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Can a framed intervention motivate older adults in assisted living facilities to exercise?

ABSTRACT: BACKGROUND:The majority of institutionalized older adults do not exercise, despite the many health benefits. The current study investigated whether a framed intervention can motivate older adults in assisted living facilities (ALFs) to perform functional resistance exercises. It was hypothesized that repeated framing of these exercises from a prevention perspective (e.g., to avoid health deterioration) would nurture the development of controlled motivation to exercise. By contrast, repeated framing of the exercises from a promotion perspective (e.g., to improve health) was expected to lead to higher exercise frequencies over time and to foster the development of autonomous motivation. Autonomous motivation was hypothesized to predict higher exercise frequencies over time. METHODS:A total of 111 residents, aged 65+ years (M?=?81.4 y; SD?=?6.4 y) participated in the study. These participants received a printed three-week individual program with a standard session of eight functional resistance exercises. Four weekly sessions were recommended. Participants were semi-randomized into three framing conditions: neutral (i.e., control), prevention or promotion. They received condition-specific written and spoken messages about the exercises at the beginning of the intervention. The spoken messages were repeated at the end of each week. Participants kept a checklist with their weekly exercise frequency and at corresponding points in time, they completed a questionnaire about their levels of autonomous and controlled motivation to exercise. RESULTS:Across conditions and time points, the exercise frequencies and the levels of autonomous motivation were generally high, whereas the levels of controlled motivation were generally low. Contrary to the expectations, there were no significant framing effects. However, higher levels of autonomous motivation predicted higher exercise frequencies. During the final exercise week, this was especially the case for intrinsic regulation (i.e., for the sake of the activity). CONCLUSIONS:This study indicates that older adults who live in ALFs can be motivated to perform functional resistance exercises. Given the importance of intrinsic regulation, we advise to create an exercise atmosphere that allows for immediate, positive experiences and in which the basic psychological needs for autonomy, competence and relatedness are satisfied. TRIAL REGISTRATION:ClinicalTrialsID NCT02780037 (23 February 2016).

SUBMITTER: Vanroy J

PROVIDER: S-EPMC6379923 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Can a framed intervention motivate older adults in assisted living facilities to exercise?

Vanroy Jari J Seghers Jan J van Uffelen Jannique J Boen Filip F

BMC geriatrics 20190218 1

<h4>Background</h4>The majority of institutionalized older adults do not exercise, despite the many health benefits. The current study investigated whether a framed intervention can motivate older adults in assisted living facilities (ALFs) to perform functional resistance exercises. It was hypothesized that repeated framing of these exercises from a prevention perspective (e.g., to avoid health deterioration) would nurture the development of controlled motivation to exercise. By contrast, repea ...[more]

PMID: 30777017

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Project description:BackgroundFor the care need of older adults, long-term care (LTC) and assisted living (AL) facilities are expanding in Alberta, but little is known about the caregivers' well-being. The purpose of the study was to investigate the physical health conditions, mental and emotional health (MEH), health behaviour, stress levels, quality of life (QOL), and turnover and absenteeism (TAA) among professional caregivers in Alberta's LTC and AL facilities.MethodsThis cross-sectional survey involved 933 conveniently selected caregivers working in Alberta's LTC and AL facilities. Standardised questions were selected from the Canadian Community Health Survey, Patient Health Questionnaire-9, and Short Form-36 QOL survey revalidated and administered to the participants. The new questionnaire was used to assess the caregivers' general health condition (GHC), physical health, health behaviour, stress level, QOL, and TAA. Data were analysed using descriptive statistics, Cronbach alpha, Pearson's correlation, one-way analysis of variance, and multiple linear regression.ResultsOf 1385 surveys sent to 39 facilities, 933 valid responses were received (response rate = 67.4%). The majority of the caregivers were females (90.8%) who were ≥ 35 years (73.6%), worked between 20 to 40 h weekly (67.3%), and were satisfied with their GHC (68.1%). The Registered Nurses had better GHC (mean difference [MD] = 0.18, p = 0.004) and higher TAA than the Health Care Aides (MD = 0.24, p = 0.005). There were correlations between caregivers' TAA and each of MEH (r = 0.398), QOL (r = 0.308), and stress (r = 0.251); p < 0.001. The most significant predictors of TAA were the propensity to quit a workplace or the profession, illness, job stress, and work-related injury, F (5, 551) = 76.62, p < 0.001, adjusted R2 = 0.998.ConclusionReducing the caregivers' job stressors such as work overload, inflexible schedule, and poor remuneration, and improving their quality of life, health behaviour, and mental, emotional, and physical health conditions may increase their job satisfaction and reduce turnover and absenteeism.

Project description:BACKGROUND:The application of technology is an important and growing aspect in the field of long-term care. Growing evidence shows the positive impact of technology aids in helping the lives of the elderly. However, it is not known which aspects of information and communications technology (ICT) are preferred by older adults living in long-term care facilities. OBJECTIVE:The goal of the research was to compare the impact of ICT-communication, ICT-entertainment, and conventional care on older adults' health and psychological change after interventions among older adults in assisted-living facilities. METHODS:A three-arm group-randomized trial design was used to evaluate participants who resided in three different but comparable assisted-living facilities and received different aspects of the ICT interventions. A total of 54 older adults with disabilities received one of the three interventions over 12 weeks and completed pre- and postevaluations on quality of life, social support, and psychological well-being. RESULTS:Participants completing this study had a mean age of 73 (SD 11.4) years, and 50% (27/54) were male. Both the ICT-communication and ICT-entertainment groups showed significant improvement in the mental component of quality of life (4.11, P=.012 and 37.32, P<.001, respectively), family/friend-related social support (0.05, P=.001 and 0.04, P<.001, respectively), happiness (0.79, P=.038 and 3.72, P=.001, respectively), and depressive symptoms (-2.74, P=.001 and -7.33, P<.001, respectively). Importantly, participants in the ICT-entertainment group improved significantly more than the other two groups. The ICT-entertainment group also showed improvement in the physical component of quality of life (20.49, P<.001) and health care worker-related social support (0.1, P=.008). CONCLUSIONS:Results suggest that the entertainment but not the communication part of ICT is the most effective health promotion method for improving the health and psychological well-being of older adults in assisted-living facilities.

Project description:BackgroundVarious technological interventions have been proposed and studied to address the growing demand for care of residents in assisted living facilities, in which a preexisting shortage of professional caregivers has been exacerbated by the COVID-19 pandemic. Care robots are one such intervention with the potential to improve both the care of older adults and the work life of their professional caregivers. However, concerns about efficacy, ethics, and best practices in the applications of robotic technologies in care settings remain.ObjectiveThis scoping review aimed to examine the literature on robots used in assisted living facilities and identify gaps in the literature to guide future research.MethodsOn February 12, 2022, following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) protocol, we searched PubMed, CINAHL Plus with Full Text, PsycINFO, IEEE Xplore digital library, and ACM Digital Library using predetermined search terms. Publications were included if they were written in English and focused on the use of robotics in assisted living facilities. Publications were excluded if they did not provide peer-reviewed empirical data, focused on user needs, or developed an instrument to study human-robot interaction. The study findings were then summarized, coded, and analyzed using the Patterns, Advances, Gaps, Evidence for practice, and Research recommendations framework.ResultsThe final sample included 73 publications from 69 unique studies on the use of robots in assisted living facilities. The findings of studies on older adults were mixed, with some studies suggesting positive impacts of robots, some expressing concerns about robots and barriers to their use, and others being inconclusive. Although many therapeutic benefits of care robots have been identified, methodological limitations have weakened the internal and external validity of the findings of these studies. Few studies (18/69, 26%) considered the context of care: most studies (48/69, 70%) collected data only on recipients of care, 15 studies collected data on staff, and 3 studies collected data on relatives or visitors. Theory-driven, longitudinal, and large sample size study designs were rare. Across the authors' disciplines, a lack of consistency in methodological quality and reporting makes it difficult to synthesize and assess research on care robotics.ConclusionsThe findings of this study call for more systematic research on the feasibility and efficacy of robots in assisted living facilities. In particular, there is a dearth of research on how robots may change geriatric care and the work environment within assisted living facilities. To maximize the benefits and minimize the consequences for older adults and caregivers, future research will require interdisciplinary collaboration among health sciences, computer science, and engineering as well as agreement on methodological standards.

Project description:BackgroundWearables and artificial intelligence (AI)-powered digital health platforms that utilize machine learning algorithms can autonomously measure a senior's change in activity and behavior and may be useful tools for proactive interventions that target modifiable risk factors.ObjectiveThe goal of this study was to analyze how a wearable device and AI-powered digital health platform could provide improved health outcomes for older adults in assisted living communities.MethodsData from 490 residents from six assisted living communities were analyzed retrospectively over 24 months. The intervention group (+CP) consisted of 3 communities that utilized CarePredict (n=256), and the control group (-CP) consisted of 3 communities (n=234) that did not utilize CarePredict. The following outcomes were measured and compared to baseline: hospitalization rate, fall rate, length of stay (LOS), and staff response time.ResultsThe residents of the +CP and -CP communities exhibit no statistical difference in age (P=.64), sex (P=.63), and staff service hours per resident (P=.94). The data show that the +CP communities exhibited a 39% lower hospitalization rate (P=.02), a 69% lower fall rate (P=.01), and a 67% greater length of stay (P=.03) than the -CP communities. The staff alert acknowledgment and reach resident times also improved in the +CP communities by 37% (P=.02) and 40% (P=.02), respectively.ConclusionsThe AI-powered digital health platform provides the community staff with actionable information regarding each resident's activities and behavior, which can be used to identify older adults that are at an increased risk for a health decline. Staff can use this data to intervene much earlier, protecting seniors from conditions that left untreated could result in hospitalization. In summary, the use of wearables and AI-powered digital health platform can contribute to improved health outcomes for seniors in assisted living communities. The accuracy of the system will be further validated in a larger trial.

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Can a framed intervention motivate older adults in assisted living facilities to exercise?

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Can a framed intervention motivate older adults in assisted living facilities to exercise?

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