A Lifestyle Physical Activity Intervention for Older Sedentary Women

Over 98% of older women do not meet national guidelines for physical activity (PA). There is
clear evidence that a physically active lifestyle reduces the human and economic cost of
heart disease in a dose-response relationship; but current efforts to increase long-term PA
in older women are inadequate. The aims of this proposed research are to: 1) determine the
feasibility of using an individually tailored motivational counseling intervention method to
promote lifestyle physical activity (LPA) in older sedentary women; 2) examine intervention
effects by comparing baseline to outcome measures at 3 and 6 months in treatment and
information/attention comparison groups; and 3) explore stage of behavior change and
self-efficacy and their relationship to LPA, along with functional health.

This will be a single blinded randomized controlled study of sedentary women aged 60 years
and older. We will replace "structured aerobic exercise" with lifestyle physical activity
(LPA), i.e., self-selected activities performed daily in a purposeful manner to meet the
national PA guidelines. A total of 120 older women who are ambulatory and cognitively intact
will be recruited from a senior health clinic and randomized to receive either the
motivational LPA intervention or information/attention. Women will be assessed at baseline,
3 and 6 months. The theoretically based behavioral intervention is derived from the
Transtheoretical Model and other evidence-based physical activity research. We will use a
Motivational Interviewing counseling technique delivered by a social worker to individually
tailor the LPA intervention to participant preferences, taking into consideration their
functional ability and need for information, readiness to change, and self-efficacy.
Outcomes of the LPA intervention sessions will include tailored goals and an LPA plan.
Intervention participants will also receive the newly developed NIA "Exercise & You" LPA
informational booklet with companion digital video disc (DVD) as well as motivational
coaching via telephone calls, tapering in frequency for 6 months. The control group will
receive the NIA LPA booklet with DVD and attention telephone calls. We will assess changes
from baseline in LPA (primary outcome), readiness to change, self-efficacy and function
(secondary outcomes) and examine the associations between primary and secondary outcomes in
both groups. The allied disciplines of Nursing, Gerontology, Social Work, and Medicine will
collaborate to promote PA and cardiovascular health of older women. Undergraduate and
graduate student research assistants will contribute to this project. This research has the
potential to increase PA of sedentary older women and reduce coronary heart disease risks.
If we could increase physical activity in our rapidly growing older population —even
modestly, we could make a significant impact to the health of our nation.

Inclusion Criteria:

- women > 60 years of age who are Senior Health clinic patients

- health care provider's approval to participate

- ability to speak/read English

- access to a telephone

Exclusion Criteria:

- report participation in a regular physical activity program

- report an unresolved acute illness, such as pneumonia or flu

- fail screening for capacity to provide informed consent

- fail a simple functional screen or are currently nonambulatory

- are unable to complete activities of daily living

- have uncorrectable severe hearing or vision deficits

- have a history of falls in the past 3 months

- have other unforeseen pathology that precludes safe participation