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01-04-2017 | Original Paper

Community-Based Healthy Aging Interventions for Older Adults with Arthritis and Multimorbidity

Authors: Janice C. Zgibor, Lei Ye, Robert M. Boudreau, Molly B. Conroy, Joni Vander Bilt, Elizabeth A. Rodgers, Elizabeth A. Schlenk, Mini E. Jacob, Jane Brandenstein, Steven M. Albert, Anne B. Newman

Published in: Journal of Community Health | Issue 2/2017

Abstract

Examine the impact of programs led by community health workers on health and function in older adults with arthritis and other health conditions. We conducted a cluster-randomized trial of the Arthritis Foundation Exercise Program (AFEP) enhanced with the “10 Keys”™ to Healthy Aging compared with the AFEP program at 54 sites in 462 participants (mean age 73 years, 88 % women, 80 % white). Trained Community health workers delivered the 10-week programs. Outcomes assessed after 6 months included physical performance [Short Physical Performance Battery (SPPB)], Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index, and preventive health behaviors. Both groups experienced improvements. Performance improved by 0.3 SPPB points in the AFEP/“10 Keys”™ group and 0.5 in AFEP alone; WOMAC scores declined by 3.0 and 3.9 points respectively. More participants had controlled hypertension at 6 months in both groups (60.1 % baseline to 76.7 % in AFEP/10 Keys and from 76.5 to 84.9 % in AFEP alone) and greater diabetes control (from 15.0 to 34.9 and 15.5 to 34.1 %, respectively). These community-based programs showed similar improvements in preventive health, mobility and arthritis outcomes.

Bellamy, N. (2009). WOMAC Osteoarthritis Index: User guide IX. Herston, Queensland.

Bellamy, N., Buchanan, W. W., Goldsmith, C. H., Campbell, J., & Stitt, L. W. (1988). Validation study of WOMAC: A health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. Journal of Rheumatology, 15(12), 1833–1840.PubMed

Bureau, U. S. C. (2011). 2005–2009 American Community Survey Allegheny County.

Callahan, L. F., Mielenz, T., Freburger, J., Shreffler, J., Hootman, J., Brady, T., Buysse, K., & Schwartz, T. (2008). A randomized controlled trial of the people with arthritis can exercise program: Symptoms, function, physical activity, and psychosocial outcomes. Arthritis & Rheumatism-Arthritis Care & Research, 59(1), 92–101.CrossRef

Center for Aging and Population Health. University of Pittsburgh, Pittsburgh PA. Retrieved April 15, 2016 from http://www.caph.pitt.edu/.

Center for Aging and Population Health. The “10 Keys” TM to Healthy Aging Instructor Manual. Healthy Aging Resource Guide. 2016 edn. University of Pittsburgh, Pittsburgh PA. Retrieved April 15, 2016 from http://www12.edc.gsph.pitt.edu/CHA_OAEP/.

Centers for Disease Control and Prevention and The Merck Company Foundation. The State of Aging and Health in America 2007. (2007 Accessed March 30, 2016). Whitehouse Station, NJ: The Merck Company Foundation Available at http://www.cdc.gov/aging and http://www.merck.com/cr. An interactive version of The State of Aging and Health in America 2007 report is available online at http://www.cdc.gov/aging.

Department of Health Vital Statistics, P. Allegheny County Death records 2005–2008.

Gibbs, B. B., Brancati, F. L., Chen, H., Coday, M., Jakicic, J. M., Lewis, C. E., Stewart, K. J., & Clark, J. M. (2014). Effect of improved fitness beyond weight loss on cardiovascular risk factors in individuals with type 2 diabetes in the Look AHEAD study. European Journal of Preventive Cardiology, 21(5), 608–617.CrossRefPubMed

10.

Gudlaugsson, J., Gudnason, V., Aspelund, T., Olafsdottir, A. S., Jonsson, P. V., Arngrimsson, S. A., Harris, T. B., & Johannsson, E. (2013). Effects of exercise training and nutrition counseling on body composition and cardiometabolic factors in old individuals. European Geriatric Medicine, 4(6), 431–437.CrossRef

11.

Guralnik, J. M., Ferrucci, L., Simonsick, E. M., Salive, M. E., & Wallace, R. B. (1995). Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. New England Journal of Medicine, 332(9), 556–561.CrossRefPubMed

12.

Guralnik, J. M., Simonsick, E. M., Ferrucci, L., Glynn, R. J., Berkman, L. F., Blazer, D. G., Scherr, P. A., & Wallace, R. B. (1994). A short physical performance battery assessing lower extremity function: Association with self-reported disability and prediction of mortality and nursing home admission. Journal of Gerontology, 49(2), M85–M94.CrossRefPubMed

13.

Jacob, M. E., Lo-Ciganic, W. H., Simkin-Silverman, L. R., Albert, S. M., Newman, A. B., Terhorst, L., Bilt, J. V., Zgibor, J. C., & Schlenk, E. A. (2016). The preventive services use self-efficacy (PRESS) scale in older women: Development and psychometric properties. BMC Health Service Research, 16(1), 71.CrossRef

14.

Kim, K., Choi, J. S., Choi, E., Nieman, C. L., Joo, J. H., Lin, F. R., Gitlin, L. N., & Han, H. R. (2016). Effects of community-based health worker interventions to improve chronic disease management and care among vulnerable populations: A systematic review. American Journal of Public Health, 106(4), e3–e28.CrossRefPubMed

15.

Kwon, S., Perera, S., Pahor, M., Katula, J. A., King, A. C., Groessl, E. J., & Studenski, S. A. (2009). What is a meaningful change in physical performance? Findings from a clinical trial in older adults (The LIFE-P Study). The Journal of Nutrition, Health & Aging, 13(6), 538–544.CrossRef

16.

Lorig, K. R., Sobel, D. S., Stewart, A. L., Brown, B. W. J., Bandura, A., Ritter, P., Gonzalez, V. M., Laurent, D. D., & Holman, H. R. (1999). Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: A randomized trial. Medical Care, 37(1), 5–14.CrossRefPubMed

17.

Mazzeo, R. S. (2015). Exercise and the Older Adult. ACSM Current Comment. Retrieved September 3, 2015, from https://www.acsm.org/docs/current-comments/exerciseandtheolderadult.pdf.

18.

Messier, S. P., Loeser, R. F., Miller, G. D., Morgan, T. M., Rejeski, W. J., Sevick, M. A., Ettinger, W. H. Jr., Pahor, M., & Williamson, J. D. (2004). Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: The arthritis, diet, and activity promotion trial. Arthritis & Rheumatism-Arthritis Care & Research, 50(5), 1501–1510.CrossRef

19.

Newman, A. B., Bayles, C. M., Milas, C. N., McTigue, K., Williams, K., Robare, J. F., Taylor, C. A., Albert, S. M., & Kuller, L. H. (2010). The 10 keys to healthy aging: Findings from an innovative prevention program in the community. Journal of Aging and Health, 22(5), 547–566.CrossRefPubMedPubMedCentral

20.

Pittman, M., Sunderland, A., Broderick, A., & Barnett, K. (2015). Bringing community health workers into the mainstream of U.S. health care. Discussion Paper. Washington, DC: Institute of Medicine.

21.

Rejeski, W. J., Brubaker, P. H., Goff, D. C. Jr., Bearon, L. B., McClelland, J. W., Perri, M. G., & Ambrosius, W. T. (2011). Translating weight loss and physical activity programs into the community to preserve mobility in older, obese adults in poor cardiovascular health. Archives of Internal Medicine, 171(10), 880–886.CrossRefPubMedPubMedCentral

22.

Rejeski, W. J., Ip, E. H., Bertoni, A. G., Bray, G. A., Evans, G., Gregg, E. W., Zhang, Q., & Look, A. R. G. (2012). Lifestyle change and mobility in obese adults with type 2 diabetes. New England Journal of Medicine, 366(13), 1209–1217.CrossRefPubMedPubMedCentral

23.

Robare, J. F., Bayles, C. M., Newman, A. B., Williams, K., Milas, C., Boudreau, R., McTigue, K., Albert, S. M., Taylor, C., & Kuller, L. H. (2011). The “10 keys” to healthy aging: 24-month follow-up results from an innovative community-based prevention program. Health Education & Behavior, 38(4), 379–388.CrossRef

24.

Ruggiero, L., Castillo, A., Quinn, L., & Hochwert, M. (2012). Translation of the diabetes prevention program’s lifestyle intervention: Role of community health workers. Current Diabetes Reports, 12(2), 127–137.CrossRefPubMed

25.

Schlenk, E. A., Bilt, J. V., Lo-Ciganic, W. H., Jacob, M. E., Woody, S. E., Conroy, M. B., Kwoh, C. K., Albert, S. M., Boudreau, R., Newman, A. B., & Zgibor, J. C. (2015). Pilot enhancement of the arthritis foundation exercise program with a healthy aging program. Research in Gerontological Nursing, 9(3), 1–10.

26.

Shediac-Rizkallah, M. C., & Bone, L. R. (1998). Planning for the sustainability of community-based health programs: Conceptual frameworks and future directions for research, practice and policy. Health Education Research, 13(1), 87–108.CrossRefPubMed

27.

US Department of Health and Human Services. (2015). Healthy People 2020: Older Adults. Healthy People 2020 Retrieved September 3, 2015, from http://www.healthypeople.gov/2020/topics-objectives/topic/older-adults.

28.

U.S. Census Bureau. (2010). 2010 Census Summary File 1. Using American FactFinder Retrieved May 7, 2013, from http://factfinder2.census.gov/.

29.

United States National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. (1978). The Belmont report: ethical principles and guidelines for the protection of human subjects of research. [Bethesda, Md.]: The Commission.

30.

US Department of Health & Human Services, Healthy People 2020. Retrieved 01/10/2013, 2013, from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=31.

31.

Villareal, D. T., Chode, S., Parimi, N., Sinacore, D. R., Hilton, T., Armamento-Villareal, R., Napoli, N., Qualls, C., & Shah, K. (2011). Weight loss, exercise, or both and physical function in obese older adults. New England Journal of Medicine, 364(13), 1218–1229.CrossRefPubMedPubMedCentral

32.

Wang, X., Miller, G. D., Messier, S. P., & Nicklas, B. J. (2007). Knee strength maintained despite loss of lean body mass during weight loss in older obese adults with knee osteoarthritis. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 62(8), 866–871.CrossRef

33.

Zgibor, J. C., Schlenk, E. A., Vater, L., Kola, S., Bilt, J. V., Woody, S., Jacob, M. E., Lo-Ciganic, W.-H., Brenckle, A., Brandenstein, J., Kwoh, C. K., Boudreau, R., Albert, S., Conroy, M., Rodgers, E., & Newman, A. B. (2016). Partnership building and implementation of an integrated healthy-aging program. Progress in Community Health Partnerships: Research, Education, and Action, 10(1), 123–132.CrossRef

Title: Community-Based Healthy Aging Interventions for Older Adults with Arthritis and Multimorbidity
Authors: Janice C. Zgibor
Lei Ye
Robert M. Boudreau
Molly B. Conroy
Joni Vander Bilt
Elizabeth A. Rodgers
Elizabeth A. Schlenk
Mini E. Jacob
Jane Brandenstein
Steven M. Albert
Anne B. Newman
Publication date: 01-04-2017
Publisher: Springer US
Published in: Journal of Community Health / Issue 2/2017
Print ISSN: 0094-5145
Electronic ISSN: 1573-3610
DOI: https://doi.org/10.1007/s10900-016-0268-5

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Community-Based Healthy Aging Interventions for Older Adults with Arthritis and Multimorbidity

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Keynote webinar | Spotlight on medication adherence

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