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BAILAMOS©: Development, Pilot Testing, and Future Directions of a Latin Dance Program for Older Latinos
Abstract
Older Latinos have low rates of physical activity (PA) and poor health outcomes. Focus groups and a single group, pre-post 3-month pilot of a culturally appropriate Latin dance program (BAILAMOS(©)) were conducted among older, inactive Latinos with a self-identified mobility limitation. Nine themes emerged from focus groups, including cultural influences of dance and barriers to dancing. In the pilot intervention, 9 of 13 older Latinos completed the program and attended 85% of the sessions. Self-reported PA significantly increased (p < .05; d = 1.39), but daily accelerometer-assessed PA decreased for moderate-intensity PA (p = .18; d = 0.29). Participants reported significantly greater enjoyment of PA (p < .05; d = 0.61) and improved physical quality of life (p = .23; d = 0.31). Improvements in mobility (p = .15; d = 0.56) and aspects of cognition were demonstrated. The BAILAMOS program appears to be feasible, culturally appropriate, and has the potential to improve psychosocial determinants of PA, self-reported PA, and aspects of health.
... Currently, there is no cure for AD; however, evidence suggests that protective factors for AD include regular physical activity (PA) (Blondell et al., 2014), cognitively and mentally stimulating leisure activities (Wilson et al., 2012), social engagement, and having a rich social network (Marioni et al., 2015). Latin dance is a particularly promising PA modality that targets these factors and is a culturally acceptable type of PA for middle-aged and older Latinos (Valenzuela et al., 2013;Marquez et al., 2014a). ...
... Given the need to address health inequities in Latinos, Marquez and colleagues created a Spanish-language, Latin dance program (BAILAMOS TM -Balance and Activity In Latinos, Addressing Mobility in Older Adults) (Marquez et al., 2014a) for middle-aged and older Latinos to increase PA, thereby reducing risk of chronic diseases, mobility disability, and cognitive impairment. An initial pilot study with twelve participants demonstrated that self-reported PA increased significantly and small positive effects for executive function and speed of processing were seen in participants, all of whom received the Latin dance program (Marquez et al., 2014a). ...
... Given the need to address health inequities in Latinos, Marquez and colleagues created a Spanish-language, Latin dance program (BAILAMOS TM -Balance and Activity In Latinos, Addressing Mobility in Older Adults) (Marquez et al., 2014a) for middle-aged and older Latinos to increase PA, thereby reducing risk of chronic diseases, mobility disability, and cognitive impairment. An initial pilot study with twelve participants demonstrated that self-reported PA increased significantly and small positive effects for executive function and speed of processing were seen in participants, all of whom received the Latin dance program (Marquez et al., 2014a). Following that small pilot, a two-group pilot trial was conducted to examine differences in cognitive performance among 57 older Latinos randomized to either the BAILAMOS TM dance program or a health education program (Marquez et al., 2017). ...
Background
Physical activity (PA) is a promising method to improve cognition among middle-aged and older adults. Latinos are at high risk for cognitive decline and engaging in low levels of PA. Culturally relevant PA interventions for middle-aged and older Latinos are critically needed to reduce risk of cognitive decline. We examined changes in cognitive performance among middle-aged and older Latinos participating in the BAILAMOS™ dance program or a health education group and compared the mediating effects of PA between group assignment and change in cognitive domains.
Methods
Our 8-month randomized controlled trial tested BAILAMOS™, a 4-month Latin dance program followed by a 4-month maintenance phase. A total of 333 older Latinos aged 55+ were randomized to either BAILAMOS™, or to a health education control group. Neuropsychological tests were administered, scores were converted to z-scores, and specific domains (i.e., executive function, episodic memory, and working memory) were derived. Self-reported PA was assessed, and we reported categories of total PA, total leisure PA, and moderate-to-vigorous PA as minutes/week. A series of ANCOVAs tested changes in cognitive domains at 4 and 8 months. A mediation analysis tested the mediating effects of each PA category between group assignment and a significant change in cognition score.
Results
The ANCOVAs found significant improvement in working memory scores among participants in the dance group at month 8 [ F (1,328) = 5.79, p = 0.017, d = 0.20], but not in executive functioning [ F (2,328) = 0.229, p = 0.80, Cohen’s d = 0.07] or episodic memory [ F (2,328) = 0.241, p = 0.78, Cohen’s d = 0.05]. Follow-up mediation models found that total PA mediated the relationship between group assignment and working memory, in favor of the dance group (β = 0.027, 95% CI [0.0000, 0.0705]). Similarly, total leisure PA was found to mediate this relationship [β = 0.035, 95% CI (0.0041, 0.0807)].
Conclusion
A 4-month Latin dance program followed by a 4-month maintenance phase improved working memory among middle-aged and older Latinos. Improvements in working memory were mediated by participation in leisure PA. Our results support the current literature that leisure time PA influences cognition and highlight the importance of culturally relevant PA modalities for Latinos.
Clinical Trial Registration
[ www.ClinicalTrials.gov ], identifier [NCT01988233].
... Two focus groups were conducted with the aim of investigating older Latinos' perceptions and attitudes toward dance and PA, as formative work to develop a dance intervention. As reported in Marquez et al. (2015), a semi-structured focus group guide was developed by the research team prior to the focus groups. The guide included questions aimed at eliciting attitudes and personal views toward PA, issues and concerns regarding engaging in PA, and perceptions of dancing. ...
... An iterative process was used for code development of transcripts, in which initial codes were supplemented with emergent codes as they surfaced during data analysis. We focus here on five themes that emerged from the data, with supporting data that is in addition to that already reported (Marquez et al. 2015), all of which were mentioned by both male and female participants. Participants were self-identified Latino/Hispanic (of unknown country of origin), on average in their seventies (M = 75.08), ...
... Using information from the focus groups conducted, the BAILAMOS dance program was created by David X. Marquez and Miguel Mendez, who has extensive dance experience, has taught older adults, and has the capacity to teach persons with different skill and experience levels (see Marquez et al. 2015 for details). We created a dance manual for instructors of the program, along with a detailed class-byclass schedule. ...
Physical activity (PA) has been linked to health across a multitude of mental and physical outcomes. Given that leisure time PA is mostly related to favorable health outcomes, strategies to increase leisure time PA among Latinos are warranted. Dance is a form of PA that can also be adjusted to different populations, ages and physical limitations, and is a main commonality across the large and diverse Latino population. To date, evidence on the health benefits of dance for older Latino adults are limited. This paper describes the development and health benefits, in traditional qualitative and quantitative studies, of a Latin dance program that aimed to increase PA, improve cognition, and build community in older Latino adults residing in a major US city. First, we present the formative work, followed by a short description of the BAILAMOS™ dance program. Subsequently, we briefly discuss the progression of trials with BAILAMOS as the intervention and the main results. It appears that regular Latin dancing can increase overall PA and influence aspects of physical and cognitive functioning. This finding highlights the importance of creating PA interventions that incorporate opinions and feedback from the community the intervention targets, are culturally relevant, that take place in older Latinos’ communities, and that are linguistically appropriate and led by bilingual and bicultural staff.
... In some cases, especially in older individuals, dance interacts with emotion and might give rise to reminiscing, perhaps bringing to mind memories of young adulthood, or experiences connected to autobiographical memory, which might promote optimism and wellbeing (Routledge et al., 2013). Additionally, dance might be an appropriate type of exercise to avoid boredom, as it includes a variety of styles that, combined with music, tend to arouse emotions in the aging mind, an aspect that might have important implications for both the motivational and cognitive functioning of elders (Marquez et al., 2015). ...
... The participants' gender was not specified in two of the 35 studies (Borges et al., 2018;Pope et al., 2019), so the mean number of females was computed over 33 studies. The number of participants in each study ranged from 13 in two pilot studies (Alpert et al., 2009;Marquez et al., 2015) to 530 (Merom et al., 2016b). All the studies included at least one dance group and, depending on the study design, either no other groups, a passive control group that did not receive any training, or one or more groups that received different training interventions (e.g., health program, cognitive training, physical training other than dance). ...
... Out of the 30 longitudinal intervention studies included in this review, 16 were RCTs (Baniqued et al., 2018;Burzynska et al., 2017;Eggenberger et al., 2015Eggenberger et al., , 2016Esmail et al., 2019;Hamacher et al., 2015;Kattenstroth et al., 2013;Kimura and Hozumi, 2012;Kirsch et al., 2018;Kosmat and Vranic, 2017;Marquez et al., 2017;Merom et al., 2016a, b;Müller et al., 2017;Rehfeld et al., 2017;and Rehfeld et al., 2018), 9 were pseudo-randomized, non-randomized or non-reported studies (Borges et al., 2018;Chuang et al., 2015;Coubard et al., 2011;Hackney et al., 2015;Kim et al., 2011;Pope et al., 2019;Zhang et al., 2014;Zilidou et al., 2018 andWu et al., 2010), and 5 were pre-post studies without a control group (Alpert et al., 2009;Douka et al., 2019;Fraser et al., 2014;Ji et al., 2018;and Marquez et al., 2015). ...
Background
: Dance is a multidomain activity that combines aerobic, coordination and cognitive exercise. This music-associated physical and cognitive exercise is a leisure activity that motivates people, elicits emotions, and avoids boredom, promoting adherence to practice. Continuing physical activity is of paramount importance, since cognitive benefits tend to disappear or even reverse when training ceases.
Objective
: The question we addressed in this systematic review is what influence dance has on the brain and cognition of healthy middle-aged and older adults.
Literature survey
: We systematically reviewed the effects of dance on brain and cognition in older adults using MEDLINE, Psyc-Info, PubMed and Scopus databases.
Methodology
: After screening 1,051 studies, thirty-five met the eligibility inclusion criteria. These studies showed that dance improves brain structure and function as well as physical and cognitive functions.
Conclusions
: The protective effect of dance training on cognition in older adults, together with the possibility of adapting intensity and style to suit possible physical limitations makes this activity very suitable for older adults.
... To our knowledge, no dance intervention studies have been conducted with older Latinos, a rapidly growing segment of the population with known low levels of LTPA (Marquez et al., 2010) and high levels of cognitive decline (Novak & Riggs, 2010). As a result, we developed the BAILAMOS © (Balance and Activity In Latinos, Addressing Mobility in Older Adults) dance program, a culturally-appropriate Latin dance program for this under-served population (Marquez, Bustamante, Aguinaga, & Hernandez, 2014). A single group, pre-post 3-month pilot of BAILAMOS © demonstrated substantial program feasibility and effect sizes (Cohen's d) indicated very small improvements in cognitive function (ds=.11-.12) ...
... A single group, pre-post 3-month pilot of BAILAMOS © demonstrated substantial program feasibility and effect sizes (Cohen's d) indicated very small improvements in cognitive function (ds=.11-.12) (Marquez et al., 2014). Feedback from participants led to a revised 4-month program. ...
... Dance program-Basics of the dance aspects of BAILAMOS © have previously been reported (Marquez et al., 2014). Based partially upon participant feedback, BAILAMOS © was revised to be 16 weeks in duration with open dance sessions. ...
Disparities exist between Latinos and non-Latino whites in cognitive function. Dance is culturally appropriate and challenges individuals physically and cognitively, yet the impact of regular dancing on cognitive function in older Latinos has not been examined. A two-group pilot trial was employed among inactive, older Latinos. Participants (N = 57) participated in the BAILAMOS(©) dance program or a health education program. Cognitive test scores were converted to z-scores and measures of global cognition and specific domains (executive function, episodic memory, working memory) were derived. Results revealed a group x time interaction for episodic memory (p<0.05), such that the dance group showed greater improvement in episodic memory than the health education group. A main effect for time for global cognition (p<0.05) was also demonstrated, with participants in both groups improving. Structured Latin dance programs can positively influence episodic memory; and participation in structured programs may improve overall cognition among older Latinos.
... Two questions were asked for each task: "Have you had difficulty (task)" and "Have you changed the way you (task) or how often you do this, due to a health or physical condition?" Older adults with difficulty or change with any one of the four tasks were eligible for the study, similar to methods used by Weiss et al. [53] and those used in our BAILAMOS pilot study [58]. ...
... As a result, all treatment group participants had the opportunity to continue dancing in months 5-8. More details about the program can be found in Marquez et al. [58,63]. ...
Background:
Latinos are the fastest growing minority group of the older adult population. Although physical activity (PA) has documented health benefits, older Latinos are less likely to engage in leisure time PA than older non-Latino whites. Dance, popular among Latinos, holds promise as a culturally relevant form of PA.
Purpose:
To describe self-reported and device-assessed changes in PA as a result of a randomized controlled trial of BAILAMOS, a 4-month Latin dance program with a 4-month maintenance program, versus a health education control group.
Methods:
Adults, aged 55+, Latino/Hispanic, Spanish speaking, with low PA levels at baseline, and risk for disability were randomized to the dance program (n = 167) or health education condition (n = 166). Data were analyzed using multilevel modeling with full information maximum likelihood.
Results:
A series of multilevel models revealed significant time × group interaction effects for moderate-to-vigorous physical activity (MVPA), dance PA, leisure PA, and total PA. Exploring the interaction revealed the dance group to significantly increase their MVPA, dance PA, leisure PA, and total PA at months 4 and 8. Household PA and activity counts from accelerometry data did not demonstrate significant interaction effects.
Conclusions:
The study supports organized Latin dance programs to be efficacious in promoting self-reported PA among older Latinos. Efforts are needed to make dancing programs available and accessible, and to find ways for older Latinos to add more PA to their daily lives.
Clinical trial information:
NCT01988233.
... A culturally relevant dance program, BAILAMOS, has previously shown that participation in this program can increase PA for cognitively intact community dwelling middle-aged and older Latinxs (D. X. Marquez et al., 2015). BAILAMOS integrates principles of social cognitive theory (SCT; Bandura, 1997) by incorporating dance styles from the simplest to the most difficult style to enhance mastery experiences, exposing participants to social modeling in a class with other individuals of similar characteristics, receiving verbal persuasion from the instructor, and informing participants of any physiological responses as a result from engaging in the program. ...
... A previous intervention involving the BAILAMOS dance program also demonstrated increases in self-reported MVPA (+285 minutes per week) comparable to the present findings (D. X. Marquez et al., 2015); however, that study reported no changes in deviceassessed PA. This finding could mean that the BAILAMOS dance program did not have a way to engage and reach participants on days when the program did not meet in person. ...
Older Latinxs engage in lower levels of leisure-time physical activity (PA) compared with non-Latinx Whites. Latin dance is a culturally relevant type of leisure-time PA that may engage older Latinx populations, particularly when coupled with mobile health technologies (mHealth). This single group pre–post feasibility study described the PA and health outcomes of middle-aged and older Latinxs participating in BAILA TECH—an intervention that combines the BAILAMOS Latin dance program with mHealth (Fitbit Charge 2, Fitbit app, and motivational text messages). Participants ( n = 20, M age = 67 ± 7.1, female n = 15, 75%) were enrolled in the 16-week BAILA TECH intervention held twice a week. Participants received a Fitbit Charge 2 to assess PA at baseline, during the intervention, and postintervention. An mHealth platform (iCardia) collected Fitbit data and staff delivered weekly motivational and informational text messages. Participants completed questionnaires about PA, sedentary behavior, cardiorespiratory fitness, social support, quality of life, and cognitive function at baseline and postintervention. Paired t tests evaluated change in pre–post measures. There was a significant increase in device-assessed moderate-to-vigorous PA ( d = 0.69), self-reported light-leisure ( d = 1.91) and moderate-to-vigorous PA ( d = 1.05), moderate-to-vigorous leisure PA ( d = 1.55), predicted cardiorespiratory fitness ( d = 1.10), and PA social support ( d = 0.81 [family]; d = 0.95 [friends]) from baseline to postintervention. Although nonsignificant, there was a small effect on physical health–related quality of life ( d = 0.32) and executive function ( d = 0.29). These data describe an increase in PA levels and health-related outcomes of middle-aged and older Latinxs from participation in an mHealth-infused Latin dance intervention. An adequately powered trial is necessary to establish efficacy.
... Lee, (2011), on the other hand, used both subjective and objective techniques and also reported increased PA of a moderate intensity following a 4 wk Latin dance intervention. In a recent 12 wk investigation of Latin dance, again using simultaneous subjective and objective methods for the assessment of PA, it was reported that questionnaire results indicated increased total PA minutes post-intervention; however, no increase was revealed when PA was evaluated using accelerometry (Marquez, Bustamante, Aguinaga, & Hernandez, 2014). This discrepancy not only confounds the issue of whether dance interventions are efficacious in terms of increasing dance-related PA, but also highlights the need for using activity-specific accelerometer data processing techniques. ...
... This discrepancy not only confounds the issue of whether dance interventions are efficacious in terms of increasing dance-related PA, but also highlights the need for using activity-specific accelerometer data processing techniques. The conversion of accelerometer counts in the research of Marquez et al. (2014) was undertaken using cut-points calibrated on a treadmill. This method has now been shown to be invalid for the processing of accelerometer data collected during dance and may explain the reported discrepancy between the two aforementioned outcome measures. ...
The purpose of this study was to gain a holistic understanding of the efficacy of Zumba® fitness in a community-recruited cohort of overweight and physically inactive women by evaluating (i) its physiological effects on cardiovascular risk factors and inflammatory biomarkers and (ii) its mental health-enhancing effects on factors of health-related quality of life (HRQoL). Participants were randomly assigned to either engagement in one to two 1 h classes of Zumba® fitness weekly (intervention group; n = 10) or maintenance of habitual activity (control group; n = 10). Laboratory assessments were conducted pre- (week 0) and post-intervention (week 8) with anthropometric, physiological, inflammatory and HRQoL data collected. In the intervention group, maximal oxygen uptake significantly increased (P < 0.05; partial η(2) = 0.56) by 3.1 mL · kg(-1) · min(-1), per cent body fat significantly decreased (P < 0.05; partial η(2) = 0.42) by -1.2%, and interleukin-6 and white blood cell (WBC) count both significantly decreased (P < 0.01) by -0.4 pg · mL(-1) (partial η(2) = 0.96) and -2.1 × 10(9) cells · L(-1) (partial η(2) = 0.87), respectively. Large magnitude enhancements were observed in the HRQoL factors of physical functioning, general health, energy/fatigue and emotional well-being. When interpreted in a community-based physical activity and psychosocial health promotion context, our data suggest that Zumba® fitness is indeed an efficacious health-enhancing activity for adults.
... Non-adherence to the accelerometer-wear protocol by study participants and the small sample size may contribute to the lack of correlation between self-reported and accelerometer-measured physical activity. Few intervention studies have used accelerometers in this target population, and although a higher adherence to accelerometer wear was reported, 41-44 minimum wear time required to have valid data in these studies 41,43,44 was different than in our study. For example, Ainsworth et al's 41 study of sedentary postpartum Latinas reported that 86% of participants at baseline were adherent to accelerometer protocol of at least 10 hours a day on 3 or more days during the week. ...
... Another study that examined adherence to accelerometer wear and performance in Latino male and female adults found that 77.7% of participants were adherent to accelerometer wear on at least 3 out of 6 days during 10 hours or more per day. 44 Interestingly, both Marquez 43 and Evenson 44 reported that adherence to accelerometer wear protocol in their studies was higher in males than in females. Matthews et al 45 recommends accelerometers be worn 3-4 days in order to identify PA levels with at least 80 percent reliability; thus, the more rigorous protocol of 4 days of minimum accelerometer wear (at least 10 hours/day) was selected for Muévete Alabama. ...
Latinas in the US report high levels of physical inactivity and are disproportionally burdened by related health conditions (eg, type 2 diabetes, obesity), highlighting the need for innovative strategies to reduce these disparities. A 1-month single-arm pretest-posttest design was utilized to assess the feasibility and acceptability of a culturally and linguistically adapted Internet-based physical activity intervention for Spanish-speaking Latinas. The intervention was based on the Social Cognitive Theory and the Transtheoretical Model. Changes in physical activity and related psychosocial variables were measured at baseline and the end of the 1-month intervention. The sample included 24 Latina adults (mean age, 35.17 ± 11.22 years). Most (83.3%) were born outside the continental US. Intent-to-treat analyses showed a significant increase (P = .001) in self-reported moderate- to vigorous-intensity physical activity from a median of 12.5 min/wk at baseline to 67.5 min/wk at the 1-month assessment. Participants reported significant increases in self-efficacy as well as cognitive and behavioral processes of change. Nearly half of the participants (45.8%) reported advancing at least one stage of change during the course of the 1-month intervention. Findings support the feasibility and acceptability of using interactive Internet-based technology to promote physical activity among Latinas in Alabama.
... In this way, HLM offers culturally informed consideration. [41][42][43] . This is particularly true in older adults and specifically older Black and Hispanic adults. ...
Countless individuals in the United States continue to experience effects related to the coronavirus disease 2019 (COVID-19) pandemic, such as job/business instability, the breaking down of school systems, isolation, and negative health consequences. There are, however, certain populations and communities that continue to be disproportionately affected, resulting in severe health outcomes, decreased quality of life, and alarmingly high death rates. These populations typically live in historically excluded communities and identify as persons of color. To advance health equity in these communities, healthy living (HL) strategies are paramount. In fact HL Medicine - getting sufficient physical activity, practicing good nutrition, maintaining a healthy body weight, and not smoking, can be a viable solution. Applying these concepts, particularly the promotion of physical activity, through community collaboration can advance the goals of social justice action.
... Nos estudos que realizaram a intervenção por meio da dança de salão [16][17][18] , verificou-se melhorias significativas nas habilidades sensoriais, autonomia, atividades passadas, presentes e futuras, na participação social e consequentemente, na qualidade de vida geral das idosas 18 , e nos demais estudos, a melhoria foi significativa em todos os domínios e componentes da qualidade de vida 16,17 . Resultados semelhantes foram identificados em um estudo realizado em 51 idosos de Belo Horizonte, no qual constatou-se que a prática regular da dança de salão contribui para a redução dos níveis de depressão na população idosa 33 .Em outro estudo realizado com indivíduos latinos, verificou-se que diversos tipos de dança de salão como merengue, cha cha cha, bachata e salsa apresentaram efeitos positivos sobre mobilidade 34 . ...
Objetivo: Revisar sistematicamente a literatura a fim de identificar estudos que avaliaram a influência da dança na qualidade de vida em indivíduos com idade ≥60 anos. Métodos: Trata-se de um estudo bibliográfico, qualitativo, realizado a partir do levantamento de artigos publicados até 06 de setembro de 2018 nas bases de dados Biblioteca Virtual em Saúde (BVS), PsycINFO, Scientific Eletronic Library Online (SciELO), Scopus e SPORTDiscus. A seleção dos artigos foi realizada a partir da utilização de descritores (DeCS), operadores Booleanos e filtros. Para as bases BVS e SciELO, utilizou-se a combinação dos descritores "dança" AND "qualidade de vida" AND "idoso". Nas bases PsycINFO, Scopus e SPORTDiscus foi utilizada a combinação dos termos "dance" AND "quality of life" AND "elderly". Resultados: Foram incluídos cinco estudos, publicados entre 2009 e 2017. A idade dos participantes variou entre 60 e 89 anos. Observou-se predominância no uso de instrumentos de avaliação da qualidade de vida do Grupo WHOQOL. Em relação ao tipo de dança, dois estudos utilizaram a dança sênior e nos demais estudos, outros tipos de dança de salão foram usados como forma de intervenção. Conclusão: Constatou-se que a dança, independentemente do estilo, contribui significativamente para a melhoria da qualidade de vida dos idosos nos aspectos físicos, psicológicos, fisiológicos, relações sociais e meio ambiente. Palavras-chave: dança, idoso, qualidade de vida. Abstract: Objective:Systematically review the literature in order to identify studies that evaluated the influence of dance of the quality of life in individuals aged ≥ 60 years. Methods: A bibliographical study, qualitative, conducted from the survey of articles published until september 06, 2018, in databases Virtual Health Library (VHL), PsicINFO, Scientific Electronic Library Online (SciELO), Scopus and SPORTDiscus. The selection of articles was held from the use of descriptors (DeCS), Boolean operators and filters. For the VHL and SciELO bases, using the combination of descriptors "dança" AND "qualidade de vida" AND "idoso". In the PsicINFO, Scopus and SPORTDiscus bases the combination of the terms "dance" AND "quality of life" and "elderly" was used.Results: we included five studies, published between 2009 and 2017. The age of participants ranged between 60 and 89 years. It was observed a predominance in the use of tools of evaluation of the quality of life the WHOQOL group. In relation to the type of dance, two studies used the senior dance and in other studies, other types of ballroom dancing were used as a form of intervention. Conclusion:It was noted that the dance, regardless of style, contributes significantly to the improvement of the quality of life of the elderly in aspects physical, psychological, physiological, social and environmental relations.
... They also face early cognitive decline (Clark et al., 2005; Federal Interagency Forum on Aging-Related Statistics, 2012), likely because of racial and ethnic disparities in chronic disease (Piedra et al., 2017). Recent studies support the use of culturally adapted exercise programs to improve the physical and cognitive health of Latino older adults (Hernandez et al., 2019;Marquez et al., 2015;Piedra et al., 2018). ...
Few studies explore the differences between diverse stakeholders’ understandings of what constitutes “positive aging” for
Latino older adults. To address this gap, we worked with a 20-member steering committee (SC) of community stakeholders
to collect concept mapping data from 38 scholars and community workers. We generated 90 statements related to positive
aging from the literature and produced concept maps based on four different stakeholder groups’ ratings of them. All
stakeholders prioritized “Financial Security,” but scholars marked “Spirituality” as least important whereas community
workers rated it second highest. The design of programs for Latino older adults should reflect such differences.
... The dance program includes 12 weeks of one-hour dance sessions. The developers noted self-reports of higher levels of physical activity, greater cognitive function, and improved physical quality of life (Marquez, Bustamante, Aguiñaga, & Hernandez, 2015). ...
Despite chronic exposure to social stressors that are known to undermine health, the Latinx population within the USA is healthier than the non-Latinx White population on most indicators of mental health. However, Latinx children and youth who were born and/or raised in the USA amid a culture of anti-immigrant sentiment, racial/ethnic discrimination, and socioeconomic disadvantage are in a context that increases the risk for depression and maladaptive behaviors. In this chapter, we examine mental health within the Latinx population by summarizing extant epidemiologic data and highlighting theoretical models that are applied to the study of Latinx mental health. We also explore how culture shapes mental health outcomes and mental health disparities related to national origin and immigrant status. We conclude with a discussion of a key mental health issue, adolescent depression, through a systems dynamics approach to illustrate potential future directions.
... Specifically, a 3-month Latin dance intervention (i.e. BAILAMOS) in older Hispanic/ Latino adults that included Cha Cha Cha, Merengue, Bachata, and Salsa, resulted in reduced sedentarism and improved quality of life over time (Marquez, Bustamante, Aguiñaga, & Hernandez, 2015). Culturally appropriate and cost-effective intervention modalities to reduce depression in Hispanics/ Latinos are both needed and critical given the stigma associated with mental illness in this population and reluctance in taking antidepressant medication (Lewis-Fernandez, Das, Alfonso, Weissman, & Olfson, 2005). ...
Objectives:
We examined the prospective effects of an evidence-based exercise intervention on depressive symptoms in older Hispanics/Latinos and the potential synergistic effects (if any) of an attribution-retraining component to counter negative ascriptions to the aging process.
Method:
We analyzed baseline, 1-, 12-, 24-month data collected from Hispanics/Latinos ≥ 60 years participating in an exercise intervention ("¡Caminemos!") across 27 senior centers (N = 572). All participants were given 4 weekly 1-hour group-based exercise classes targeting strength training, endurance, balance and flexibility. In addition, they were randomly assigned to one of two conditions: a) treatment group-a 1-hour attribution retraining session where participants were taught that aging does not mean one inevitably becomes sedentary, or b) control group-generic health education. The Geriatric Depression Scale was used to assess depressive symptoms. Covariates included age, sex, education, income, marital status, acculturation, and number of chronic conditions.
Results:
In prospective analyses, participants in both trial arms displayed lower scores for depressive symptoms at 12- (β1 = -0.17, p = 0.04) and 24-months (β2 = -0.33, p < 0.001) when compared to baseline values.
Conclusion:
Given expected growth of the older Hispanic/Latino adult population, exercise programs are a promising strategy in promoting favorable mental health.
... Older Latinos, in particular, have low rates of PA, which may contribute to frailty and other adverse health outcomes. In a fourth article in this theme section, Marquez et al. (2015) describe the pilot findings of their novel Latin dance program, BAILAMOS©, which was created for older Latinos. Their data indicate not only that the program is feasible and culturally appropriate but that it may enhance enjoyment of PA and influence psychosocial factors related to PA. ...
We tested if a dance trial yielded improvements in physical function and cardiorespiratory fitness (CRF) in middle-aged/older Latino adults. Physical activity was assessed using the Community Healthy Activities Model Program for Seniors, physical function with the Short Physical Performance Battery (SPPB) protocol, and estimated CRF with the Jurca nonexercise test model. Multivariate analysis of covariance models found significant change in SPPB protocol total scores, F (1, 329) = 4.23, p = .041, and CRF, F (1, 329) = 5.16, p = .024, between the two study arms in favor of the dance group. Mediation models found moderate- to vigorous-intensity physical activity to mediate to mediate between group and SPPB scores (β = 0.054, 95% confidence interval [0.0142, 0.1247]). Moderate- to vigorous-intensity physical activity and total physical activity were found to partially mediate between group and CRF (β = 0.02, 95% confidence interval [−0.0261, 0.0751]), with the direct pathway no longer being significant ( p > .05). This provides support for Latin dance programs to have an effect on SPPB protocol and CRF.
Background and Objectives
Evidence suggests a significant prevalence of race and ethnic disparities in the United States among people with neurologic conditions including stroke, Alzheimer disease and related dementia (ADRD), Parkinson disease (PD), epilepsy, spinal cord injury (SCI), and traumatic brain injury (TBI). Recent neurologic research has begun the paradigm shift from observational health disparities research to intervention research in an effort to narrow the disparities gap. There is an evidence base that suggests that community engagement is a necessary component of health equity. While the increase in disparities focused neurologic interventions is encouraging, it remains unclear whether and how community-engaged practices are integrated into intervention design and implementation. The purpose of this scoping review was to identify and synthesize intervention studies that have actively engaged with the community in the design and implementation of interventions to reduce disparities in neurologic conditions and to describe the common community engagement processes used.
Methods
Two databases, PubMed and CINAHL, were searched to identify eligible empirical studies within the United States whose focus was on neurologic interventions addressing disparities and using community engagement practices.
Results
We identified 392 disparity-focused interventions in stroke, ADRD, PD, epilepsy, SCI, and TBI, of which 53 studies incorporated community engagement practices: 32 stroke studies, 15 ADRD, 2 epilepsy studies, 2 PD studies, 1 SCI study, and 1 TBI study. Most of the interventions were designed as randomized controlled trials and were programmatic in nature. The interventions used a variety of community engagement practices: community partners (42%), culturally tailored materials and mobile health (40%), community health workers (32%), faith-based organizations and local businesses (28%), focus groups/health need assessments (25%), community advisory boards (19%), personnel recruited from the community/champions (19%), and caregiver/social support (15%).
Discussion
Our scoping review reports that the proportion of neurologic intervention studies incorporating community engagement practices is limited and that the practices used within those studies are varied. The major practices used included collaboration with community partners and utilization of culturally tailored materials. We also found inconsistent reporting and dissemination of results from studies that implemented community engagement measures in their interventions. Future directions include involving the community in research early and continuously, building curricula that address challenges to community engagement, prioritizing the inclusion of community engagement reporting in peer-reviewed journals, and prioritizing and incentivizing research of subpopulations that experience disparities in neurologic conditions.
Aim:
There is a growing recognition of the contribution that participation in group-based arts and creativity interventions makes to our health and wellbeing. Despite this acknowledgement, more empirical investigation is required to more fully understand its impact. The aim of this mixed-method systematic review was to develop a better understanding of the evidence on the impact of arts and creativity on older people's physical and psychological health and wellbeing.
Method:
Extensive searches of 14 electronic bibliographic databases were carried out using predefined search criteria for the period 2013-2020. Ninety-three studies were included within the review and appraised using the Mixed Methods Appraisal Tool (MMAT).
Results:
Dance was the most common form of arts identified within studies, followed by music and singing. Dance was associated with improved balance, lower body physical strength, flexibility, and aerobic fitness in older adults. Promising evidence showed that music and singing on a regular basis were associated with improved cognitive function, quality of life, affective states and a sense of wellbeing in older adults. Preliminary evidence showed that visual and creative arts were associated with reduced feelings of loneliness, improved sense of community and social connectedness. Initial evidence showed that theatre and drama were associated with emotional wellbeing; however, more evidence is required in this area.
Conclusion:
The evidence shows that participation in group-based arts and creativity can have positive physical, mental, and social health impacts for older adults, ageing and for population health. These findings support the importance of participation in the arts for older adults, especially for the promotion of positive health and for the prevention, or mitigation, of ill health in later life for both public health and the arts and creativity agenda.
Physical activity (PA) has been associated with a multitude of beneficial mental and physical outcomes. It is well documented, however, that there are health disparities and inequities for segments of the population, especially as related to PA. Engagement of traditionally minoritized populations into research is essential for justice in health. We discuss a community engagement model that can be used for recruiting and retaining traditionally minoritized populations into PA research, and then we go into three major ethnic/racial groups in the United States: Latinos, African Americans, and Asian Americans. Background information of each group, cultural values that play a role in health for each of the groups, and research demonstrating how culture plays a role in the formation and implementation of PA interventions in these groups is presented.
Background:
Understanding perceptions of health and illness among older Hispanic adults is vital for nurses when designing effective health promotion programs.
Purpose:
The purpose of this study was to explore the perceptions of health and illness and how health was maintained during times of illness.
Method:
This inductive qualitative descriptive study used a single focus group with interviews over three sessions. All eight members of the focus group were Spanish-speaking, older adults living in the community. Immersion/crystallization and editing analytic styles were used to analyze the data.
Results:
Participants were parishioners at a local church and knew each other from participating in community events. Perceptions of health mainly focused on both the absence of illness and physical limitations. Maintaining health included a healthy lifestyle and being physically active; however, food was central to maintaining health. Perceptions of illness were described as "feelings of sickness" such as sadness and worry. Dealing with illness was equated with physical limitations, with strategies suggested, including going to the doctor, preparing natural and folk remedies, spirituality, and support from family and friends.
Conclusion:
Nurses have an important role in assessing the health management strategies of older Hispanic adults and need to incorporate the older adults' understanding of health and illness into their plan of care.
Background and Objectives
In the United States, Latino adults are a growing segment of the aging population who will need research-informed interventions to help them age successfully. Arguably, how Latino older adults and service providers understand “positive aging” serves as an important precursor for the cultivation of such interventions. This investigation explored whether Latino older adults’ conceptualizations of positive aging aligned with those of service providers.
Research Design and Methods
We compared how Latino older adults (n = 93) and service providers (n = 45) rated 85 positive aging statements produced by Latino older adults. These 85 items were used to generate a concept map, which displays those items thematically by clusters and overarching regions of meaning.
Results
We found divergences at each level of the map—statements, clusters, and regions—which illuminate differences between how service providers and Latino older adults think about Latino positive aging. For example, whereas Latino older adults prioritized the cluster containing items related to internal wellbeing, service providers rated it seventh of eleven clusters. The region comprising clusters related to relationships garnered the highest agreement between groups, but also a notable departure; compared to Latino older adults, service providers rated community and social involvement as less important.
Discussion and Implications
Understanding such differences can help providers tailor services consistent with the interests of Latino older adults. Future studies should examine the extent to which stakeholders believe various aspects of positive aging are modifiable.
Background
Breast cancer survivors (BCS), particularly Latina BCS, experience weight gain and reduced physical activity (PA) post-treatment increasing the risk for recurrence. There is a lack of evidence on the intensity and type of PA needed to engage cultural subgroups and improve clinical outcomes. This study developed and piloted two non-traditional PA interventions among a diverse sample of BCS.
Methods
Twenty BCS (65% Latina; age 25–75) participated in a 2-arm parallel group-randomized pilot study to test the effects of an 8-week latin dance and Qigong/Tai Chi intervention on PA and body composition. A seven-day pedometer protocol was used to measure steps/week and a bioelectric impedence scale was used to assess BMI and %body fat. T-tests were used to examine preliminary outcomes across both interventions and within intervention arms.
Results
There were no significant changes in steps/week, BMI, or %body fat across or in each separate intervention. A small effect size for increase in steps/day was found among participants in the Qigong/Tai Chi arm (0.10) and low-to-moderate effect sizes for reductions in % body fat overall (0.36), and separately for participants in Latin dance (0.26) and Qigong/Tai chi (0.46).
Conclusion
Latin dance and Qigong/Tai Chi are engaging and acceptable PA modalities that are promising for improving PA and body fat among diverse, high-risk BCS. Our findings highlight the need to continue to reach and engage high-risk BCS, including Latina survivors, using novel, culturally-sensitive PA interventions. Future studies should extend and more rigorously test these novel approaches to improving outcomes associated with recurrence.
Latinxs have low levels of leisure-time physical activity. Mobile health (mHealth) interventions incorporating smartphone apps and wearable PA tracking devices represent a promising solution for promoting leisure-time physical activity. This study aimed to assess the feasibility of the BAILA TECH intervention for middle-aged and older Latinxs. A single-group feasibility trial was conducted for 16 wk, with 2-h in-person sessions twice a week. The Fitbit® Charge 2™, its mobile application, and text messages (TM) were added to the BAILAMOS™ Latin dance program. In-person sessions comprised Fitbit instructional sessions, the BAILAMOS™ program, and technology Q&A sessions. Participants wore Fitbits for 19 wk (16 wk of BAILAMOS™ + two baseline and one posttest week) and received TM for the last 12 wk. Feasibility was assessed by recruitment capability (e.g., recruitment rates), acceptability and suitability (e.g., enjoyment), and resources (e.g., monetary requirements). Feasibility metrics were tracked and interviews were conducted, descriptive statistics and themes are presented. Fifty-one middle-aged and older Latinxs were screened, 28 (55%) were eligible, and 20 (39%) started the intervention (female n = 15, M age = 67 yr old, SD = 7.1). All 20 participants wore their wearable PA tracker for 19 wk, and 3 participants (15%) dropped out of the in-person sessions. Participants reported enjoyment of learning and wearing the Fitbit, dancing, and receiving TM. Total intervention costs were $9572, not including personnel costs. A Latin dance program with mHealth components appears feasible for middle-aged and older Latinxs.
Background:
South Asian Indian immigrants residing in the United States are at high risk of cardiovascular disease (prevalence ≥35%), diabetes (prevalence 45.4%), and stroke (prevalence 26.5%). This study examined the effect of culturally relevant physical activity interventions on the improvement of physiological measures and average daily steps in at-risk midlife South Asian Indian immigrant women.
Methods:
In this 2-arm interventional research design, the dance (n = 25) and the motivational phone calls group (n = 25), attended social cognitive theory-based motivational workshops every 2 weeks for the first 12 weeks. Data for weight, waist circumference, blood pressure, blood sugar, cholesterol level, and 12-lead electrocardiogram were collected at the baseline, 12 weeks, and 24 weeks.
Results:
Significant differences were seen in body weight (F2,94 = 4.826, P = .024; ηp2=.093), waist circumference (F2,92 = 7.496, P = .001; ηp2=.140), systolic blood pressure (F2,94 = 19.865, P = .000; ηp2=.2970), triglyceride (F2,94 = 11.111, P = .000; ηp2=.191), cholesterol (F2,94 = 8.925, P = .001; ηp2=.160), blood sugar level (F2,94 = 8.851, P = .000; ηp2=.158), and average daily steps across both intervention groups over time (F2,96 = 30.94, P = .000; ηp2=.392).
Conclusion:
Culturally relevant motivational workshops with Indian dance and walking are an innovative approach to increasing lifestyle physical activity among South Asian Indian immigrant women.
Objective
African Americans and Latinos/Hispanics have a higher prevalence of dementia compared to non-Latino Whites. This scoping review aims to synthesize non-pharmaceutical interventions to delay or slow age-related cognitive decline among cognitively healthy African American and Latino older adults.
Design
A literature search for articles published between January 2000 and May 2019 was performed using the databases PubMed, CINAHL, PsycINFO and Web of Science. Relevant cited references and grey literature were also reviewed. Four independent reviewers evaluated 1,181 abstracts, and full-article screening was subsequently performed for 145 articles. The scoping review consisted of eight studies, which were evaluated according to the peer-reviewed original manuscript, non-pharmaceutical intervention, cognitive function as an outcome, separate reporting of results for African American and Latinos, minimum age of 40, and conducted in the US. A total of 8 studies were considered eligible and were analyzed in the present scoping review.
Results
Eight studies were identified. Four studies focused on African Americans and four focused on Latinos. Through the analysis, results indicated cognitive training-focused interventions were effective in improving memory, executive function, reasoning, visuospatial, psychological function, and speed among African Americans. Exercise interventions were effective in improving cognition among Latinos.
Conclusion
This scoping review identified effective non-pharmaceutical interventions among African American and Latinos. Effective interventions focused on cognitive training alone for African Americans and exercise combined with group educational sessions for Latinos. Future research should explore developing culturally appropriate non-pharmaceutical interventions to reduce disparities and to enhance cognition among older African American and Latinos.
In this chapter, we outline the health status and experiences of aging among Latinx persons. Aging among Latinx persons is heterogeneous, based on country of origin, place of residence, generation, socioeconomic status, social support networks, and life experiences. Despite having higher life expectancies than White non-Hispanics, this population suffers from a greater burden of disability, their utilization of existing health services is lower, and the proportion of Latinx older adults living at the poverty level is greater compared to other racial/ethnic groups. With fewer economic resources, Latinx older adults may be highly dependent on family and social services for long-term care. We conclude by providing alternative frameworks for examining aging in the Latinx population.
Background/Aims: Community-based participatory research (CBPR) is an optimal approach that brings together community stakeholders, researchers and practitioners in an effort to understand and address social issues and health disparities experienced by vulnerable populations. Latino immigrant families in the United States with youth and young families with disabilities have experienced a number of barriers in gaining positive health outcomes. These families face challenges in maintaining a healthy lifestyle, placing them at high risk for obesity, diabetes, and other chronic health conditions. The purpose of this study was to develop a healthy lifestyles intervention in collaboration with Latino immigrant families with youth and young adults with disabilities using a CBPR approach, and to examine the impact of the intervention from participants’ perspectives.
Methods: Grounded in the principles of CBPR, we developed a partnership with community stakeholders to create a healthy lifestyles intervention aimed at meeting the needs of Latino families in the United States. During and following implementation of the intervention, we conducted focus groups with 12 intervention participants to examine the impact of the intervention.
Results: Participants identified the intervention program as meeting a need in the community and reported specific positive aspects related to health behaviors, social learning, inclusion, community participation, and peer advocacy.
Discussion: CBPR healthy lifestyle interventions are relevant to the needs of Latino immigrant families with youth and young adults with disabilities. Health professionals should involve community residents in the design of healthy lifestyles programming to ensure strategies for change are relevant and relatable.
Son muchos los estudios que corroboran los beneficios de la práctica asidua de la actividad física en la población de personas mayores, los cuales abarcan muchos aspectos de la vida, bien a través de aspectos físicos, o bien como es el caso de la presente investigación, donde se pretende evaluar los cambios producidos sobre aspectos cognitivos (Colcombe y cols., 2003), emocionales (Kattenstroth y cols., 2010), y de condición física saludable de la persona mayor practicante (Rikli y Jones 1999). De ahí la necesidad de trabajar estos aspectos mediante el uso del ritmo como medio principal de práctica física, mediante su modalidad latina denominada “Bachata”, donde a través del baile, se pretende demostrar su relación con los beneficios sobre el estado de ánimo, la movilidad funcional y confianza personal de quién la práctica, así como en el equilibrio y disminución de la ansiedad y depresión (Cobo y cols., 2011). La presente investigación quiere integrar todas las variables citadas, mediante una intervención dirigida de Bachata, de seis meses de duración, organizado por la Universidad de Almería, y en colaboración conjunta con el Aula de Mayores de la misma, con una frecuencia semanal de dos días y una hora cada día.
Objective:
The aim of this study was to determine whether a Latin dance program with sedentary behavior information would have an impact on physical activity, cardiorespiratory fitness (CRF), and sedentary behavior among older Latinos attending an adult day center (ADC).
Method:
Participants ( N = 21, 75.4 ± 6.3 years old, Mini-Mental State Examination [MMSE] score = 22.4 ± 2.8) were randomized into a dance or wait-list control group. Participants wore an accelerometer and inclinometer and completed a sedentary behavior questionnaire, and a nonexercise equation was used to calculate CRF.
Results:
Findings indicate small to medium effect sizes in the desired direction during midpoint of the intervention for physical activity, sedentary behavior-related outcomes, CRF, and self-reported sedentary behavior in the dance group; however; dance participants did not maintain that trajectory for the remaining 2 months of the intervention.
Discussion:
Future studies may consider implementing behavioral strategies during midpoint of the intervention to encourage participants attending an ADC to maintain physical activity and sedentary behavior changes.
This study investigates the feasibility of a Latin dance program in older Latinos with mild cognitive impairment (MCI) via a feasibility mixed methods randomized controlled design. Spanish-speaking older Latinos (N = 21, 75.4 [6.3] years old, 16 females/5 males, 22.4 [2.8] Mini-Mental State Examination [MMSE] score) were randomized into a 16-week dance intervention (BAILAMOS) or wait-list control; the control group crossed over at week 17 and received the dance intervention. Feasibility was determined by assessing reach, retention, attendance, dance logs, and postintervention focus groups. Reach was 91.3% of people who were screened and eligible. Program retention was 95.2%. The dropout rate was 42.8% (n = 9), and attendance for all participants was 55.76%. The focus group data revealed 4 themes: enthusiasm for dance, positive aspects of BAILAMOS, unfavorable aspects of BAILAMOS, and physical well-being after BAILAMOS. In conclusion, older Latinos with MCI find Latin dance as an enjoyable and safe mode of physical activity.
The goal of Dance for Your Health was to explore the relationship between social Latin dance and health as described by members of the Tucson social Latin dance community. Social Latin dance was selected because of the variety of dances, cultural relevance and popularity in Tucson, and the low-key, relaxed atmosphere. Dance has been prescribed to help manage diseases such as Parkinson’s; however, not much is known about the use of dance for health promotion. Through qualitative methodologies, the project focused on the role dance can play in health promotion and in creating community connections. The project explored personal stories and experiences on the broader impact of health, the meaning of community from the social Latin dancer’s point of view, thoughts on how social Latin dancing could be applied to help people in the community live healthier lives, and how to demystify social Latin dancing for people who are not currently dancing.
Culturally appropriate, innovative strategies to increase physical activity (PA) in women of color are needed. This study examined whether participation in SALSA, an 8-week randomized, crossover pilot study to promote PA, led to improved psychosocial outcomes and whether these changes were associated with changes in PA over time. Women of color (N=50) completed internet-based questionnaires on PA, exercise self-efficacy, motivational readiness, stress and social support at three time points. Women reported high socioeconomic status and decreases in exercise self-efficacy and increases in motivational readiness for exercise and number of stressful events (p<.05); changes in motivational readiness for exercise varied by group (p=.043). Changes in psychosocial factors were associated with increases in PA. Latin dance improved motivational readiness for PA. Future studies are needed to determine whether Latin dance improves other psychological measures and quality of life in women of color in an effort to increase PA and reduce health disparities.
Regression methods were used to select and score 12 items from the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) to reproduce the Physical Component Summary and Mental Component Summary scales in the general US population (n = 2,333). The resulting 12-item short-form (SF-12) achieved multiple R squares of 0.911 and 0.918 in predictions of the SF-36 Physical Component Summary and SF-36 Mental Component Summary scores, respectively. Scoring algorithms from the general population used to score 12-item versions of the two components (Physical Component Summary and Mental Component Summary) achieved R squares of 0.905 with the SF-36 Physical Component Summary and 0.938 with the SF-36 Mental Component Summary when cross-validated in the Medical Outcomes Study. Test-retest (2-week) correlations of 0.89 and 0.76 were observed for the 12-item Physical Component Summary and the 12-item Mental Component Summary, respectively, in the general US population (n = 232). Twenty cross-sectional and longitudinal tests of empirical validity previously published for the 36-item short-form scales and summary measures were replicated for the 12-item Physical Component Summary and the 12-item Mental Component Summary, including comparisons between patient groups known to differ or to change in terms of the presence and seriousness of physical and mental conditions, acute symptoms, age and aging, self-reported 1-year changes in health, and recovery from depression. In 14 validity tests involving physical criteria, relative validity estimates for the 12-item Physical Component Summary ranged from 0.43 to 0.93 (median = 0.67) in comparison with the best 36-item short-form scale. Relative validity estimates for the 12-item Mental Component Summary in 6 tests involving mental criteria ranged from 0.60 to 1.07 (median = 0.97) in relation to the best 36-item short-form scale. Average scores for the 2 summary measures, and those for most scales in the 8-scale profile based on the 12-item short-form, closely mirrored those for the 36-item short-form, although standard errors were nearly always larger for the 12-item short-form.
During aging, sensorimotor, cognitive and physical performance decline, but can improve by training and exercise indicating that age-related changes are treatable. Dancing is increasingly used as an intervention because it combines many diverse features making it a promising neuroplasticity-inducing tool. We here investigated the effects of a 6-month dance class (1 h/week) on a group of healthy elderly individuals compared to a matched control group (CG). We performed a broad assessment covering cognition, intelligence, attention, reaction time, motor, tactile, and postural performance, as well as subjective well-being and cardio-respiratory performance. After 6 months, in the CG no changes, or further degradation of performance was found. In the dance group, beneficial effects were found for dance-related parameters such as posture and reaction times, but also for cognitive, tactile, motor performance, and subjective well-being. These effects developed without alterations in the cardio-respiratory performance. Correlation of baseline performance with the improvement following intervention revealed that those individuals, who benefitted most from the intervention, were those who showed the lowest performance prior to the intervention. Our findings corroborate previous observations that dancing evokes widespread positive effects. The pre-post design used in the present study implies that the efficacy of dance is most likely not based on a selection bias of particularly gifted individuals. The lack of changes of cardio-respiratory fitness indicates that even moderate levels of physical activity can in combination with rich sensorimotor, cognitive, social, and emotional challenges act to ameliorate a wide spectrum of age-related decline.
Two studies examined the reliability and validity of the Physical Activity Enjoyment Scale (PACES). In Study 1, each of 37 undergraduates rode an exercise bicycle under control and external focus conditions. As predicted, Ss reported enjoying the exercise more, as measured by the PACES, in the external focus condition. Moreover, there was a significant negative correlation in the control condition between Ss PACES scores and their scores on a measure of boredom proneness. In Study 2, each of 37 undergraduates rode an exercise bicycle and jogged on a minitrampoline in separate sessions; each then chose one of these activities for their 3rd session. As predicted, there was a significant relationship between Ss PACES ratings (completed after each activity) and their choices of activity. Test–retest reliability was high for jogging and moderate for bicycling. The PACES had high internal consistency in both studies. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This study examined the predictive validity of accelerometers (ACC) to estimate physical activity intensity (PAI) across age and differences in intensity predictions when expressed in relative and absolute PAI terms. Ninety adults categorized into 3 age groups (20-29, 40-49, and 60-69 yr) completed a treadmill calibration study with simultaneous ACC (7164 Actigraph) and oxygen-consumption assessment. Results revealed strong linear relations between ACC output and measured PAI (R2 = .62-.89) across age and similar ACC cut-point ranges across age delineating absolute PAI ranges compared with previous findings. Comparing measured metabolic equivalents (METs) with estimated METs derived from previously published regression equations revealed that age did not affect predictive validity of ACC estimates of absolute PAI. Comparing ACC output expressed in relative vs. absolute terms across age revealed substantial differences in PAI ACC count ranges. Further work is warranted to increase the applicability ofACC use relative to PAI differences associated with physiological changes with age.
Dancing is a mode of physical activity that may allow older adults to improve their physical function, health, and well-being. However, no reviews on the physical benefits of dancing for healthy older adults have been published in the scientific literature. Using relevant databases and keywords, 15 training and 3 cross-sectional studies that met the inclusion criteria were reviewed. Grade B-level evidence indicated that older adults can significantly improve their aerobic power, lower body muscle endurance, strength and flexibility, balance, agility, and gait through dancing. Grade C evidence suggested that dancing might improve older adults' lower body bone-mineral content and muscle power, as well as reduce the prevalence of falls and cardiovascular health risks. Further research is, however, needed to determine the efficacy of different forms of dance, the relative effectiveness of these forms of dance compared with other exercise modes, and how best to engage older adults in dance participation.
En este trabajo se examinan los efectos de un programa de actividad física, aeróbica y no aeróbica, de 8 meses de duración en una muestra de personas mayores inicialmente sedentarias (rango 61-77 años) sobre el bienestar psicológico, el esfuerzo percibido y satisfacción por el ejercicio. Los sujetos participantes en el estudio fueron asignados a cuatro grupos: 1) grupo de ejercicio aeróbico (n=34), 2) grupo de ejercicio no-aeróbico (yoga) (n=30), 3) grupo control de actividades sociales (n=23) y 4) grupo control en lista de espera (n=20). Se utilizó como instrumento de evaluación de las respuestas psicológicas globales inducidas por el ejercicio la Subjective Excercise Experiences Scale (SEES; McAuley y Courneya, 1994), como medida de la sensación del esfuerzo percibido, la Perceived Exertion Scales (RPE-Scales; Borg, 1982) y como medida de la satisfacción por el ejercicio la Physical Activity Enjoyment Scale (PACES; Kendzierski y DeCarlo, 1991). Los resultados obtenidos señalaron incrementos significativos en el bienestar psicológico y en la satisfacción en los dos grupos de ejercicio en comparación con los controles. El grupo de actividad aeróbica mostró puntuaciones significativamente más elevadas en el bienestar psicológico, la sensación de fatiga y la satisfacción por el ejercicio, que las observadas en el grupo de actividad no-aeróbica
This study examined if reported physical activity has beneficial outcomes on disability through cognitive performance-mediated effects and if these mediation effects are comparable for White and African American elders. Longitudinal data from the Assets and Health Dynamics among the Oldest Old study (N = 4,472) are used to test mediation in multilevel models. During the 7-year follow-up, cognitive performance mediated the effects of reported physical activity on disability in the entire sample and in Whites but not in African Americans. Our results indicate that reported physical activity may delay the disability development through improvement in cognitive performance. Unmeasured education and comorbidity influences may have obscured the mediation effects in African Americans. Reported physical activity plays a key role in the independence of older adults and should be particularly promoted in African Americans and during the entire life course.
Accurate assessment is required to assess current and changing physical activity levels, and to evaluate the effectiveness of interventions designed to increase activity levels. This study systematically reviewed the literature to determine the extent of agreement between subjectively (self-report e.g. questionnaire, diary) and objectively (directly measured; e.g. accelerometry, doubly labeled water) assessed physical activity in adults.
Eight electronic databases were searched to identify observational and experimental studies of adult populations. Searching identified 4,463 potential articles. Initial screening found that 293 examined the relationship between self-reported and directly measured physical activity and met the eligibility criteria. Data abstraction was completed for 187 articles, which described comparable data and/or comparisons, while 76 articles lacked comparable data or comparisons, and a further 30 did not meet the review's eligibility requirements. A risk of bias assessment was conducted for all articles from which data was abstracted.
Correlations between self-report and direct measures were generally low-to-moderate and ranged from -0.71 to 0.96. No clear pattern emerged for the mean differences between self-report and direct measures of physical activity. Trends differed by measure of physical activity employed, level of physical activity measured, and the gender of participants. Results of the risk of bias assessment indicated that 38% of the studies had lower quality scores.
The findings suggest that the measurement method may have a significant impact on the observed levels of physical activity. Self-report measures of physical activity were both higher and lower than directly measured levels of physical activity, which poses a problem for both reliance on self-report measures and for attempts to correct for self-report - direct measure differences. This review reveals the need for valid, accurate and reliable measures of physical activity in evaluating current and changing physical activity levels, physical activity interventions, and the relationships between physical activity and health outcomes.
A short battery of physical performance tests was used to assess lower extremity function in more than 5,000 persons age 71 years and older in three communities.
Balance, gait, strength, and endurance were evaluated by examining ability to stand with the feet together in the side-by-side, semi-tandem, and tandem positions, time to walk 8 feet, and time to rise from a chair and return to the seated position 5 times.
A wide distribution of performance was observed for each test. Each test and a summary performance scale, created by summing categorical rankings of performance on each test, were strongly associated with self-report of disability. Both self-report items and performance tests were independent predictors of short-term mortality and nursing home admission in multivariate analyses. However, evidence is presented that the performance tests provide information not available from self-report items. Of particular importance is the finding that in those at the high end of the functional spectrum, who reported almost no disability, the performance test scores distinguished a gradient of risk for mortality and nursing home admission. Additionally, within subgroups with identical self-report profiles, there were systematic differences in physical performance related to age and sex.
This study provides evidence that performance measures can validly characterize older persons across a broad spectrum of lower extremity function. Performance and self-report measures may complement each other in providing useful information about functional status.
Regression methods were used to select and score 12 items from the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) to reproduce the Physical Component Summary and Mental Component Summary scales in the general US population (n=2,333). The resulting 12-item short-form (SF-12) achieved multiple R squares of 0.911 and 0.918 in predictions of the SF-36 Physical Component Summary and SF-36 Mental Component Summary scores, respectively. Scoring algorithms from the general population used to score 12-item versions of the two components (Physical Components Summary and Mental Component Summary) achieved R squares of 0.905 with the SF-36 Physical Component Summary and 0.938 with SF-36 Mental Component Summary when cross-validated in the Medical Outcomes Study. Test-retest (2-week)correlations of 0.89 and 0.76 were observed for the 12-item Physical Component Summary and the 12-item Mental Component Summary, respectively, in the general US population (n=232). Twenty cross-sectional and longitudinal tests of empirical validity previously published for the 36-item short-form scales and summary measures were replicated for the 12-item Physical Component Summary and the 12-item Mental Component Summary, including comparisons between patient groups known to differ or to change in terms of the presence and seriousness of physical and mental conditions, acute symptoms, age and aging, self-reported 1-year changes in health, and recovery for depression. In 14 validity tests involving physical criteria, relative validity estimates for the 12-item Physical Component Summary ranged from 0.43 to 0.93 (median=0.67) in comparison with the best 36-item short-form scale. Relative validity estimates for the 12-item Mental Component Summary in 6 tests involving mental criteria ranged from 0.60 to 107 (median=0.97) in relation to the best 36-item short-form scale. Average scores for the 2 summary measures, and those for most scales in the 8-scale profile based on the 12-item short-form, closely mirrored those for the 36-item short-form, although standard errors were nearly always larger for the 12-item short-form.
Data from general population surveys (n = 1483 to 9151) in nine European countries (Denmark, France, Germany, Italy, the Netherlands, Norway, Spain, Sweden, and the United Kingdom) were analyzed to cross-validate the selection of questionnaire items for the SF-12 Health Survey and scoring algorithms for 12-item physical and mental component summary measures. In each country, multiple regression methods were used to select 12 SF-36 items that best reproduced the physical and mental health summary scores for the SF-36 Health Survey. Summary scores then were estimated with 12 items in three ways: using standard (U.S.-derived) SF-12 items and scoring algorithms; standard items and country-specific scoring; and country-specific sets of 12 items and scoring. Replication of the 36-item summary measures by the 12-item summary measures was then evaluated through comparison of mean scores and the strength of product-moment correlations. Product-moment correlations between SF-36 summary measures and SF-12 summary measures (standard and country-specific) were very high, ranging from 0.94-0.96 and 0.94-0.97 for the physical and mental summary measures, respectively. Mean 36-item summary measures and comparable 12-item summary measures were within 0.0 to 1.5 points (median = 0.5 points) in each country and were comparable across age groups. Because of the high degree of correspondence between summary physical and mental health measures estimated using the SF-12 and SF-36, it appears that the SF-12 will prove to be a practical alternative to the SF-36 in these countries, for purposes of large group comparisons in which the focus is on overall physical and mental health outcomes.
Increasing physical activity is a goal of Healthy People 2010. Although the health benefits of physical activity are documented, older adults are less physically active than any other age group. The purpose of this study was to examine barriers and facilitators to physical activity and exercise among underserved, ethnically diverse older adults.
Seventy-one older adults were recruited through community agencies to participate in seven ethnic-specific focus groups: American Indian/Alaska Native, African American, Filipino, Chinese, Latino, Korean, and Vietnamese. Groups were conducted in the participants' primary language and ranged in size from 7-13 participants. Mean age was 71.6 years (range from 52 to 85 years; SD +/- 7.39). Professional translators transcribed audiotapes into the language of the group and then translated the transcript into English. Transcripts were systematically reviewed using content analysis.
Suggested features of physical activity programs to enhance participation among ethnically diverse minority older adults included fostering relationships among participants; providing culture-specific exercise; offering programs at residential sites; partnering with and offering classes prior to or after social service programs; educating families about the importance of physical activity for older adults and ways they could help; offering low- or no-cost classes; and involving older adults in program development. Walking was the exercise of choice across all ethnic groups. Health served as both a motivator and a barrier to physical activity. Other factors influencing physical activity were weather, transportation, and personal safety.
Findings from this study suggest strategies for culture-specific programming of community-based physical activity programs.
The recent development of the Late-Life Function and Disability Instrument (LL-FDI) was an important contribution to the measurement of function and disability in older adults. The present study examined the psychometric properties and construct validity of the LL-FDI measure in a sample of older women.
Older black (n = 81) and white (n = 168) women completed the LL-FDI, several measures of physical function, and physical activity measures, and had their body mass index assessed at baseline of an ongoing prospective study. Confirmatory factor analyses (CFA) and correlational analyses were used to examine factorial and construct validity of the measure.
The CFA, using an iterative model modification technique, resulted in an acceptable 15-item solution for the function component and an 8-item solution for the disability component. This abbreviated instrument demonstrated high correlations with the original scales. Construct validity for the LL-FDI was supported. Participants who demonstrated better physical function, reported being more active, and had lower body mass index reported less disability and less difficulty with function on the LL-FDI.
The LL-FDI appears to be an effective instrument for assessing function and disability in older women, and the abbreviated version reported here may prove useful in certain circumstances due to its brevity. However, continued determination of the construct validity of the complete and abbreviated scales is recommended.
We provide a brief review of the literature on exercise effects on brain and cognition. To this end, we focus on both prospective and retrospective human epidemiological studies that have examined the influence of exercise and physical activity on cognition and dementia. We then examine the relatively small set of human randomized clinical trials that have, for the most part, focused on exercise training effects on cognition. Next, we discuss animal research that has examined the molecular, cellular, and behavioral effects of exercise training. Finally, we conclude with a summary and brief discussion of important future directions of research on fitness cognition and brain.
Preventing mobility disability depends on matching interventions to individual needs. The purpose of this study is to improve targeting by determining whether mobility performance is associated with, and predicts, mobility disability hierarchically. The hypothesis is that poorer performance tested by more demanding tasks is more strongly associated with current and future mobility "limitation" (self-reported task modification or difficulty) than is that tested by less demanding tasks, in a graded manner.
Data come from the Women's Health and Aging Study II (n = 436) at baseline and at 36-month follow-up. Logistic and multinomial regression models examined associations between performance on mobility tests and reported limitation in walking one-half mile, adjusting for risk factors for disability.
We found that 76.6% of prevalent and 88.4% of new-onset self-reported limitation fit within the hypothesized hierarchical pattern. The estimated strength of association between a decrement in lower extremity performance and reported limitation increased with task demand for the primary outcome, reported limitation in walking one-half mile. For example, the odds ratios for prevalent report of walking limitation, versus no limitation, for 10% lower performance walking, dressing, repeating chair stands, and climbing, respectively, were 1.05 (95% confidence interval, 0.97-1.17), 1.08 (1.00-1.16), 1.15 (1.06-1.25), and 1.22 (1.12-1.33).
This study partially supports the hypothesis that mobility performance tends to follow a hierarchical pattern. For studying mild mobility disability, walking speed may not be as useful as more demanding tests. Identifying declines in performance through more demanding tests such as climbing should improve the ability to target preventive interventions to individuals at risk of mild mobility decline within a high-functioning population.
Americans age 65 and over are an important and growing segment of our population. Many federal agencies provide data on aspects of older Americans' lives, but it can be difficult to fit the pieces together. Thus, it has become increasingly important for policymakers and the general public to have an accessible, easy-to-understand portrait that shows how older Americans are faring. This new book provides a comprehensive picture of our older population's health and well-being.
In this work we examine the effects of an 8-months aerobic and no-aerobic exercise program on psychological well-being, perceived effort and enjoyment in an initially sedentary elderly sample (aged 61-77 yrs). Ss were assigned to 1 of 4 groups: an aerobic exercise training group (n=34), a non-aerobic (yoga) training group (n=30), a social activity control group (n=23), or a waiting list control group (n=20). The Subjective Exercise Experiences Scale (SEES; McAuley & Courneya, 1994) was used to evaluate the global psychological responses induced by the exercise, the Perceived Exertion Scale (RPE-Scale; Borg, 1982) was used to measure the perceived effort, and the Physical Activity Enjoyment Scale (PACES; Kendzierski & DeCarlo, 1991) was used to evaluate the degree of satisfaction of the exercise. Results showed increments in the psychological well-being and in the satisfaction in both exercise groups compared to the control groups. The aerobic activity training group showed significant higher scorings in the psychological well-being, sensation of fatigue and enjoyment than the no-aerobic activity group.
To validate the Short-Form Late-Life Function and Disability Instrument (SF-LLFDI), a valid measure of functional limitations and disability in older adults, in Spanish-speaking populations and to analyze its psychometric properties.
Validation study.
Complejo Hospitalario Universitario de Albacete, Spain.
Sample population of 876 participants aged 70 and older from Albacete, Spain.
Forward and back translation of the SF-LLFDI; concurrent validity was determined according to the Barthel Index and the Lawton Scale for disability and according to grip strength, gait speed, the Timed Up and Go Test, and the Short Physical Performance Battery (SPPB) for function. Construct validity, internal consistency, and floor and ceiling effect were determined. The area under the receiver operating characteristic curve (AUC) was calculated to identify function and disability. Intraclass correlation coefficients (ICCs) were used to analyze reliability in a subsample of 50 participants.
The SF-LLFDI was significantly correlated with the Barthel Index (correlation coefficient (r)=0.827), the Lawton Scale (r=0.693), gait speed (r=0.661), and the SPPB (r=0.650). Internal consistency (Cronbach α=0.974), interobserver reliability (ICC=0.989; 95% confidence interval (CI)=0.984-0.993), and intraobserver reliability (ICC=0.982, 95% CI=0.967-0.990) were all excellent. The SF-LLFDI demonstrated excellent discriminant validity, as evidenced by an AUC for a Barthel Index less than 65 points of 0.991 (95% CI=0.986-0.996), with a better cutoff of less than 65 points (sensitivity, 94%; specificity, 94%), and for a Lawton Scale score of less than 4 of 0.976 (95% CI% 0.967-0.985), with a better cutoff of less than 72 (sensitivity, 91%; specificity, 91%). No participant had a maximum score; 36 (4.1%) obtained the minimum.
The Spanish SF-LLDFI is a valid instrument for detecting disability and functional limitation.
One of the factors distinguishing non-Latino blacks (NLB) and Latinos from non-Latino whites (NLW) is higher rates of occupational physical activity (OPA) and less participation in leisure time physical activity (LTPA). We examined participation in OPA and LTPA among employed individuals and the relationship between OPA and LTPA across select racial or ethnic groups and Latino subgroups.
We pooled data from 2000 to 2003 of the National Health Interview Survey. We divided the survey participants into three groups: 1) those with no LTPA, 2) those who reported some LTPA but not for sufficient time and intensity to meet recommended guidelines, and 3) those who reported LTPA at levels that met or exceeded recommendations. We used ordinal logistic regression to examine whether NLB and Latinos or Latino subgroups were less likely to report LTPA than NLW while controlling for social, economic, and demographic factors that may have accounted for group differences. We further examined the prevalence of OPA and the relationship between LTPA and OPA.
Among employed individuals, NLB and Latinos had significantly more individuals reporting no LTPA compared with NLW. Latinos had the greatest proportion of individuals reporting no LTPA. Furthermore, it was found that significantly more Latinos had physically active occupations compared with NLB and NLB compared with NLW, respectively. Among employed Latinos, Cubans and Dominicans were most likely to report no LTPA, and Mexicans had the greatest percentage of workers with a physically active occupation. LTPA was not significantly associated with having a physically active occupation across races and Latino subgroups.
Participation in LTPA among ethnic or racial minorities is lower than that of NLW, and the OPA rates are higher. OPA does not significantly impact participation in LTPA in employed adults.
With the proportion of older Latinos in the United States rapidly growing, dementia is expected to be an increasing public health problem in this segment of the population. Yet relatively few cognitive test batteries have been developed for evaluating older Spanish-speaking persons. We selected a battery of cognitive tests used in cognitive aging studies of English speakers, adapted it for Spanish speakers, and administered it to 66 older Latinos (mean age=71.1, SD=8.1). The results of a factor analysis supported grouping the tests into the same 5 functional domains identified for English speakers. Composite measures of performance in each domain were positively related to education and, with some exceptions, inversely related to age. The results suggest that this battery may be useful in epidemiologic research on cognition in older Latinos.
The purpose of this Position Stand is to provide an overview of issues critical to understanding the importance of exercise and physical activity in older adult populations. The Position Stand is divided into three sections: Section 1 briefly reviews the structural and functional changes that characterize normal human aging, Section 2 considers the extent to which exercise and physical activity can influence the aging process, and Section 3 summarizes the benefits of both long-term exercise and physical activity and shorter-duration exercise programs on health and functional capacity. Although no amount of physical activity can stop the biological aging process, there is evidence that regular exercise can minimize the physiological effects of an otherwise sedentary lifestyle and increase active life expectancy by limiting the development and progression of chronic disease and disabling conditions. There is also emerging evidence for significant psychological and cognitive benefits accruing from regular exercise participation by older adults. Ideally, exercise prescription for older adults should include aerobic exercise, muscle strengthening exercises, and flexibility exercises. The evidence reviewed in this Position Stand is generally consistent with prior American College of Sports Medicine statements on the types and amounts of physical activity recommended for older adults as well as the recently published 2008 Physical Activity Guidelines for Americans. All older adults should engage in regular physical activity and avoid an inactive lifestyle.
The Community Healthy Activities Model Program for Seniors (CHAMPS) is a physical activity monitoring questionnaire for people between 65 to 90 years old. This questionnaire has been previously translated to Spanish to be used in the Latin American population.
To adapt the Spanish version of the CHAMPS questionnaire to Puerto Rico and assess its internal consistency.
An external review committee adapted the existent Spanish version of the CHAMPS to be used in the Puerto Rican population. Three older adults participated in a second phase with the purpose of training the research team. After the second phase, 35 older adults participated in a third content adaptation phase. During the third phase, the preliminary Spanish version for Puerto Rico of the CHAMPS was given to the 35 participants to assess for clarity, vocabulary and understandability. Interviews to each participant in the third phase were carried out to obtain feedback and create a final Spanish version of the CHAMPS for Puerto Rico. After analyses of this phase, the external review committee prepared a final Spanish version of the CHAMPS for Puerto Rico. The final version was administered to 15 older adults (76 +/- 6.5 years) to assess the internal consistency by using Cronbach's Alpha analysis.
The questionnaire showed a strong internal consistency of 0.76. The total time to answer the questionnaire was 17.4 minutes.
The Spanish version of the CHAMPS questionnaire for Puerto Rico suggested being an easy to administer and consistent measurement tool to assess physical activity in older adults.
Two brief screening tests, the Short Portable Mental Status Questionnaire (SPMSQ) and the East Boston Memory Test (EBMT), were included in a population questionnaire administered to 3,811 persons 65 years of age and older. A detailed clinical evaluation was then administered to 467 persons (drawn from high, medium and low performers on the EBMT) to determine who was cognitively impaired and the disorders that were responsible for that cognitive impairment. The results showed that the EBMT was better at enriching the population of the poor performance group with persons who had Alzheimer's disease (AD). It had a lower refusal rate among non-proxy respondents: 2% for the EMBT versus 9% for the SPMSQ. The sensitivity and positive predictive value were also higher for the EBMT than the SPMSQ when the diagnosis of interest was AD. However, there were persons with AD in all strata of performance on both the EBMT and the SPMSQ, emphasizing the importance of selecting persons from all performance strata in multistage community studies of AD.
The neuropsychological tests developed for the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) are currently used to measure cognitive impairments of Alzheimer's disease (AD) in clinical investigations of this disorder. This report presents the normative information for the CERAD battery, obtained in a large sample (n = 413) of control subjects (ages 50 to 89) who were enrolled in 23 university medical centers in the United States participating in the CERAD study from 1987 to 1992. We compared separately the performance of subjects with high (> or = 12) and low (< 12) years of formal education. For many of the individual cognitive measures in the highly educated group, we observed significant age and gender effects. Only the praxis measure showed a significant age effect in the low-education group. Delayed recall, when adjusted for amount of material acquired (savings), was relatively unaffected by age, gender, and level of education. Our findings suggest that the savings scores, in particular, may be useful in distinguishing between AD and normal aging.
The role played by exercise self-efficacy in the maintenance of exercise participation of previously sedentary middle-aged adults 4 months after the termination of a formal exercise program is reported. Correlational and multiple regression analyses examined the influence of self-efficacy, physiological (aerobic capacity, sex, body composition), and behavioral (past exercise frequency and intensity) parameters in the maintenance of exercise participation. Self-efficacy significantly predicted exercise behavior at follow-up when controlling for biological and behavioral influences. Aerobic capacity, exercise efficacy, and exercise behavior in combination were significantly related to current energy expenditure in aerobic physical activity. The discussion focuses on the need to examine the impact of different correlates of exercise behavior at different stages of the exercise process.
To evaluate effectively interventions to increase physical activity among older persons, reliable and valid measures of physical activity are required that can also detect the expected types of physical activity changes in this population. This paper describes a self-report physical activity questionnaire for older men and women, developed to evaluate the outcomes of the Community Healthy Activities Model Program for Seniors (CHAMPS), an intervention to increase physical activity.
The questionnaire assesses weekly frequency and duration of various physical activities typically undertaken by older adults. We estimated caloric expenditure/wk expended in physical activity and created a summary frequency/wk measure. We calculated measures of each of these for: 1) activities of at least moderate intensity (MET value >/= 3.0); and 2) all specified physical activities, including those of light intensity. Six-month stability was estimated on participants not likely to change (assessment-only control group, physically active cohort). Several tests of construct validity were conducted, and sensitivity to change was analyzed based on response to the CHAMPS intervention.
The sample (N = 249) comprised underactive persons (N = 173 from the CHAMPS trial) and active persons (N = 76). The sample was aged 65-90 yr (mean = 74, SD = 6); 64% were women, and 9% were minorities. Six-month stability ranged from 0.58 to 0.67, using intraclass correlation coefficients. Nearly all construct validity hypotheses were confirmed, though correlations were modest. All measures were sensitive to change (P < or = 0.01), with small to moderate effect sizes (0.38-0.64).
The CHAMPS measure may be useful for evaluating the effectiveness of programs aimed at increasing levels of physical activity in older adults.
A 6-month randomized controlled trial examined the effect of walking and stretching/toning activity on changes in self-efficacy to overcome barriers and engage in incremental periods of activity in older, formerly sedentary adults (N = 174, M age = 65.5 years). Additionally, we were interested in the extent to which social, affective, and behavioral influences contributed to self-efficacy at the end of the 6-month program. Multiple sample latent growth curve analyses revealed a nonsignificant curvilinear growth pattern for barriers efficacy with increases in efficacy occurring from baseline to 2 months and then declining at 4 and 6 months. In the case of efficacy related to continued activity participation, there was a significant growth pattern demonstrating declines in efficacy over the 4 time points. Structural modeling analyses revealed significant direct effects of physical activity, affect experienced during activity, and exercise social support on both types of self-efficacy. These relationships were not significantly different between modes of activity. The findings are discussed in terms of the need to target sources of efficacy information prior to program end and the implications that such an approach might have for long-term maintenance of physical activity in older adults.
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.
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.
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.
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.
Despite the well-documented benefits of leisure time physical activity, Latinos are reported to be highest among all ethnic groups in leisure time inactivity. The present study examined the relationship between leisure time physical activity and exercise self-efficacy, exercise barriers self-efficacy, exercise social support, and perceived importance of physical activity. Data were obtained from 153 Latinos (n = 86 female, n = 67 male). Comparisons were made between Latinos with high and low levels of leisure time physical activity and between men and women. Results revealed that Latinos high in leisure time physical activity had significantly greater exercise and barriers self-efficacy, received more social support from friends to exercise, and placed greater importance on physical activity outcomes than did Latinos low in leisure time physical activity. No significant differences were revealed for social support from family, nor between men and women on the psychosocial variables. Physical activity interventions targeting sources of self-efficacy, increasing social support, and emphasizing the importance of regular physical activity should be helpful in increasing leisure time physical activity of Latinos. Future research should examine the influence of environmental and cultural variables on the leisure time physical activity of Latinos and how they interact with psychosocial factors.
Increasing physical activity, especially for high-risk groups, is a national priority; yet little is known about the lifelong patterns of physical activity of older Mexican American women. This article describes Mexican American women's current sedentary status by reviewing their physical activity history. Interventions aimed at promoting health in older adults require an understanding of the impact of prior experiences on current health behaviors. Thus, in-depth semistructured interviews were conducted with 71 Mexican American women (aged 50 years or older) recruited from local churches and senior centers. Household, occupational, and leisure activities from age 15 years to present time were reviewed. A lifelong pattern of low occupational and leisure activity and low to moderate household activity were found, with sedentary occupations and no leisure activities predominating. Most believed that current household, occupational and leisure activities provide enough physical activity, thus influencing participation in exercise programs or activities. Attempts to increase physical activity for this group need to begin by teaching them age-appropriate and culturally acceptable physical activities.
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