Applying the ecological model of behavior change to a physical activity trial in retirement communities: Description of the study protocol

Abstract

OBJECTIVES To describe the intervention protocol for the first multilevel ecological intervention for physical activity in retirement communities that addresses individual, interpersonal and community influences on behavior change. DESIGN A cluster randomized controlled trial design was employed with two study arms: a physical activity intervention and an attention control successful aging condition. SETTING Sixteen continuing care retirement communities in San Diego County. PARTICIPANTS Three hundred twenty older adults, aged 65 years and older, are being recruited to participate in the trial. In addition, peer leaders are being recruited to lead some study activities, especially to sustain the intervention after study activities ceased. INTERVENTION Participants in the physical activity trial receive individual, interpersonal and community intervention components. The individual level components include pedometers, goal setting and individual phone counseling. The interpersonal level components include group education sessions and peer-led activities. The community level components include resource audits and enumeration, tailored walking maps, and community improvement projects. The successful aging group receives individual and group attention about successful aging topics. MEASUREMENTS The main outcome is light to moderate physical activity, measured objectively by accelerometry. Other objective outcomes included physical functioning, blood pressure, physical fitness, and cognitive functioning. Self report measures include depressive symptoms and health related quality of life. RESULTS The intervention is being delivered successfully in the communities and compliance rates are high. CONCLUSION Ecological Models call for interventions that address multiple levels of the model. Previous studies have not included components at each level and retirement communities provide a model environment to demonstrate how to implement such an intervention.

Independent Associations Between Sedentary Behaviors and Mental, Cognitive, Physical, and Functional Health Among Older Adults in Retirement Communities

“…Participants (N = 307) were older adults living in 11 continuing care retirement communities in San Diego County who completed a baseline measurement as part of a randomized controlled trial (Multilevel Intervention for Physical Activity in Retirement Communities (17). Details of the trial can be found elsewhere (17).…”

“…Details of the trial can be found elsewhere (17). The study was approved by the University of California, San Diego Institutional Review Board.…”

A Framework for Using GPS Data in Physical Activity and Sedentary Behavior Studies

“…As such, these types of measures cannot directly be used to predict behavior in a given environment. Intervention studies, however, with GPS assessing changes in PA locations after local environment improvements will provide better evidence of causality(20). However, they will allow a wealth of new research questions focused on better matching of behavior and environment, resulting in more specific assessments of PA as related to locations, times, and behaviors.…”

Fe en Accion/Faith in Action: Design and implementation of a church-based randomized trial to promote physical activity and cancer screening among churchgoing Latinas

“…A key tenet of ecological models is that interventions that target multiple levels of influence (e.g., individual, social, and environmental) should be more effective in changing behavior than those that target only one level [4]. There have been a limited number of multi-level interventions focusing on the promotion of physical activity among adults [5–7] and, to our knowledge, only one study used a randomized controlled design [6]. When considering interventions for cancer prevention, a fewer programs have used the ecological approach to inform program development.…”