Faith D. Lees

The Relationship Between Obesity, Physical Activity, and Physical Function in Older Adults

Objective: This study investigated the relationship between overweight and obesity, age, and gender with physical activity and physical function in community-dwelling older men and women. Method: Multivariate analysis of covariance was used to analyze differences between normal weight, overweight, and obese adults (n = 821) above the age of 60 years. Results: Obesity but not overweight was associated with lower levels of physical activity and physical function. Within BMI groups, individuals who were physically active were less likely to have abnormal physical function scores compared to those who were sedentary. Compared to men, obese women had lower physical function scores, placing them at higher risk for future disability. Aging was associated with lower levels of physical activity and physical function. Discussion: The study illustrates the importance of avoiding obesity and participating in regular physical activity to prevent or slow down the loss of functioning in older age.

Intervening on exercise and nutrition in older adults: the Rhode Island SENIOR Project.

Presented are the basic design, methods, and baseline data analyses for the Study of Exercise and Nutrition in Older Rhode Islanders (SENIOR Project) an experimental study to investigate the relative effectiveness of a 12-month, stage of readiness to change-based multiple-behavior intervention (exercise and nutrition) compared to single-behavior interventions in a community-dwelling population of 1,277 older adults. Relationships between stage of readiness to change in the two target behaviors, as well as the relationship between stage of readiness and self-reported exercise levels and fruit and vegetable consumption, were examined using a combination of Pearson chi-squares, analyses of variance (ANOVA), and Spearman’s rank order correlations. Stage of change (SOC) for fruit and vegetable consumption was significantly associated with the dietary measure, and SOC for exercise was associated with both the three physical activity measures and servings of fruits and vegetables per day. Overall, individual older adults readiness to change seems largely to be behavior-specific.

Physical activity, physical function, and stages of change in older adults.

OBJECTIVE To characterize physical activity and physical function by stage of change and age in older adults. METHODS One thousand two hundred thirty-four individuals completed The Yale physical activity survey (YPAS), stage of change for exercise, and the Up-and-Go physical function test. RESULTS Most subjects were in the maintenance (50.4%) or precontemplation stages (21/0%). YPAS scores were higher and Upand-Go scores were lower as exercise stage increased. Physical activity and physical function scores were lower in older age groups. CONCLUSION Higher stages were positively associated with physical activity and physical function. Age was a significant moderator variable affecting stage, physical activity, and physical function.

Accumulation of Behavioral Validation Evidence for Physical Activity Stage of Change

OBJECTIVE The purpose of this study was to accumulate behavioral validity evidence for physical activity Stage of Change (SOC). DESIGN Nine studies used a common physical activity SOC measure and examined self-report, objective, and performance physical activity indicators to accumulate behavioral validity evidence for SOC. Type of measure, the strength of the expected relationship between the measure and SOC, and the predicted SOC differences were examined. Validity evidence for the SOC was also examined by population and sampling method. MAIN OUTCOME MEASURES Validity evidence for physical activity SOC was classified with respect to the type of measurement instrument and the hypothesized magnitude of the relationship between the measure and the SOC. RESULTS Physical activity SOC was found to be behaviorally valid as evidenced by self-reported physical activity, self-reported exercise, self-reported sedentary behaviors, pedometers, and physical functioning. Physical activity SOC does not appear to be related to physical fitness or weight indicators. CONCLUSIONS This study highlights a successful multi-site collaboration. Physical activity data from nine large-scale, health trials was combined and accumulated behavioral validation evidence for the physical activity SOC.

Maintaining exercise and healthful eating in older adults: the SENIOR project II: study design and methodology.

The Study of Exercise and Nutrition in Older Rhode Islanders (SENIOR) Project II is an intervention study to promote the maintenance of both exercise and healthful eating in older adults. It is the second phase of an earlier study, SENIOR Project I, that originally recruited 1277 community-dwelling older adults to participate in behavior-specific interventions designed to increase exercise and/or fruit and vegetable consumption. The general theoretical framework for this research is the Transtheoretical Model (TTM) of Health Behavior Change. The current intervention occurs over a 48-month period, using a manual, newsletters, and phone coaching calls. Annual assessments collect standardized data on behavioral outcomes (exercise and diet), TTM variables (stage of change and self-efficacy), psychosocial variables (social support, depression, resilience, and life satisfaction), physical activity and functioning (SF-36, Up and Go, Senior Fitness Test, and disability assessment), cognitive functioning (Trail Making Test and Forward and Backward Digit Span), physical measures (height, weight, and waist circumference), and demographics. The SENIOR Project II is designed to answer the following question as its primary objective: (1) Does an individualized active-maintenance intervention with older adults maintain greater levels of healthful exercise and dietary behaviors for 4years, compared to a control condition? In addition, there are two secondary objectives: (2) What are the psychosocial factors associated with the maintenance of health-promoting behaviors in the very old? (3) What are the effects of the maintenance of health-promoting behaviors on reported health outcomes, psychosocial measures, anthropometrics, and cognitive status?

Achieving recruitment goals through community partnerships: the SENIOR Project.

Summary: This article discusses the process of developing collaborative relationships for a community-based health promotion project. A partnership was established among the university, the city where the intervention took place, and the community senior center. A community advisory board was created to identify the strengths, diversity, and needs of each partner. The community advisory board guided the partnership to recruit 1,277 older adults to participate in the intervention study. A sample was deemed representative after comparison with Census 2000 data, with gender and educational attainment being similar.

Recruiting and retaining older adults for health promotion research: the experience of the SENIOR Project.

Abstract This paper examines recruitment and retention efforts utilized by a community-based health promotion intervention with older adults (N = 1,277). Recruitment strategies were classified as either involving or not involving personal interaction with project staff. There was no difference by recruitment method in demographic characteristics, but a greater proportion of participants recruited using strategies without personal interaction were in the earlier stage of change (SOC) for fruit and vegetable consumption compared with those recruited using strategies involving personal contact. Conversely, a greater proportion recruited without interaction with project staff was in action/maintenance SOC for exercise. Attrition was greater among individuals in the earlier SOC for exercise and among those who perceived their health to be fair/poor. As most participants were recruited using strategies involving interaction with project staffs, it may be best to emphasize techniques involving personal contact when recruiting older adults to participate in research studies.

What older adults find useful for maintaining healthy eating and exercise habits.

Abstract Four focus groups were conducted with a total of 29 adults 60 years of age and older enrolled in the SENIOR Project, a health promotion intervention study designed to increase fruit and vegetable consumption and exercise among communitydwelling older adults. The focus groups explored the motivations of older adults to eat five or more servings of fruits and vegetables and/or exercise and the strategies used to adopt or maintain these behaviors. Participants stated that maintaining health, remaining independent, and fearing illness provided the motivation needed to adhere to these behaviors. The strategies or the behavioral processes used to adopt or maintain these behaviors included counterconditioning, helping relationships, stimulus control, and selfliberation.

Psychosocial Factors Associated With Physical Activity in Older Adults

Overwhelming evidence supports the health benefits of physical activity and the negative health consequences associated with physical inactivity. Nonetheless, the vast majority of older adults (65+ years of age) are insufficiently active. There is an array of psychosocial factors associated with physical activity among older adults. This chapter provides an overview of several of these key psychosocial factors that may be unique to older adults and are amenable to change through intervention. They should be considered when developing interventions to increase or maintain physical activity participation, regardless of intervention setting. Expanding our understanding of, and addressing psychosocial factors associated with, physical activity among older adults may strengthen programs designed to increase physical activity in this age group, which can lead to both reduced chronic diseases and disabilities and increased quality of life.

Exploring How the Home Environment Influences Eating and Physical Activity Habits of Low-Income, Latino Children of Predominantly Immigrant Families: A Qualitative Study

Latinos are the largest and fastest growing minority population group in the United States, and children in low-income Latino families are at elevated risk of becoming overweight or having obesity. A child’s home is an important social environment in which he/she develops and maintains dietary and physical activity (PA) habits that ultimately impact weight status. Previous research suggests the parents are central to creating a home environment that facilitates or hinders the development of children’s early healthy eating and PA habits. Therefore, the purpose of this study was to explore low-income Latino parents’ beliefs, parenting styles, and parenting practices related to their children’s eating and PA behaviors while at home. Methods: Qualitative study using focus group discussions (FGDs) with 33 low-income Latino parents of preschool children 2 to 5 years of age. FGDs were transcribed verbatim and analyzed using thematic analysis. Results: Data analyses revealed that most parents recognize the importance of healthy eating and PA for their children and themselves. However, daily life demands including conflicting schedules, long working hours, financial constraints, and neighborhood safety concerns, etc., impact parents’ ability to create a home environment supportive of these behaviors. Conclusions: This study provides information about how the home environment may influence low-income Latino preschool children’s eating and PA habits, which may be useful for health promotion and disease prevention efforts targeting low-income Latino families with young children, and for developing home-based and parenting interventions to prevent and control childhood obesity among this population group. Pediatric healthcare providers can play an important role in facilitating communication, providing education, and offering guidance to low-income Latino parents that support their children’s development of early healthy eating and PA habits, while taking into account daily life barriers faced by families. Moreover, pediatric healthcare providers also can play an important role in the integration and coordination of home-visitations to complement office-based visits and provide a continuum of care to low-income Latino families.