Development and implementation of worksite health and wellness programs: a focus on non-communicable disease

The development and implementation of worksite health and wellness programs (WHWPs) in the United States (US) hold promise as a means to improve population health and reverse current trends in non-communicable disease incidence and prevalence. However, WHWPs face organizational, economic, systematic, legal, and logistical challenges which have combined to impact program availability and expansion. Even so, there is a burgeoning body of evidence indicating WHWPs can significantly improve the health profile of participating employees in a cost effective manner. This foundation of scientific knowledge justifies further research inquiry to elucidate optimal WHWP models. It is clear that the development, implementation and operation of WHWPs require a strong commitment from organizational leadership, a pervasive culture of health and availability of necessary resources and infrastructure. Since organizations vary significantly, there is a need to have flexibility in creating a customized, effective health and wellness program. Furthermore, several key legal issues must be addressed to facilitate employer and employee needs and responsibilities; the US Affordable Care Act will play a major role moving forward. The purposes of this review are to: 1) examine currently available health and wellness program models and considerations for the future; 2) highlight key legal issues associated with WHWP development and implementation; and 3) identify challenges and solutions for the development and implementation of as well as adherence to WHWPs

Pocket Rehab - mHealth-based rehabilitation program for patients with cardiovascular disease as a prevention and treatment strategy for COVID-19 victims : an international multicentric collaborative study

Pacientes com doença cardiovascular e fatores de risco para doença cardiovascular (DCV) têm sido afetados com mais frequência e mais gravemente pelo novo coronavírus. Isso agravou o cenário anterior de subutilização dos programas de reabilitação cardiovascular (RCV) antes da pandemia, exigindo alternativas otimizadas de RCV, como por exemplo aquelas baseadas em aplicativos móveis (mHeath), não apenas por gerar benefícios bem estabelecidos, mas agora também para manter esses pacientes clinicamente estáveis, diminuindo a chance de eventos cardiovasculares e risco de contaminação naqueles não infectados pelo vírus, bem como tratando dos sobreviventes da COVID-19, tendo em vista as disfunções adicionais que tem sido descritas nos sistemas respiratório, cardiovascular e muscular. Serão realizados dois estudos: o estudo 1, qualitativo, de concordância e reprodutibilidade. Criação aplicativo baseado em tecnologia móvel (mHealth), para dar suporte a um programa otimizado (capaz de avaliar após COVID-19) de reabilitação cardiovascular (RCV) em ambiente domiciliar, desenvolvido pela Universidade do Luxemburgo (Centro 4), integrando instrumentos reconhecidos internacionalmente, como o EXPERT Tool, Hasselt University (Centro 3) e PACERProject, University of Miami (Centro 2). O aplicativo será testado e avaliado por profissionais de saúde nos dois centros colaboradores do estudo (Centro 2 e Centro 3) e na instituição executora - Universidade de Brasília (Centro 1)

Recommending Physical Activity to Your Aging Patients? What Clinicians Need to Know to Increase Adherence From the Older Adult Perspective

A wealth of scientific evidence supports that being physically active may prevent or delay the onset of cognitive impairment and dementia. However, a critical barrier is that while most clinicians recommend physical activity (PA) and older adults recognize its health benefits, most older adults fail to regularly practice PA. Thus, it is necessary to explore and disseminate knowledge on how to help clinicians truly partner with people and help them to change their behavior and become more active. Clinical and scientific efforts are underway to establish dose-specific PA recommendations for cognitive brain health. However, an important knowledge gap is how to develop effective strategies to increase PA adherence in aging. To better understand the perspective of older adults, we undertook a mixed-method study on sixty-five sedentary older adults at risk for cognitive decline. Participants answered a questionnaire battery related to PA engagement, and a subcohort participated in a remote focus group. Our findings revealed four main themes: First, age and aging are determinants in PA practice. Second, maintaining both an active mind and autonomy are priorities, but planned PA is not usually related as part of being “active.” Third, motivational challenges in PA engagement were noted. And fourth, they emphasized a call for tailored recommendations. Therefore, we present a multidimensional model of PA adherence to maximize brain health in older adults and suggest a tool kit and key questions to effectively screen sedentary aging adults and translate current guidelines into the needs of the individual by using behavior change strategies

Exercise engagement drives changes in cognition and cardiorespiratory fitness after 8 weeks of aerobic training in sedentary aging adults at risk of cognitive decline

BackgroundWith our aging population, many individuals are at risk of developing age-related cognitive decline. Physical exercise has been demonstrated to enhance cognitive performance in aging adults. This study examined the effects of 8 weeks of aerobic exercise on cognitive performance and cardiorespiratory fitness in sedentary aging adults at risk for cognitive decline.MethodsFifty-two participants (age 62.9 ± 6.8, 76.9% female) engaged in eight weeks of moderate-to high-intensity exercise (19 in-person, 33 remotely). Global cognition was measured by the Repeatable Battery for the Assessment of Neuropsychological Status, the Delis-Kaplan Executive Function System, and the Digit Span subtest of the Wechsler Adult Intelligence Scale (WAIS) Fourth Edition. Cardiorespiratory fitness was measured via heart rate recovery at minute 1 (HRR1) and 2 (HRR2), and exercise engagement (defined as percent of total exercise time spent in the prescribed heart rate zone). We measured pre and post changes using paired t-tests and mixed effects models, and investigated the association between cardiorespiratory and cognitive performance using multiple regression models. Cohen's d were calculated to estimate effect sizes.ResultsOverall, 63.4 % of participants demonstrated high engagement (≥ 70% total exercise time spent in the prescribed heart rate zone). There were significant pre-post improvements in verbal fluency and verbal memory, and a significant decrement in working memory, but these were associated with small effect sizes (Cohen's d <0.5). Concerning cardiorespiratory fitness, there was a pre-to-post significant improvement in HRR1 (p = 0.01, d = 0.30) and HRR2 (p < 0.001, d = 0.50). Multiple regressions revealed significant associations between cardiorespiratory and cognitive performance, but all were associated with small effect sizes (Cohen's d < 0.5). Interestingly, there were significant between-group differences in exercise engagement (all p < 0.001), with remote participants demonstrating greater exercise engagement than in-person participants.ConclusionImprovements in cognition and cardiorespiratory fitness were observed after 8 weeks of moderate to high-intensity exercise in aging adults. These results suggest that committing to a regular exercise regimen, even for a brief two-month period, can promote improvements in both cardiorespiratory fitness and cognitive performance, and that improvements are driven by exercise engagement

Job strain and older workers: Can a reduction in job strain help to eliminate the social security drain?

Job strain is the psychological and physiological response to a lack of control or support in the work environment. It appears to be an important risk factor for continued employment throughout the lifespan. Reducing job strain earlier in a workers life has the potential to have substantial beneficial health effects throughout a workers life. Early screening for job strain should be implemented in known high risk or high strain jobs. This is particularly important since there a fewer younger workers entering the labor force and there will be a growing need for older workers to remain in the workforce. Furthermore, healthier workers will require less medical care and are likely to work longer if they are willing and able. Healthier older workers who are willing and able to work longer will defer receipt of retirement benefits while continuing to pay into the Social Security System. Further investigation of older individuals (1) willingness and motivation to work past the normal retirement age, (2) career and employment security, skills development, and reconciliation of working and non-working life, and (3) job strain and effects of reducing job strain is needed. The current job strain literature has been expanded to the Social Security System arena and suggests that reducing job strain has the potential to help eliminate the Social Security drain by increasing older worker labor force retention