Improving Personal Characterization of Meaningful Activity in Adults with Chronic Conditions Living in a Low-Income Housing Community
Abstract
:1. Introduction
2. Experimental Section
2.1. Design
2.2. Participants
2.3. QUAL Procedures and Measure
- How is activity encouraged for people that live here?
- Some of you do not participate in these activities just discussed. Why are they less attractive for you?
- Tell me about the meaningful activities that you do every day.
- What problems or obstacles would have to be removed for you to perform the way you desire?
- What do healthy people look like and act like in the center? What do unhealthy people look like and act like in the center?
- What would you like to learn about your health and wellness?
2.4. QUAN Procedures and Measures
2.5. QUAL Data Analysis
2.6. QUAN Data Analysis
2.7. Data Integration
3. Results
3.1. QUAL Results
3.2. QUAN Intervention
3.3. QUAN Results
# | Session Topic | Group Objectives | Model of Aging Theoretical Concepts * | Behavioral Change Techniques Employed |
---|---|---|---|---|
1 | Understanding health and meaningful activity | 1. Define health and meaningful activity. 2. Brainstorm activities that each considers healthy. Introduce idea of meaningful activities such as such as cooking with the family as a healthy activity. 3. Discuss and sort the activities by how each might contribute to improved performance in 3 areas of health: (1) physical. (2) cognitive. (3) mental 4. Reflect on how healthy activities can be chosen and prioritized to meet health goals for improving HBP and DM. | A, B, C | Tailored message, problem solving/ planning, prompts, cues, persuasive argument, health consequences. |
2 | Exploring your meaningful activity | 1. Devise a schedule of their current daily activities for one week, including self-care, exercise, leisure and socialization. 2. Categorize their activities by emphasis on physical, cognitive or mental health if applicable. 3. Identify strengths and gaps in activities and set goals for weak areas. | B, C | Self-monitoring of behavior, social support, problem solving/planning, discrepancy between current and desired behavior, goal setting behavior. |
3 | How to overcome barriers to meaningful activities | 1. Brainstorm a variety of barriers that interfere with meaningful activity engagement. 2. Problem-solve creative ways to overcome barriers including community resources. 3. Reflect on how they will use these suggestions to overcome barriers to the activities they would like to engage in. | B, C | Self-monitoring of behavior, restructuring of physical environment, social support, problem/solving and planning, persuasive argument, prompts, cues, discrepancy between current and desired behavior, tailored message. |
4 | Meaningful activity that promotes physical activity | 1. Consider how physical exercise positively affects many healthy variables, such as lowering risk of death, reducing depression and improving sleep. 2. Understand differences in the 3 types of physical exercise recommended for older adults, cardiovascular, resistance training and balance training, as well as the dosage for improving health. 3. Practice using a pedometer (or for those in a wheelchair, an arm bike), elastic exercise bands and balance exercise under the supervision of the group leaders. (Elastic exercise bands issued to each participant for home use). 4. Reflect on how physical exercise may contribute to improving health in people with HBP/DM. | A, B, C | Health consequences and benefits, self-monitoring of behavior, instruction on how to perform behavior, behavioral practice, behavioral demonstration, goal setting, self-monitoring of progress, feedback on behavior, tailored message. |
5 | Meaningful activity that promotes cognitive health | 1. Consider how mental exercise positively affects many health variables, such as lowering risk of dementia and maintaining independence in daily activity. 2. Understand how activities such as exercise, sleep, and socialization improve cognition; provide current evidence on dosage for effectiveness. 3. Brainstorm activities that require “thinking” (e.g. playing cards) and then identify the activities that they currently do that require thinking. 4. Develop a weekly schedule that includes physical, mental and mood-improving activities. 5. Reflect on how mental exercise may contribute to improving health in people with HBP/DM. | A, B, C | Health consequences and benefits, self-monitoring of behavior, instruction on how to perform behavior, behavioral practice, behavioral demonstration, goal setting, self-monitoring of progress, feedback on behavior, tailored message. |
6 | Meaningful activity that promotes mental health | 1. Complete a social and leisure inventory of activities they engage in now or in the past. 2. Discuss within the group, how social and leisure activities improve health (e.g., prevent illness, improve mood and life satisfaction); provide appropriate dosage for effectiveness. 3. Brainstorm familial and community resources. 4. Engage in “play” with group members by trying a new card game and a new dice game while enjoying sugar-free snacks. 5. Reflect on how social and leisure activity may help HBP/DM and reinforce the need to put them in their written schedules devised last week. | A, B, C | Health consequences and benefits, self-monitoring of behavior, instruction on how to perform behavior, behavioral practice, behavioral demonstration, goal setting, self-monitoring of progress, feedback on behavior, tailored message. |
7 | Graduation and wrap-up group | 1. Engage in a group overview, including “take home messages” from each group. 2. Review their very first daily schedule and compare to the last so that they can see the progress made in healthy activity selection. 3. Complete post-assessments. 4. Receive validation for their work and participation by receiving a formal certificate of training through a “graduation” ceremony. | A, B, C | Tailored message, non-specific encouragement, persuasive argument, review behavior goals. |
Demographics | QUAL Sample (n = 6) | QUAN Sample (n = 11) |
---|---|---|
Age Mean (SD:range) | 62.5(4.37:57–68) | 65.3 (8.86: 55–81) |
Race | Black 6/6, Caucasian 0/6 | Black 6/11, Caucasian 5/11 |
Gender | Male 3/6, Female 3/6 | Male 4/11, Female 7/11 |
Marital Status | Single 3/6, Married 1/6, Divorced 2/6 | Single 5/1l, Married 1/11, Divorced 5/11 |
Lives alone | 5/6 | 11/11 |
Education | Below HS: 2/6, HS Graduate: 3/6, Post HS: 1/6 | Below HS: 2/11, HS Graduate: 4/11, Post HS : 5/11 |
Health insurance | No: 2/6 Yes: 4/6, Not sure: 0/6 | No: 1/11, Yes: 10/11, Not sure: 1/11 |
+ Hypertension | 3/6 | 8/11 |
+ Diabetes | 2/6 | 4/11 |
+ Depression | 1/6 | 6/11 |
+ Mental illness | 1/6 | 6/11 |
Assistance with walking | None: 4/6, WC/ scooter: 2/6, Walker: 0/6 | None: 6/11, WC/scooter: 2/11, Walker: 3/11 |
Assistance to use bathroom | Trouble getting to restroom in time: 3/6 | None: 9/11, Yes: 2/11 |
CESD Mean (SD; range) | NA | 40 (13.70; 26–61) |
PRQ 2000 Median (25th, 75th quartiles) | NA | 83 (61,103) |
4. Discussion
4.1. Health Literacy and Focus Groups.
4.2. Environmental Barriers to Participation in Meaningful Activity
4.3. How Understanding of Meaningful Activity, Health and Interconnectedness of Both Constructs Framed the Intervention Groups
4.4. Perception of and Engagement in Personally-Meaningful Activity
4.5. Delivery Models for Future Interventions and Research
4.6. Limitations
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Ciro, C.A.; Smith, P. Improving Personal Characterization of Meaningful Activity in Adults with Chronic Conditions Living in a Low-Income Housing Community. Int. J. Environ. Res. Public Health 2015, 12, 11379-11395. https://doi.org/10.3390/ijerph120911379
Ciro CA, Smith P. Improving Personal Characterization of Meaningful Activity in Adults with Chronic Conditions Living in a Low-Income Housing Community. International Journal of Environmental Research and Public Health. 2015; 12(9):11379-11395. https://doi.org/10.3390/ijerph120911379
Chicago/Turabian StyleCiro, Carrie A., and Patsy Smith. 2015. "Improving Personal Characterization of Meaningful Activity in Adults with Chronic Conditions Living in a Low-Income Housing Community" International Journal of Environmental Research and Public Health 12, no. 9: 11379-11395. https://doi.org/10.3390/ijerph120911379