Marcia G Ory
- Center for Population Health and Aging, Texas A&M University, College Station, TX; Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX
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19
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Wang T, Ren M, Shen Y, Zhu X, Zhang X, Gao M, Chen X, Zhao A, Shi Y, Chai W, Liu X, Sun X. The Association Among Social Support, Self-Efficacy, Use of Mobile Apps, and Physical Activity: Structural Equation Models With Mediating Effects. JMIR Mhealth Uhealth 2019; 7:e12606. [PMID: 31573936 PMCID: PMC6785721 DOI: 10.2196/12606] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 06/29/2019] [Accepted: 07/28/2019] [Indexed: 01/20/2023] Open
Abstract
Background Physical inactivity is a risk factor for chronic noncommunicable diseases. Insufficient physical activity has become an important public health problem worldwide. As mobile apps have rapidly developed, physical activity apps have the potential to improve the level of physical activity among populations. Objective This study aimed to evaluate the effect of physical activity apps on levels of physical activity among college students. Methods A Web-based questionnaire was used to survey college students in Beijing from December 27, 2017, to January 5, 2018. According to a previous survey, 43% of college students using physical activity apps and 36% of those who never used such apps achieved the physical activity recommendations. In this study, the sample size was calculated to be 500. The questionnaire consisted of 5 parts: the use of physical activity apps, sports habits, social support, self-efficacy, and social demographic information. Structural equation modeling was used to test the relationships between the use of physical activity apps, self-efficacy, social support, and level of physical activity. Results Of the 1245 participants, 384 college students (30.8%) used physical activity apps (in the past month). Of these 384 students, 191 (49.7%) gained new friends via the app. College students who were using physical activity apps had a higher level of physical activity and higher scores for social support and self-efficacy (P<.001) than those who did not use such apps. The use of physical activity apps significantly affected the mediating effect of physical activity level through social support (beta=.126; P<.001) and self-efficacy (beta=.294; P<.001). Gender played an important role in app use, self-efficacy, and physical activity in the mediation model: male users spent more time on physical activity and had higher self-efficacy scores (P<.001). Conclusions This study focused on college students in Beijing and found that the use of physical activity apps is associated with higher physical activity levels among these students. This effect is mainly through the mediation effect of social support and self-efficacy, rather than the direct effect of physical activity apps. The use of physical activity apps is associated with a higher social support level and higher self-efficacy score. Furthermore, a high social support level and high self-efficacy score are associated with higher physical activity levels.
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Affiliation(s)
- Taotao Wang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Mengyuan Ren
- Institute of Reproductive and Child Health, School of Public Health, Peking University, Beijing, China
| | - Ying Shen
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Xiaorou Zhu
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Xing Zhang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Min Gao
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Xueying Chen
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Ai Zhao
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Yuhui Shi
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Weizhong Chai
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Xinchuan Liu
- School of Journalism and Communication, Peking University, Beijing, China
| | - Xinying Sun
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
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20
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Sriram U, Sandreuter K, Graham M, Folta S, Pullyblank K, Paul L, Seguin R. Process Evaluation of Strong Hearts, Healthy Communities: A Rural Community-Based Cardiovascular Disease Prevention Program. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:138-149. [PMID: 30738562 PMCID: PMC6422156 DOI: 10.1016/j.jneb.2018.10.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 10/13/2018] [Accepted: 10/21/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To evaluate the implementation of a community-based cardiovascular disease prevention program for rural women: Strong Hearts, Healthy Communities (SHHC). DESIGN Mixed-methods process evaluation. SETTING/PARTICIPANTS A total of 101 women from 8 rural towns were enrolled in the SHHC program; 93 were enrolled as controls. Eligible participants were aged ≥40 years, sedentary, and overweight or obese. Local health educators (n = 15) served as program leaders within each town. OUTCOME MEASURES Reach, fidelity, dose delivered, dose received, and program satisfaction were assessed using after-class surveys, participant satisfaction surveys, interviews with program leaders, and participant focus groups. ANALYSIS Descriptive statistics, chi-square tests of independence, and thematic analysis were employed. RESULTS Intervention sites reported high levels of fidelity (82%) and dose delivered (84%). Overall reach was 2.6% and program classes were rated as effective (3.9/5). Participants were satisfied with their experience and reported benefits such as camaraderie and awareness of healthy eating and exercise strategies. Common recommendations included increasing class time and enhancing group discussion. CONCLUSIONS AND IMPLICATIONS Implementation was good in terms of fidelity, dose delivered, and satisfaction, although low reach. Findings from this research have informed a second round of implementation and evaluation of the SHHC program in rural communities.
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Affiliation(s)
- Urshila Sriram
- Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | | | - Meredith Graham
- Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Sara Folta
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | | | - Lynn Paul
- College of Education, Health and Development, Montana State University, Bozeman, MT
| | - Rebecca Seguin
- Division of Nutritional Sciences, Cornell University, Ithaca, NY.
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21
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Towne SD, Li Y, Lee S, Smith ML, Han G, Quinn C, Du Y, Benden M, Ory MG. Physical activity and associated medical cost savings among at-risk older adults participating a community-based health & wellness program. PLoS One 2018; 13:e0198239. [PMID: 29894478 PMCID: PMC5997342 DOI: 10.1371/journal.pone.0198239] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 05/16/2018] [Indexed: 12/04/2022] Open
Abstract
Introduction Physical activity declines are seen with increasing age; however, the US CDC recommends most older adults (age 65 and older) engage in the same levels of physical activity as those 18–64 to lessen risks of injuries (e.g., falls) and slow deteriorating health. We aimed to identify whether older adults participating in a short (approx. 90-minute sessions) 20 session (approximately 10-weeks) health and wellness program delivered in a community setting saw improvements in physical activity and whether these were sustained over time. Methods Employing a non-equivalent group design, community-dwelling older adults were purposely recruited into either an intervention or comparison group. The intervention was a multicomponent lifestyle enhancement intervention focused on healthy eating and physical activity, including structured physical activity exercises within the class sessions. Two groups were included: intervention (survey group: n = 65; accelerometer subgroup: n = 38) and the comparison group (survey group: n = 102; accelerometer subgroup: n = 55). Measurements were made at baseline and approximately three months later to reflect immediate post-treatment period (survey, accelerometer) with long-term follow-up 6 months after baseline (survey). Adults not meeting the physical activity guidelines (i.e., 150/75 minutes of moderate-to-vigorous physical activity or MVPA) were targeted for subgroup analyses. Paired t-tests were used for bivariate comparisons, while repeated measures random coefficient models (adjusting for propensity scores using inverse probability of treatment weighted (IPTW) estimation) were used for multivariate models. Estimated medical costs associated with gains in physical activity were also measured among survey respondents in the intervention group. Results The accelerometer group contained 38 participants in the intervention group with 71% insufficiently active at baseline and 55 participants in the comparison group with 76% insufficiently active at baseline (<150 weekly MVPA minutes). The survey group contained 65 participants in the intervention group with 73.85% insufficiently active at baseline and 102 participants in the comparison group with 76.47% insufficiently active at baseline. In paired t-tests with the accelerometer group, a moderate effect size (-0.4727, p = 0.0210) indicating higher MVPA was found for intervention participants with <150 weekly MVPA at baseline. In fully adjusted analyses using propensity score matching, among the subjectively measured physical activity (survey) group, there was a differential impact from baseline to 6-month post among the intervention group with an improvement of 160 minutes among all study participants (p < .0001) versus no difference among the comparison group. For those insufficiently active at baseline, there was an improvement of 103 minutes among intervention (p < .0001) and 55 minutes among the comparison (p < .0001) with the improvement of the intervention significantly greater than that among the comparison (p = 0.0224). Further, among those insufficiently active at baseline there was a relative cost savings from baseline to 6-months over and above the estimated cost of the intervention estimated between $143 and $164 per participant. Discussion This intervention was able to reach and retain older adults and showed significant MVPA gains and estimated medical cost savings among more at-risk individuals (baseline <150 MVPA). This intervention can be used in practice as a strategy to improve MVPA among the growing population of older community-dwelling adults.
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Affiliation(s)
- Samuel D. Towne
- Health Promotion & Community Health Sciences, School of Public Health, Texas A&M University, College Station, Texas, United States of America
- Center for Population Health and Aging, Texas A&M University, College Station, Texas, United States of America
- Southwest Rural Health Research Center, Texas A&M University, College Station, Texas, United States of America
- * E-mail:
| | - Yajuan Li
- Department of Agricultural Economics, Texas A&M University, College Station, Texas, United States of America
| | - Shinduk Lee
- Center for Population Health and Aging, Texas A&M University, College Station, Texas, United States of America
| | - Matthew Lee Smith
- Center for Population Health and Aging, Texas A&M University, College Station, Texas, United States of America
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, Texas, United States of America
- Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, Georgia, United States of America
| | - Gang Han
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, Texas, United States of America
| | - Cindy Quinn
- Center for Population Health and Aging, Texas A&M University, College Station, Texas, United States of America
| | - Yuxian Du
- Center for Population Health and Aging, Texas A&M University, College Station, Texas, United States of America
- Department of Health Policy and Management, School of Public Health, Texas A&M University Health Science Center, College Station, Texas, United States of America
| | - Mark Benden
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, Texas, United States of America
| | - Marcia G. Ory
- Center for Population Health and Aging, Texas A&M University, College Station, Texas, United States of America
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, Texas, United States of America
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