Tuesday, October 25, 10:30
a.m.-noon
Increasing Physical Activity and Movement for Older Adults
Living With Health Limitations
Authors
R.M. Savage Jackman1; C. Saint Jean1; F.
Sharma2.
1State University of New York Health Science Center
at Brooklyn, Brooklyn, NY;
2Greater Southern Brooklyn Health Coalition, NY.
Background
Many older adults with health limitations such as
heart disease, diabetes, or arthritis, hesitate to exercise
because of fear/barrier or they are unaware of alternative
exercise options. To address these problems, we developed a fun
fitness and movement program for older adults. To assist them
with their barriers we implemented modification of movement so
they could exercise comfortably. The program offered Chair
Aerobics (low intensity) and Dance Aerobics (moderate intensity)
3 days per week for 16 weeks. The classes were taught by a
certified fitness instructor. Our objectives for the program
were 1) to increase the frequency of days that participants
exercised from 0 days per week to 3 days per week, and 2)
progress participants from low intensity to moderate intensity.
Methods
A recruitment campaign was directed at community
members and physicians. A pre/post self-administered
questionnaire was completed by each participant which assessed
health, nutrition and exercise behaviors. All participants were
assigned initially to Chair Aerobics for the first 12 weeks and
Dance Aerobics for the remaining 4 weeks.
Results
Of the 39 participants, 82% were between the ages of
41-64. African-Americans represented 56%, and
Caribbean-Americans 32%. Pre-results: 72% reported a
pre-existing health limitation/disability such as heart disease,
diabetes or arthritis. 89% reported that they did not exercise
at all. Post-results: 88% of the participants reported that they
exercised 3 days per week. 75% of the participants progressed
from low intense aerobics class to moderate intense aerobics
class after 12 weeks. 6% progressed to a high intense aerobics
class after 16 weeks.
Discussion
Many older adults with health limitations can engage
in exercise and movement classes under the supervision of a
certified fitness instructor. In partnership with physicians we
can recruit individuals who can greatly benefit from an exercise
and movement program. After a period of three months most
individuals can progress from a low intense to a moderate
intense exercise class.
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EnhanceFitness Program
Author
S. Snyder, Senior Services of Seattle/King County, Seattle,
WA.
Background
BACKGROUND: EnhanceFitness (formerly Lifetime Fitness
Program), since its beginning, has been managed by Senior
Services, in collaboration with Group Health Cooperative (GHC)
and the University of Washington Health Promotion Research
Center (HPRC). The original goals of EnhanceFitness were to
provide an exercise class that could be undertaken by
sedentary older adults utilizing the same type of fitness
instructors commonly found working throughout the community in
parks departments, senior centers and commercial gyms. The
original concept used the group model of training to give
participants an understanding of, and confidence in their
ability to, increase resistance and exercise vigor. It was
specifically designed to be “low-tech” and the only equipment
required was wrist and ankle weights. While seniors may do the
exercises on their own, and are encouraged to do so outside of
the class setting, there is a strong preference to continue
the group model activity because of the other health benefits
associated with social interaction
Methods
A 1993 pilot study launched EnhanceFitness at a
Senior Services of Seattle/King County affiliated senior
center and the study received an overwhelmingly positive
response from participants. Classes are held in hourly
sessions, three times per week and include aerobics, strength
conditioning and balance and flexibility. Classes are taught
by nationally certified fitness instructors who have received
training on EnhanceFitness exercise protocols and outcomes
testing.
Results
There have been three EnhanceFitness programmatic
evaluations. The first program evaluation, conducted in 1994,
was a randomized control trial with 85% of the participants
completing the program, 90% attending classes, and
significantly better scores on 7 of 8 SF-36 subscales and
fewer depressive symptoms than controls.
Discussion
Program material to assist in successful
implementation is provided to each site and instructor. Group
Health Cooperative provides EnhanceFitness classes as a
benefit to their Medicare members.
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Community Prevention in Practice: A Public Health Tool
Targeting Older Adults
Authors
K.A. Williams1; C.M. Bayles1; N. Milas1;
K.J. Winters1; C.B. Johnson1; J.F.
Robare1.
1Center for Healthy Aging, University of Pittsburgh
Graduate School of Public Health, Pittsburgh, PA.
Background
Innovative and cost effective community approaches
to target risk factor control in adults 50+ are needed. The
University of Pittsburgh's Center for Healthy Aging, a member
of the Prevention Research Centers Program, supported by the
Centers for Disease Control and Prevention (CDC) cooperative
agreement number U48/CCU320171-01, has designed a Community
Prevention in Practice (PIP) tool to assess 10 key areas of
prevention in conjunction with action statements intended to
prompt discussion with the individual and his/her physician.
The 10 key areas include: systolic blood pressure (SBP),
smoking, LDL cholesterol, glucose, cancer screening,
immunization, socialization, muscle and bone health, physical
activity and depression.
Methods
The PIP tool was implemented in 93 healthy community
volunteers 50+ who agreed to participate in a 10-week walking
promotion program and to provide demographic information. The
PIP tool was self-administered in only a few minutes and used
to generate data on the 10 key risk areas.
Results
Preliminary findings indicate that 49% of volunteers
assessed were not adherent to at least three of the keys and
30.5% lacked adherence to at least five keys. Many volunteers
were unaware of their blood glucose (62.4%) and LDL
cholesterol levels (64.5%).
Discussion
Re-administration of this tool at a later date
could provide important data on the effectiveness of community
risk reduction efforts. The PIP was effective in describing
the risk status of this community and could be used to
mobilize risk reduction programs.
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Community Gardening in a Senior Center: A Public Health
Initiative
Author
E.N. Austin, State University of New York at Binghamton,
Binghamton, NY.
Background
The lack of physical activity in many older adults
contributes to physical decline and depression, which further
worsens the cycle of deteriorating health and increases risks of
disease, obesity, and falls. Physical activity is a basic
component of lifestyle modification recommendations for many
debilitating and chronic disorders such as diabetes and
cardiovascular disease. As part of the Steps to a Healthier New
York Initiative, the Broome County Health Department (BCHD)
adopted community gardening in a senior center as a model to
increase physical activity, reduce the proportion of obese older
adults, and increase the number of seniors who eat at least
three daily servings of vegetables.
Methods
An eight week quantitative and qualitative study was
undertaken to evaluate the first year of the community garden
program in 2004. Qualitative data were obtained through a focus
group discussion at the end of the study. Participants reported
increased physical activity and opportunities for socialization,
improved nutrition and access to fresh vegetables, and
opportunities to learn new skills. Participants were very
enthusiastic about the garden. Quantitative data were obtained
using the Dartmouth COOP Project Functional Assessment Charts
(COOP Charts), the Six-Minute Walk Distance, and the Geriatric
Depression Scale (Short Form). Each participant chose one
health-related goal for improvement.
Results
All participants improved in one or more aspects of
their physical and/or emotional health. Statistically
significant results were obtained in the areas of Change in
Health, Social Activities, and Total Emotional Scores, as
measured by the COOP Charts. All areas of change were
improvements in participant health. A key component to the
success of the community garden program is sustainability.
Discussion
While the senior center in the study had weekly
organizational support from the BCHD, the gardeners took
ownership of the program for the second year and required no
input from the BCDH.
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