Date of Award

August 2013

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Health Sciences

First Advisor

Scott Strath

Committee Members

Ann Swartz, Kevin Keenan, Amy Harley, Razia Azen

Keywords

Community Fitness Center, Older Adults, Physical Activity, Physical Functioning, Walking

Abstract

The number of older adults living in the United States is growing at an increasingly rapid rate, and is host to a high prevalence of chronic diseases and physical impairments. Physical activity and exercise have been shown to be beneficial in impacting such conditions, yet the majority of older adults remain inactive. The purpose of this dissertation was to employ a sequence of studies to investigate mediators to physical activity, leading to an intervention to increase activity and promote health.

The purpose of Project VOICE was to examine whether awareness and utilization of community resources to promote physical activity and exercise differed by residential spatial tiers of increasing distance from the resources. Results showed that approximately 50% of the sample was aware of the resources, yet utilization rates fluctuated around a paltry 3% (there were no differences across spatial tiers). The most notable barriers that influenced participation were interest in resources available, current health status, and transportation to and from community resources. Efforts are warranted to increase interest in using such resources, and/or developing interventions that overcome noted barriers.

Extending upon the results of Project VOICE, Project PACE employed a home-based intervention aimed at increasing physical activity and engagement in exercise, to improve physical functioning levels in community-dwelling older adults. An enhanced physical activity prescription of daily step goals (increasing 10% weekly) and resistance band exercises was provided for the intervention group, compared to a standard of care group who were prescribed 10,000 steps/day. The intervention group significantly increased the amount of steps taken daily, compared to the standard of care group, and improved physical functioning. These results were enhanced within those who had greater compliance to the prescribed intervention, however, this included only 25% of the total group sample. Future studies should include a larger sample size and a longer study design with follow up measurements, focusing on improving intervention adherence.

Considering the low utilization of community resources for physical activity and exercise, a low-cost, home-based intervention was successful in increasing physical activity and improving physical functioning, demonstrating the potential and advantages of programs easily translatable into everyday life.

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