Online Group-exercises for Older Adults of Different Physical Abilities

In this paper we describe the design and validation of a virtual fitness environment aiming at keeping older adults physically and socially active. We target particularly older adults who are socially more isolated, physically less active, and with less chances of training in a gym. The virtual fitness environment, namely Gymcentral, was designed to enable and motivate older adults to follow personalised exercises from home, with a (heterogeneous) group of remote friends and under the remote supervision of a Coach. We take the training activity as an opportunity to create social interactions, by complementing training features with social instruments. Finally, we report on the feasibility and effectiveness of the virtual environment, as well as its effects on the usage and social interactions, from an intervention study in Trento, Ital

Getting the Message Out About Cognitive Health: A Cross-Cultural Comparison of Older Adults' Media Awareness and Communication Needs on How to Maintain a Healthy Brain

Purpose: Evidence suggests that physical activity and healthy diets may help to maintain cognitive function, reducing risks of developing Alzheimer's disease and vascular dementia. Using a cross-cultural focus, we describe older adults‘ awareness about cognitive health, and their ideas about how to inform and motivate others to engage in activities that may maintain brain health. Design and Methods: Nineteen focus groups were conducted in 3 states (California, North Carolina, South Carolina) with 177 adults aged 50 years and older. Six groups were with African Americans (AAs), 4 with Chinese, 3 with Vietnamese, 4 with non-Hispanic Whites, and 2 with American Indians (AIs). A qualitative thematic analysis was conducted. Results: Many participants did not recall reading or hearing about brain health in the media. Participants recommended a multimedia approach to inform others about brain health. Both interpersonal and social/group motivational strategies were suggested. Word of mouth and testimonials were recommended most often by Chinese and Vietnamese. AAs and AIs suggested brain health education at church; AAs, Chinese, and Vietnamese said brain health slogans should be spiritual. Participants‘ perceived barriers to seeking brain health information included watching too much TV and confusing media information. Implications: Findings on communication strategies for reaching racial/ethnic groups with brain health information will help guide message and intervention development for diverse older adults

Establishing the effectiveness of public health interventions using sequential meta-analysis: Case study using stair-promotion interventions

Prevention trials often generate significant health or risk factor improvements, but these improvements are limited to the selected samples of people enrolled in these studies. To make population health gains, we need to develop methods for translating evidence from these trials into practice at the broader community and population levels. One barrier to this process is researchers themselves, who conduct replications of small-scale trials, rather than conducting intervention research at scale. Our example of this is interventions to encourage short episodes of physical activity through signs promoting stair use. We pooled the evidence from these interventions from 1980 to 2014. We carried out a meta-analysis to estimate the proportion of people that changed from the elevator to the stairs following the introduction of signage. Our innovation was to use a sequential meta-analysis method, usually described in clinical settings and trials. We used this method to estimate when there was sufficient evidence of stair sign effectiveness for public health actions to be scaled up, and we found this was around 2006. Studies since then have not contributed new evidence to the field. Methods here enabled us to see when policy makers should have implemented this intervention to the community at large, and researchers then should have focused their investigations on identifying barriers and facilitators to their implementation and assessing intervention effects at scale

Waiting Room Health Promotion for Older Adults in Rural Primary Care

Background: Advances in health care technology have lead to adults living longer than in previous decades. Longer life expectancy in combination with the aging of the Baby Boomer generation is predicted to result in rapid and exponential growth among the older adult population. Adults in the U.S. over the age of 65 have on average five or more chronic illnesses, many of which are often poorly managed. Older adults who experience chronic diseases often report decreased quality of life, limitations in functional ability, loss of independence, and periods of decline and increasing disability. Health promotion efforts can help in delaying the onset of disability and preventing rapid decline associated with many chronic conditions. Purpose: The purpose of this project was to assess the effectiveness of the implementation of a brief waiting room health promotion activity that informs older adults about the benefits of walking, such as reducing the risk of chronic disease, improving mood, and maintaining weight, physical and cognitive function. This project took place at a federally qualified health center in Plainfield, Vermont. Methods: The target population for this educational intervention included patients, as well as family members and visitors to the primary care practice who were age 55 and older. All age-eligible participants were encouraged to participate regardless of health status or the presence of comorbid health conditions. The activity comprised of participants viewing a brief audiovisual educational activity explaining the health benefits of walking, supplemented with paper materials to support the health messages; the intervention was then followed by completion of a brief paper survey evaluation. Results: During the two-month period the health promotion activity was available, 56 individuals participated and completed the survey. Of the 56 participants, 87% indicated they either “strongly agreed” or “agreed” that watching the video increased knowledge about health-related benefits of walking. In total, approximately 73% of participants who participated in this health promotion activity agreed that they paid attention to educational materials in the waiting room setting. Approximately 57% of participants shared a health related goal that they created as a result of the health promotion activity. Conclusion: This project has suggested that implementation of waiting room health promotion activities, specifically for older adults, is a simple and cost-effective way to promote good health practices and provide patients with in-depth health care information that may not be addressed during the health care visit. Activities in the waiting room can help to supplement information provided during the clinical encounter, leaving patients more satisfied with their visits, and promoting positive behavior change

Beyond Zero Tolerance: A Reality-Based Approach to Drug Education and School Discipline

Beyond Zero Tolerance is a comprehensive, cost-effective approach to secondary school drug education and school discipline that is all about helping teenagers by bolstering the student community and educational environment. This innovative model combines honest, reality-based information with interactive learning, compassionate assistance, and restorative practices in lieu of exclusionary punishment

System development guidelines from a review of motion-based technology for people with MCI or dementia

As the population ages and the number of people living with dementia or mild cognitive impairment (MCI) continues to increase, it is critical to identify creative and innovative ways to support and improve their quality of life. Motion-based technology has shown significant potential for people living with dementia or MCI by providing opportunities for cognitive stimulation, physical activity and participation in meaningful leisure activities, while simultaneously functioning as a useful tool for research and development of interventions. However, many of the current systems created using motion-based technology have not been designed specifically for people with dementia or MCI. Additionally, the usability and accessibility of these systems for these populations has not been thoroughly considered. This paper presents a set of system development guidelines derived from a review of the state of the art of motion-based technologies for people with dementia or MCI. These guidelines highlight three overarching domains of consideration for systems targeting people with dementia or MCI: (i) cognitive, (ii) physical, and (iii) social. We present the guidelines in terms of relevant design and use considerations within these domains and the emergent design themes within each domain. Our hope is that these guidelines will aid in designing motion-based software to meet the needs of people with dementia or MCI such that the potential of these technologies can be realized

Development, Implementation and Evaluation of a Physical Activity and Nutrition Program for Older Adults Residing in Retirement Villages

Physical activity and a healthy diet are recognised as important lifestyle factors for maintaining a healthy bodyweight and preventing chronic disease. Retirement villages are a unique setting to reach older adults to test the effectiveness of approaches to increase physical activity levels. improve nutrition and maintain a healthy bodyweight. This cluster-RCT based in Perth, Western Australia evaluated the effectiveness of a 6-month physical activity and nutrition program for ‘insufficiently’ active adults aged 60-80 years

The road to reducing dementia onset and prevalence: are diet and physical activity interventions worth investing in?

In Australia, deaths as a result of dementia have now taken over cerebrovascular disease as the second leading cause of death. At present, over a quarter million Australians suffer from dementia and projected estimates indicate that the figure can reach a high of nearly one million by 2050. Diet and physical activity have been shown to promote brain health and offer some protection against cognitive decline. Moreover, they have also been recognised as risk factors for developing other conditions such as cardiovascular disease, diabetes, hypertensive diseases and certain cancers all of which are leading causes of death in Australia. Research shows that higher ratios of saturated fat to monounsaturated fats are predictive of negative mental function. In addition, high mid-life serum cholesterol levels and excessive caloric intake have been found to be associated with impaired cognitive function. Increased intakes of fish, vegetables and legumes, antioxidant rich foods and adequate amounts of certain B-vitamins have been reported to have a protective brain effect. Increased levels of physical activity have been found to promote neuro-protective changes in the hippocampus of the brain – a region central to learning and memory. This brain region is one of the first areas affected by dementia. Most studies have demonstrated that a high level of physical activity in adults with no dementia is associated with a 30% to 50% reduction in the risk of cognitive decline and dementia. Some studies have also theorised that poor physical function may precede the onset of dementia and Alzheimer’s disease and higher levels of physical function may be associated with delayed onset. Results from the Australian Bureau of Statistics National Health Survey (2011 – 2013) show that many Australian adults do not meet the National Physical Activity Guidelines (to do at least 30 minutes of moderate intensity physical activity on most days) as more than half the population is inactive. Further, two-thirds of Australians are now overweight/obese and a large proportion of total energy consumed comes from foods considered to be of little nutritional value. An intervention that focuses on improving diet and physical activity habits therefore has the ability to produce inestimable benefits. There are many factors that must be considered when developing a successful diet and physical activity intervention. These span a gamut of issues from carefully defining the target audience, utilising a multidisciplinary approach, tailoring content and materials, determining forms of delivery and identifying specific behaviour change techniques to determining financial costs in relation to health benefits and training staff. The success of any intervention also relies on the setting and method that will be employed in its implementation. Policy-makers must be cognizant of the fact that no singular government intervention/policy, operating on its own, can have the effect of directly reducing dementia onset/prevalence and changing lifestyle habits. Six actions for policy-makers are identified in this issues brief which have the potential to have immeasurable benefits: i) development of a comprehensive dementia prevention strategy, ii) establishment of a body whose aim is to keep track of scientific research (central to this will be the establishment of a national digital dementia research repository), iii) ensuring a multisectoral approach is adopted in the fight against dementia that includes both ‘traditional’ and ‘incidental’ health agencies, iv) continued investment into research and innovation, v) identifying incentives beyond the health domain and vi) development of longevity literacy programs. These actions all have as their foundation the Health in all Policies Initiative and social determinants of health approach

Physical Activity and Nutrition Program for Seniors (PANS): Process Evaluation

Issue addressed: The Physical Activity and Nutrition Program for Seniors (PANS) program aimed to increase levels of physical activity and improve the diet of insufficiently active community-based seniors aged 60 to 70 years using a range of strategies. Comprehensive process evaluation was used to determine the suitability and appropriateness of the resources and effectiveness of the strategies. Method: Process evaluation data (qualitative and quantitative) were collected on the program strategies and resources throughout, and at the conclusion of the intervention period. Results: The program strategies/resources were found to be relevant to the population, assisting participants to increase their level of physical activity and improve their diet. Participants reported that the program resources were suitable for their age-group (84%), encouraged them to think about physical activity (78%), and nutrition (70%). Participants reported that they used the pedometer (91%) and recorded daily steps (78%). Moreover, the provision of group guides facilitated individuals to set and achieve personal goals. Conclusion: The PANS strategies and resources were appropriate, which supported the seniors in identifying, establishing, and achieving their physical activity and nutrition goals. Minor refinements of the program were recommended based on the findings