multilevel intervention for physical activity in retirement communities

Conditions: Physical Activity; Blood Pressure; Physical Functioning; Quality of Life; Sedentary

Summary: the purpose of this study was to assess whether a 6-month multilevel physical activity intervention can significantly increase physical activity levels in sedentary adults, 65 and older, living in continuing care retirement communities (ccrcs). sedentary residents (n=307) in 11 ccrcs received the multilevel miparc intervention or a control health education program for 6 months. a group randomized control design was employed with site as the unit of randomization. the intervention was delivered through group sessions, phone calls, printed materials, tailored signage and mapping and targeted peer led advocacy efforts.

objective monitoring of physical activity suggests that fewer than 3% of adults over age 60 meet current physical activity guidelines. ecological models posit that behavioral interventions are most effective when they operate on multiple levels. the miparc study intervenes on four levels: individual (pedometer-based self monitoring, educational materials and monthly counseling calls), interpersonal (monthly group sessions and peer mentoring), environment (walking signage prompts, tailored walking maps, step counts)and policies (review of on-site activity opportunities and walkability, recommendations for change and peer led advocacy)to increase the activity levels of residents. the study promotes walking as the primary means to increase light to moderate pa, with a secondary focus on strength and flexibility and decreased sedentary behavior. as most continuing care retirement communities have management structures that provide the opportunity to improve the social and built environments for physical activity and walking, this study also aims to train participants on how to advocate for improvements in the environment that would improve walkability.

Eligibility criteria:
inclusion criteria: * over the age of 65 * able to walk 20 meters independently (without human assistance, can use cane/walker) * able to speak and read in english * no cognitive, vision or hearing impairments that would prevent provision of informed consent, comprehension of instructions, completion of surveys and participation in phone conversations * able to complete the timed up and go test to assess falls risk within 30 seconds * live within the selected retirement community (facility-dwelling) able to hold brief conversation over the telephone. * will be in san diego for the duration of the study * provision of consent to participate * willing to wear a pedometer, accelerometer and gps device * willing to complete all surveys and attend weekly meetings * no history of falls in previous that resulted in an injury or hospitalization in the past 12 months * physician clearance to participate exclusion criteria: * inability to give informed, voluntary consent * inability to complete assessments * lack of written physician consent to participate in unsupervised light-to-moderate intensity walking * inability to speak and read english

Keywords: older adults physical activity sedentary retirement communities advocacy built environment peer mentoring walkability