Regular physical activity benefits older adults physically and mentally. However, the availability and the evidence for physical activity programs that are safe and appropriate for home-bound seniors at risk for nursing home admission are severely limited. The long-term goal of this project is to develop a sustainable health promotion program led by home care aides that can be used by community-based organizations, such as home care agencies and state units on aging, to maintain independence among nursing home-eligible older adults living in their homes. The proposed project will examine the effectiveness of a safe physical activity program, led by home care aides who regularly help hard-to-reach older home care clients with housekeeping and routine personal care services in the home. The primary objective is to test whether the safe physical activity program with a built-in motivational enhancement component, performed in a seated position, preserves the function and well-being of home care clients. The secondary objective is to understand for whom the program is efficacious, the extent to which the program can reach the target population, the extent to which participants drop out of the program, the extent to which program participants maintain the behavioral change introduced by the intervention, and what the program's cost-effectiveness is. Building on a pilot project that demonstrated the program's feasibility in a large Medicaid home care program, this randomized controlled trial will inform future expansion of the physical activity program into real-world home care settings. This research will provide evidence and guidelines for a new model of home care, which will facilitate older home care clients and their home care aides to work together to maintain or improve the function of nursing home-eligible seniors so that they can remain in the community.

Public Health Relevance

This project will produce knowledge on whether a safe, low-intensity physical activity program led by home care aides for community-dwelling nursing home eligible seniors is efficacious and how it works in a Medicaid funded home care program. The results will facilitate the adoption and implementation of the sustainable physical activity program in real-life home care settings. It proposes a new model of home care, which would facilitate a cultural shift towards an 'active service model' where home care aides and their clients work together on a safe, simple physical activity program to maintain or improve function to remain in the community.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Research Project (R01)
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Study Section
Community-Level Health Promotion Study Section (CLHP)
Program Officer
Fazio, Elena
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University of Illinois at Chicago
Public Health & Prev Medicine
Schools of Public Health
United States
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Muramatsu, Naoko; Yin, Lijuan; Berbaum, Michael L et al. (2018) Promoting Seniors' Health With Home Care Aides: A Pilot. Gerontologist 58:779-788
Muramatsu, Naoko; Yin, Lijuan; Lin, Ting-Ti (2017) Building Health Promotion into the Job of Home Care Aides: Transformation of the Workplace Health Environment. Int J Environ Res Public Health 14: