Predicting long-term maintenance of physical activity in older adults

BACKGROUND: Considerable research has established that self-efficacy is a consistent correlate of physical activity. Additional factors, such as exercise-induced affect, social support, and value judgments, have also been identified as having the potential to influence adherence to activity. This study examined the utility of such variables in predicting the long-term exercise behavior of older adults. METHOD: In the context of a 6-month randomized controlled trial with an 18-month follow-up, we tested the extent to which adherence during the trial, affective responses to exercise, exercise value, and social support from the exercise group had either a direct or indirect effect through the mediation of exercise self-efficacy on physical activity levels at 6- and 18-month follow-up in a sample (N=174) of older adults (M age, 66 years). Structural equation modeling tested several models of exercise prediction. RESULTS: The best fitting model indicated significant paths from social support, affect, and exercise frequency to efficacy at the end of the program. Efficacy, in turn, was related to physical activity at 6- and 18-month follow-up. The model accounted for 40% of the variance in 18-month activity levels. CONCLUSION: This prospective study provides support for the inclusion of social cognitive variables in models of exercise adherence and highlights the pivotal role of self-efficacy in long-term exercise behavior. Subsequent trials are called for to replicate and extend these findings.     

Health benefits of a pedometer-based physical activity intervention in sedentary workers

BACKGROUND: Inactivity is a leading contributor to chronic health problems. Here, we examined the effects of a pedometer-based physical activity intervention (Prince Edward Island-First Step Program, PEI-FSP) on activity and specific health indices in 106 sedentary workers. METHODS: Participants were recruited from five workplaces where most jobs were moderately-highly sedentary. Using subjects as their own control, physical activity (pedometer-determined steps per day) was compared before and after a 12-week intervention. Changes in body mass index (BMI), waist girth, resting heart rate, and blood pressure were evaluated. RESULTS: The PEI-FSP was completed by 59% of participants. Steps per day increased from 7,029 +/- 3,100 (SD) at baseline to a plateau of 10,480 +/- 3,224 steps/day by 3.96 +/- 3.28 weeks of the intervention. The amount that participants were able to increase their steps per day was not related to their baseline BMI. On average, participants experienced significant decreases in BMI, waist girth, and resting heart rate. Reductions in waist girth and heart rate were significantly related to the increase in steps per day. In contrast, reductions in BMI were predicted by the initial steps per day. CONCLUSIONS: The PEI-FSP increased physical activity in a sedentary population. Importantly, those with a higher BMI at baseline achieved relatively similar increases in their physical activity as participants with a lower BMI.     

Depression and use of a health plan-sponsored physical activity program by older adults

BACKGROUND: The purpose of this study was to determine the associations between depression and the likelihood of enrollment in a health plan-sponsored physical activity program and pattern of program participation over 2 years; a secondary aim was to examine the association between participation dose and depression risk. There are no published studies on how depression influences participation in health plan-sponsored physical activity programs and how participation affects depression risk in older adults in nonresearch settings. METHODS: This study used administrative data from a Medicare Advantage plan. Participants (n=4766) were enrolled in the plan for at least 1 year prior to participating in the plan-sponsored health club benefit (Silver Sneakers). Controls were age- and gender-matched to participants (n=9035). Members were identified as having depression based on ICD-9-CM codes. Multivariate regression and generalized estimating equations models were used. Data were collected between 1998 and 2003 and analyzed in 2008. RESULTS: Members who had a history of depression were as likely to participate in Silver Sneakers as nondepressed members (OR: 1.03; 95% CI=0.89, 1.20; p=0.67). The risk of lapse in Silver Sneakers attendance was 28%-55% (p<0.05) higher for depressed participants during months 15-24. For nondepressed Silver Sneakers participants, attendance of at least 2 visits/week during Year 1 was significantly associated with lower risk of depression in Year 2 (OR=0.54; 95% CI=0.37, 0.79; p=0.002); a similar but statistically nonsignificant association was observed for previously depressed participants (OR=0.51; 95% CI=0.26, 1.02; p=0.06). CONCLUSIONS: While depressed older adults are as likely to enroll in a health plan-sponsored physical activity as nondepressed members, they were at higher risk of attendance lapses. Greater participation in the physical activity program was associated with lower depression risk.     

职业性长期接触氯仿对接触者的健康损害

本文对61名接触氟仿工人和23名无明显毒物接触史的对照组工人进行了初步的职业流行病学调查研究。作业车间空气中氯仿浓度的几何均数分别为13.40和29.51mg/m~3。接触工人的健康检查结果表明,29.51 mg/m~3的浓度可引起接触者乏力、嗜睡等症状检出率增高及肝脏合成蛋白的能力降低,表现为血清前白蛋白、转铁蛋白含量异常率明显高于对照组(分别为46.8%vs13%,76.6%vs43.5%)。以血清BUN含量为指标,未发现肾脏功能受损。初步认为,若以30mg/m~3为长期慢性接触氟仿的阈浓度,取1.5～2.0的安全系数,氟仿的最高容许浓度应在15～20 mg/m~3。并建议对血清前白蛋白、转铁蛋白含量测定作为慢性中毒性肝病的应用价值进行进一步的研究。     

The health benefits of a physical activity program for older adults living in congregate housing

BACKGROUND: In Saskatoon in 2002, as one of the key strategies for the in motion health promotion strategy, the Forever...in motion program was developed with the general goal of increasing opportunities for physical activity among older adults living in congregate housing. The three components of the program were a low-intensity exercise program, informal socialization and educational sessions. The objective of the present study was to examine whether participation in this program positively influenced participants' physical, emotional, psychological and social well-being. METHODS: A quasi-experimental, pretest/post-test design was employed to examine the impact of the program on various aspects of participant well-being. Thirty-six program participants and a comparison group of 22 non-participants from two congregate housing facilities took part in the study. The pretest was administered to the study and comparison groups before or shortly after the 12-week session commenced, and the post-test was administered after the 12-week session had concluded. Pretest and post-test assessment consisted of self-report measures of (1) vitality, (2) self-rated health, 3) mental health, (4) social functioning, (5) role limitations due to emotional problems, 6) physical activity-related knowledge, and (7) self-efficacy for exercise. A multivariate analysis of covariance (MANCOVA) was conducted using the seven post-test scores as dependent variables and the pretest scores as covariates. RESULTS: After adjusting for differences in baseline characteristics, the findings revealed statistically significant improvements in self-reported health and self-efficacy for exercise in the program participant group as compared with non-participants. CONCLUSION: The results of this study suggest that a relatively low-cost, low-intensity exercise program such as the Forever...in motion program may positively influence the well-being of older adults living in congregate housing. However, additional research with a larger number of participants and a more rigorous study design is needed to further elucidate the health benefits of the Forever...in motion program.     

Changes in physical health among participants in a multidisciplinary health programme for long-term unemployed persons

Background  

The relationship between poor health and unemployment is well established. Health promotion among unemployed persons may improve their health. The aims of this study were to investigate characteristics of non-participants and drop-outs in a multidisciplinary health promotion programme for long-term unemployed persons with health complaints, to evaluate changes in physical health among participants, and to investigate determinants of improvement in physical health.     

Health effects of long-term mercury exposure among chloralkali plant workers

BACKGROUND: Inorganic mercury is toxic to the nervous system, kidneys, and reproductive system. We studied the health effects of mercury exposure among former employees of a chloralkali plant that operated from 1955 to 1994 in Georgia. METHODS: Former plant workers and unexposed workers from nearby employers were studied. Exposure was assessed with a job-exposure matrix based on historical measurements and personnel records. Health outcomes were assessed with interviews, physical examinations, neurological and neurobehavioral testing, renal function testing, and urinary porphyrin measurements. Exposure-disease associations were assessed with multivariate modeling. RESULTS: Exposed workers reported more symptoms, and tended toward more physical examination abnormalities, than unexposed workers. Exposed workers performed worse than unexposed subjects on some quantitative tests of vibration sense, motor speed and coordination, and tremor, and on one test of cognitive function. Few findings remained significant when exposure was modeled as a continuous variable. Neither renal function nor porphyrin excretion was associated with mercury exposure. CONCLUSIONS: Mercury-exposed chloralkali plant workers reported more symptoms than unexposed controls, but no strong associations were demonstrated with neurological or renal function or with porphyrin excretion.     

Sustainability of a physical activity and nutrition program for seniors

Objective

This prospective cohort study aimed to determine the impact of a low cost, home-based physical activity and nutrition program for older adults at 6 months follow-up.

Design

A follow-up survey was conducted 6 months after program completion via computer-assisted telephone interviewing. The International Physical Activity Questionnaire and the Fat and Fibre Barometer were used to measure physical activity levels and dietary behaviours, respectively. Self-reported height, weight, waist and hip circumferences were obtained. Changes over three time points of data collection (baseline, post-program, follow-up) and differences between the intervention and control groups were assessed. The use of program materials was also evaluated.

Setting

Community and home-based.

Participants

Insufficiently active 60 to 70 year olds (n = 176, intervention and n = 198, control) residing in suburbs within the Perth metropolitan area.

Results

A sustained improvement was observed for the intervention group in terms of fat avoidance behaviours (p interaction =.007). Significant improvements were found for strength exercises, fibre intake, body mass index and waist-to-hip ratio at either post-program or follow-up, however the overall effect was not significant. At post-program, the intervention group increased time spent participating in moderate activity by 50 minutes (p >.05), which was followed by a significant decline at follow-up (p <.05). Among intervention group participants, males and females differed with respect to strength exercises and moderate physical activity.

Conclusion

This low-cost physical activity and nutrition intervention resulted in a sustained improvement in fat avoidance behaviours and overall short-term gains in physical activity. Future studies for older adults are recommended to investigate gender-specific behavioural barriers as well as booster interventions which focus on physical activity.     

Recruitment strategies and costs for a community-based physical activity program

A community-based participatory research project using social marketing strategies was implemented to promote physical activity among women aged 35 to 54 who were insufficiently active or completely inactive. A variety of media were used to disseminate messages about how to enroll in Step Up. Step Out! This article describes the effectiveness and cost of the recruitment strategies and lessons learned in recruiting the women. Of the total inquiries (n = 691), 430 women were eligible and enrolled in the program. Based on data from questionnaires, the most effective method of recruiting women into Step Up. Step Out! was word of mouth (36%). Newspaper ads accounted for 29% of the women's responses. The least effective method was billboards. Mass media was not as effective in recruiting women for the program as interpersonal efforts such as word of mouth. Interpersonal efforts are a valuable and possibly underrated recruitment and promotion tool.     

长期低剂量职业照射对放射工作者健康影响

目的了解长期低剂量职业照射对放射工作人员健康影响。方法采用流行病学横断面调查方法, 调查分析2013年山东省临沂市6所三级医院的624名放射工作者健康状况。结果放射工作人员人均年剂量<5 mSv者占97.28%;淋巴细胞微核率为57.85%(361/624), 染色体畸变率为53.21%(332/624);血常规指标受暴露年限、年均剂量及累计剂量的影响, 差异均有统计学意义(均P<0.05);甲状腺激素水平、染色体畸变率、淋巴细胞微核率及眼晶状体浑浊率与暴露年限及累计剂量有关, 差异均有统计学意义(均P<0.05)。结论长期低剂量职业辐射可使机体产生一定的辐射损伤, 应加强放射工作人员防护。     

The FABS trial: A randomised control trial of the effects of a 6-month physical activity intervention on adherence and long-term physical activity and self-efficacy in older adults with memory complaints

Objective

The aim of this study is to assess in older adults with memory complaints, the effects of a 6-month home-based physical activity (PA) intervention on short-term adherence, short and long-term self-efficacy and the predictors of adherence.

Methods

Participants with memory complaints with or without mild cognitive impairment (MCI) were recruited from Perth, Western Australia between May 2004 and July 2006 and randomly assigned to a control or an intervention group. The intervention group received a 6-month PA programme and recorded sessions on a diary. Pedometer readings, questionnaires, and physical and cognitive measures were completed at 0, 6, 12 and 18 months.

Results

One hundred and seventy participants started the study. Retention rates were similar for both groups at all time-points however retention was higher for men than women (P < 0.01). Adherence to the prescribed PA was 72.8% (95% CI, 70.8 74.9%). Men had higher adherence rate than women (P < 0.001). Those with and without MCI had similar adherence. Compared to controls self-efficacy was higher in the intervention group after 6 months only (P < 0.01).

Conclusions

Older adults with memory complaints, with or without MCI, can successfully participate in and enjoy home-based PA programmes. Long-term adherence to such interventions may require continued support and increased self-efficacy. (Trial registration: ACTRN012605000136606.)     

Effectiveness of physical activity interventions for older adults: a review

OBJECTIVE: This review evaluates the effectiveness of physical activity interventions among older adults. METHODS: Computerized searches were performed to identify randomized controlled trials. Studies were included if: (1) the study population consisted of older adults (average sample population age of > or =50 years and minimum age of 40 years); (2) the intervention consisted of an exercise program or was aimed at promoting physical activity; and (3) reported on participation (i.e., adherence/compliance) or changes in level of physical activity (e.g., pre-post test measures and group comparisons). RESULTS: The 38 studies included 57 physical activity interventions. Three types of interventions were identified: home-based, group-based, and educational. In the short-term, both home-based interventions and group-based interventions achieved high rates of participation (means of 90% and 84%, respectively). Participation declined the longer the duration of the intervention. Participation in education interventions varied widely (range of 35% to 96%). Both group-based interventions and education interventions were effective in increasing physical activity levels in the short-term. Information on long-term effectiveness was either absent or showed no difference of physical activity level between the study groups. CONCLUSIONS: Home-based, group-based, and educational physical activity interventions can result in increased physical activity, but changes are small and short-lived. Participation rates of home-based and group-based interventions were comparable, and both seemed to be unrelated to type or frequency of physical activity. The beneficial effect of behavioral reinforcement strategies was not evident. Comparative studies evaluating the effectiveness of diverse interventions are needed to identify the interventions most likely to succeed in the initiation and maintenance of physical activity.     

The effectiveness of the JOBS program among the long-term unemployed: a randomized experiment in the Netherlands

Given the adverse effects of long-term unemployment, it is of major concern that evidence-based interventions are available for the long-term unemployed. Therefore, we examined the effectiveness of the JOBS program, a group training for the unemployed [Caplan, R. D., Vinokur, A. D., Price, R. H. and Van Ryn, M. (1989). Journal of Applied Psychology, 74, 759-769], among long-term unemployed individuals. In a randomly controlled trial, JOBS was compared with a control condition and a voucher intervention, in which individuals were given the opportunity to spend a certain budget on services that could help them reintegrate. After 6 months JOBS participants had more often found a job and were more satisfied with the intervention. After 12 months effects were still visible, but less pronounced.     

Correlates of self-regulation for physical activity among older adults

OBJECTIVES: To examine correlates of self-regulation (personal regulation of goal-directed behavior or performance) for physical activity (PA) in older adults. METHODS: A convenience sample (N=296) of older adults was surveyed (M age=70.4 years). RESULTS: Hierarchical regression analyses revealed current PA engagement and sets of sociodemographic, health-related, and theoretical variables as independent correlates of self-regulation (model R2 = 37%, P < 0.0001). In the final model, female gender, older age, social support, self-efficacy, and greater PA were positive, independent correlates. CONCLUSIONS: Self-regulatory strategies are vital to PA promotion across the life span. Therefore, it is important to understand factors associated with self-regulation and use this information for intervention design and implementation.     

Health effects of unemployment--I. Long-term unemployed men in a rural and an urban setting.

Between 1983 and 1987 in an urban and a rural Dutch area employed and long-term unemployed men, between 30 and 50 years old, have been interviewed. The main topics of the study were the independent health effects of unemployment, the factors related to these health effects and socio-cultural differences. Long-term unemployment is considered to be a social phenomenon that restructures individual's social positions into multiple deprived positions. The characteristics of this restructuring are a relative lack of socio-structural resources, low social participation and emotional problems. Independent effects on the health status (perceived somatic and depressive complaints and self reported chronic disease) have been found to exist among both the rural and the urban unemployed. There is no clear effect of unemployment on health care use, but regional differences in health care use among rural and urban unemployed have been found. Between the urban and rural unemployed there are more similarities than differences in the factors and models explaining ill-health. The most important factors are: loneliness, disadvantageous consequences of unemployment, money worries and ill-health prior to job loss (health selection at the labour market). One important difference is that among the urban unemployed the perceived size of the network is an explanatory factor, but among the rural unemployed perceived stigmatization is more important. In general, ill-health can be better explained for the rural unemployed than for the urban unemployed.     

The relationships between delivery agents' physical activity level and the likelihood of implementing a physical activity program

PURPOSE: To determine the relationships between delivery agents'physical activity characteristics and subsequent adoption of a physical activity promotion program for community implementation. METHODS: Agents responsible for county health promotion in Kansas (n = 91; 94.5% women; mean age = 43.0 +/- 11) completed interviews that assessed physical activity self-efficacy, value, and participation. Subsequent implementation of a physical activity program was monitored. The response rate was 100%. RESULTS: Fifty-five percent of the agents met Centers for Disease Control and Prevention (CDC) recommendations for physical activity, 35% were active but did not meet CDC recommendations, and 10% were inactive. On the basis of logistic regression analysis (Wald statistic = 7.63; p < .05), agents who met recommendations were more likely to adopt the program for their county (69%) than were agents who were less active (41%) and inactive (11%). DISCUSSION: The data suggest that increasing the proportion of delivery agents who meet the CDC recommendations for physical activity could be related with a higher proportion of communities implementing physical activity programs.