The Study of Exercise and Nutrition in Older Rhode Islanders (SENIOR): translating theory into research

Abstract

Innovative and effective health promotion interventions targeted on older adults within a public health framework will be increasingly important as the US population ages dramatically. The benefits of healthier lifestyles for older adults include increased functional ability and improved quality of life. The Study of Exercise and Nutrition in Older Rhode Islanders (SENIOR) Project is a multibehavioral health promotion intervention for community-dwelling older adults focusing on increasing exercise and fruit and vegetable consumption. Intervention materials are stage-tailored for each individual, and include manuals, newsletters, expert system assessments and reports, and telephone coaching. The primary purpose of the SENIOR Project is to investigate the relative effectiveness of a multiple-behavior intervention-based on a single theoretical framework-compared to single-behavior interventions. The secondary purposes are to investigate the intervention's effects on both functional ability and general health outcomes, and how older adults move along a continuum of changing health behaviors. The Transtheoretical Model of Health Behavior Change, the conceptual framework for the SENIOR Project, was chosen for the following reasons: performance potential with older adults, individual tailoring on a stage basis, technological features, and interdisciplinary research base and community partnership.

Which Behaviour Change Techniques Are Most Effective at Increasing Older Adults’ Self-Efficacy and Physical Activity Behaviour? A Systematic Review

“…A greater variability in effect size estimates existed than could be explained by random sampling error alone (Q=33.7, p<0.01), although all variance could be explained by sampling error alone. Effect sizes ranged from d= -0.02 [28] to d= 0.63 [22].…”

A Randomized Trial of an Intervention to Increase Fruit and Vegetable Intake in Curatively Treated Patients with Early-Stage Head and Neck Cancer

“…Recently, Clark et al (26) have used the model as the basis for developing an intervention to increase fruit and vegetable intake in older people. We used this model to design and tailor an intervention by assessing each participant's readiness to change and providing a stageappropriate intervention to motivate dietary behaviors.…”

Interventions directed at eating habits and physical activity using the Transtheoretical Model: a systematic review

“…The treatment of the CG was generally defined as "usual care" (1,6,7,(10)(11)(12)20,22,8), and only five studies (7,10,12,27,28) described the intensity and type of care. In the majority of the studies, the comparability of the control and intervention groups (IG) was tested on the baseline values (1,(6)(7)(8)(9)(10)(11)(12)14,20,24,25,27,28) for demographical and socio-economic variables, among others, with the exception of two studies (5,22). In the study of Van Wier et al (22,23), the groups were not statistically compared before the intervention, although all the analyses were adjusted by baseline values, which created an adjusted follow-up score.…”

“…All studies evaluated the CG and IG (intervention group) at comparable time points, and additional analyses were performed only with the IG; in some studies, this was done for supporting the intervention (8,11). Seven investigations (39%) did not mention whether the researchers or the participants were blind to status (1,5,7,11,20,22,24), and the reason given was the nature of the interventions (18,20) or the presence of research assistants, who were not blind to the group assignment, during assessments (25,26). The remaining studies explained how blind analyses were performed or the data collection was carried out using self-report questionnaires without the involvement of the researcher (6,8,10,12,14,27,28).…”

“…This study focused on the multi-behavioral TTM because it addresses multiple behaviors, which makes it a promising strategy to control multifactorial morbidities, such as chronic diseases (1). The main pillars of TTM encompass the stages of change (SC), decisional balance, self-efficacy, and processes of change.…”