Impact of Experience Corps® Participation on Children's Academic Achievement and School Behavior.

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 h 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-1st grade students in EC schools had fewer principal office referrals compared to K-1st 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.

Impact of Experience Corps(®) participation on school climate.

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 h 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.

Impact of the Baltimore Experience Corps Trial on cortical and hippocampal volumes.

INTRODUCTION: There is a substantial interest in identifying interventions that can protect and buffer older adults from atrophy in the cortex and particularly, the hippocampus, a region important to memory. We report the 2-year effects of a randomized controlled trial of an intergenerational social health promotion program on older men's and women's brain volumes. METHODS: The Brain Health Study simultaneously enrolled, evaluated, and randomized 111 men and women (58 interventions; 53 controls) within the Baltimore Experience Corps Trial to evaluate the intervention impact on biomarkers of brain health at baseline and annual follow-ups during the 2-year trial exposure. RESULTS: Intention-to-treat analyses on cortical and hippocampal volumes for full and sex-stratified samples revealed program-specific increases in volumes that reached significance in men only (P's ≤ .04). Although men in the control arm exhibited age-related declines for 2 years, men in the Experience Corps arm showed a 0.7% to 1.6% increase in brain volumes. Women also exhibited modest intervention-specific gains of 0.3% to 0.54% by the second year of exposure that contrasted with declines of about 1% among women in the control group. DISCUSSION: These findings showed that purposeful activity embedded within a social health promotion program halted and, in men, reversed declines in brain volume in regions vulnerable to dementia. CLINICAL TRIAL REGISTRATION: NCT0038.

Marketing public health through older adult volunteering: Experience Corps as a social marketing intervention.

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.

Potential for intensive volunteering to promote the health of older adults in fair health.

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 > or =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.

Experience Corps Baltimore: Exploring the Stressors and Rewards of High-intensity Civic Engagement.

PURPOSE: Experience Corps (EC) represents a high-intensity, intergenerational civic engagement activity where older adults serve as mentors and tutors in elementary schools. Although high-intensity volunteer opportunities are designed to enhance the health and well being of older adult volunteers, little is known about the negative and positive aspects of volunteering unique to intergenerational programs from the volunteer's perspective. DESIGN AND METHODS: Stressors and rewards associated with volunteering in EC were explored in 8 focus group discussions with 46 volunteers from EC Baltimore. Transcripts were coded for frequently expressed themes. RESULTS: Participants reported stressors and rewards within 5 key domains: intergenerational (children's problem behavior, working with and helping children, observing/facilitating improvement or transformation in a child, and developing a special connection with a child); external to EC (poor parenting and children's social stressors); interpersonal (challenges in working with teachers and bonding/making social connections); personal (enjoyment, self-enhancement/achievement, and being/feeling more active); and structural (satisfaction with the structural elements of the EC program). IMPLICATIONS: Volunteers experienced unique intergenerational stressors related to children's problem behavior and societal factors external to the EC program. Overall, intergenerational, interpersonal, and personal rewards from volunteering, as well as program structure may have balanced the stress associated with volunteering. A better understanding of stressors and rewards from high-intensity volunteer programs may enhance our understanding of how intergenerational civic engagement volunteering affects well being in later life and may inform project modifications to maximize such benefits for future volunteers and those they serve.

The evolution of an academic-community partnership in the design, implementation, and evaluation of experience corps® Baltimore city: a courtship model.

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.

Experience Corps: a dual trial to promote the health of older adults and children's academic success.

BACKGROUND: As 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. METHODS: Dual 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. OUTCOMES: For 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. SUMMARY: This 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.

Blunted diurnal decline of cortisol among older adults with low socioeconomic status.

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.

Evidence for neurocognitive plasticity in at-risk older adults: the experience corps program.

OBJECTIVE: To determine whether Experience Corps (EC), a social service program, would improve age-vulnerable executive functions and increase activity in brain regions in a high-risk group through increased cognitive and physical activity. METHODS: Eight community-dwelling, older female volunteers and nine matched wait-list controls were recruited to serve in the ongoing EC: Baltimore program in three elementary schools. We employed functional magnetic resonance imaging (fMRI) preintervention and postintervention to examine whether EC volunteers improved executive function and showed increased activity in the prefrontal cortex relative to controls. fMRI volunteers were trained and placed with other volunteers 15 h/wk for 6 months during the academic year to assist teachers in kindergarten through third grade to promote children's literacy and academic achievement. RESULTS: Participants were African American and had low education, low income, and low Mini-Mental State Examination scores (M = 24), indicative of elevated risk for cognitive impairment. Volunteers exhibited intervention-specific increases in brain activity in the left prefrontal cortex and anterior cingulate cortex over the 6-month interval relative to matched controls. Neural gains were matched by behavioral improvements in executive inhibitory ability. CONCLUSIONS: Using fMRI, we demonstrated intervention-specific short-term gains in executive function and in the activity of prefrontal cortical regions in older adults at elevated risk for cognitive impairment. These pilot results provide proof of concept for use-dependent brain plasticity in later life, and, that interventions designed to promote health and function through everyday activity may enhance plasticity in key regions that support executive function.

The long-term relationship between high-intensity volunteering and physical activity in older African American women.

OBJECTIVES: 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. METHODS: 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. RESULTS: 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.

Exploring the effects of an "everyday" activity program on executive function and memory in older adults: Experience Corps.

PURPOSE: There is little empirical translation of multimodal cognitive activity programs in "real-world" community-based settings. This study sought to demonstrate in a short-term pilot randomized trial that such an activity program improves components of cognition critical to independent function among sedentary older adults at greatest risk. DESIGN AND METHODS: We randomized 149 older adults to Experience Corps (EC) or a wait-list control arm. Participants randomized to EC trained in teams to help elementary school children with reading achievement, library support, and classroom behavior for 15 hr/week during an academic year. We compared baseline and follow-up assessments of memory, executive function (EF), and psychomotor speed at 4 to 8 months by intervention arm, adjusting for exposure duration. We observed a range of EF abilities at baseline and stratified analyses according to the presence of baseline impairment using established norms. RESULTS: Overall, EC participants tended to show improvements in EF and memory relative to matched controls (ps < .10). EC participants with impaired baseline EF showed the greatest improvements, between 44% and 51% in EF and memory at follow-up, compared to declines among impaired-EF controls (ps < .05). IMPLICATIONS: Short-term participation in this community-based program designed to increase cognitive and physical activity in a social, real-world setting may train memory and, particularly, executive functions important to functional independence. This community-based program represents one potentially effective model to bring high doses of sustainable cognitive exercise to the greatest proportion of older adults, particularly those sedentary individuals at elevated risk for health disparities.

Can older adult volunteers serve effectively to improve asthma management for children? Experience Corps Baltimore.

The present study was conducted to determine whether older adults can learn and retain information on asthma and play a role as community health workers to teach children about asthma. A total of 36 older adults and 28 students in grades K-6 participated. Pre-tests and post-tests were administered to participants. Improvement in older adult scores after training was significant (p = .001), and improvement persisted through the conclusion of teaching sessions (p = 0.001). The increase in lower student scores was significant (p = 0.050). Results suggest that older adults can learn and retain asthma information and schoolchildren can learn asthma-related information taught by older adults.

Modeled cost-effectiveness of the Experience Corps Baltimore based on a pilot randomized trial.

The Experience Corps program was designed to harness the social capital of an aging society to improve outcomes for public elementary schools. The objectives of this article are (1) to model the cost-effectiveness of the Experience Corps Baltimore using data from a pilot randomized trial, including costs, older adults' health status, and quality of life and cost data from the Medical Expenditure Panel Survey, and (2) to describe the relationship between children experiencing increased expected lifetime earnings through improved educational attainment resulting from exposure to the Experience Corps Baltimore volunteers and the program's costs and cost-effectiveness. On average, each quality adjusted life year (QALY) gained by older adults in Experience Corps Baltimore costs $205,000. The lower bound of the 95% confidence interval for the cost-effectiveness is $65,000/QALY. The upper bound is undefined as 15% of the simulations indicated no QALY improvements. If 0.3% of students exposed to the Experience Corps Baltimore changed from not graduating to graduating, the increased lifetime earnings would make the incremental cost-effectiveness ratio $49,000/QALY. If an additional 0.1% changed to graduating from high school, the program would be cost-saving. Using conservative modeling assumptions and excluding benefits to teachers, principals, and the surrounding community, the Experience Corps Baltimore appears expensive for the older adults' health improvements, but requires only small long-term benefits to the target children to make the program cost-effective or cost-saving.

A social model for health promotion for an aging population: initial evidence on the Experience Corps model.

This report evaluates whether a program for older volunteers, designed for both generativity and health promotion, leads to short-term improvements in multiple behavioral risk factors and positive effects on intermediary risk factors for disability and other morbidities. The Experience Corps(R) places older volunteers in public elementary schools in roles designed to meet schools' needs and increase the social, physical, and cognitive activity of the volunteers. This article reports on a pilot randomized trial in Baltimore, Maryland. The 128 volunteers were 60-86 years old; 95% were African American. At follow-up of 4-8 months, physical activity, strength, people one could turn to for help, and cognitive activity increased significantly, and walking speed decreased significantly less, in participants compared to controls. In this pilot trial, physical, cognitive, and social activity increased, suggesting the potential for the Experience Corps to improve health for an aging population and simultaneously improve educational outcomes for children.

Short-term impact of Experience Corps participation on children and schools: results from a pilot randomized trial.

This article reports on the short-term impact of a school-based program using older adult volunteers and aimed at improved academic achievement and reduced disruptive classroom behavior in urban elementary school students. The Experience Corps Baltimore (Maryland) program places a critical mass of older adult volunteers, serving 15 hours or more per week, in public schools to perform meaningful and important roles to improve the educational outcomes of children and the health and well-being of the volunteers. This article reports on the preliminary impact of the program on children in grades K-3. A total of 1,194 children in grades K-3 from six urban elementary schools participated in this pilot trial. At follow-up, third grade children whose schools were randomly selected for the program had significantly higher scores on a standardized reading test than children in the control schools, and there was a nonsignificant trend for improvement in alphabet recognition and vocabulary ability among kindergarten children in the program. Office referrals for classroom misbehavior decreased by about half in the Experience Corps schools, but remained the same in the control schools. Teachers had somewhat more favorable attitudes toward senior volunteers as a result of having older volunteers in the classroom, although the difference between the intervention and control schools was not statistically significant. In this pilot trial, the Experience Corps program led to selective improvements in student reading/academic achievement and classroom behavior while not burdening the school staff.

Experience Corps: design of an intergenerational program to boost social capital and promote the health of an aging society.

Population aging portends a crisis of resources and values. Desired solutions could include intergenerational strategies to harness the untapped potential of older adults to address societal needs and to generate health improvements for older adults. Despite the desire of many older adults to remain socially engaged and productive, the creation of productive roles has lagged. This report describes the conceptual framework and major design features of a new model of health promotion for older adults called Experience Corps. Experience Corps operates at, and leads to benefits across, multiple levels, including individuals, schools, and the larger community. At the individual level, we propose a model based on Erikson's concept of generativity to explain how and why Experience Corps works. At the level of schools, we propose a parallel model based on social capital. Experience Corps is a volunteer service program designed to improve the lives of urban children and to yield health improvement for older persons. It illustrates how population aging creates new opportunities to address difficult social problems. This article explores how the linkage of concepts at multiple levels motivates a potentially cost-effective, feasible, and high-impact program.