A three-times-per-week, 6-month Tai Chi program is effective in decreasing the number of falls, the risk for falling, and the fear of falling, and it improves functional balance and physical performance in physically inactive persons aged 70 years or older.

Objective: To examine the relation between built environment factors (representing several dimensions of urban form of neighbourhoods) and walking activity at both the neighbourhood level and the resident level, in an older adult sample. Design, setting, participants: A cross sectional, multilevel design with neighbourhoods as the primary sampling unit and senior residents as the secondary unit. Five hundred and seventy seven residents (mean age = 74 years, SD = 6.3 years) participated in the survey, which was conducted among 56 city defined neighbourhoods in Portland, Oregon, USA. Neighbourhood level variables were constructed using geographical information systems. Resident level variables consisted of a mix of self reports and geocoded data on the built environment. Main outcome measure: Self reported neighbourhood walking. Main results: A positive relation was found between built environment factors (density of places of employment, household density, green and open spaces for recreation, number of street intersections) and walking activity at the neighbourhood level. At the resident level, perceptions of safety for walking and number of nearby recreational facilities were positively related to high levels of walking activity. A significant interaction was observed between number of street intersections and perceptions of safety from traffic. Conclusions: Certain neighbourhood built environment characteristics related to urban form were positively associated with walking activity in the neighbourhoods of senior residents. Public health promotion of walking activity/urban mobility and the design of interventions need to consider the contribution of neighbourhood level built environment influences.

Older adults with moderate sleep complaints can improve self-rated sleep quality through a 6-month, low- to moderate-intensity tai chi program. Tai chi appears to be effective as a nonpharmacological approach to sleep enhancement for sleep-disturbed elderly individuals.

There is a need for greater understanding of setting-specific influences on physical activity to complement the predominant research paradigm of individual-centered influences on physical activity. In this study, the authors used a cross-sectional multilevel analysis to examine a range of neighborhood-level characteristics and the extent to which they were associated with variation in self-reported physical activity among older adults. The sample consisted of 582 community-dwelling residents age 65 years and older (M = 73.99 years, SD = 6.25) recruited from 56 neighborhoods in Portland, OR. Information collected from participants and neighborhood data from objective sources formed a two-level data structure. These hierarchical data (i.e., individuals nested within neighborhoods) were subjected to multilevel structural-equation-modeling analyses. Results showed that neighborhood social cohesion, in conjunction with other neighborhood-level factors, was significantly associated with increased levels of neighborhood physical activity. Overall, neighborhood-level variables jointly accounted for a substantial variation in neighborhood physical activity when controlling for individual-level variables.

This study examined heterogeneity in response patterns of the participants of the Survey of Activities and Fear of Falling in the Elderly (SAFFE) and their relationships to falls, functional ability, quality of life, and activity restriction measures in a cohort of 256 older people (mean age = 77.5 years). Participants recruited from local primary care clinics were administered the SAFFE instrument, an activity restriction measure, a combination of self-reported and performance-based functional ability tests, and quality-of-life measures. Latent class analyses identified two classes: Class 1 (n = 209), which had a low SAFFE fear of falling, and Class 2 (n = 47), which had a high SAFFE fear of falling. Subsequent analyses of variance indicated that the two-class (low fear and high fear) SAFFE fear of falling profiles discriminated fallers from nonfallers, and low and high levels of functional ability, activity restriction, and quality of life. The findings from this study suggest that variations in the SAFFE response patterns on a single dimension of fear of falling and that high levels of fear of falling measured by the SAFFE are linked to a range of adverse health consequences.

SCS has shown repeatability, criterion related validity and sensitivity to change. It has clinical utility and wider use is recommended.

One of the major rationales for conducting health promotion/disease prevention activities at the worksite is the potential to reach a high percentage of employees, including many who would otherwise be unlikely to engage in preventive health behaviors. Most studies of worksite health promotion do not report participation data, but among those that do, definitions of participation and participation rates vary dramatically. In general, men and blue-collar employees appear less likely to participate, but little is known about other employee variables related to participation. There have been few studies of worksite characteristics associated with participation and even fewer experimental evaluations of interventions to increase participation. In this paper we review what is known about participation in worksite health promotion programs and recommend procedures for defining participation for different types of programs, for reporting determinants of participation, and for increasing participation. We conclude that participation is both an important process measure and an outcome that should be reported routinely. Participation data have important implications for generalizability of results, feasibility of interventions, and health outcomes.

Tai chi--moving for better balance, a falls-prevention program developed from a randomized controlled trial for community-based use, was evaluated with the re-aim framework in 6 community centers. The program had a 100% adoption rate and 87% reach into the target older adult population. All centers implemented the intervention with good fidelity, and participants showed significant improvements in health-related outcome measures. This evidence-based tai chi program is practical to disseminate and can be effectively implemented and maintained in community settings.