Benefits of a Pole Walking Program Offered by Community Organizations on Physical Fitness, Psychological Well-Being, and Cognitive Function Among Older Adults.

The authors examined the effects of a 12-week pole walking program on function and well-being in 123 older adults aged 60 years and older, recruited by community organizations. The results showed a significant improvement in the participants' upper and lower limb strength in the experimental groups compared with those in the control groups (p < .05) and a significant deterioration in the walking speed and grip strength in women in the control groups compared with those in the experimental groups (p < .05). Although not statistically significant, the results also showed a trend toward greater improvement in global cognitive function in the participants in the experimental groups (p = .076). These results suggest that a pole walking program provided in natural conditions can improve physical capabilities in older adults. Other studies are warranted to further explore the impact of pole walking programs on older adults offered in such conditions, especially their impact on cognitive functions.

Influence of Lifestyle Redesign® on Health, Social Participation, Leisure, and Mobility of Older French-Canadians.

IMPORTANCE: Developed in California to enable community-dwelling older adults to maintain healthy and meaningful activities, Lifestyle Redesign® is a well-known cost-effective preventive occupational therapy intervention. The impact of a newly adapted French version on older French-Canadians was, however, unknown. OBJECTIVE: To explore the influence of Lifestyle Redesign on older French-Canadians' health, social participation, leisure, and mobility. DESIGN: A mixed-methods design included a preexperimental component (questionnaires administered before and after the intervention and 3 and 6 mo postintervention) and an exploratory descriptive qualitative clinical study. Individual semidirected interviews were digitally audiotaped and transcribed, then underwent thematic content analysis using mix extraction grids. SETTING: Community. PARTICIPANTS: Sixteen volunteers (10 women) aged 65-90 yr (mean = 76.4, standard deviation = 7.6), 10 without and 6 with disabilities. Inclusion criteria were age ≥65 yr, normal cognitive functions, residence in a conventional or senior home, and French speaking. INTERVENTION: French-Canadian 6-mo version of Lifestyle Redesign. OUTCOMES AND MEASURES: Health, social participation, leisure, and mobility were measured using the 36-item Short Form Health Survey, Social Participation Scale, Leisure Profile, and Life-Space Assessment, as well as a semistructured interview guide. RESULTS: The French-Canadian Lifestyle Redesign had a beneficial effect on participants' mental health (p = .02) and interest in leisure (p = .02) and, in those with disabilities, social participation (p = .03) and attitudes toward leisure (p = .04). Participants reported positive effects on their mental health, leisure, mobility, and social participation, including frequency and quality of social interactions, and indicated that having an occupational routine fostered better health. None of the participants reported no effect. CONCLUSION AND RELEVANCE: The translated and culturally adapted Lifestyle Redesign is a promising occupational therapy intervention for community-dwelling older French-Canadians. WHAT THIS ARTICLE ADDS: This study sheds light on the influence of the French-Canadian version of the intervention not only on older adults' health and social participation but also on their leisure activities and life-space mobility, two important outcomes not addressed in previous Lifestyle Redesign studies. Moreover, this study provides an in-depth understanding of the Lifestyle Redesign experience of French-Canadian older adults with and without disabilities, including participants with significant communication and mobility disabilities.

Categories, diversity, and relevance of memory strategies reported by community-dwelling seniors.

BACKGROUND: Memory strategies help seniors remember information that is essential for the performance of their daily activities and contribute to their independence in the context of declining memory skills. This study aimed to analyze the categories, the diversity, and relevance of memory strategies known by seniors, and to identify individual characteristics that correlated with these variables. METHODS: The sample consisted of 294 participants aged 60 and over who decided to take part in a cognitive vitality promotion program. An adapted version of the memory situation questionnaire (Troyer, 2001) was administered to identify the memory strategies that seniors would use in five daily life situations. A scoring grid, also adapted from the questionnaire's original version (Troyer, 2001), was used to quantify the relevance of the strategies that were reported by participants. RESULTS: All participants mentioned at least once that they would use a strategy from the physical category of memory strategies. Out of a possible range of 26 strategies, participants answered an average of 6.14 (SD = 1.7) different answers across the five situations. Based on expert consensus, 67.7% of the mentioned memory strategies were relevant. Diversity and relevance were significantly higher when trying to remember appointments, things to bring or phone numbers (p ≤ 0.05). The level of education, cognitive skills, and participation in leisure activities were related to diversity and relevance of reported strategies. CONCLUSIONS: Seniors know various and relevant memory strategies to perform daily activities. The advantages of integrating strategies that they already know in cognitive health promotion programs should be considered in further studies.

Attitudes and lifestyle changes following Jog your Mind: results from a multi-factorial community-based program promoting cognitive vitality among seniors.

This study examined the effects on attitudes and lifestyle behavior of Jog your Mind, a multi-factorial community-based program promoting cognitive vitality among seniors with no known cognitive impairment. A quasi-experimental study was conducted. Twenty-three community organizations were assigned either to the experimental group (offering the program) or to the control group (creating a waiting list). They recruited 294 community-dwelling seniors. The aims of the study were to verify the effects of the program on attitudes and behaviors related to cognitive vitality and to explore its effects on cognitive vitality. Data was collected at baseline and after the program. Regression analyses revealed that, following their participation in the program, experimental group participants reported: (i) in terms of attitudes, having a greater feeling of control concerning their cognitive capacities, (ii) in terms of behaviors, using significantly more memory strategies and practicing more physical activity and stimulating activities than control group participants. However, the program had no significant effects on measures of cognitive vitality. This study supports the fact that a multi-factorial community-based program can have significant effects on seniors' attitudes and lifestyle behaviors related to cognitive vitality but at short term, no effects on cognitive vitality it-self were found.

[Co-construction of a program to promote community participation among seniors living with psychosocial issues, with or without mental health problems]. / Participe-présent : co-construction d'un programme visant la participation communautaire des aînés qui vivent des difficultés psychosociales.

Objectives A significant proportion of Quebec seniors are living with mental health problems or psychosocial issues such as isolation, bereavement, and psychological distress. These people face many forms of exclusion and are likely to have limited social participation. This paper describes the co-construction steps of a program aimed at promoting community participation among this population.Methods A method for the co-construction of innovative practices in health promotion was used to develop a program that is relevant, rigorous and feasible in diverse settings. The process included several steps, notably: need analysis among seniors and practitioners, development of a logical model for the program, preparation of the leader's manual, validation of the manual by experts, and pilot testing of the program among groups of seniors.Results The goal of the Count me in! program is to promote utilization of the resources of the community that can provide seniors living with mental health conditions or psychosocial issues with activities and positive social contact. The intervention is based on the Strength Model. It includes an individual interview, an eight-meeting workshop, visits to community resources, and collective production of media communication.Conclusion A co-construction process allowed the program to be continuously adjusted in response to stakeholders' feedback. The most important lever for the co-construction was the reconciliation of the partners' practical, conceptual, and experiential expertise. However, contextual factors such as the organization and the availability of mental health services for seniors constituted important barriers to the process.

Jog Your Mind: methodology and challenges of conducting evaluative research in partnership with community organizations.

BACKGROUND: Jog Your Mind is a community-based program aiming at empowering elderly people to maintain their cognitive abilities using a multi-strategic approach including cognitively stimulating activities, mnemonic strategies, and strategies to promote healthy behaviors. It is offered to elderly individuals without known or diagnosed cognitive impairment by volunteers or community practitioners over ten weekly sessions. This paper describes the protocol of a quasi-experimental study designed to evaluate Jog Your Mind. METHODS: Community responsible to recruit participants were either assigned to the experimental group (participating in the Jog Your Mind program) or to the control group (one-year waiting list). All participants were interviewed at baseline (T1), after the program (T2), and 12 months after the baseline (T3). Primary outcomes were the use of everyday memory strategies and aids and subjective memory functioning in daily life. Secondary outcomes included attitudes, knowledge, and behaviors related to cognitive vitality and cognitive abilities (memory and executive functions). Program delivery, organizational and environmental variables were recorded to document the implementation process. RESULTS: Twenty-three community organizations recruited 294 community-dwelling elderly individuals in total at T1. Between T1 and T3, an attrition rate of 15.2% was obtained. CONCLUSIONS: Jog Your Mind is one of the only programs targeting cognition among older adults being offered in community settings by community practitioners. The protocol described was designed with a focus on maximizing broad generalizations of the results while achieving scientific rigor. It can serve as an example to guide future research aiming to evaluate health interventions under natural conditions.

[Le programme Participe-présent auprès d'aînés vivant avec une problématique de santé mentale ou des difficultés psychosociales affectant leur participation communautaire : résultats d'une étude pilote sur sa faisabilité].

Les aînés qui vivent avec des problèmes de santé mentale ou des difficultés psychosociales sont souvent isolés et marginalisés. Le programme Participe-présent a été développé dans le but de promouvoir leur participation communautaire. Les objectifs de cette étude étaient de 1) décrire la pertinence, l'acceptabilité, et la faisabilité du programme lors de sa mise à l'essai et 2) d'explorer les bienfaits et les effets à court-terme du programme pour les participants. Vingt-trois aînés, quatre animateurs et trois responsables provenant de quatre organismes ont participé à l'étude. Les aînés ont été satisfaits de leur expérience de participation au programme et ont rapporté une meilleure connaissance des ressources et une plus grande satisfaction à l'égard de leur vie sociale. Les animateurs et les responsables d'organismes ont souligné l'adaptabilité de Participe-présent aux besoins de leur clientèle et à leur contexte de pratique, et ont identifié les facilitateurs et les obstacles à sa mise en œuvre. D'autres études mèneront à des recommandations favorisant le succès de la mise en œuvre de Participe-présent dans différents contextes.

Deployment of professional expertise during a period of disruption: A phenomenological study of rehabilitation clinicians.

RATIONALE: Practice context is known to influence the deployment of competencies. The COVID-19 pandemic created a major disruption in many practice contexts. The objective was to understand the lived experience of rehabilitation clinicians during a major disruption of their practice context, namely, the COVID-19 pandemic. METHODS: We used a longitudinal phenomenological design. Eligible clinicians were occupational therapists (OT), physical therapists (PT), physiotherapy technologists (Phys T.), speech-language pathologists (S-LP) and audiologists (AUD), working in the same rehabilitation workplace for at least 2 years before March 2020 (the pandemic). Clinicians who were reassigned to roles outside the field of rehabilitation were excluded. We conducted individual online interviews using a guide developed by the team with expertise and knowledge of the phenomenon. An interpretative phenomenological analysis was carried out. Results were discussed until the research team reached a consensus. RESULTS: A total of 32 clinicians participated in the study (12 OT, 5 PT, 5 Phys T., 7 S-LP, 3 AUD), working with a variety of clienteles and work settings, for an average of 11.7 ± 7.6 years in the same practice setting. A wide range of emotions (e.g. anger, sadness, guilt, fear, pride) reflected clinicians' experience during disruption. Professional expertise was perceived as being enhanced by disruption as clinicians stepped out of their comfort zone; this encouraged reflective practice and a recognition of the need to be more explicit about their decision-making process. Collaboration with colleagues was perceived as key for effective coping and deployment of adaptative expertise. CONCLUSIONS: A disruption in the practice context may have positive effects on professional expertise through the mobilization of reflective practice.

Cognitive Health Promotion Program for Community-Dwelling Seniors: Who Are We Reaching?

This exploratory study examines the reach of Jog Your Mind, a multifactorial community-based program promoting cognitive vitality among seniors with no known cognitive impairment. The aim was to determine whether the program successfully reached its target population and to compare the characteristics of participants (sociodemographic, health, lifestyle, attitudes, and cognitive profile) with the general population of seniors. Twenty-three community organizations recruited 294 community-dwelling seniors willing to participate in the program. Descriptive analyses revealed that the participants were mostly Canadian-born educated women living alone. Participants' health profile and lifestyle behaviors were fairly similar to those of seniors in Québec and Canada. A large proportion of the participants were concerned about their memory. These results suggest that the program did not attract many hard-to-reach members of the population and reached seniors who may have had some cognitive challenges. Cues to action for improving the reach of cognitive health promotion programs are discussed.

Implementing a community-based falls-prevention program: from drawing board to reality.

Several studies have demonstrated the efficacy of falls-prevention programs designed for community-dwelling seniors using randomized designs. However, little is known about the feasibility of implementing these programs under natural conditions and about the success of these programs when delivered under such conditions. The objectives of this paper are to (a) describe a multifactorial falls-prevention program (called Stand Up!) designed for independent community-dwelling seniors and (b) present the results of an analysis of the practicability of implementing this program in community-based settings. The program was implemented in the context of an effectiveness study in 10 community-based organizations in the Montreal metropolitan area. Data pertaining to the reach and delivery of the program as well as participation level show that a falls-prevention program addressing multiple risk factors can be successfully implemented in community-based settings.

Development and validation of a French Canadian version of the Falls Behavioral (FaB) Scale.

PURPOSE: To develop a French Canadian version of the Falls Behavioral (FaB) Scale and examine its psychometric properties. METHODS: The FaB was adapted in French Canadian (FaB-FC) and validated according to standard guidelines for cross-cultural adaptation of questionnaires. The internal consistency and construct validity of the FaB-FC were studied among 64 community-dwelling adults aged 60 and over. The concurrent validity and test-retest reliability of the FaB-FC were respectively examined among subsamples including 31 bilingual and 33 unilingual participants. RESULTS: The FaB-FC showed good concurrent validity with the original FaB (ICC2 = 0.94; 0.87-0.97), as well as good test-retest reliability (ICC2 = 0.94; 0.88-0.97). The FaB-FC also demonstrated high internal consistency (α = 0.91). Moreover, analyses showed significant associations of the FaB-FC scores with fear of falling and balance confidence scores, attesting to its construct validity. CONCLUSION: This study provides evidence that the FaB-FC has sound psychometric properties. Since falls are associated with multiple risk factors, including behavioral factors, the FaB-FC is undoubtedly a relevant assessment tool for clinicians and researchers working toward fall prevention among French-speaking community-dwelling seniors. IMPLICATIONS FOR REHABILITATION: Fall-related behaviors should be addressed in the assessment of community-dwelling seniors' fall risks. Like the original FaB, the French Canadian version of the tool (FaB-FC) is valid and reliable for assessing fall-related behaviors. The FaB-FC is a relevant complementary assessment tool for identifying seniors at risk for falls. The FaB-FC could also be useful in guiding fall prevention interventions and measuring the impact of these interventions on seniors' behaviors.

[An ecological perspective on the determinants of the cognitive vitality of seniors]. / Perspective écologique sur les déterminants de la vitalité cognitive des aînés.

Cognitive aging is a heterogeneous reality among the senior population. Studies have recently identified certain factors that may contribute to maintaining the cognitive health of seniors. To date, these research studies have primarily focused on individual determinants, namely: health conditions and lifestyle habits. A review of the literature was conducted in order to explore the socio-environmental factors that may influence the cognitive vitality of seniors. This review demonstrates that studies that have examined this potential link are very rare. Only the type and socioeconomic level of the neighbourhood of the residence, as well as the size of the social network, were identified as influential factors. However, studies have shown that the environment could modulate certain lifestyle habits which, in turn, can influence cognition. This article uses an ecological approach to illustrate individual and socio-environmental targets for the promotion of the cognitive health of seniors.

The role of social reinforcement in the maintenance of short-term effects after a self-management intervention for frail housebound seniors with arthritis.

Following the program I'm Taking Charge of My Arthritis!, study participants reported fewer functional limitations, less helplessness, and better coping effectiveness than did controls. This study examined the maintenance of these effects and the role of social reinforcement in maintaining benefits eight months post-intervention. The study collected information (1) at baseline (n=125); (2) two months later, before randomization (pre-intervention); (3) two months post-randomization (post-intervention 1); and (4) ten months post-randomization (post-intervention 2) (n=80). We conducted a randomized controlled trial comparing three groups: a control group, intervention group without social reinforcement, and intervention group with social reinforcement after the program. A multilevel analysis revealed that intervention participants with social reinforcement following the program continued to report significantly fewer functional limitations and greater coping effectiveness compared to intervention group participants without social reinforcement. This research provides preliminary evidence for the value of additional contact with frail housebound seniors post-intervention for maintaining the intervention benefits.

Evidence of the psychometric qualities of a simplified version of the Activities-specific Balance Confidence scale for community-dwelling seniors.

OBJECTIVE: To evaluate the validity, reliability, and item hierarchy of a modified version of the Activities-specific Balance Confidence (ABC) scale using an item-response theory framework and integrating modifications aimed at increasing user-friendliness and promoting better congruence of the scale with public health falls prevention strategies. DESIGN: Cross-sectional study. SETTING: Community-based. PARTICIPANTS: Two hundred community-dwelling seniors involved in an effectiveness study of a falls prevention program. Participants were recruited by community-based organizations. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Balance confidence. RESULTS: The modified ABC scale (called ABC-Simplified [ABC-S] scale) has high internal consistency (reliability index, .86) and good convergent validity (statistically significant associations with perceived balance; performances on the one-leg stance, tandem stance, tandem walking, functional reach, and lateral reach [on the right side] tests; fear of falling; and occurrence of falls in the previous 12 mo). Analyses also showed differing degrees of difficulty across items, allowing for a determination of the scale's item hierarchy. CONCLUSIONS: The ABC-S scale is a valid and reliable measure for the assessment of balance confidence among community-dwelling seniors. The fact that this measure was validated with high-functioning seniors makes it particularly well-suited for identifying community-dwelling seniors who are beginning to lose confidence in their balance and who could benefit from community falls prevention programs.

Moving forward in fall prevention: an intervention to improve balance among older adults in real-world settings.

OBJECTIVES: We investigated the effectiveness of a group-based exercise intervention to improve balancing ability among older adults delivered in natural settings by staff in local community organizations. METHODS: The main component of the intervention consisted of biweekly group-based exercise sessions conducted over 12 weeks by a professional, coupled with home-based exercises. In a quasiexperimental design, 10 community organizations working with older adults offered the intervention to groups of 5 to 15 persons concerned about falls, while 7 organizations recruited similar groups to participate in the control arm of the study. Participants (98 experimental and 102 control) underwent balance assessments by a physiotherapist at registration and 3 months later. RESULTS: Eighty-nine percent of participants attended the 3-month measurement session (n=177). A linear regression analysis showed that after adjusting for baseline levels of balance and demographic and health characteristics, the intervention significantly improved static balance and mobility. CONCLUSION: Structured, group-based exercise programs offered by community organizations in natural settings can successfully increase balancing ability among community-dwelling older adults concerned about falls.