This research examined demographic factors and reported preferential learning mode among a sample of Florida Osher Lifelong Learning Institute (OLLI) members compared to a national sample profile of OLLI members. This study was prompted by an earlier study of OLLI members conducted by the National Resource Center (NRC) for OLLIs, which produced a national profile describing OLLI members. Although there was a national profile for OLLI members, there were no existing profiles of Florida OLLI members that could be used by OLLI administrators and instructors. This study employed an online survey to compare data between the national OLLI member profile and the Florida profile. Demographic factors such as age, gender, marital status, educational level, employment status, and relocation after retirement, as well as reported preferential learning mode were compared. The data resulting from this comparison indicated that although the gender and marital status distributions of the sample participants were similar, a majority of the other demographic variables were different for the Florida and national OLLI samples. The reported preferential learning mode between national and Florida OLLI members also were significantly different, in contrast to earlier research, which suggested that OLLI members were a homogenous group. The findings from this study suggest that it is important for adult education field educators, administrators, and OLLI instructors to recognize the growing diversity and technical proficiency of current retirees in order to continue to promote effective lifelong learning practices.

Chronic disease affects 80% of adults over the age of 65 and is expected to increase in prevalence. To address the burden of chronic disease, self-management programs have been developed to increase self-efficacy and improve quality of life by reducing or halting disease symptoms. Two programs that have been developed to address chronic disease are the Chronic Disease Self-Management Program (CDSMP) and Tomando Control de su Salud (TCDS). CDSMP and TCDS both focus on improving participant self-efficacy, but use different curricula, as TCDS is culturally tailored for the Hispanic population. Few studies have evaluated the effectiveness of CDSMP and TCDS when translated to community settings. In addition, little is known about the correlation between demographic, baseline health status, and psychosocial factors and completion of either CDSMP or TCDS. This study used secondary data collected by agencies of the Healthy Aging Regional Collaborative from 10/01/2008 - 12/31/2010. The aims of this study were to examine six week differences in self-efficacy, time spent performing physical activity, and social/role activity limitations, and to identify correlates of program completion using baseline demographic and psychosocial factors. To examine if differences existed a general linear model was used. Additionally, logistic regression was used to examine correlates of program completion. Study findings show that all measures showed improvement at week six. For CDSMP, self-efficacy to manage disease (p = .001), self-efficacy to manage emotions (p = .026), social/role activities limitations (p = .001), and time spent walking (p = .008) were statistically significant. For TCDS, self-efficacy to manage disease (p = .006), social/role activities limitations (p = .001), and time spent walking (p = .016) and performing other aerobic activity (p = .005) were significant. For CDSMP, no correlates predicting program completion were found to be significant. For TCDS, participants who were male (OR=2.3, 95%CI: 1.15-4.66), from Broward County (OR=2.3, 95%CI: 1.27-4.25), or living alone (OR=2.0, 95%CI: 1.29-3.08) were more likely to complete the program. CDSMP and TCDS, when implemented through a collaborative effort, can result in improvements for participants. Effective chronic disease management can improve health, quality of life, and reduce health care expenditures among older adults.

The unprecedented increase in the number of older adults is expected to increase the burden of osteoporosis on the individual and society. Blacks have been understudied in osteoporosis prevention education research. Although the risk of osteoporosis is low in this population, its consequences are significant. This study employs a two-group experimental design (experimental and wait-list control groups) to evaluate the effect of an osteoporosis education on two osteoporosis prevention behaviors (OPBs) – calcium intake (CI) and physical activity (PA), in a group of community-dwelling Black older adults, 50 years and older resident in South Florida. A final sample of 110 (mean age 70.15 years), 90% female and 10% male completed a battery of questionnaires at two assessment periods. The experimental group participated in six weekly education program sessions immediately following baseline assessment, and the wait-list control group received the education following end of program assessment by all participants. The weekly educational sessions were conducted in social settings (church or senior center) employing constructs of the Revised Health Belief Model. The sessions focused on improving CI; osteoporosis knowledge (OKT), self-efficacy (SE), health beliefs (HB) and PA. Findings revealed significantly greater increase in reported CI (M = 556 mg, Wilks’ λ = .47, F(1,108)=122.97, p< .001, η2=.53), OKT (p< .001), and SE (p< .001) among participants in the experimental compared to the wait-list control group. There was no significant difference between the two groups for PA and most of the HB subscales. OKT and SE were the best predictors of CI, while perceived barrier was a predominant factor predicting PA. Over the study period, a change in SE was the only variable related to changes in both OPBs. Attrition rate was lower than expected, which can be attributed to the settings utilized for the study. These findings support the importance of utilizing a familiar social setting. These results suggested the effectiveness of a program offered in multiple short sessions among this underserved minority population to improve OKT and SE resulting in a change in OPBs (increase in CI). However, there is need to explore alternative strategies to improve PA in this population group.

The negative effects of cognitive decline and impairment can be devastating for older adults and their families, and extremely costly for the healthcare system and the society. Cognitive training aims to maintain or improve cognition by utilizing repetitive tasks that target specific cognitive skills. The majority of cognitive training studies in healthy older adults involved home-based, individual, computerized approach or onsite, group, paper-and-pencil format. These approaches may not be suitable for individuals with serious health or mobility issues, caregiving responsibilities, limited transportation, or limited computer or internet access. A novel, home-based, self-administered cognitive training intervention was developed to address these barriers. It involves two older adults taking turns to administer paper-and-pencil tasks to one another. The purpose of the study was to evaluate feasibility and participant acceptability of this novel approach to cognitive training. Eighteen participants (9 dyads) 65-91 years (M = 75.94, SD = 7.66) underwent assessment and began intervention. Assessment included measures of cognitive skills and self-reported quality of life, health status, and daily functioning. Four dyads were married couples who had sessions at home. Other dyads met at various public locations and included friends, neighbors, or unfamiliar older adults connected by the researcher. Fourteen participants (7 dyads) completed cognitive training intervention that included 9-24 sessions (M = 15.14, SD = 5.30) over 4-21 weeks (M = 12.21, SD = 5.44), post-intervention assessment, and detailed interviews. Quantitative data demonstrated that the sample did not decline on any cognitive measures and exhibited improvement on visuospatial skills and delayed visual memory (Cohen’s d = .67 & -1.10). Additional analyses revealed that the results were mainly attributable to improvement in females (Cohen’s d = -1.84 & -1.35), who demonstrated weaknesses in these cognitive skills at baseline. The participants reported that the dyadic approach was flexible, convenient, and enjoyable. They also provided valuable feedback and suggestions for modifying the content and other aspects of the intervention. The findings suggest that dyadic cognitive training is feasible and well-received by older adults. Those with weaknesses in cognitive domains may show larger gains in respective domains and benefit most from cognitive training.

Falls are the primary cause of injuries among older adults, and accidents that result from falls can lead to personal suffering and extensive societal burdens. The overall aims of this thesis were to explore and describe falls and fall prevention strategies in community-dwelling older adults and to evaluate a fall prevention home exercise program, the Otago Exercise Program (OEP), with or without motivational interviewing (MI). Methods: Qualitative and quantitative research methods were uses. The designs were as follows: a cross-sectional, descriptive and comparative study (study I); a descriptive feasibility investigation (study II) and a randomized controlled trial (RCT) with two interventions, the OEP and OEP+MI, as well as a control group, with a 12-month follow-up (study III); and a prospective and descriptive study (study IV). The four studies comprised community-dwelling individuals aged 75 years or older. Study I included 262 individuals and studies II-IV had 175 participants who needed walking aids or home support. Study II also included 12 physical therapists.  Data collection was performed via self-reported questionnaires, fall calendars, exercise diaries, physical performance tests and a semi-structured questionnaire.  Results and conclusions: Suggested actions to prevent falls significantly differed between high and low active older adults (study I). Support for self-directed behavioral strategies could be important for preventing falls in older adults who have low physical activity levels. The study protocol for the RCT had acceptable feasibility (study II), and only minor changes of the protocol were needed. There were no benefits for OEP or OEP+MI with personal support implemented nine times over the 12-month period. However, all groups maintained physical functioning and activity (study III). To increase physical functioning and reduce falls in this sub-group of older adults, more frequent personal support and/or an alternative delivery format may be required for efficient intensity and challenge in home exercises. Over 12 months, falls and fall-related injuries in the RCT sample were the most common when moving around within the home and transitioning from sitting to standing (study IV). Special attention to these activities might be important for preventing falls in community-dwelling older adults who need walking aids or home support.

Title: What explains variability in blood pressure readings? Multilevel analysis of data from 8,731 older adults in 20 Ontario Communities Objectives: Despite universal healthcare and drug coverage for adults aged 65 and over in Ontario, hypertension, a treatable condition, remains uncontrolled among many older adults. Moreover, there are geographic disparities in blood pressure and hypertension within and across Canadian provinces and territories. Using baseline data collected on 8,731 older adults participating in the Cardiovascular Health Awareness Program (CHAP) in 20 randomly selected Ontario communities, we investigated associations between systolic blood pressure (SBP) and individual- and community-level characteristics, controlling for self-reported use of blood pressure medications. Method: Older adults were recruited via invitation by local family physicians, public advertising and word of mouth to attend community pharmacy sessions. During the sessions, trained older adult volunteers assisted participants to complete a cardiovascular disease risk factor questionnaire and blood pressure assessments using an automated blood pressure measuring device. The Postal Code Conversion File Plus was used to confirm residence within one of the 20 study communities. A multilevel linear regression analysis with participants nested within communities was used to determine which individual- and/or community-level characteristics were associated with measured systolic blood pressure level controlling for self-reported use of blood pressure medication. Results: 4,706 participants (53.9%) reported the use of blood pressure medication. Mean systolic blood pressure (SBP) levels varied among the 20 communities from 128.1 mmHg to 134.7 mmHg for participants not using blood pressure medication and from 131.9 mmHg to 139.0 mmHg for participants using blood pressure medication. The intraclass correlation coefficients were very small: less than 0.2% of the total variance was between communities. Among participants not using blood pressure medication, SBP was associated with the following individual- level characteristics: age, sex, body mass index , smoking, physical activity, stress, fruit/vegetable intake, and alcohol consumption and the following community-level characteristics: community size, community growth and the Rurality Index. Among participants using blood pressure medication, SBP was associated with the following individual-level characteristics: age, sex, body mass index, diabetes, fruit/vegetable intake, alcohol intake and one community-level characteristic: community size. The significance and magnitude of these associations were modified by the use of blood pressure medication. Conclusion: The majority of the variability in blood pressure occurs at the individual-level. There are specific individual- and community-level factors that explain variability in blood pressure readings among communities. These results can be used to inform health promotion strategies to decrease mean levels of blood pressure among older adults.

Background: Gaining insight into factors related to moderate-to-vigorous physical activity (MVPA) behavior may assist development of behavior change interventions targeting older adults. Purpose: To explore direct and indirect associations between older adults’ affective responses during MVPA and future MVPA behavior via self-efficacy beliefs and self-determined motivation. Methods: Data were collected from 82 older adults before, during, and after a walking bout; MVPA behavior was measured 1 month later via telephone. Results: Increases in tranquility during MVPA were indirectly correlated with future MVPA behavior via self-determined motivation (p < .05), but not self-efficacy beliefs (p > .05). Decreases in positive engagement and tranquility during MVPA were directly and positively linked with future MVPA behavior, whereas increases in revitalization during MVPA and self-determined motivation were directly and positively linked with future MVPA behavior (p < .05). Conclusions: Changes in older adults’ affective responses during MVPA may be important correlates of future MVPA behavior.

It is well established that aging is associated with numerous health concerns, including poor balance. Deteriorations in attention demand also place older adults at a greater risk for falls. Emerging experiments have explored the impact of dual-task training programs and have improved dual-tasking in older adults. However, it is unknown whether these performance-related improvements are a function of the intervention itself or the repeated exposure to the testing protocol. Study 1 explored the implications of repeated administration, once per week for 5 weeks, of a protocol involving standing postural sway while concurrently performing reaction time (RT) tasks in older adults. Results revealed that postural sway was stable across testing sessions whereas the difficult RT task gradually improved over time. Study 2 examined the influence of repeated exposure, once per week for 5 weeks, of a protocol involving negotiating a series of obstacles while performing RT tasks in older adults. Participants walked significantly faster with repeated exposure and gradually improved RT. Study 3 investigated the impact of repeated exposure, once per week for 5 weeks, to three functional mobility measures in older adults. It also examined the influence of a 12-week balance and mobility training (BMT) program as well as a 12-week balance and mobility plus cognitive training (BMT+C) program on functional mobility in older adults. Functional mobility served to be stable over time. Both the BMT and BMT+C groups significantly improved functional mobility and sustained these improvements at the 12-week follow-up, while no changes were observed in the control group. No differences between the BMT and BMT+C groups emerged. Experiment 4 examined the influence of BMT and BMT+C on postural sway and RT in older adults. Participants in both training groups significantly improved RT and sustained these improvements at the follow-up, while no changes were observed in the control group. No changes to postural control were shown in any group. No differences between the BMT and BMT+C groups emerged. Experiment 5 examined the influence of BMT and BMT+C on negotiating a series of obstacles while performing RT tasks in older adults. Both the BMT and BMT+C groups significantly improved RT and sustained these improvements at the follow-up, while no changes were observed in the control group. All groups showed faster time to completion of the obstacle series. No differences between the BMT and BMT+C groups emerged. Collectively, these findings suggest that BMT and BMT+C significantly improve functional mobility and divided attention, and sustain these improvements over time. Although some improvements were observed after repeated exposure over 5 weeks, no changes in the control group were observed. Therefore, the improvements exhibited from BMT and BMT+C are likely not a function of repeated exposure to the testing protocol, as participants may be more susceptible to performance-related improvements when the testing sessions are close in proximity. Altogether, these findings propose that, whether or not cognitive training is included, attention demanding dual-task training not only improves functional mobility and RT, but also sustains these improvements over time in older adults. These results may be used to improve the prescription of exercise in older adults.

The main goal of this project was to enhance the use and usability of Interactive Voice Response Systems (IVR) for older people. The objective of study one was to examine older people’s perceptions of the technology and identify the most common difficulties experienced by older people when interactive with IVR using focus groups. Twenty-six people aged 65 and older took part in the study. Data were analyzed using frequency and chi square analyses. The results revealed negative attitudes towards the technology. Long menus, frustration about not being able to reach an operator and absence of shortcuts were some of the most common difficulties reported by participants. Study two examined the cognitive factors predicting successful IVR interaction in four commercially available IVR systems in a sample of 185 older adults. Linear regressions were performed on the data. Results indicated that working memory and auditory memory were the best predictors of successful IVR interaction. Using the same sample of participants as study two, study three examined older adults’ attitudes towards the four IVR systems in relation to their success in interacting with the technology. The study also evaluated the impact of gender on success and attitudes towards IVR. There was a significant positive correlation between success with IVR and favorable attitudes towards the technology. No gender differences emerged in both performance on IVR tasks and attitudes towards the technology. Study four evaluated the feasibility of using a voice-activated IVR to administer and score three short neuropsychological tests using a sub sample of the original sample of 185 older adults involved in study two and three. One hundred and fifty eight participants took part in the study. Results showed high correlations between the IVR and clinician scoring of the three tests. Nevertheless, a number of discrepancies and technical issues were discovered.

The present investigation assessed Health Belief Model (HBM) variables and a measure of physical activity for both younger and older adults. Results of discriminant analyses suggest HBM variables and physical activity can predict age-group membership with 89% accuracy. The younger sample (n = 88; M= 21.5 years) was significantly more anxious about aging, perceived more barriers to exercise, less control from powerful others, and more social support than the older sample (n = 56; M = 71.8 years). For the younger sample, those who perceived more benefits of exercise, had social support, were male, and were less anxious about aging were more active. For the older sample, those who perceived more benefits of exercise were more likely to be active.