Too much sedentary behavior increases the risk for chronic disease, loss of physical function, disability, and all-cause mortality. The 2018 physical activity guidelines emphasize the importance of moving more and sitting less. There is a great need for interventions to reduce sedentary behavior in older adults because they are the most sedentary age group. Little work has been done to address sedentary behavior in older adults residing in assisted living (AL) facilities, even though these individuals tend to be more sedentary than community-dwelling older adults. Exercise-specific self-efficacy enhancing interventions have been successful in promoting physical activity in middle-aged adults, healthy older adults, and older adults with chronic disease. Ms. Webster modified a well-established self-efficacy enhancing intervention (Active for Life) to be appropriate for older adults in AL. She interviewed AL residents about their preferences, requested their feedback and suggestions on the intervention, and modified the intervention based on their recommendations.
Specific aims are to 1) describe feasibility and acceptability of the intervention for older adults in AL settings and 2) examine the feasibility and acceptability of collecting outcome measurements of objectively- measured sedentary behavior and physical activity, self-efficacy for exercise, value of physical activity, self- rated health, physical function, anxiety, depression, and fatigue. Ms. Webster will recruit residents from four AL facilities. The intervention will be conducted in small groups, twice a week for three months. Each session will include walking, behavioral strategies/education, and circuit training (strength and balance exercises). A thorough evaluation of feasibility and acceptability will be conducted. Ms. Webster is working on a three-manuscript dissertation and this fellowship will support the completion of her work. The first manuscript is a systematic review on sedentary behavior in the oldest-old adults, >80 years of age. The second is a measurement project to identify valid methods for processing accelerometer data that can be used to measure sedentary behavior in older adults. These two projects are currently in progress. The third will describe results of the proposed feasibility and acceptability study. The proposed training plan will provide Ms. Webster with skills and knowledge to build a program of research focused on sedentary behavior and physical activity in older adults. The training plan includes objectives for developing methodological skills, becoming a proficient researcher, and obtaining expertise in the field of sedentary behavior and physical activity in older adults. Training will take place at the University of Michigan School of Nursing, an institution with abundant resources, and Ms. Webster will work with a primary sponsor who has successfully implemented similar interventions in older adult populations. Her mentoring team includes experts in kinesiology, health behavior change, gerontology and assisted living, and statistics.
There is a significant need for interventions to reduce sedentary behavior in older adults, especially in the assisted living setting, as residents? high levels of sedentary behavior increase their risk for numerous health conditions and loss of function. This training fellowship will include testing the feasibility and acceptability of an intervention to reduce sedentary behavior and increase light physical activity in residents of assisted living, which will be foundational for future larger studies. The fellowship will support the PI (Ms. Webster) to complete her three-manuscript dissertation and become a substantive expert in this area.
