The overarching goal is to advance knowledge about long-term maintenance, particularly in older adults, by systematically analyzing maintenance factors in: 1) types of treatment;and 2) types of populations. The research analyzes 14 change processes within and across 10 behaviors that are of increasing significance to the health of aging populations. The 10 behaviors are 1. smoking;2. alcohol;3. adherence to anti- hypertensives;4. adherence to statins;5. self-monitoring of blood glucose;6. stress management;7. depression management;8. exercise;9. diet;and 10. sun exposure. The primary goals are: 1) to compare maintenance rates and pathways to maintenance within and between types of treatment (e.g., treatment vs. no-treatment;multiple level treatments vs. single level);and 2) types of populations differing by age, gender, education or ethnicity. The project would assess on which behaviors older adults are better, worse or the same as other adults in maintaining change depending on factors related to motivation, self-efficacy and resistance to change. The project would assess maintenance models specific to each behavior and models that are general across behaviors. The analyses would: 1. Calculate and compare maintenance rates across behaviors for each type of treatment and population;2. Graphically represent longitudinal use of 14 maintenance factors by three dynatypes (maintainers, relapsers, and non-adopters);3. Assess statistical differences between the three dynatypes, groups representing treatments or populations, and time;4. Assess causal influences and mediating effects of the 14 maintenance factors and 5. Identify common and unique use of maintenance factors and mediation models across behaviors by use of meta-analyses. The proposal would be the largest comparative study of maintenance and would analyze 22 studies with over 40,000 participants supported by more than 40 million dollars in grants with co-investigators from multiple disciplines. The knowledge generated would produce 60 publications of importance for theories of behavior change and for interventions for long-term maintenance. Special relevance for older adults includes the identification of maintenance factors related to their doing better, worse or the same in maintaining changes in particular health behaviors. Given increasing risks of developing diseases related to these behaviors, this research has special relevance for prevention and management of chronic diseases in older adults.
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