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Background: Few programs assess for outcomes once translated into practice. The Physical Activity for Lifelong Success program was developed as a center-based public health intervention and shown to improve walking speed and distance among older adults with type 2 diabetes. We adapted the program for community-based delivery by lay leaders to physically inactive older adults. Methods: We followed the Replicating Effective Programs framework to identify community stakeholders, adapt, implement, and evaluate fidelity of delivery in community settings, and plan for maintenance and evolution. Sixteen community sites enrolled 184 adults (mean age 73.5 y, 85% female, 93% White) in 21 workshops. Baseline and postworkshop measures assessed participants' health-related quality of life, physical function, and physical fitness. Data were analyzed using Fisher exact tests, Student t test, and paired linear regression with fixed effects. Results: Fidelity testing indicated leader training was sufficient to maintain key elements with delivery. Data from 122 participants showed improvements in chair stands (P <.001), arm curls (P <.001), 2-minute step test (P <.001), sit-and-reach (P =.001), 8-foot up-and-go (P <.001), and 10-m walk (P <.001). Conclusions: Adaptation of Physical Activity for Lifelong Success for implementation by community organizations for physically inactive older adults demonstrates that fidelity and effectiveness can be maintained after program translation. [ABSTRACT FROM AUTHOR]

Background: Diabetes-related disability occurs in approximately two-thirds of older adults with diabetes and is associated with loss of independence, increased health care resource utilization, and sedentary lifestyle. The objective of this randomized controlled trial was to determine the effect of a center-based functional circuit exercise training intervention followed by a 10-week customized home-based program in improving mobility function in sedentary older adults with diabetes. Methods: Participants (n = 111; mean age 70.5 [7.1] y; mean body mass index 32.7 [5.9] kg/m2) were randomized to either a moderate-intensity functional circuit training (FCT) plus 10-week home program to optimize physical activity (FCT-PA) primary intervention or one of 2 comparison groups (FCT plus health education [FCT-HE] or flexibility and toning plus health education [FT-HE]). Results: Compared with FT-HE, FCT-PA improvements in comfortable gait speed of 0.1 m/s (P <.05) and 6-minute walk of 80 ft were consistent with estimates of clinically meaningful change. At 20 weeks, controlling for 10-week outcomes, improvements were found between groups for comfortable gait speed (FCT-PA vs FT-HE and FCT-HE vs FT-HE) and 6-minute walk (FCT-PA vs FCT-HE). Conclusions: Functional exercise training can improve mobility in overweight/obese older adults with diabetes and related comorbidities. Future studies should evaluate intervention sustainability and adaptations for those with more severe mobility impairments. [ABSTRACT FROM AUTHOR]

This study examined the effectiveness of a unique extracurricular after-school initiative designed to promote healthy diets and exercise in urban African Americans. The Students and Parents Actively Involved in Being Fit after-school program was offered for 12 weeks to students and their parents/guardians at an urban middle school. Specific aims of the intervention were to increase participants' vegetable and fruit intake by using established 5 A Day for Better Health educational resource materials/activities and to affect their health-related fitness through dance, games, and fitness activities. Fifty-six children and 25 parents/guardians completed a standard battery of evaluations before and after the program. Pre-post pairwise t test revealed that both children and their parents/guardians showed an increase in fruit consumption and a reduction in diastolic blood pressure (P<.05). Moreover, children showed improvements in systolic blood pressure and fruit juice, salad, and nonfried potato consumption while parents/guardians showed a decrease in body fat, body mass index, and endurance walk/run time (P<.05). Overall, findings indicate that children tended to gain more diet-related benefits while parents/guardians tended to derive more fitness-related benefits. After-school programs like the Students and Parents Actively Involved in Being Fit initiative can potentially contribute to improved health levels in urban African Americans. J Am Diet Assoc. 2005;105:455-459.

Background: Regular walking improves overall health and functional ability of older adults, yet most are sedentary. Dog ownership/pet responsibility may increase walking in older adults. Goals of this study were to identify factors that influence older adult walking and compare physical activity, functional ability and psychosocial characteristics by dog ownership status. Methods: In this cross-sectional study, older adults (65-95 years of age, n = 1091) completed and returned questionnaires via postal mail. Measures included: Physical Activity Scale for the Elderly, Physical Functioning Questionnaire and Theory of Planned Behavior Questionnaire. Results: Dog owner/dog walkers (n = 77) reported significantly (P < .05) more total walking, walking frequency, leisure and total physical activity and higher total functional ability than dog owner/nondog walkers (n = 83) and nondog owners (n = 931). Dog owner/nondog walkers reported lower intention and perceived behavioral control and a less positive attitude than dog owner/dog walkers (P < .05). Conclusions: Dog owner/ dog walkers were significantly different than the nondog walker groups in nearly every study variable. Many dog owners (48.1%) reported walking their dogs regularly and the dog owner/dog walkers participated in nearly 50% more total walking than the 2 nondog walking groups, suggesting that pet obligation may provide a purposeful activity that motivates some older dog owners to walk. [ABSTRACT FROM AUTHOR]

Focus-group and photo-voice methodology were used to identify the salient factors of the neighborhood environment that encourage or discourage walking in older, urban African Americans. Twenty-one male (n = 2) and female (n = 19) African Americans age 60 years and older (M = 70 ± 8.7, range = 61-85) were recruited from a large urban senior center. Photographs taken by the participants were used to facilitate focus-group discussions. The most salient factors that emerged included the presence of other people, neighborhood surroundings, and safety from crime, followed by sidewalk and traffic conditions, animals, public walking tracks and trails, and weather. Future walking interventions for older African Americans should include factors that encourage walking, such as the presence of other friendly or active people, attractive or peaceful surroundings, and a sense of safety from crime. [ABSTRACT FROM AUTHOR]

Objectives: To prospectively examine whether physical activity or change in physical activity increases or decreases the risk of disability later in life. Methods: Tobit regression models were used to examine the effect of physical activity at baseline and change from baseline on disability 10 and 20 years later in 6913 adults. Results: Increasing recreational physical activity was associated with reduced risk of disability whereas reducing recreational physical activity increased the risk of disability after 10 years. Conclusions: The analyses reveal a protective effect of sustained physical activity on disability among adults. [ABSTRACT FROM AUTHOR]

This study was conducted to determine if specific factors (physical activity self-efficacy, sense of community, social support, perceived physical and mental health, and neighborhood environment and facilities) predicted physical activity among 258 older Thais living in six registered, low-socioeconomic, urban communities across metropolitan Bangkok. The theoretical model was based on integrated concepts from Pender's Health Promotion Model and the Social Ecological Model. The hypothesized model was tested using path analysis. The final model explained 33%, 51% and 22% of the variance in physical activity, physical activity self-efficacy and sense of community, respectively. Physical activity self-efficacy was the most powerful predictor in explaining physical activity. Sense of community and perceived physical health had a positive direct effect and a positive indirect effect, through physical activity self-efficacy, on physical activity. Perceived mental health had a negative indirect effect on physical activity, through physical activity self-efficacy, but a positive direct effect on physical activity. Social support, as well as neighborhood environment and facilities, did not significantly predict physical activity. However, social support had a positive indirect effect on physical activity through sense of community. Neighborhood environment and facilities had a positive indirect effect on physical activity through sense of community and physical activity self- efficacy. These findings provide a greater understanding of factors that predict physical activity among older Thais living in low-socioeconomic urban communities across metropolitan Bangkok. The results may be useful in the development of effective interventions and/or guidelines for promoting physical activity for older Thais. [ABSTRACT FROM AUTHOR]