Health Contract With Sedentary Older Adults

Haber, David; Rhodes, Darson

doi:10.1093/geront/44.6.827

Cited by 24 publications

(22 citation statements)

References 15 publications

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“…Findings of prior research indicate behavioral contracts have improved treatment adherence and related outcomes in other patient populations, e.g. hemodialysis patients (20)(21)(22)(23)(24)(25)(26)(27). Similar patterns of increased adherence were noted in the current study.…”

Section: Discussionsupporting

confidence: 81%

“…IST adherence contracts generally followed the format described by Haber and Rhodes (22): goal setting, motivation, social support, memory techniques and problem-solving. We added a sixth component, consequences of nonadherence, as such knowledge has been identified as part of effective behavioral contracts (18,32,33).…”

Section: Interventionmentioning

confidence: 99%

“…eating disorders) and patient populations (e.g. adult dialysis patients) (20)(21)(22)(23)(24)(25)(26)(27). However, no published articles were found concerning behavioral contracting effects on IST adherence in a renal transplant population.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Improving Outcomes of Renal Transplant Recipients With Behavioral Adherence Contracts: A Randomized Controlled Trial

Chisholm-Burns

Spivey

Zivin

et al. 2013

American Journal of Transplantation

103

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The objective of this randomized controlled trial was to assess the effects of a 1-year behavioral contract intervention on immunosuppressant therapy (IST) adherence and healthcare utilizations and costs among adult renal transplant recipients (RTRs). The sample included adult RTRs who were at least 1 year posttransplant, taking tacrolimus or cyclosporine and served by a specialty pharmacy. Pharmacy refill records were used to measure adherence and monthly questionnaires were used to measure healthcare utilizations. Direct medical costs were estimated using the 2009 Medicare Expenditure Panel Survey. Adherence was analyzed using the GLM procedure and the MIXED procedure of SAS. Rate ratios and 95% confidence intervals were estimated to quantify the rate of utilizing healthcare services relative to treatment assignment. One hundred fifty RTRs were enrolled in the study. Intervention group RTRs (n ¼ 76) had higher adherence than control group RTRs (n ¼ 74) over the study period (p < 0.01). And 76.1% of the intervention group compared with 42.7% of the control group was not hospitalized during the 1-year study period (RR ¼ 1.785; 95% CI: 1.314, 2.425), resulting in cost savings. Thus, evidence supports using behavioral contracts as an effective adherence intervention that may improve healthcare outcomes and lower costs.

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Section: Discussionsupporting

confidence: 81%

Section: Interventionmentioning

confidence: 99%

See 1 more Smart Citation

Improving Outcomes of Renal Transplant Recipients With Behavioral Adherence Contracts: A Randomized Controlled Trial

Chisholm-Burns

Spivey

Zivin

et al. 2013

American Journal of Transplantation

103

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“…This finding indicates that patients are more candid and/or attentive to this issue in the diary data collection method, lending much value to their use as a more accurate data collection method for future research in adherence. 19 Future research should systematically examine the impact of delaying medication-taking on kidney transplant recipients' graft outcomes. Consideration of the drug half-lives may be essential to determining the actual impact of delayed medication-taking on graft outcomes.…”

Section: Discussionmentioning

confidence: 99%

Adherence to Immunosuppression: A Prospective Diary Study

Gordon

Prohaska

Gallant

et al. 2007

Transplantation Proceedings

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Immunosuppression adherence among kidney transplant recipients is essential for graft survival. However, nonadherence is common, jeopardizing graft survival. Besides skipping dosages, little is known about other forms of medication nonadherence and their underlying reasons. This study was undertaken to examine patients' extent of medication adherence over time and reasons for nonadherence. Thirty-nine new kidney transplant recipients were asked to complete a month-long medication-taking diary that included reporting medication nonadherence such as skipped medications, medications taken early or late, taking dosages greater or less than prescribed, and the reason for each occurrence of nonadherence. Of the 20 (51%) patients who completed the diary, 11 (55%) reported at least one form of nonadherence. Eleven patients reported taking their immunosuppression at least one hour later than the prescribed time, one patient reported skipping medication, but no patients reported changing the dosage on their own. Immunosuppression was taken on average 1.5 hours after the prescribed time. Of those patients who took their medications late, there were on average 3.1 occasions of taking it late. The most common reasons for this behavior included health care related issues, followed by oversleeping, being away from home, work-related barriers, and forgetting. A large minority of kidney transplant recipients took medications later than prescribed during one month. Future research should determine the clinical impact on graft function of late administration of immunosuppression. Interventions should be designed to better assist kidney recipients with taking medications on time, especially when they are away from home.

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“…It was specifically designed to achieve a sustained increase in patients' PA levels and was based on the Social Cognitive Theory (SCT), 16 which acknowledges the role of self-efficacy, goal setting and performance feedback as core elements of behaviour change. The present intervention incorporated these concepts using the Health contract technique 17,18 and objective feedback provided by pedometers. The intervention is described in detail below.…”

Section: Pa-focused Behavioural Interventionmentioning

confidence: 99%

Walk2Bactive

2015

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The aim of this study was to investigate the impact of a physical activity (PA)-focused behavioural intervention during and after pulmonary rehabilitation (PR) on PA levels (primary aim), health-related outcomes and selfefficacy (secondary aims) of patients with COPD. Thirty-two patients were randomly assigned to an experimental group (EG) or control group (CG). The EG received a PA-focused behavioural intervention during PR (3 months) and follow-up support (3 months). The CG received PR (3 months). Daily PA was collected: number of steps; time spent in moderate-to-vigorous PA (MVPA), total PA and sedentary activities (SA). Secondary outcomes comprised exercise capacity, muscle strength, health-related quality of life (HRQOL) and self-efficacy. Measures were collected at baseline, 3 and 6 months. Compared with the CG, the EG improved the number of steps (p ¼ 0.006) and time spent in MVPA (p ¼ 0.007), total PA (p ¼ 0.014) and SA (p ¼ 0.018) at 3 months. Differences were maintained after follow-up support (0.025 p 0.040), except for SA (p ¼ 0.781). Exercise capacity, muscle strength and HRQOL were increased at 3 and 6 months (p 0.002) with no between-group differences (0.148 p 0.987). No changes were observed in self-efficacy (p ¼ 0.899). A PA-focused behavioural intervention during and after PR may improve patients' PA levels. Further research is warranted to assess the sustainability of the findings.

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Health Contract With Sedentary Older Adults

Abstract: This technique may be applied by health educators or clinicians in a variety of settings and can be focused on one of several potential risk factors.

Cited by 24 publications

References 15 publications

Improving Outcomes of Renal Transplant Recipients With Behavioral Adherence Contracts: A Randomized Controlled Trial

Improving Outcomes of Renal Transplant Recipients With Behavioral Adherence Contracts: A Randomized Controlled Trial

Adherence to Immunosuppression: A Prospective Diary Study

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