An educational program based on the successful aging approach on health-promoting behaviors in the elderly: a clinical trial study

Psychache status and associated contributing factors among the Hakka elderly in Fujian, China

BACKGROUND

Little is known about the state of psychological distress of the elderly in China, and research on specific subgroups such as Hakka older adults is almost lacking. This study investigates psychache and associated factors among Hakka elderly in Fujian, China.

METHODS

The data analysed in this study were derived from China's Health-Related Quality of Life Survey for Older Adults 2018. The Chinese version of the Psychache Scale (PAS) was used to assess the frequency and intensity of psychache in Hakka older adults. Generalized linear regression analysis was conducted to identify the main socio-demographic factors associated with psychache overall and its frequency and intensity.

RESULTS

A total of 1,262 older adults participated, with mean scores of 18.27 ± 6.88 for total PAS, 12.50 ± 4.79 for PAS-Frequency and 5.77 ± 2.34 for PAS-Intensity. On average, females scored higher than males on PAS-Frequency (β = 0.84, 95% CI = 0.34, 1.35) and PAS-Intensity (β = 0.48, 95% CI = 0.22, 0.73). Older adults currently living in towns (β = -2.18, 95% CI = -2.81, -1.54), with their spouse only (β = -3.71, 95% CI = -4.77, -2.65), or with children (β = -3.24, 95% CI = -4.26, -2.22) were more likely to score lower on PAS-Frequency. Conversely, older adults who were regular sleepers (β = -1.19, 95% CI =-1.49, -0.88) or lived with their spouse only (β = -1.25, 95% CI = -1.78, -0.72) were more likely to score lower on PAS-Intensity.

CONCLUSION

Among Hakka elderly, we found a higher frequency and greater intensity of psychache in females, those with poor health status, irregular sleepers, rural residents, solo dwellers, those with below CNY 10,000 in personal savings, and the medically uninsured. The study's findings indicate that policymakers should give more attention to the susceptible population and implement practical interventions to reduce their psychological burden.

Successful Aging of Korean Older Adults Engaging in Sports Regularly: Health Beliefs, Exercise Adherence Intention, and Health Promotion Behavior

The population of older adults is increasing more rapidly in Korea than in any other country, making successful aging a salient need in Korean society. For successful aging, older adults must engage in sports activities regularly. This study determined the relationships among health beliefs, exercise adherence intention, health promotion behavior, and successful aging among older adults who engage in sports activities regularly. The participants were 287 adults aged 65 years or older who live in Korea and exercise regularly. Data were collected through a survey and analyzed using descriptive statistics, correlation analysis, and structural equation modeling. The integrated model lacked explanatory power in terms of goodness of fit, but the alternative model had sufficient explanatory power. The alternative model showed that health beliefs, exercise adherence intention, and health promotion behavior are significantly related and that health promotion behavior positively predicts successful aging. It also showed that health beliefs affect successful aging through the mediation of exercise adherence intention and health promotion behavior. This study is meaningful because it verifies the structural and theoretical relationships among health beliefs, exercise adherence intention, health promotion behavior, and successful aging. As a result, it provides information that can improve the welfare of older adults in Korean society.

Associated factors of health-promoting lifestyle of the elderly based on the theory of social ecosystem

OBJECT

To explore the factors related to health-promoting lifestyles of the elderly based on social-ecosystem theory.

DESIGN

A cross-sectional survey study was carried out to include 627 elderly people in communities in three cities of Hebei Province (Shijiazhuang, Tangshan, and Zhangjiakou) from October 2021 to January 2022 for questionnaire survey (601 validly returned cases).

VENUE

Three cities of Hebei Province (Shijiazhuang, Tangshan, and Zhangjiakou).

PARTICIPANTS

627 elderly people.

INTERVENTIONS

A cross-sectional survey study.

MAIN MEASUREMENTS

The questionnaire survey was conducted by using the general demographic data, health promotion life scale, frailty scale, general self-efficacy scale, health engagement scale, General Self-Efficacy Scale, The family Adaptability, Partnership, Growth, Affection, and Resolve scale, and Perceived Social Support Scale.

RESULTS

The total health promotion lifestyle score for the elderly was 100.20±16.21, which was at the lower limit of the good level, with the highest mean score for nutrition (2.71±0.51) and the lowest mean score for physical activity (2.25±0.56). Stepwise linear regression showed that exercise frequency (95% confidence interval (CI) 1.304-3.885), smoking status (95% CI -4.190 to -1.556), self-efficacy (95% CI 0.071-0.185), health management (95% CI 0.306-0.590), frailty (95% CI -3.327 to -1.162) in the microsystem, marital status (95% CI 0.677-3.660), children's attention to the elderly health (95% CI 4.866-11.305), family care in the mesosystem (95% CI 1.365-4.968), and pre-retirement occupation (95% CI 2.065-3.894), living area (95% CI 0.813-3.912), whether receive community-based chronic disease prevention and management services (95% CI 2.035-8.149), social support (95% CI 1.667-6.493) in the macrosystem were the main factors affecting health promotion of life in the elderly (P<0.05). Hierarchical regression analysis showed the microsystem accounted for 17.2%, the mesosystem accounted for 7.1%, and the macrosystem accounted for 11.4%.

CONCLUSION

The health promotion lifestyle of the elderly in Hebei Province was at the lower limit of good level. Among them, exercise frequency, children's attention to the elderly health, and pre-retirement occupation played a major role in relation to the health-promoting lifestyle of the elderly. Hence, it needs the joint action of individuals, families, and society to promote the elderly to adopt the health promotion lifestyle and realize healthy aging.

A new multidimensional group intervention for cognitive and psychosocial functioning for older adults: Background, content, and process evaluation

Introduction

An essential element of quality aging is the maintenance of cognitive and psychosocial functioning. The principal objective of the present paper was to present the theoretical framework, content and process evaluation of a newly developed multi-dimensional group intervention designed to strengthen/improve areas of cognitive and psychosocial functioning in adults over 65.

Methods

The intervention implements multiple methodologies aiming to facilitate contextual integration of learned concepts and strategies derived from clinical psychology and rehabilitation. It moves seamlessly on the cognition-emotion axes and consists of five active ingredients selected to address challenges associated with aging: Memory Compensatory Strategies, Problem-Solving, Emotion Regulation, Mindfulness, and Locus of Control. Thirty participants joined the intervention group aged 65-75  years (M = 69.03; SD = 3.04). All 30 participants who were included in the intervention group completed the program.

Results

Results from the Participant Satisfaction Scale indicate that the program was perceived very positively by participants, who also reported implementing their newly learned strategies in activities of daily life. Furthermore, there was high correlation between internal locus of control and the learned strategies.

Discussion

The outcomes of this analysis indicate that the intervention is feasible and well tolerated by our target group. This multidimensional intervention may offer a valuable contribution to public health care and dementia prevention for older adults.

Clinical Trial Registration

[https://clinicaltrials.gov/ct2/results?cond=NCT01481246], identifier [NCT01481246].

Predictors of retirement satisfaction in the older adults of Urmia: a cross-sectional study

Background

Retirement is a challenge that, as a process, influences the individual’s role, status, life patterns, expectations, and available resources. Therefore, the present study aims at determining the predictors of retirement satisfaction among men in the city of Urmia.

Methods

In this descriptive-analytical study, 140 retired men living in Urmia were selected by multi-stage sampling method. The instruments used are the Retirement Satisfaction Scale, life satisfaction, and quality of life questionnaires. Data were analyzed in SPSS v.21 using descriptive statistics, one-way ANOVA, and regression at a significance level of p ≤ 0.05.

Results

Based on the results of this study, the mean score of retirement satisfaction was 115.37 + 10.13 and there was no significant difference (p = .068) in retirement satisfaction of the retired men based on level of education. Also, the retrospective multiple linear regression model indicated that 44.4% of the variance of retirement satisfaction score is predicted by two subscales of life satisfaction and quality of life.

Conclusion

According to the results, it seems that life satisfaction and quality of life are inseparable, effective factors in retirement satisfaction, so, to promote retirement satisfaction in all of its scales and subscales, it is recommended to improve these two factors.

Evaluation of a self-care education program for older adults in Iran using a lifestyle improvement model

BACKGROUND

Older adults and their caregivers often believe it is either too late or too difficult to make health-focused lifestyle changes. However, this is inaccurate, as older adults can make health promotion focused lifestyle changes thereby improving their health. This study developed and evaluated a self-care education program using Pender's Health Promotion Model and its influence on health-focused behaviour changes among older Iranians.

METHOD

This was a quasi-experimental study with a convenience sample of 136 community-living older adults from Tabriz, Iran. The participants were randomly assigned to either an intervention (n = 69) or control (n = 67) group. Chi-square test, independent t tests and Analysis of covariance (ANCOVA) statistical methods were used to compare pre- and post-intervention data, control and intervention groups and changes over time. The intervention was an eight-week educational program with pre- and post-intervention data collected using the Health Promoting Lifestyle Profile II (HPLP II) questionnaire.

RESULTS

The mean difference and confidence limits of the older adults' health behaviours pre- and post-intervention scores were 2.228 (-5.450 - 9.916) and - 35.820 (-32.051 - 39.588). The covariance analysis adjusting for the baseline values showed significant differences post-intervention (p<0.0001) in the areas of interpersonal communication, physical activity, nutrition, stress management and spiritual growth.

CONCLUSION

The health promotion education intervention illustrated that older Iranians could improve their health outcomes in several areas. Thus, culturally tailored intervention programs can be successful in challenging the opinion that older adults cannot make behaviour changes supporting their health.

Effectiveness of education based on family-centered empowerment model on health-promoting behaviors and some metabolic biomarkers in elderly women: A stratified randomized clinical trial

OBJECTIVE

The purpose of family-centered care interventions is to enhance the abilities of family members in certain areas that overcome the barriers to health and well-being, The purpose of the present research was to determine the effect of education based on family-centered empowerment model on health-promoting behaviors and some serum metabolic indicators in elderly women.

MATERIALS AND METHODS

In this stratified randomized controlled trial, 60 elderly women aged 60 years and older referring to elderly-friendly health centers in Tabriz-East Azerbaijan were divided randomly into intervention and control groups in 2019. Intervention group received a family-centered healthy lifestyle intervention once a week for 10 sessions and the control group received the routine care. The mean score of health-promoting behaviors using the Health Promoting Lifestyle Profile-II questionnaire, glycemia and serum lipid profile, liver and renal function, 25-hydroxy Vitamin D, and calcium serum levels were assessed before the intervention, 2 and 6 months after the intervention through SPSS/version 23 using independent t-test, ANCOVA, and repeated measure analysis.

RESULTS

The ANCOVA test showed a significant increase in total lifestyle score in the intervention compared to the control group, 2 (adjusted mean difference [aMD]: 13.7; 95% confidence interval [CI]: 5.6-21.8) and 6 months (aMD: 17.2; 95% CI: 7.7-26.7) after education. The score of the nutrition and health responsibility domains significantly increased two (P < 0.05) and 6 months (P < 0.001) after the intervention in the intervention group compared to control. In both groups, serum levels of total cholesterol, low-density lipoprotein cholesterol, urea, and creatinine showed a significant decrease, and high-density lipoprotein cholesterol and calcium levels showed a significant increase (P < 0.05).

CONCLUSION

A healthy lifestyle education based on family-centered empowerment model increased the total lifestyle score. So, it is recommended as an effective educational approach to improve the health of elderly.

Health promotion and active aging among seniors in Malaysia

Purpose

This paper explores the relationship between health promotion and active aging among seniors in Malaysia. The specific objectives were to (1) identify the contributing factors for seniors undergoing full medical check-up and (2) to explore the association between selected active aging factors and health promotion behavior and beliefs.

Design/methodology/approach

The study used data from 662 seniors from three different states in Peninsular Malaysia. Logistic regression was used to identify significant determinants of full medical check-up, and chi-square statistics were used to explore the association of active aging and selected health promotion behavior and beliefs. Healthy aging was characterized by being employed or traveling outdoors for leisure.

Findings

Household income was found to be a significant barrier to seniors undergoing a full medical check-up. Overall, active seniors were more likely to have positive self-rated health, positive health responsibility and health promotion beliefs but were less likely to undergo a full medical check-up.

Practical implications

Given that cost of a medical check-up could be a barrier for seniors, authorities could consider subsidizing medical check-ups to promote early detection of disease. There is also a need for continuous effort to educate seniors on health risk factors and the importance of taking fuller responsibility for their own health.

Originality/value

This study examined the relationship between active aging and health promotion together, as both components are essential in enhancing the mental and physical well-being of seniors.

Factors Affecting Health-Promoting Lifestyle Among Older Women With Chronic Disease

The current cross-sectional descriptive study applies the Health Promotion Model to explore associations among sociodemographics, psychological factors (self-esteem), self-efficacy, perceptions of current health, and social support affecting older women with at least one chronic disease in South Korea. Convenience sampling of 232 older women aged ≥65 from a welfare center in South Korea showed that a health-promoting lifestyle is significantly and positively correlated with self-esteem, self-efficacy, perception of current health, and social support. Multiple regression analysis revealed that social support had the greatest effect on health-promoting lifestyle, explaining 49% of the dependent variable variance. Nurses serve a crucial role in providing care for older women by helping them within community settings to find resources for senior fitness, encouraging them to pursue health-related habits, and strengthening support systems by encouraging participation in social activities and maintaining strong relationships and interactions with family and friends. [Journal of Gerontological Nursing, 45(10), 29-38.].

A systematic review of global health capacity building initiatives in low-to middle-income countries in the Middle East and North Africa region

INTRODUCTION

Low-and Middle-Income Countries (LMICs) in the Middle East and North Africa (MENA) region are facing increasing global health challenges with a reduced ability to manage them. Global Health Capacity Building (GHCB) initiatives have the potential to improve health workforce performance and health outcomes, however little is known about the GHCB topics and approaches implemented in this region. This is the first systematic review of GHCB initiatives among LMICs in the MENA region.

METHODS

An academic database search of Medline (OVID), PubMed, Scopus, Embase.com , and Open Grey was conducted for articles published between January 2009 and September 2019 in English. Next, a grey literature search following a recommended search framework was conducted. Reviewed records addressed a global health topic, had a capacity building component, looked at specific learning outcomes, and reflected an LMIC in the MENA. Primary outcomes included country, topic, modality, pedagogy, and population.

RESULTS

Reports of GHCB initiatives were retrieved from grey sources (73.2%) and academic sources (26.8%). Most GHCB initiatives were mainly conducted face-to-face (94.4%) to professional personnel (57.5%) through a theoretical pedagogical approach (44.3%). Dominant global health themes were non-communicable diseases (29.2%), sexual and reproductive health (18.4%), and mental health (14.5%). When matched against the Global Burden of Disease data, important gaps were found regarding the topics of GHCB initiatives in relation to the region's health needs. There were limited reports of GHCB initiatives addressing conflict and emergency topics, and those addressing non-communicable disease topics were primarily reported from Egypt and Iran.

CONCLUSION

Innovative and practicum-based approaches are needed for GHCB initiatives among LMICs in the MENA region, with a focus on training community workers. Regional and country-specific analyses of GHCB initiatives relative to their health needs are discussed in the manuscript based on the results of this review.

Predictors of Health-Promoting Lifestyle in Pregnant Women Based on Pender's Health Promotion Model

Background and Objectives

Pregnancy causes changes in women’s lifestyle; therefore, their health-promoting behaviors should be improved in order to avoid problems during this critical period, which requires knowledge of the factors affecting these behaviors. This study was conducted to determine the predictors of health-promoting lifestyles in pregnant women based on Pender’s health promotion model constructs.

Methods

This descriptive study was carried out on 300 pregnant women in their second and third trimesters of pregnancy and sought to determine the correlation between lifestyle and the constructs of Pender’s health promotion model. Data were collected using a demographic questionnaire, the Health Promoting Lifestyle Profile II (HPLP-II) and a questionnaire based on Pender’s model constructs. Data were analyzed using descriptive and analytical statistics.

Findings

A health-promoting lifestyle had a significant positive correlation with the constructs of social support and perceived benefits and a significant negative correlation with the construct of perceived barriers (P<0.05). A health-promoting lifestyle also had a significant relationship with the constructs of perceived barriers, social support and perceived benefits in pregnant women (P<0.05) based on the results of the regression analysis. The regression coefficients showed that all the three variables can significantly explain the variance in health promoting lifestyles in pregnant women (P<0.05).

Conclusion

According to the results of the present study and based on the constructs of Pender’s health promotion model, social support, perceived benefits and perceived barriers were the most important predictors of health-promoting lifestyles in pregnant women. These predictor constructs are recommended to be further considered in designing and implementing training packages and interventions for promoting pregnant women’s lifestyle.

The Concept of Successful Aging: A Review Article

Background

With the increasing number of elderly people in the world, usage of concepts and terminology related to this phenomenon has substantially increased. One concept in this context is successful aging. The purpose of the present study is to extract and introduce a common concept to be used in studies on measuring successful aging.

Methods

This is a review study. First, by searching the databases of Magiran, Noormags, Medlib, Irandoc, Iranmedex, Barakat Knowledge Network System, Civilica, SID, ISI Web Of Science, PubMed, Scopus, Science Direct and search engines, Google Scholar and Elmnet as well as using standard keywords such as elder, elderly, aging, and successful aging, all related published articles during the period 1995 to 2017 were retrieved. A total of 3417 documents were retrieved. By removing 3390 unrelated, duplicate and unusable documents, 27 articles were included in the study after quality control.

Results

The findings of the study were categorized in three areas: “defining successful aging by focusing on dimensions”, “successful aging principles” and “factors influencing successful aging”. Reviewing various studies, we found that the definition of successful aging deals with cognitive action, perception, control, life satisfaction, and ethics. Successful aging is also defined as having inner feelings of happiness and satisfaction with life for the present and the past. Sometimes successful aging is also considered to be survival with health.

Conclusion

Health care professionals as community health supporters can use the results from the present study for providing the grounds for successful aging. Then, they can use the designed successful aging program for preserving and promoting active and healthy aging for every elderly person in old age.

Health-Promoting Lifestyle among People Without Heart Disease in Isfahan

Background

The present research conducted with aim to determine the health-promoting behaviors (HPBs) of public of Isfahan, and study the associations of HPBs with demographic characteristics.

Methods

In a cross-sectional study conducted on 369 people without heart disease living in Isfahan, HPBs were assessed using a questionnaire which consists of two parts: personal information and Health-Promoting Lifestyle Profile II (HPLP-II). Data were analyzed by t-test and one-way analysis of variance.

Results

The mean score for overall HPLP-II (158.30 ± 19.38) indicated the acceptable level of performing HPBs in Isfahan. Physical activity got the lowest score (16.36 ± 5.13), and the highest score was for interpersonal relations (53.16 ± 5.59). There were significant differences on physical activity and interpersonal relation dimensions between males and females (P < 0.05). The mean score of physical activity was highest in single participants (P < 0.05). Mean score of physical activity for people with college education was greater than others (P < 0.05). Overall HPLP-II and its domains mean scores for people that received education about prevention of cardiovascular disease were greater than others (P < 0.05).

Conclusions

Results showed HPBs in people of Isfahan society is acceptable but physical activity is in the worst condition. The role of physical activity in preventing and controlling cardiovascular disease is well established. Therefore, it seems that providing information about physical activity can lead to an improvement of health-promoting lifestyle.

Investigating the effect of education on health-promoting lifestyle among the elderly of Ramsar in 2017

Introduction and Objective:

Providing and enhancing the level of health are one of the essential needs of all people, and implementation of health promotion lifestyle is the most important and effective factor in maintaining and improving the health of the elderly. The present study aimed at defining the effect of aging on health-promoting lifestyle.

Methodology:

This randomized clinical trial was conducted on 72 individuals from the retirees clubs of Education department, Social Security, and Health centers in Ramsar, in 2017. Sampling was done randomly with blocking and random allocation in two groups: Experimental and control. Data were collected in two steps by Demographic profile questionnaire, AMT, ADL, OHI and HPlP II which validity and reliability of them were confirmed. Participants attended eight training sessions (twice each week). Data analysis was performed with the use of SPSS 18 and descriptive (Frequency) and analytic tests (Chi-square, Fisher's exact test, Independent Sample t test and Paired Sample t test) with a significance level of 0.05.

Results:

The results showed that the mean age of the elderly was 64.4 ± 4.1 years. The mean score of lifestyle enhancement was 148.59 and 173.25 before and after training in the experimental group, respectively. Based on the results of paired t-test (P < 0. 323), there was no significant difference between the mean life expectancy of elderly health promotion in control group before and after educational intervention; however, there was a significant difference between the two groups before and after training (P = 0.001).

Conclusion:

Educational programs play an important role in integrating health-promoting lifestyle to encourage the elderly to accept more accountability regarding health, sustained physical fitness, proper nutrition, healthy interpersonal relationships, expected spiritual growth, and the proper management of stress and anxiety in life.

A Cross-Disciplinary Successful Aging Intervention and Evaluation: Comparison of Person-to-Person and Digital-Assisted Approaches

Background: Successful aging has been the paradigm of old-age life. The purpose of this study was to implement and evaluate a cross-disciplinary intervention program using two approaches for community-based older adults in Taichung, Taiwan. Methods: The content of the intervention included successful aging concepts and preparation, physical activity, chronic disease and health management, dietary and nutrition information, cognitive training, emotional awareness and coping skills, family relationship and resilience, legal concepts regarding financial protection, and Internet use. The traditional person-to-person (P2P) intervention approach was implemented among participants at urban centers, and the personal-and-digital (P&D) intervention approach was implemented among participants at rural centers; before the P&D group received the intervention, participants were assessed as the control group for comparison. Results: Healthy behavior and nutrition improved for the P2P group, although not significantly. Strategies for adapting to old age and reducing ineffective coping were significantly improved in the P2P group. The ability to search for health information improved in the P&D group, and knowledge of finance-related law increased in the P2P group. Conclusion: A continuous, well-designed and evidence-based intervention program is beneficial for improving the health of older adults, or at least delaying its decline.

Design and implementation of an empowerment model to prevent elder abuse: a randomized controlled trial

Background

Older adults are more vulnerable to health risks than younger people and may get exposed to various dangers, including elder abuse. This study aimed to design and implement an empowerment educational intervention to prevent elder abuse.

Methods

This parallel randomized controlled trial was conducted in 2014–2016 for 18 months on 464 older adults aged above 60 years who visited health houses of 22 municipalities in Tehran. Data were collected using standard questionnaires, including the Elder Abuse-Knowledge Questionnaire, Health-Promoting Behavior Questionnaire, Health-Promoting Lifestyle Profile II, Barriers to Healthy Lifestyle, Perceived Social Support, Perceived Self-Efficacy, Loneliness Scale, Geriatric Depression Scale, Multidimensional Health Locus of Control Scale, and the SCARED (stress, coping, argument, resources, events, and dependence) tool. The intervention was done in twenty 45- to 60-minute training sessions over 6 months. Data analysis were performed using χ² tests, multiple linear and logistic regression, and structural equation modeling (SEM).

Results

The frequency of knowledge of elder abuse, self-efficacy, social support and health promoting lifestyle before the intervention was similar in the two groups. However, the frequency of high knowledge of elder abuse (94.8% in the intervention group and 46.6% in the control group), high self-efficacy (82.8% and 7.8%, respectively), high social support (97.0% and 10.3%, respectively) and high health promoting lifestyle (97.0% and 10.3%, respectively) was significantly higher (P<0.001) and the frequency of elder abuse risk (28.0% and 49.6%, respectively) was significantly less in the intervention group after the intervention. SEM standardized beta (Sβ) showed that the intervention had the highest impact on increase social support (Sβ=0.80, β=48.64, SE=1.70, P<0.05), self-efficacy (Sβ=0.76, β=13.32, SE=0.52, P<0.05) and health promoting behaviors (Sβ=0.48, β=33.08, SE=2.26, P<0.05), respectively. The effect of the intervention on decrease of elder abuse risk was indirect and significant (Sβ=−0.406, β=−0.340, SE=0.03, P<0.05), and through social support, self-efficacy, and health promoting behaviors.

Conclusion

Educational interventions can be effective in preventing elder abuse.

Effectiveness of the Vital Aging program to promote active aging in Mexican older adults

Introduction

Aging is not only a population phenomenon but also an experience and an individual reality. Vital Aging^® is a program that considers active aging as the lifelong adaptation process of maximizing health and independence, physical and cognitive functioning, positive affect regulation and control, and social engagement. Through its different versions and editions, it has demonstrated being an effective program to promote active aging. The aim of this study is to determine the effectiveness of the “face-to-face” and “combined” versions of the program to promote active aging in Mexican older adults trial.

Methods

Seventy-six older adults aged 60 years and over participated in a quasi-experimental study and were recruited in a senior center to participate in the two experimental conditions: Vital Aging face-to-face (VA-FF) (n=35) and Vital Aging combined (VA-C; multimedia/face-to-face) (n=15), and the remaining 26 adults were assigned to a control group. Pretest and posttest assessments were performed after the theoretical–practical intervention. Mean differences and size effects were calculated for estimating the effect of the program.

Results

At the end of the study, participants showed improvements in the active aging outcome measures. Positive effects were observed in the frequency of intellectual, cultural – artistic, and social activities, perceptions of aging, satisfaction with social relationships, and self-efficacy for aging. Additionally, those who participated in VA-FF showed better memory performance, meta-memory, and a trend to report less memory problems, while older persons in VA-C showed a trend to have better life satisfaction. No effects were observed in physical activity, frequency of social relationships, and subjective health.

Conclusion

Findings show that the Vital Aging program in face-to-face and combined versions encourages active aging in Mexican older persons. These results are in general similar to those found in editions performed in Spain, revealing its consistency as a cross-cultural practical initiative for promoting active aging.

Older People's Perspectives on Health, Physical Activity and Nutritional Behaviors

Background: Approaches for investigating health-promoting lifestyle generally focus on physical activity and regular diet. To explore the perspectives of Iranian elders regarding health, healthy eating and physical activity (PA) this study was conducted in 2012.

Methods: Participants in this qualitative study were selected through purposeful sampling. Ten focus groups were conducted with 60 older adults in 3 elderly centers in Tehran. A moderator’s guideline that consisted of general and specific questions was used. Focus groups were audio recorded, transcribed verbatim and analysis was performed using conventional content analysis.

Results: Participants explained their perspectives regarding health, healthy eating and PA in the following 5 categories: meaning of health was represented based on issues such as absence of pain and disorder, complete body wellbeing, staying away from hazards, complete individual satisfaction, experiencing positive events, effective communication, faithfulness and trust in God. The healthy eating category was featured by adequate eating, age balanced diet, refraining from under or over nutrition and sensible consumption of fruits and vegetables. The PA was described - according to the level of performing outdoor activities or household tasks. Expressions about the perceived benefits and barriers of healthy eating and PA were aligned the two remaining categories.

Conclusions: Participants have referred to the association between both PA and dietary practices and health. Understanding how older people define physical activity and nutritional behavior and recognition of the most important perceived benefits and barriers that might contribute to have a healthy eating or adequate PA profile could procure insight into the type of interventions that are required to promote healthy lifestyle among Iranian older adults.

"I am active": effects of a program to promote active aging

BACKGROUND

Active aging involves a general lifestyle strategy that allows preservation of both physical and mental health during the aging process. "I am Active" is a program designed to promote active aging by increased physical activity, healthy nutritional habits, and cognitive functioning. The purpose of this study was to assess the effectiveness of this program.

METHODS

Sixty-four healthy adults aged 60 years or older were recruited from senior centers and randomly allocated to an experimental group (n=31) or a control group (n=33). Baseline, post-test, and 6-month follow-up assessments were performed after the theoretical-practical intervention. Effect sizes were calculated.

RESULTS

At the conclusion of the program, the experimental group showed significant improvement compared with the control group in the following domains: physical activity (falls risk, balance, flexibility, self-efficacy), nutrition (self-efficacy and nutritional status), cognitive performance (processing speed and self-efficacy), and quality of life (general, health and functionality, social and economic status). Although some declines were reported, improvements at follow-up remained in self-efficacy for physical activity, self-efficacy for nutrition, and processing speed, and participants had better nutritional status and quality of life overall.

CONCLUSION

Our findings show that this program promotes improvements in domains of active aging, mainly in self-efficacy beliefs as well as in quality of life in healthy elders.

Clinical effect size of an educational intervention in the home and compliance with mobile phone-based reminders for people who suffer from stroke: protocol of a randomized controlled trial

Background

Stroke is the third-leading cause of death and the leading cause of long-term neurological disability in the world. Cognitive, communication, and physical weakness combined with environmental changes frequently cause changes in the roles, routines, and daily occupations of stroke sufferers. Educational intervention combines didactic and interactive intervention, which combines the best choices for teaching new behaviors since it involves the active participation of the patient in learning. Nowadays, there are many types of interventions or means to increase adherence to treatment.

Objective

The aim of this study is to enable patients who have suffered stroke and been discharged to their homes to improve the performance of the activities of daily living (ADL) in their home environment, based on advice given by the therapist. A secondary aim is that these patients continue the treatment through a reminder app installed on their mobile phones.

Methods

This study is a clinical randomized controlled trial. The total sample will consist of 80 adults who have suffered a stroke with moderate severity and who have been discharged to their homes in the 3 months prior to recruitment to the study. The following tests and scales will be used to measure the outcome variables: Barthel Index, the Functional Independence Measure, the Mini-Mental State Examination, the Canadian Neurological Scale, the Stroke Impact Scale-16, the Trunk Control Test, the Modified Rankin Scale, the Multidimensional Scale of Perceived Social Support, the Quality of Life Scale for Stroke, the Functional Reach Test, the Romberg Test, the Time Up and Go test, the Timed-Stands Test, a portable dynamometer, and a sociodemographic questionnaire. Descriptive analyses will include mean, standard deviation, and 95% confidence intervals of the values for each variable. The Kolmogov-Smirnov (KS) test and a 2x2 mixed-model analysis of variance (ANOVA) will be used. Intergroup effect sizes will be calculated (Cohen’s d).

Results

Currently, the study is in the recruitment phase and implementation of the intervention has begun. The authors anticipate that during 2015 the following processes should be completed: recruitment, intervention, and data collection. It is expected that the analysis of all data and the first results should be available in early-to-mid 2016.

Conclusions

An educational intervention based on therapeutic home advice and a reminder app has been developed by the authors with the intention that patients who have suffered stroke perform the ADL more easily and use their affected limbs more actively in the ADL. The use of reminders via mobile phone is proposed as an innovative tool to increase treatment adherence in this population.

Trial Registration

ClinicalTrials.gov NCT01980641; https://clinicaltrials.gov/ct2/show/NCT01980641 (Archived by WebCite at http://www.webcitation.org/6WRWFmY6U).