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Effectiveness of a Disability Preventive Intervention for Minority and Immigrant Elders: The Positive Minds-Strong Bodies Randomized Clinical Trial.
- Source :
-
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry [Am J Geriatr Psychiatry] 2019 Dec; Vol. 27 (12), pp. 1299-1313. Date of Electronic Publication: 2019 Aug 13. - Publication Year :
- 2019
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Abstract
- Objective: To test the acceptability and effectiveness of a disability prevention intervention, Positive Minds-Strong Bodies (PMSB), offered by paraprofessionals to mostly immigrant elders in four languages.<br />Design: Randomized trial of 307 participants, equally randomized into intervention or enhanced usual care.<br />Setting: Community-based organizations in Massachusetts, New York, Florida, and Puerto Rico serving minority elders. Data collected at baseline, 2, 6, and 12 months, between May 2015 and March 2019.<br />Participants: English-, Spanish-, Mandarin-, or Cantonese-speaking adults, age 60+, not seeking disability prevention services, but eligible per elevated mood symptoms and minor to moderate physical dysfunction.<br />Interventions: Ten individual sessions of cognitive behavioral therapy (PM) concurrently offered with 36 group sessions of strengthening exercise training (SB) over 6 months compared to enhanced usual care.<br />Measurements: Acceptability defined as satisfaction and attendance to >50% of sessions. Effectiveness determined by changes in mood symptoms (HSCL-25 and GAD-7), functional performance (SPPB), self-reported disability (LLFDI), and disability days (WHODAS 2.0).<br />Results: Around 77.6% of intervention participants attended over half of PM Sessions; 53.4% attended over half of SB sessions. Intent-to-treat analyses at 6 months showed significant intervention effects: improved functioning per SPPB and LLFDI, and lowered mood symptoms per HSCL-25. Intent-to-treat analyses at 12 months showed that effects remained significant for LLFDI and HSCL-25, and disability days (per WHODAS 2.0) significantly decreased 6-month after the intervention.<br />Conclusions: PMSB offered by paraprofessionals in community-based organizations demonstrates good acceptability and seems to improve functioning, with a compliance-benefit effect showing compliance as an important determinant of the intervention response.<br /> (Copyright © 2019 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Black or African American
Aged
Asian
Community Health Workers
Disability Evaluation
Feasibility Studies
Female
Health Status
Hispanic or Latino
Humans
Male
Middle Aged
Patient Health Questionnaire
Patient Satisfaction
Preventive Medicine
White People
Activities of Daily Living
Cognitive Behavioral Therapy
Emigrants and Immigrants
Exercise
Mental Health
Minority Groups
Patient Acceptance of Health Care
Physical Functional Performance
Subjects
Details
- Language :
- English
- ISSN :
- 1545-7214
- Volume :
- 27
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 31494015
- Full Text :
- https://doi.org/10.1016/j.jagp.2019.08.008