28 results on '"Erwin J. Tan"'
Search Results
2. Healthy Longevity: An Introduction to the Special Issue
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Erwin J. Tan and Thomas T. Perls
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Gerontology ,Aging ,business.industry ,media_common.quotation_subject ,Longevity ,MEDLINE ,Healthy Aging ,Humans ,Medicine ,Geriatrics and Gerontology ,Healthy aging ,business ,Healthy longevity ,Aged ,media_common ,Introductory Journal Article - Published
- 2019
3. Highlights From an Expert Meeting on Opportunities for Cancer Prevention Among Older Adults
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Elisa Epel, Erwin J. Tan, Roland J. Thorpe, David X. Marquez, Michele Marcus, Linda Rhodes, Thomas R. Prohaska, Paige A. Green, Sei J. Lee, Reginald D. Tucker-Seeley, Peggy Toy, Robyn I. Stone, Dilip V. Jeste, Siran M. Koroukian, Dawn M. Holman, Eugene J. Lengerich, and Rima E. Rudd
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Counseling ,Male ,Gerontology ,Aging ,medicine.medical_specialty ,Health Promotion ,Article ,Neoplasms ,Preventive Health Services ,medicine ,Humans ,Mass Screening ,Social isolation ,Aged ,Preventive healthcare ,Cancer prevention ,business.industry ,Cancer ,Loneliness ,Environmental Exposure ,Health Status Disparities ,General Medicine ,medicine.disease ,Obesity ,Health Literacy ,Mental Health ,Health promotion ,Female ,Geriatrics and Gerontology ,medicine.symptom ,business ,Psychosocial - Abstract
This paper provides highlights from an expert meeting to explore opportunities to reduce cancer risk and promote health at older ages. Factors that increase cancer risk among older adults include exposure to carcinogens from multiple sources, chronic conditions such as obesity and diabetes, and unhealthy behaviors. Emerging research points to chronic social stressors – social isolation, loneliness, and financial hardship – as being linked to accelerated biological aging and increased cancer risk later in life. Older adults may disproportionately encounter these stressors as well as barriers to preventive health care services, accurate health information, and environments that promote health. Researchers can use existing cohort studies of older adults to deepen our understanding of the relative benefit of modifying specific behaviors and circumstances. The evidence points to the value of comprehensive, transdisciplinary approaches to promote health and reduce cancer risk across the entire lifespan, extending through older adulthood. Clinical encounters with older adults provide opportunities for psychosocial and behavioral screening and counseling. In the presence of multiple morbidities, preventive health services may offer greater health benefits than cancer-screening tests. Strategies that involve families and caregivers, promote positive attitudes about aging, and engage many different community sectors have the potential to prevent or delay the development of cancer at older ages.
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- 2019
4. How Growing Geographic and Racial Disparities Inhibit the Ability to Live Longer and Healthier Lives: Report 1: National Level Analysis
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Erwin J. Tan
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Geography ,National level ,Socioeconomics - Published
- 2020
5. Concomitant Cholinesterase Inhibitor and Anticholinergic Drug Use Among Older Adults With Dementia
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Elizabeth Carter and Erwin J. Tan
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Drug ,Health (social science) ,biology ,business.industry ,medicine.drug_class ,media_common.quotation_subject ,Pharmacology ,medicine.disease ,Health Professions (miscellaneous) ,Abstracts ,Dementia I ,Concomitant ,biology.protein ,Anticholinergic ,Medicine ,Dementia ,Life-span and Life-course Studies ,business ,Session 2920 (Paper) ,AcademicSubjects/SOC02600 ,Cholinesterase ,media_common - Abstract
Anticholinergic medications (ACh) are frequently prescribed to older adults despite being associated with impaired physical functioning. Moreover, the concomitant use of ACh and cholinesterase inhibitors (ChEI) reduces the body’s response to both drugs, thereby diminishing the modest effectiveness of ChEI at slowing the progression of dementia symptoms. The objective of this study was to assess the risk of concomitant ACH/ChEI use on functional outcomes, including fall, fracture, and traumatic brain injury (TBI). We conducted a retrospective review of data from the OptumLabs® Data Warehouse, a de-identified administrative claims database for commercially insured and Medicare Advantage (MA) enrollees, representing a diverse mixture of ages, ethnicities, and geographical regions across the U.S. Our cohort included adults 65 and older enrolled in MA between 1998 and 2017. Subjects were required to have dementia (by a diagnosis and/or prescription for a dementia drug (memantine or ChEI)) and at least one claim for ChEI during 12 months of follow-up. Subjects had to be enrolled in MA 6 months prior to the dementia index date. We defined concomitant ACh/ChEI use as an overlap of 30 days or more. Nearly one-third (29%) were concomitantly prescribed ACh and ChEI. Half (51%) of concomitant users were prescribed ChEI first, 46% were prescribed ACh first, and 3% received prescriptions on the same day. Results from multiple logistic regression analyses show that older adults with dementia who had concomitant ACh/ChEI use were 18%, 16%, and 25% more likely to experience a fall, fracture, or TBI, respectively, than those taking ChEI alone.
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- 2020
6. Positive Aging Expectations Are Associated With Physical Activity Among Urban-Dwelling Older Adults
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Erwin J. Tan, Vijay R. Varma, Ryan M. Andrews, William A. Romani, Teresa E. Seeman, Tara L. Gruenewald, Michelle C. Carlson, Elizabeth K. Tanner, and George W. Rebok
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Male ,Gerontology ,Aging ,and promotion of well-being ,medicine.medical_specialty ,Urban Population ,Epidemiology ,Clinical Sciences ,Physical fitness ,Physical activity ,Attitudes & perception toward aging ,Affect (psychology) ,Basic Behavioral and Social Science ,03 medical and health sciences ,0302 clinical medicine ,Clinical Research ,Surveys and Questionnaires ,Behavioral and Social Science ,medicine ,Humans ,Longitudinal Studies ,030212 general & internal medicine ,Healthy aging ,Association (psychology) ,Exercise ,Aged ,Cancer ,African american ,business.industry ,General Medicine ,Middle Aged ,Prevention of disease and conditions ,Black or African American ,Analysis-hierarchical linear modeling ,Baltimore ,Linear Models ,3.1 Primary prevention interventions to modify behaviours or promote wellbeing ,Positive aging ,Female ,Geriatrics and Gerontology ,business ,Psychology ,Attitude to Health ,030217 neurology & neurosurgery ,Research Article ,African American older adults - Abstract
Purpose Regular physical activity is a key component of healthy aging, but few older adults meet physical activity guidelines. Poor aging expectations can contribute to this lack of activity, since negative stereotypes about the aging process can be internalized and affect physical performance. Although prior cross-sectional studies have shown that physical activity and aging expectations are associated, less is known about this association longitudinally, particularly among traditionally underrepresented groups. It is also unclear whether different domains of aging expectations are differentially associated with physical activity. Design and Methods The number of minutes/week of physical activity in which Baltimore Experience Corps Trial participants (N = 446; 92.6% African American) engaged were measured using the CHAMPS questionnaire, while their aging expectations were measured using the ERA-12 survey. Linear mixed effects models assessed the association between physical activity and aging expectations over 2 years, both in full and sex-stratified samples. Separate models were also fit for different ERA-12 domains. Results We found that higher overall expectations regarding aging are associated with higher engagement in moderate- to high-intensity physical activity over a 2-year period of time for women only. When the ERA-12 domains were examined separately, only the physical domain was associated with physical activity, both in women and overall. Implications Low expectations regarding physical aging may represent a barrier to physical activity for older adults. Given that most older adults do not meet recommended physical activity guidelines, identifying factors that improve aging expectations may be a way to increase physical activity levels in aging populations.
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- 2017
7. Impact of Experience Corps® Participation on Children's Academic Achievement and School Behavior
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Elizabeth K. Tanner, Li Xing, Christine M. Ramsey, Jin Huang, Linda P. Fried, Sylvia McGill, Kevin D. Frick, Ike Diibor, Jeremy Barron, Erwin J. Tan, Qian Li Xue, William A. Romani, Teresa E. Seeman, George W. Rebok, Jeanine M. Parisi, Tara L. Gruenewald, and Michelle C. Carlson
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Volunteers ,medicine.medical_specialty ,education ,Child Behavior ,Academic achievement ,Article ,03 medical and health sciences ,Childhood education ,medicine ,Humans ,0501 psychology and cognitive sciences ,Child ,Medical education ,030505 public health ,Academic Success ,Schools ,Matched control ,Public health ,05 social sciences ,Public Health, Environmental and Occupational Health ,Test (assessment) ,Health psychology ,Baltimore ,0305 other medical science ,Mathematical achievement ,Psychology ,050104 developmental & child psychology ,Program Evaluation - Abstract
This article reports on the impact of the Experience Corps® (EC) Baltimore program, an intergenerational, school-based program aimed at improving academic achievement and reducing disruptive school behavior in urban, elementary school students in Kindergarten through third grade (K-3). Teams of adult volunteers aged 60 and older were placed in public schools, serving 15 hours or more per week, to perform meaningful and important roles to improve the educational outcomes of children and the health and well-being of volunteers. Findings indicate no significant impact of the EC program on standardized reading or mathematical achievement test scores among children in grades 1–3 exposed to the program. K-1(st) grade students in EC schools had fewer principal office referrals compared to K-1(st) grade students in matched control schools during their second year in the EC program; second graders in EC schools had fewer suspensions and expulsions than second graders in non-EC schools during their first year in the EC program. In general, both boys and girls appeared to benefit from the EC program in school behavior. The results suggest that a volunteer engagement program for older adults can be modestly effective for improving selective aspects of classroom behavior among elementary school students in under-resourced, urban schools, but there were no significant improvements in academic achievement. More work is needed to identify individual- and school-level factors that may help account for these results.
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- 2019
8. Effect of Community Volunteering on Physical Activity
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Greg Harris, William A. Romani, George W. Rebok, Linda P. Fried, Vijay R. Varma, Alden L. Gross, Erwin J. Tan, and Michelle C. Carlson
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Gerontology ,medicine.medical_specialty ,030505 public health ,Epidemiology ,business.industry ,Walking (activity) ,Public Health, Environmental and Occupational Health ,Physical activity ,Psychological intervention ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Health promotion ,Randomized controlled trial ,law ,Intervention (counseling) ,Physical therapy ,Medicine ,030212 general & internal medicine ,0305 other medical science ,business ,Volunteer ,School system - Abstract
Introduction Older adults with a high number of chronic conditions and who live in environments that do not promote physical activity have great difficulty initiating and adhering to exercise programs. Novel lifestyle activity interventions that can effectively increase physical activity may address disparities in health in these populations. This study evaluates the effects of the Baltimore Experience Corps program, a community-based volunteer program, on walking activity in older adults. Methods The Baltimore Experience Corps Trial is a sex-stratified RCT that recruited participants from 2006 to 2009. Older adult participants aged ≥60 years ( n =123) were from a nested objective physical activity trial within the larger Baltimore Experience Corps Trial. Participants randomized to the intervention group were placed as volunteers within the Baltimore public school system for 2 years. The primary study outcome was objectively measured total amount of walking activity measured in steps/day. Differences between intervention and control groups were measured at 12 and 24 months using linear mixed effects models. Data were analyzed in 2014. Results At 24 months, women, but not men, in the intervention group showed an increased amount of walking activity, averaging 1,500.3 (95% CI=77.6, 2,922.9) greater steps/day compared with the control group. Women in the control group showed a decline of 1,191.6 (95% CI=–2243.7, –139.5) steps/day at 24 months compared to baseline. Conclusions A community-based volunteer intervention increased walking activity among older women, who were at elevated risk for both inactivity and adverse health outcomes. Trial registration This study is registered at www.clinicaltrials.gov NCT00380562.
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- 2016
9. Effects of Age Discrimination on Self-perceptions of Aging and Cancer Risk Behaviors
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Sandi Phibbs, Shannon T. Mejía, Erwin J. Tan, Jonathan Stevens, and Karen Hooker
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musculoskeletal diseases ,Research design ,Male ,Aging ,media_common.quotation_subject ,Health Behavior ,Physical activity ,050105 experimental psychology ,03 medical and health sciences ,0302 clinical medicine ,Risk-Taking ,Perception ,Neoplasms ,Medicine ,Humans ,0501 psychology and cognitive sciences ,030212 general & internal medicine ,media_common ,Aged ,Aged, 80 and over ,Cancer prevention ,business.industry ,05 social sciences ,General Medicine ,Health and Retirement Study ,Middle Aged ,Health Surveys ,Self Concept ,Age discrimination ,stomatognathic diseases ,Logistic Models ,Female ,Geriatrics and Gerontology ,Health behavior ,Cancer risk ,business ,Gerontology ,Demography - Abstract
Background and objectives Almost one-third of older adults report experiencing age discrimination. We hypothesized sequential links between older adults' everyday experiences of age discrimination and future health behaviors related to cancer risk through self-perceptions of aging (SPA). Research design and methods Participants were community-dwelling respondents (age: 51-96 years) from the 2008, 2012, and 2014 waves of the Health and Retirement Study (N = 4,467). Generalized path models estimated the immediate and enduring effects of age discrimination in 2008 on proximal SPA in 2012 and distal health behaviors in 2014. Results Age discrimination was associated with lower positive SPA and higher negative SPA in 2012. The effect of age discrimination on physical activity, smoking, and drinking in 2014 was mediated by positive and negative SPA in 2012. Through subsequent SPA, those who experienced age discrimination in 2008 were less likely to engage in regular moderate physical activity, more likely to smoke, and less likely to drink more than 3 times per week in 2014. Analysis of change in positive and negative SPA showed the effect of age discrimination on physical activity to be mediated by change in positive, but not negative, SPA. Discussion and implications The enduring effects of age discrimination were found through a reduction in positive SPA. Elevating positive SPA could be as important as reducing negative SPA for future health behaviors related to cancer risk.
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- 2018
10. Validating Grant-Making Processes: Construct Validity of the 2013 Senior Corps RSVP Grant Review
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Robin Ghertner, Vielka E. Garibaldi, Erwin J. Tan, Patricia J. Stengel, and Malcolm Coles
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Public Administration ,Sociology and Political Science ,Operations research ,Process (engineering) ,Strategy and Management ,Geography, Planning and Development ,05 social sciences ,050401 social sciences methods ,Construct validity ,050109 social psychology ,Confirmatory factor analysis ,0504 sociology ,Convergent validity ,Accountability ,0501 psychology and cognitive sciences ,Measurement invariance ,Operations management ,Business and International Management ,Selection (genetic algorithm) ,Reliability (statistics) ,Earth-Surface Processes - Abstract
Accountability in grant-making requires a valid, fair and transparent selection process. This study proposes a four-step framework for validating such a process: determine standards for qualified applicants, assess inter-reviewer reliability, assess factorial validity, and assess reliability. This framework is applied to the Corporation for National and Community Service’s 2013 RSVP grant-making process. The standards were close to the highest points of reliability. Inter-reviewer reliability was above 0.90, a common threshold for high-stakes measurement. After conducting confirmatory factor analysis, the final model merged two of the original five domains of selection criteria, resulting in four domains. The final model was found to have strict measurement invariance, high convergent validity, and measurement reliability between 0.88 and 0.93 for all domains. The results validate the 2013 review process and indicated that the scores exhibited high degrees of reliability, giving public assurance that the process was sufficiently objective and accurately reflected program priorities.
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- 2015
11. Low-intensity daily walking activity is associated with hippocampal volume in older adults
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Michelle C. Carlson, Erwin J. Tan, Vijay R. Varma, Yi-Fang Chuang, and Gregory C. Harris
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medicine.medical_specialty ,medicine.diagnostic_test ,Cognitive Neuroscience ,Cognition ,Hippocampal formation ,medicine.disease ,Affect (psychology) ,Developmental psychology ,Physical medicine and rehabilitation ,medicine ,Aerobic exercise ,Dementia ,Cognitive decline ,Functional magnetic resonance imaging ,Psychology ,Neuroscience ,Body mass index - Abstract
Hippocampal atrophy is associated with memory impairment and dementia and serves as a key biomarker in the preclinical stages of Alzheimer's disease. Physical activity, one of the most promising behavioral interventions to prevent or delay cognitive decline, has been shown to be associated with hippocampal volume; specifically increased aerobic activity and fitness may have a positive effect on the size of the hippocampus. The majority of older adults, however, are sedentary and have difficulty initiating and maintaining exercise programs. A modestly more active lifestyle may nonetheless be beneficial. This study explored whether greater objectively measured daily walking activity was associated with larger hippocampal volume. We additionally explored whether greater low-intensity walking activity, which may be related to leisure-time physical, functional, and social activities, was associated with larger hippocampal volume independent of exercise and higher-intensity walking activity. Segmentation of hippocampal volumes was performed using Functional Magnetic Resonance Imaging of the Brain's Software Library (FSL), and daily walking activity was assessed using a step activity monitor on 92, nondemented, older adult participants. After controlling for age, education, body mass index, cardiovascular disease risk factors, and the Mini Mental State Exam, we found that a greater amount, duration, and frequency of total daily walking activity were each associated with larger hippocampal volume among older women, but not among men. These relationships were specific to hippocampal volume, compared with the thalamus, used as a control brain region, and remained significant for low-intensity walking activity, independent of moderate- to vigorous-intensity activity and self-reported exercise. This is the first study, to our knowledge, to explore the relationship between objectively measured daily walking activity and hippocampal volume in an older adult population. Findings suggest the importance of examining whether increasing nonexercise, lifestyle physical activities may produce measurable cognitive benefits and affect hippocampal volume through molecular pathways unique to those related to moderate-intensity exercise.
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- 2014
12. Senior Corps—RSVP: Disaster Services and Community Resilience During 2012 Colorado Wildfires: Table 1
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Christopher Spera, Kelly Menzie DeGraff, Ventana Harding, and Erwin J. Tan
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021110 strategic, defence & security studies ,03 medical and health sciences ,Community resilience ,030505 public health ,business.industry ,Political science ,Environmental resource management ,0211 other engineering and technologies ,02 engineering and technology ,General Medicine ,0305 other medical science ,business - Published
- 2016
13. Doctor’s Orders: Life’s Healthier with Travel and Play Breaks
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Erwin J. Tan
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- 2019
14. Experience Corps: A dual trial to promote the health of older adults and children's academic success
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Michelle C. Carlson, Laprisha Berry-Vaughn, Iveris L. Martinez, George W. Rebok, Barbara K. Martin, John F. Stewart, Elizabeth K. Tanner, Teresa E. Seeman, Kevin D. Frick, Rachel L. Piferi, Sylvia McGill, Qian Li Xue, Tara L. Gruenewald, Linda P. Fried, Erwin J. Tan, Constantine Frangakis, Kay Dickersin, Paul R. Willging, and Jeremy Barron
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Gerontology ,Research design ,Volunteers ,medicine.medical_specialty ,Aging ,Community-Based Participatory Research ,Activities of daily living ,Time Factors ,Health Status ,Population ,education ,Community-based participatory research ,Child Behavior ,Intergenerational programs ,Academic achievement ,Health Promotion ,Article ,Mental Processes ,Intervention (counseling) ,Activities of Daily Living ,Children's academic success ,Medicine ,Humans ,Learning ,Pharmacology (medical) ,Mobility Limitation ,Child ,Postural Balance ,Aged ,Medicine(all) ,education.field_of_study ,Retirement ,Schools ,business.industry ,Public health ,Senior service ,General Medicine ,Health promotion ,Cross-Sectional Studies ,Healthy aging ,Socioeconomic Factors ,Research Design ,Intergenerational Relations ,Educational Status ,business - Abstract
BackgroundAs the population ages, older adults are seeking meaningful, and impactful, post-retirement roles. As a society, improving the health of people throughout longer lives is a major public health goal. This paper presents the design and rationale for an effectiveness trial of Experience Corps™, an intervention created to address both these needs. This trial evaluates (1) whether senior volunteer roles within Experience Corps™ beneficially impact children's academic achievement and classroom behavior in public elementary schools and (2) impact on the health of volunteers.MethodsDual evaluations of (1) an intention-to-treat trial randomizing eligible adults 60 and older to volunteer service in Experience Corps™, or to a control arm of usual volunteering opportunities, and (2) a comparison of eligible public elementary schools receiving Experience Corps™ to matched, eligible control schools in a 1:1 control:intervention school ratio.OutcomesFor older adults, the primary outcome is decreased disability in mobility and Instrumental Activities of Daily Living (IADL). Secondary outcomes are decreased frailty, falls, and memory loss; slowed loss of strength, balance, walking speed, cortical plasticity, and executive function; objective performance of IADLs; and increased social and psychological engagement. For children, primary outcomes are improved reading achievement and classroom behavior in Kindergarten through the 3rd grade; secondary outcomes are improvements in school climate, teacher morale and retention, and teacher perceptions of older adults.SummaryThis trial incorporates principles and practices of community-based participatory research and evaluates the dual benefit of a single intervention, versus usual opportunities, for two generations: older adults and children.
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- 2013
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15. The Evolution of an Academic-Community Partnership in the Design, Implementation, and Evaluation of Experience Corps(R) Baltimore City: A Courtship Model
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Michelle C. Carlson, Elizabeth K. Tanner, Sylvia McGill, Linda P. Fried, George W. Rebok, Teresa E. Seeman, and Erwin J. Tan
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Volunteers ,Program evaluation ,Community-Based Participatory Research ,medicine.medical_specialty ,National service ,Participatory action research ,Community-based participatory research ,Health Promotion ,Public administration ,Practice Concepts ,medicine ,Humans ,Sociology ,Cooperative Behavior ,Aged ,business.industry ,Public health ,Courtship ,General Medicine ,Models, Theoretical ,Public relations ,Memorandum of understanding ,Community-Institutional Relations ,Health promotion ,General partnership ,Baltimore ,Public Health ,Geriatrics and Gerontology ,business ,Gerontology ,Program Evaluation - Abstract
Purpose: Experience Corps Baltimore City (EC) is a product of a partnership between the Greater Homewood Community Corporation (GHCC) and the Johns Hopkins Center on Aging and Health (COAH) that began in 1998. EC recruits volunteers aged 55 and older into high-impact mentoring and tutoring roles in public elementary schools that are designed to also benefit the volunteers. We describe the evolution of the GHCC–COAH partnership through the “Courtship Model.” Design and Methods: We describe how community-based participatory research principals, such as shared governance, were applied at the following stages: (1) partner selection, (2) getting serious, (3) commitment, and (4) leaving a legacy. Results: EC could not have achieved its current level of success without academic–community partnership. In early stages of the “Courtship Model,” GHCC and COAH were able to rely on the trust developed between the leadership of the partner organizations. Competing missions from different community and academic funders led to tension in later stages of the “Courtship Model” and necessitated a formal Memorandum of Understanding between the partners as they embarked on a randomized controlled trial. Implications: The GHCC–COAH partnership demonstrates how academic–community partnerships can serve as an engine for social innovation. The partnership could serve as a model for other communities seeking multiple funding sources to implement similar public health interventions that are based on national service models. Unified funding mechanisms would assist the formation of academic–community partnerships that could support the design, implementation, and the evaluation of community-based public health interventions.
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- 2013
16. Lifestyle Activities in Sociodemographically At-Risk Urban, Older Adults Prior to Participation in the Baltimore Experience Corps®Trial
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Qian Li Xue, Kevin D. Frick, George W. Rebok, Teresa E. Seeman, Michelle C. Carlson, Linda P. Fried, Erwin J. Tan, Jeanine M. Parisi, and Elizabeth K. Tanner
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Gerontology ,Randomization ,Intervention (counseling) ,Cognition ,Academic achievement ,Geriatrics and Gerontology ,Psychology ,Health Professions (miscellaneous) ,Article ,Cognitive health - Abstract
Experience Corps(®) places teams of trained volunteers in elementary school classrooms to promote academic achievement in children, and serve as a health promotion intervention for older adults. Prior to randomization, individuals reported participation in several activities of varying cognitive, physical, and social demands. Maintaining an active lifestyle, particularly in intellectually demanding activities, was associated with physical, mental, and cognitive health in adulthood. Establishing how individuals allocated their time before randomization to this program provides insight to prevalent health behaviors for at-risk older adults, and can provide the basis for examining intervention-related changes in lifestyle as a result of volunteer participation.
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- 2012
17. Blunted diurnal decline of cortisol among older adults with low socioeconomic status
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Vijay R. Varma, Teresa E. Seeman, Erwin J. Tan, Qian Li Xue, Sylvia McGill, Jeanine M. Parisi, Christopher L. Seplaki, Gregory C. Harris, Elizabeth K. Tanner, Owhofasa Agbedia, George W. Rebok, Lingsheng Li, Michelle C. Carlson, and Linda P. Fried
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Gerontology ,General Neuroscience ,Diurnal temperature variation ,Area under the curve ,General Biochemistry, Genetics and Molecular Biology ,History and Philosophy of Science ,medicine ,Life course approach ,Chronic stress ,Circadian rhythm ,Psychology ,Volunteer ,Socioeconomic status ,Hydrocortisone ,medicine.drug ,Demography - Abstract
Low socioeconomic status (SES) is associated with increased risk for adverse health outcomes; those with low SES are thought to experience greater environmental disadvantage and exposure to chronic stress over the life course. The effects of chronic stress on health have been measured by cortisol levels and variations in their diurnal pattern. However, the patterns of association between SES and cortisol have been equivocal in older adults. This paper examined in 98 older adults participating in the Brain Health Substudy of the Baltimore Experience Corps Trial baseline patterns of diurnal variation in salivary cortisol associated with lower versus higher SES using total income and perceived SES relative to others. For each measure, participants stratified into lower versus higher SES showed a more blunted rate of decline in diurnal salivary cortisol over the day in adjusted models (P values ≤ 0.05). There were no SES-related differences in awakening cortisol, cortisol-awakening response, or area under the curve. These findings confirm prior evidence of a biologic pathway through which socioeconomic disadvantage is linked to biologic vulnerability, and through which the impact of volunteer service in Experience Corps may be measured.
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- 2011
18. Volunteering, Driving Status, and Mortality in U.S. Retirees
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Erwin J. Tan, Sei J. Lee, and Michael A. Steinman
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Geriatrics ,Gerontology ,medicine.medical_specialty ,Activities of daily living ,business.industry ,Poison control ,Odds ratio ,Health and Retirement Study ,Injury prevention ,medicine ,Geriatrics and Gerontology ,business ,Psychosocial ,Socioeconomic status - Abstract
OBJECTIVES: To evaluate how accounting for driving status altered the relationship between volunteering and mortality in U.S. retirees. DESIGN: Observational prospective cohort. SETTING: Nationally representative sample from the Health and Retirement Study in 2000 and 2002 followed to 2006. PARTICIPANTS: Retirees aged 65 and older (N=6,408). MEASUREMENTS: Participants self‐reported their volunteering, driving status, age, sex, race or ethnicity, presence of chronic conditions, geriatric syndromes, socioeconomic factors, functional limitations, and psychosocial factors. Death by December 31, 2006, was the outcome. RESULTS: For drivers, mortality in volunteers (9%) and nonvolunteers (12%) was similar; for limited or non‐drivers, mortality for volunteers (15%) was markedly lower than for nonvolunteers (32%). Adjusted results showed that, for drivers, the volunteering‐mortality odds ratio (OR) was 0.90 (95% confidence interval (CI)=0.66–1.22), whereas for limited or nondrivers, the OR was 0.62 (95% CI=0.49–0.78) (interaction P=.05). The effect of driving status was greater for rural participants, with greater differences between rural drivers and rural limited or nondrivers (interaction P=.02) and between urban drivers and urban limited or nondrivers (interaction P=.81). CONCLUSION: The influence of volunteering in decreasing mortality seems to be stronger in rural retirees who are limited or nondrivers. This may be because rural or nondriving retirees are more likely to be socially isolated and thus receive more benefit from the greater social integration from volunteering.
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- 2011
19. Marketing Public Health Through Older Adult Volunteering: Experience Corps as a Social Marketing Intervention
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Michelle C. Carlson, Teresa E. Seeman, Tao Wang, George W. Rebok, Sylvia McGill, Kevin D. Frick, Erwin J. Tan, Elizabeth K. Tanner, Rachel L. Piferi, Qlan Li Xue, Keith E. Whitfield, and Linda P. Fried
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Male ,Volunteers ,Gerontology ,medicine.medical_specialty ,Research and Practice ,Health Status ,Health Behavior ,Social Welfare ,Health Promotion ,law.invention ,fluids and secretions ,Randomized controlled trial ,law ,Intervention (counseling) ,medicine ,Humans ,Sociology ,Aged ,Chi-Square Distribution ,Generativity ,Public health ,Public Health, Environmental and Occupational Health ,equipment and supplies ,Social marketing ,Health promotion ,Conceptual framework ,Social Marketing ,Baltimore ,Costs and Cost Analysis ,Income ,Female - Abstract
Objectives. We present a social marketing conceptual framework for Experience Corps Baltimore City (EC) in which the desired health outcome is not the promoted product or behavior. We also demonstrate the feasibility of a social marketing–based recruitment campaign for the first year of the Baltimore Experience Corps Trial (BECT), a randomized, controlled trial of the health benefits of EC participation for older adults. Methods. We recruited older adults from the Baltimore, MD, area. Participants randomized to the intervention were placed in public schools in volunteer roles designed to increase healthy behaviors. We examined the effectiveness of a recruitment message that appealed to generativity (i.e., to make a difference for the next generation), rather than potential health benefits. Results. Among the 155 participants recruited in the first year of the BECT, the average age was 69 years; 87% were women and 85% were African American. Participants reported primarily generative motives as their reason for interest in the BECT. Conclusions. Public health interventions embedded in civic engagement have the potential to engage older adults who might not respond to a direct appeal to improve their health.
- Published
- 2010
20. Impact of Experience Corps® Participation on School Climate
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Michelle C. Carlson, Jin Huang, Jeanine M. Parisi, Elizabeth K. Tanner, Linda P. Fried, Ike Diibor, Tara L. Gruenewald, Qian Li Xue, Teresa E. Seeman, George W. Rebok, Jeremy Barron, Erwin J. Tan, Christine M. Ramsey, Sylvia McGill, and William A. Romani
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Male ,Volunteers ,medicine.medical_specialty ,School climate ,Urban Population ,education ,Academic achievement ,Social Environment ,Article ,Intervention (counseling) ,Pedagogy ,medicine ,Humans ,Child ,Problem Behavior ,Medical education ,Schools ,Social perception ,Public health ,High intensity ,Public Health, Environmental and Occupational Health ,Social environment ,Achievement ,Health psychology ,Social Perception ,Socioeconomic Factors ,Baltimore ,Female ,Psychology ,Follow-Up Studies - Abstract
We examined the impact of the Experience Corps® (EC) program on school climate within Baltimore City public elementary schools. In this program, teams of older adult volunteers were placed in high intensity (>15 hours per week), meaningful roles in public elementary schools, to improve the educational outcomes of children as well as the health and well-being of volunteers. During the first year of EC participation, school climate was perceived more favorably among staff and students in EC schools as compared to those in comparison schools. However, with a few notable exceptions, perceived school climate did not differ for staff or students in intervention and comparison schools during the second year of exposure to the EC program. These findings suggest that perceptions of school climate may be altered by introducing a new program into elementary schools; however, research examining how perceptions of school climate are impacted over a longer period is warranted.
- Published
- 2015
21. Effect of Community Volunteering on Physical Activity: A Randomized Controlled Trial
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Vijay R, Varma, Erwin J, Tan, Alden L, Gross, Greg, Harris, William, Romani, Linda P, Fried, George W, Rebok, and Michelle C, Carlson
- Subjects
Male ,Volunteers ,Sex Factors ,Accelerometry ,Baltimore ,Humans ,Female ,Health Promotion ,Walking ,Middle Aged ,Exercise ,Article ,Aged - Abstract
Older adults with a high number of chronic conditions and who live in environments that do not promote physical activity have great difficulty initiating and adhering to exercise programs. Novel lifestyle activity interventions that can effectively increase physical activity may address disparities in health in these populations. This study evaluates the effects of the Baltimore Experience Corps program, a community-based volunteer program, on walking activity in older adults.The Baltimore Experience Corps Trial is a sex-stratified RCT that recruited participants from 2006 to 2009. Older adult participants aged ≥60 years (n=123) were from a nested objective physical activity trial within the larger Baltimore Experience Corps Trial. Participants randomized to the intervention group were placed as volunteers within the Baltimore public school system for 2 years. The primary study outcome was objectively measured total amount of walking activity measured in steps/day. Differences between intervention and control groups were measured at 12 and 24 months using linear mixed effects models. Data were analyzed in 2014.At 24 months, women, but not men, in the intervention group showed an increased amount of walking activity, averaging 1,500.3 (95% CI=77.6, 2,922.9) greater steps/day compared with the control group. Women in the control group showed a decline of 1,191.6 (95% CI=-2243.7, -139.5) steps/day at 24 months compared to baseline.A community-based volunteer intervention increased walking activity among older women, who were at elevated risk for both inactivity and adverse health outcomes.This study is registered at www.clinicaltrials.gov NCT00380562.
- Published
- 2015
22. Volunteering: A Physical Activity Intervention for Older Adults—The Experience Corps® Program in Baltimore
- Author
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Michelle C. Carlson, Tao Li, Qian Li Xue, Linda P. Fried, and Erwin J. Tan
- Subjects
Male ,Volunteers ,Gerontology ,medicine.medical_specialty ,Health (social science) ,Calorie ,Urban Population ,Pilot Projects ,Health Promotion ,Motor Activity ,Article ,law.invention ,Randomized controlled trial ,law ,Epidemiology ,medicine ,Humans ,Volunteer ,Aged ,Aged, 80 and over ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,Cognition ,Middle Aged ,Health equity ,Black or African American ,Urban Studies ,Health promotion ,Baltimore ,Female ,business - Abstract
There is compelling evidence supporting the benefits of increased regular physical activity in older adults. The Experience Corps program in Baltimore MD was designed in part as a community based approach to increasing physical activity that would also appeal to older adults who have historically not utilized health promotion programs. The Baltimore Experience Corps program places older volunteers in public elementary schools for 15 h a week in roles designed to improve the academic outcomes of children and, simultaneously, increase the physical, cognitive and social activity of volunteers. This paper reports on the change in physical activity levels among older adults associated with participation in the Baltimore Experience Corps. In a pilot randomized controlled evaluation, older adults were randomly assigned to Experience Corps (EC participants) or a waiting list control group. Ages ranged from 59–86 years, 96% were African American, 94% were women, and 84% had annual incomes less than $15,000. EC participants were required to serve ≥15 h a week. At follow-up after 4–8 months, an analysis of 113 randomized volunteers revealed 53% of the EC participants were more active than the previous year by self-report, as compared to 23% of the controls (p
- Published
- 2006
23. EXPECTATIONS OF AGING AS A MEDIATOR OF COGNITIVE BENEFITS IN THE BALTIMORE EXPERIENCE CORPS TRIAL
- Author
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Teresa E. Seeman, Ryan M. Andrews, George W. Rebok, Erwin J. Tan, Josephine A. Menkin, Tara L. Gruenewald, Michelle C. Carlson, and Jeanine M. Parisi
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Abstracts ,Health (social science) ,Mediator ,Psychotherapist ,genetic structures ,Cognition ,Life-span and Life-course Studies ,Psychology ,Health Professions (miscellaneous) ,Clinical psychology - Abstract
Background: Having low age-expectations is a risk factor for worse cognitive and physical functions in older adults. Here, we asked whether a community-based volunteer program, designed to promote generativity and wisdom, improved cognition by increasing positive perceptions of aging.
- Published
- 2017
24. EVIDENCE FOR THE NEED TO DISRUPT AGING: IMPACT OF PERCEPTIONS OF AGING AND AGING STEREOTYPES
- Author
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Erwin J. Tan and J. Stevens
- Subjects
Abstracts ,Health (social science) ,Perception ,media_common.quotation_subject ,Life-span and Life-course Studies ,Psychology ,Health Professions (miscellaneous) ,Developmental psychology ,media_common - Abstract
This symposium explores the potential health effects of negative stereotypes of aging and self-perceptions on aging. Prior research has linked self-perceptions of aging to self-reported health, health care utilization, functional status and cognitive status. Menkin, Seeman and Sarkisian examine the association between expectations regarding aging and health and walking in four diverse minority communities in Los Angeles. Prior research suggests that under stereotype threat conditions, older adults tend to underperform on tasks that emphasize memory performance. Gallant and co-authors from Canada report on a meta-analysis that shows a significant and robust impact of the of stereotype threat effect on memory performance. The authors report on the ability of age and level of education to moderate in the impact of negative age stereotypes on memory performance in old age. Mejía and Gonzalez report on the extent to which couples in middle age and older adulthood share positive and negative self-perceptions of aging. Using data from the 2008 through 2014 waves of the Health and Retirement Study they report how these shared perceptions predict future functional limitations above and beyond individual. Finally Sun and Smith use data from the Health and Retirement Study and the Health Care Mail Survey to determine the association between self-perceptions of aging and the likelihood of delaying medical care and older adults’ decision-making processes when considering whether to seek medical care. Stevens concludes with an integrative discussion on AARP’s “disrupt aging” agenda that seeks to improve self-perceptions on aging and combat stereotypes on aging.
- Published
- 2017
25. Low-intensity walking activity is associated with better health
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Erwin J. Tan, Teresa E. Seeman, Qian Li Xue, Linda P. Fried, Vijay R. Varma, Abby C. King, George W. Rebok, Tao Wang, Christopher L. Seplaki, and Michelle C. Carlson
- Subjects
Male ,medicine.medical_specialty ,Aging ,and promotion of well-being ,Activities of daily living ,Monitoring ,Cross-sectional study ,Health Status ,Physical fitness ,Clinical Sciences ,Physical activity ,physical activity ,Monitoring, Ambulatory ,low-intensity activity ,Walking ,Physical function ,Outcome and Process Assessment ,Article ,Quality of life ,Clinical Research ,Ambulatory ,Behavioral and Social Science ,Activities of Daily Living ,Medicine ,Humans ,Aged ,Randomized Controlled Trials as Topic ,African Americans ,business.industry ,Depression ,Prevention ,Walking (activity) ,Rehabilitation ,Middle Aged ,Prevention of disease and conditions ,mobility ,Intensity (physics) ,Health Care ,Mental Health ,Cross-Sectional Studies ,Outcome and Process Assessment, Health Care ,Physical therapy ,Quality of Life ,3.1 Primary prevention interventions to modify behaviours or promote wellbeing ,Female ,Geriatrics and Gerontology ,business ,Gerontology - Abstract
Recommended levels of physical activity may represent challenging targets for many older adults at risk for disability, leading to the importance of evaluating whether low-intensity activity is associated with health benefits. We examined the cross-sectional association between low-intensity walking activity (
- Published
- 2014
26. Volunteering, driving status, and mortality in U.S. retirees
- Author
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Sei J, Lee, Michael A, Steinman, and Erwin J, Tan
- Subjects
Male ,Volunteers ,Automobile Driving ,Retirement ,Health Status ,United States ,Article ,Survival Rate ,Risk Factors ,Activities of Daily Living ,Humans ,Female ,Prospective Studies ,Social Behavior ,Aged - Abstract
To evaluate how accounting for driving status altered the relationship between volunteering and mortality in U.S. retirees.Observational prospective cohort.Nationally representative sample from the Health and Retirement Study in 2000 and 2002 followed to 2006.Retirees aged 65 and older (N=6,408).Participants self-reported their volunteering, driving status, age, sex, race or ethnicity, presence of chronic conditions, geriatric syndromes, socioeconomic factors, functional limitations, and psychosocial factors. Death by December 31, 2006, was the outcome.For drivers, mortality in volunteers (9%) and nonvolunteers (12%) was similar; for limited or non-drivers, mortality for volunteers (15%) was markedly lower than for nonvolunteers (32%). Adjusted results showed that, for drivers, the volunteering-mortality odds ratio (OR) was 0.90 (95% confidence interval (CI)=0.66-1.22), whereas for limited or nondrivers, the OR was 0.62 (95% CI=0.49-0.78) (interaction P=.05). The effect of driving status was greater for rural participants, with greater differences between rural drivers and rural limited or nondrivers (interaction P=.02) and between urban drivers and urban limited or nondrivers (interaction P=.81).The influence of volunteering in decreasing mortality seems to be stronger in rural retirees who are limited or nondrivers. This may be because rural or nondriving retirees are more likely to be socially isolated and thus receive more benefit from the greater social integration from volunteering.
- Published
- 2011
27. Potential for Intensive Volunteering to Promote the Health of Older Adults in Fair Health
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Jeremy Barron, Linda P. Fried, Erwin J. Tan, Qilu Yu, Sylvia McGill, and Meilin Song
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Program evaluation ,Gerontology ,Male ,Volunteers ,medicine.medical_specialty ,Aging ,Health (social science) ,Urban Population ,Health Status ,Disease ,Health Promotion ,Walking ,Health informatics ,Article ,Surveys and Questionnaires ,Epidemiology ,Medicine ,Humans ,Students ,Volunteer ,Geriatric Assessment ,Aged ,Aged, 80 and over ,Analysis of Variance ,Schools ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,Middle Aged ,Urban Studies ,Preferred walking speed ,Health promotion ,Baltimore ,Chronic Disease ,Female ,business ,Program Evaluation - Abstract
Volunteer service opportunities for older adults may soon be expanded. Although volunteering is thought to provide health benefits for healthier older adults, it is not known whether older adults in less than very good health are suitable candidates for high-intensity volunteering and can derive health benefits. This manuscript presents a prospective analysis of 174 older adult volunteers serving in Experience Corps Baltimore®, a high-intensity senior volunteer program in Baltimore, Maryland. Volunteers served ≥15 h per week, for a full school year, in elementary schools helping children with reading and other skills between 1999 and 2002. Volunteers were assessed with standardized questionnaires and performance-based testing including grip strength, walking speed, chair stand speed, and stair-climbing speed prior to school volunteering and at the end of the school year. Results were stratified by health status. Among 174 volunteers, 55% initially reported “good” and 12% “fair” or “poor” health status. At baseline, those in fair health reported higher frequencies of disease and disability than volunteers in excellent or very good health. After volunteering, a majority of volunteers in every baseline health status category described increased strength and energy. Those in fair health were significantly more likely to display improved stair-climbing speed than those in good or excellent/very good health (100.0% vs. 53.4% vs. 37.5%, p = 0.05), and many showed clinically significant increases in walking speed of >0.5 m/s. Satisfaction and retention rates were high for all health status groups. Clinicians should consider whether their patients in fair or good health, as well as those in better health, might benefit from high-intensity volunteer programs. Productive activity such as volunteering may be an effective community-based approach to health promotion for older adults.
- Published
- 2009
28. The long-term relationship between high-intensity volunteering and physical activity in older African American women
- Author
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Erwin J. Tan, Constantine Frangakis, Michelle O. Ricks, Michelle C. Carlson, Elizabeth K. Tanner, Qilu Yu, Linda P. Fried, Sylvia McGill, George W. Rebok, and Tao Wang
- Subjects
Gerontology ,Volunteers ,Social Psychology ,Urban Population ,Ethnic group ,Community-based participatory research ,Health Promotion ,Motor Activity ,Cohort Studies ,Medicine ,Humans ,Socioeconomic status ,Volunteer ,Aged ,Aged, 80 and over ,Journal of Gerontology: Social Sciences ,business.industry ,Health Status Disparities ,Black or African American ,Clinical Psychology ,Health promotion ,Cohort ,Propensity score matching ,Baltimore ,Female ,Geriatrics and Gerontology ,business ,Cohort study - Abstract
Experience Corps (EC) places older volunteers in public elementary schools in 20 cities across the country. The EC program in Baltimore is a health promotion intervention designed to improve the academic outcomes of children and increase older adult volunteer physical activity. We sought to determine if there were sustained increases in physical activity with participation in EC.Seventy-one African American women volunteers in the Baltimore EC were compared with 150 African American women in the Women's Health and Aging Studies (WHAS) I and II; all were aged 65-86 years with comparable Social Economic Status, frailty, and self-reported health status. Using a regression model, we evaluated physical activity adjusting for a propensity score and time of follow-up over 3 years.EC volunteers reported a sustained increase in physical activity as compared with the comparison cohort. Baseline physical activity for individuals with a median propensity score was 420 kcal/wk for both groups. At 36 months, EC volunteers reported 670 kcal/week compared with 410 kcal/week in WHAS (p = .04). Discussion These findings suggest that high-intensity senior service programs that are designed as health promotion interventions could lead to sustained improvements in physical activity in high-risk older adults, while simultaneously addressing important community needs.
- Published
- 2009
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