Multilevel Intervention for Physical Activity in Retirement Communities

Not Applicable

Completed

Conditions: Physical Activity
Blood Pressure
Physical Functioning
Quality of Life
Sedentary

Interventions: Behavioral: Physical Activity
Behavioral: Group educational sessions
Behavioral: Health check phone call
Behavioral: Phone counseling call
Behavioral: Pedometer
Behavioral: Peer Mentoring
Behavioral: Policy Change
Behavioral: Support
Behavioral: Tailored environmental resources

Registration Number: NCT01155011

Lead Sponsor: University of California, San Diego

Brief Summary: The purpose of this study was to assess whether a 6-month multilevel physical activity intervention can significantly increase physical activity levels in sedentary adults, 65 and older, living in Continuing Care Retirement Communities (CCRCs).

Sedentary residents (N=307) in 11 CCRCs received the multilevel MIPARC intervention or a control health education program for 6 months. A group randomized control design was employed with site as the unit of randomization. The intervention was delivered through group sessions, phone calls, printed materials, tailored signage and mapping and targeted peer led advocacy efforts.

Detailed Description: Objective monitoring of physical activity suggests that fewer than 3% of adults over age 60 meet current physical activity guidelines. Ecological models posit that behavioral interventions are most effective when they operate on multiple levels. The MIPARC study intervenes on four levels: individual (pedometer-based self monitoring, educational materials and monthly counseling calls), interpersonal (monthly group sessions and peer mentoring), environment (walking signage prompts, tailored walking maps, step counts)and policies (review of on-site activity opportunities and walkability, recommendations for change and peer led advocacy)to increase the activity levels of residents. The study promotes walking as the primary means to increase light to moderate PA, with a secondary focus on strength and flexibility and decreased sedentary behavior.

As most Continuing Care Retirement Communities have management structures that provide the opportunity to improve the social and built environments for physical activity and walking, this study also aims to train participants on how to advocate for improvements in the environment that would improve walkability.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 307

Inclusion Criteria

Over the age of 65
Able to walk 20 meters independently (without human assistance, can use cane/walker)
Able to speak and read in English
No cognitive, vision or hearing impairments that would prevent provision of informed consent, comprehension of instructions, completion of surveys and participation in phone conversations
Able to complete the Timed Up and Go Test to assess falls risk within 30 seconds
Live within the selected retirement community (facility-dwelling) Able to hold brief conversation over the telephone.
Will be in San Diego for the duration of the study
Provision of consent to participate
Willing to wear a pedometer, accelerometer and GPS device
Willing to complete all surveys and attend weekly meetings
No history of falls in previous that resulted in an injury or hospitalization in the past 12 months
Physician clearance to participate

Exclusion Criteria

Inability to give informed, voluntary consent
Inability to complete assessments
Lack of written physician consent to participate in unsupervised light-to-moderate intensity walking
Inability to speak and read English

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
MIPARC intervention	Phone counseling call	Eleven Continuing Care Retirement Communities were randomized to either the MIPARC intervention or an attention-control condition. The intervention focused on increasing light to moderate PA. The MIPARC study intervenes on four levels: individual (pedometer self monitoring, educational materials and monthly counseling calls, support), interpersonal (monthly group educational sessions and peer mentoring), environment (walking signage prompts, tailored environmental resources, step counts)and policies (review of on-site activity opportunities and walkability, recommendations for policy change and peer led advocacy)to increase the activity levels of residents. For the first 3 months, intervention participants will engage in either a group educational session, phone counseling call, or a peer led session, on a rotating basis.
MIPARC intervention	Policy Change	Eleven Continuing Care Retirement Communities were randomized to either the MIPARC intervention or an attention-control condition. The intervention focused on increasing light to moderate PA. The MIPARC study intervenes on four levels: individual (pedometer self monitoring, educational materials and monthly counseling calls, support), interpersonal (monthly group educational sessions and peer mentoring), environment (walking signage prompts, tailored environmental resources, step counts)and policies (review of on-site activity opportunities and walkability, recommendations for policy change and peer led advocacy)to increase the activity levels of residents. For the first 3 months, intervention participants will engage in either a group educational session, phone counseling call, or a peer led session, on a rotating basis.
MIPARC intervention	Physical Activity	Eleven Continuing Care Retirement Communities were randomized to either the MIPARC intervention or an attention-control condition. The intervention focused on increasing light to moderate PA. The MIPARC study intervenes on four levels: individual (pedometer self monitoring, educational materials and monthly counseling calls, support), interpersonal (monthly group educational sessions and peer mentoring), environment (walking signage prompts, tailored environmental resources, step counts)and policies (review of on-site activity opportunities and walkability, recommendations for policy change and peer led advocacy)to increase the activity levels of residents. For the first 3 months, intervention participants will engage in either a group educational session, phone counseling call, or a peer led session, on a rotating basis.
MIPARC intervention	Group educational sessions	Eleven Continuing Care Retirement Communities were randomized to either the MIPARC intervention or an attention-control condition. The intervention focused on increasing light to moderate PA. The MIPARC study intervenes on four levels: individual (pedometer self monitoring, educational materials and monthly counseling calls, support), interpersonal (monthly group educational sessions and peer mentoring), environment (walking signage prompts, tailored environmental resources, step counts)and policies (review of on-site activity opportunities and walkability, recommendations for policy change and peer led advocacy)to increase the activity levels of residents. For the first 3 months, intervention participants will engage in either a group educational session, phone counseling call, or a peer led session, on a rotating basis.
Health Education Control	Pedometer	The control group received an active health education intervention. The education curriculum will involve both lectures and mailed materials. The lectures were delivered to match the MIPARC intervention schedule. Sessions included information on general health and healthy aging. Physical activity was not discussed in these sessions but participants received information on the benefits of PA. Control participants also received health check phone calls to match the individual attention paid to participants in the MIPARC intervention sites.
Health Education Control	Health check phone call	The control group received an active health education intervention. The education curriculum will involve both lectures and mailed materials. The lectures were delivered to match the MIPARC intervention schedule. Sessions included information on general health and healthy aging. Physical activity was not discussed in these sessions but participants received information on the benefits of PA. Control participants also received health check phone calls to match the individual attention paid to participants in the MIPARC intervention sites.
MIPARC intervention	Peer Mentoring	Eleven Continuing Care Retirement Communities were randomized to either the MIPARC intervention or an attention-control condition. The intervention focused on increasing light to moderate PA. The MIPARC study intervenes on four levels: individual (pedometer self monitoring, educational materials and monthly counseling calls, support), interpersonal (monthly group educational sessions and peer mentoring), environment (walking signage prompts, tailored environmental resources, step counts)and policies (review of on-site activity opportunities and walkability, recommendations for policy change and peer led advocacy)to increase the activity levels of residents. For the first 3 months, intervention participants will engage in either a group educational session, phone counseling call, or a peer led session, on a rotating basis.
MIPARC intervention	Support	Eleven Continuing Care Retirement Communities were randomized to either the MIPARC intervention or an attention-control condition. The intervention focused on increasing light to moderate PA. The MIPARC study intervenes on four levels: individual (pedometer self monitoring, educational materials and monthly counseling calls, support), interpersonal (monthly group educational sessions and peer mentoring), environment (walking signage prompts, tailored environmental resources, step counts)and policies (review of on-site activity opportunities and walkability, recommendations for policy change and peer led advocacy)to increase the activity levels of residents. For the first 3 months, intervention participants will engage in either a group educational session, phone counseling call, or a peer led session, on a rotating basis.
MIPARC intervention	Tailored environmental resources	Eleven Continuing Care Retirement Communities were randomized to either the MIPARC intervention or an attention-control condition. The intervention focused on increasing light to moderate PA. The MIPARC study intervenes on four levels: individual (pedometer self monitoring, educational materials and monthly counseling calls, support), interpersonal (monthly group educational sessions and peer mentoring), environment (walking signage prompts, tailored environmental resources, step counts)and policies (review of on-site activity opportunities and walkability, recommendations for policy change and peer led advocacy)to increase the activity levels of residents. For the first 3 months, intervention participants will engage in either a group educational session, phone counseling call, or a peer led session, on a rotating basis.
Health Education Control	Group educational sessions	The control group received an active health education intervention. The education curriculum will involve both lectures and mailed materials. The lectures were delivered to match the MIPARC intervention schedule. Sessions included information on general health and healthy aging. Physical activity was not discussed in these sessions but participants received information on the benefits of PA. Control participants also received health check phone calls to match the individual attention paid to participants in the MIPARC intervention sites.

Primary Outcome Measures

Name	Time	Method
Daily Minutes of Physical Activity	6 months	Measured by 7 day accelerometry in adults, ≥65, with a 760 CPM cutpoint.
Minutes of Light to Moderate Physical Activity	12 months	Measured by 7 day accelerometry in adults, ≥65, using a 760 CPM cutpoint.

Secondary Outcome Measures