Explore the vast range of titles available.

BackgroundOlder people are at risk for health decline and loss of independence. Lifestyle interventions offer potential for reducing such negative outcomes. The aim of this study was to determine the effectiveness and cost-effectiveness of a preventive lifestyle-based occupational therapy intervention, administered in a variety of community-based sites, in improving mental and physical well-being and cognitive functioning in ethnically diverse older people.MethodsA randomised controlled trial was conducted comparing an occupational therapy intervention and a no-treatment control condition over a 6-month experimental phase. Participants included 460 men and women aged 60–95 years (mean age 74.9±7.7 years; 53% <$12 000 annual income) recruited from 21 sites in the greater Los Angeles metropolitan area.ResultsIntervention participants, relative to untreated controls, showed more favourable change scores on indices of bodily pain, vitality, social functioning, mental health, composite mental functioning, life satisfaction and depressive symptomatology (ps<0.05). The intervention group had a significantly greater increment in quality-adjusted life years (p<0.02), which was achieved cost-effectively (US $41 218/UK £24 868 per unit). No intervention effect was found for cognitive functioning outcome measures.ConclusionsA lifestyle-oriented occupational therapy intervention has beneficial effects for ethnically diverse older people recruited from a wide array of community settings. Because the intervention is cost-effective and is applicable on a wide-scale basis, it has the potential to help reduce health decline and promote well-being in older people.Trial Registrationclinicaltrials.gov identifier: NCT0078634.

This study evaluated the psychometric properties of the Engagement in Meaningful Activities Survey (EMAS) (Goldberg, Brintnell, & Goldberg, 2002) in a sample of older adults living in the greater Los Angeles area. The EMAS evidenced moderate test—retest reliability (r = .56) and good internal consistency (α = .89). Exploratory factor analysis (principal components) discerned a two-component structure within the EMAS, indicative of Personal—Competence and Social—Experiential meaning. The EMAS demonstrated theoretically predicted zero-order correlations with measures of meaning and purpose in life, depressive symptomology, life satisfaction, and health-related quality of life. Regression analyses discerned that purpose and meaning in life consistently predicted the EMAS and its components. Furthermore, individuals reporting greater levels of Social—Experiential relative to Personal—Competence meaning had the lowest levels of physical health-related quality of life. This study offers initial evidence in support of the EMAS as a valid measure of meaningful activity in older adults.

Recently, there have been major advances in statistical techniques for assessing central tendency and measures of association. The practical utility of modern methods has been documented extensively in the statistics literature, but they remain underused and relatively unknown in clinical trials. Our objective was to address this issue. The first purpose was to review common problems associated with standard methodologies (low power, lack of control over type I errors, and incorrect assessments of the strength of the association). The second purpose was to summarize some modern methods that can be used to circumvent such problems. The third purpose was to illustrate the practical utility of modern robust methods using data from the Well Elderly 2 randomized controlled trial. In multiple instances, robust methods uncovered differences among groups and associations among variables that were not detected by classic techniques. In particular, the results demonstrated that details of the nature and strength of the association were sometimes overlooked when using ordinary least squares regression and Pearson correlation. Modern robust methods can make a practical difference in detecting and describing differences between groups and associations between variables. Such procedures should be applied more frequently when analyzing trial-based data.

OBJECTIVE. To describe sleeping behaviors and trends over time among an ethnically diverse group of community-living older adults. METHOD. A descriptive secondary data analysis of a subsample (n = 217) from the Lifestyle Redesign randomized controlled trial was done to explore baseline napping and sleeping patterns as well as 6-mo changes in these outcomes. RESULTS. At baseline, the average time sleeping was 8.2 hr daily (standard deviation = 1.7). Among all participants, 29% reported daytime napping at baseline, of which 36% no longer napped at follow-up. Among participants who stopped napping, those who received an occupation-based intervention (n = 98) replaced napping time with nighttime sleep, and those not receiving an intervention (n = 119) experienced a net loss of total sleep (p < .05). CONCLUSION. Among participants who stopped napping, the occupation-based intervention may be related to enhanced sleep. More research examining the role of occupation-based interventions in improving sleep is warranted.

Date Presented 3/30/2017 Poor sleep quality is associated with decreased social activity satisfaction and increased stress in rural-living, late-middle-aged Latinos. Study results help characterize this understudied minority group at high risk for poor occupational health and outcomes. Primary Author and Speaker: Stacey Schepens Niemiec Contributing Authors: Cheryl Vigen, Jeanine Blanchard, Jenny Martinez, Mike Carlson

The manualization of a complex occupational therapy intervention is a crucial step in ensuring treatment fidelity for both clinical application and research purposes. Toward the latter end, intervention manuals are essential for ensuring trustworthiness and replicability of randomized controlled trials that aim to provide evidence of the effectiveness of occupational therapy. In this article, we review the literature on the process of intervention manualization. We then illustrate the prescribed steps through our experience in implementing the University of Southern California/Rancho Los Amigos National Rehabilitation Center’s collaborative Pressure Ulcer Prevention Project. In this research program, qualitative research provided the initial foundation for manualization of a multifaceted occupational therapy intervention designed to reduce the incidence of medically serious pressure ulcers in adults with spinal cord injury.

AimThe aim of this study was to determine the feasibility and efficacy of a culturally tailored lifestyle intervention, ¡Vivir Mi Vida! (Live My Life!). This intervention was designed to improve the health and well-being of high risk late middle-aged Latino adults and to be implemented in a rural primary care system. Rural-dwelling Latino adults experience higher rates of chronic disease compared with their urban counterparts, a disparity exacerbated by limited access to healthcare services. Very few lifestyle interventions exist that are both culturally sensitive and compatible for delivery within a non-metropolitan primary care context. Participants were 37 Latino, Spanish-speaking adults aged 50-64-years-old, recruited from a rural health clinic in the Antelope Valley of California. ¡Vivir Mi Vida! was delivered by a community health worker-occupational therapy team over a 16-week period. Subjective health, lifestyle factors, and cardiometabolic measures were collected pre- and post-intervention. Follow-up interviews and focus groups were held to collect information related to the subjective experiences of key stakeholders and participants.FindingsParticipants demonstrated improvements in systolic blood pressure, sodium and saturated fat intake, and numerous patient-centered outcomes ranging from increased well-being to reduced stress. Although participants were extremely satisfied with the program, stakeholders identified a number of implementation challenges. The findings suggest that a tailored lifestyle intervention led by community health workers and occupational therapists is feasible to implement in a primary care setting and can improve health outcomes in rural-dwelling, late middle-aged Latinos.

Late-midlife Latinos (50–64 years old) living in rural regions experience significant health disparities, oftentimes exacerbated by limited access to healthcare services. In a previous pilot study, we observed psychosocial, behavioral, and cardiometabolic health improvements sustained over 12-months in late-midlife Latinos who participated in ¡Vivir Mi Vida! (¡VMV!), a culturally tailored lifestyle intervention led by a Latino community health worker (promotor) and occupational therapist team. For the present study, we assessed the feasibility of telehealth-delivered ¡VMV! modules. Participants (N=10) received an abbreviated three-week version of ¡VMV! consisting of an in-person promotor-led orientation and two one-hour telehealth sessions. Telehealth opinions/experiences were assessed at baseline and follow-up using study-specific questionnaires and by interview. Patient-identified health quality was measured pre-post intervention using the Measure Yourself Medical Outcome Profile (MYMOP2) and a single-item stress index. Participants generally agreed that telehealth session quality was equivalent to in-person sessions, and demonstrated confidence in their ability to communicate freely with the promotor and actively participate in telehealth sessions. We observed significant improvements in nearly all MYMOP2 components and a trend in stress reduction. The intervening promotor reflected that telehealth ¡VMV! extended healthcare to patients impacted by risk factors such as geographic isolation, lack of available services, and hesitancy to access in-person services due to fear of discrimination or deportation. Participants provided highly positive feedback, highlighting the practicality and convenience of the telehealth program. Feasibility of delivering ¡VMV! via telehealth to late-midlife rural-dwelling Latinos and its potential for positive effect was supported.

Late-midlife Latinos (50–64 years old) living in rural regions experience significant health disparities, oftentimes exacerbated by limited access to healthcare services. In a previous pilot study, we observed psychosocial, behavioral, and cardiometabolic health improvements sustained over 12-months in late-midlife Latinos who participated in ¡Vivir Mi Vida! (¡VMV!), a culturally tailored lifestyle intervention led by a Latino community health worker (promotor) and occupational therapist team. For the present study, we assessed the feasibility of telehealth-delivered ¡VMV! modules. Participants (N=10) received an abbreviated three-week version of ¡VMV! consisting of an in-person promotor-led orientation and two one-hour telehealth sessions. Telehealth opinions/experiences were assessed at baseline and follow-up using study-specific questionnaires and by interview. Patient-identified health quality was measured pre-post intervention using the Measure Yourself Medical Outcome Profile (MYMOP2) and a single-item stress index. Participants generally agreed that telehealth session quality was equivalent to in-person sessions, and demonstrated confidence in their ability to communicate freely with the promotor and actively participate in telehealth sessions. We observed significant improvements in nearly all MYMOP2 components and a trend in stress reduction. The intervening promotor reflected that telehealth ¡VMV! extended healthcare to patients impacted by risk factors such as geographic isolation, lack of available services, and hesitancy to access in-person services due to fear of discrimination or deportation. Participants provided highly positive feedback, highlighting the practicality and convenience of the telehealth program. Feasibility of delivering ¡VMV! via telehealth to late-midlife rural-dwelling Latinos and its potential for positive effect was supported.

Date Presented 4/16/2015 Sleep problems threaten occupational engagement in older adults. This pilot study suggests that occupational therapy may enhance sleep by targeting engagement in occupation. This study provides a structure for future researchers analyzing the role of occupational therapy in older adult sleep behaviors.