Promoting Active Aging: Lessons Learned in an Implementation Pilot in Primary Care.

BACKGROUND Physical activity (PA) preserves mobility, but few practices screen older adults for mobility impairment or counsel on PA. DESIGN "Promoting Active Aging" (PAA) was a mixed‐methods randomized‐controlled pilot, to test the feasibility and acceptability of a video‐based PA counseling tool a...

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Publicado en:Journal of the American Geriatrics Society Vol. 69; no. 2; pp. 373 - 381
Autores principales: Callahan, Kathryn E., Willard, James, Foley, Kristie L., Miller, Michael E., Houston, Denise K., Kritchevsky, Stephen B., Williamson, Jeff D., Applegate, William B., Girma, Feben, Whitehead, Sarah E., Rejeski, W. Jack
Formato: Artículo
Publicado: Wiley-Blackwell Feb2021
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Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2021
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      pub: Wiley-Blackwell
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        10.1111/jgs.16838
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        atl: Promoting Active Aging: Lessons Learned in an Implementation Pilot in Primary Care.
      aug:
        au:
          Callahan, Kathryn E.
          Willard, James
          Foley, Kristie L.
          Miller, Michael E.
          Houston, Denise K.
          Kritchevsky, Stephen B.
          Williamson, Jeff D.
          Applegate, William B.
          Girma, Feben
          Whitehead, Sarah E.
          Rejeski, W. Jack
        affil:
          Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston‐Salem North Carolina
          Sticht Center for Healthy Aging and Alzheimerʼs Prevention, Wake Forest School of Medicine, Winston‐Salem North Carolina
          Center for Healthcare Innovation, Wake Forest School of Medicine, Winston‐Salem North Carolina
          Division of Public Health Sciences, Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston‐Salem North Carolina
          Division of Public Health Sciences, Department of Implementation Science, Wake Forest School of Medicine, Winston‐Salem North Carolina
          Wake Forest School of Medicine, Wake Forest Translational Science Institute, Winston‐Salem North Carolina
          Cancer Prevention and Control Program, Wake Forest Comprehensive Cancer Center, Winston‐Salem North Carolina
          Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston‐Salem North Carolina
          Department of General Internal Medicine, Wake Forest School of Medicine, Winston‐Salem North Carolina
          Paris View Family Practice, Bon Secours St. Francis Health System, Greenville South Carolina
          Department of Health and Exercise Science, Wake Forest University, Winston‐Salem North Carolina
          Department of Psychology, Wake Forest University, Winston‐Salem North Carolina
      su:
        Medical screening
        Active aging
        Health promotion
        Primary health care
        Physical mobility
        Walking
      sug:
        subj:
          Medical screening
          Active aging
          Health promotion
          Primary health care
          All Other Miscellaneous Ambulatory Health Care Services
          Physical mobility
          Walking
      keyword:
        implementation science
        mobility assessment
        physical activity
        implementation science
        mobility assessment
        physical activity
      ab: BACKGROUND Physical activity (PA) preserves mobility, but few practices screen older adults for mobility impairment or counsel on PA. DESIGN "Promoting Active Aging" (PAA) was a mixed‐methods randomized‐controlled pilot, to test the feasibility and acceptability of a video‐based PA counseling tool and implementation into practice of two mobility assessment tools. SETTING Three primary care practices affiliated with Wake Forest Baptist Health. PARTICIPANTS Adults aged 65 years and older who presented for primary care follow‐up and were willing and able to answer self‐report questions and walk 4 meters (n = 59). INTERVENTION Video‐based PA counseling intervention versus control video, "Healthy Eating." MEASUREMENTS Potential participants completed mobility assessments: self‐report (Mobility Assessment Tool‐short form (MAT‐sf)) and performance based (4‐meter walk test). We assessed PAAʼs implementation—feasibility, acceptability, and value—via interviews and surveys. Effectiveness was measured via participant attendance at a PA information session. RESULTS: Of 92 patients approached, 89 (96.7%) agreed to mobility assessment. Eighty‐nine completed MAT‐sf, and 97.8% (87/89) completed 4‐meter walk test. Sixty‐seven (75%) met eligibility criteria, and 59 (88%) consented to be randomized either to the PA counseling intervention (Video‐PA) or to active control (Video‐C). Most participants viewed the walk test positively (51/59; 86.4%). Staff reported that completion of patient surveys, MAT‐sf, and videos required significant staff time and support (median = 26 minutes for all), resulting in low acceptability of MAT‐sf and the videos. Attendance at a PA information session did not differ by randomization group (Video‐PA = 11/29 (37.9%); Video‐C = 12/30 (40%); 95% confidence interval for difference in proportion = −0.29 to 0.25). CONCLUSIONS: Mobility assessment, particularly a 4‐meter walk test, was feasible in primary care. Tablet‐based assessment (MAT‐sf) and video counseling tools, selected to reduce staff effort, instead required significant time to implement. Future work to promote PA should identify effective ways to facilitate adoption of PA in sedentary older adults that do not burden staff.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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