Despite accumulating evidence of cardiovascular benefits associated with physical activity in older people, sedentary behavior increases with age. Few physical activity research studies focus on underactive adults 75 years and older. In-depth qualitative interviews using open-ended questions explored perceptions, motivations, and barriers to physical activity in 33 previously sedentary or underactive adults age > or =75. Data were analyzed using the NUD*IST (Non-numerical, Unstructured Data Indexing, Searching, and Theorizing) qualitative analysis program. Participants saw sedentary behavior as harmful, considered themselves relatively active, were unsure of amounts of physical activity to do, and welcomed more physical activity information from their doctors. Motivations included health, independence, family, and appearances. Barriers were poor health, lack of time, aging, and adverse environments. Results suggest that people continue to be interested in physical activity as they age, but some misperceptions about physical activity exist. Even with health problems and age, physical activity counseling by doctors is valued and considered helpful by this age group.

Objectives We evaluated a community-based, translational lifestyle program to reduce diabetes risk in lower–socioeconomic status (SES) and ethnic minority adults. Methods Through an academic–public health department partnership, community-dwelling adults at risk for diabetes were randomly assigned to individualized lifestyle counseling delivered primarily via telephone by health department counselors or a wait-list control group. Primary outcomes (6 and 12 months) were fasting glucose level, triglycerides, high- and low-density lipoprotein cholesterol, weight, waist circumference, and systolic blood pressure. Secondary outcomes included diet, physical activity, and health-related quality of life. Results Of the 230 participants, study retention was 92%. The 6-month group differences for weight and triglycerides were significant. The intervention group lost 2 pounds more than did the control group (P = .03) and had decreased triglyceride levels (difference in change, 23 mg/dL; P = .02). At 6 months, the intervention group consumed 7.7 fewer grams per day of fat (P = .05) and more fruits and vegetables (P = .02) than did control participants. Conclusions Despite challenges designing effective translational interventions for lower-SES and minority communities, this program modestly improved some diabetes risk factors. Thus, individualized, telephone-based models may be a promising alternative to group-based interventions.

Providing diabetes health education and screening prior to study recruitment may help overcome barriers to research participation in underserved communities, thus helping address difficulties recruiting minority and older populations into research, particularly research pertaining to chronic disease risk factors.

Person-centered care (PCC) has emerged over the last several decades as the benchmark for providing quality care for diverse populations, including older adults with multiple chronic conditions that affect daily life. This article critiques current conceptualizations of PCC, including the social work competencies recently developed by the Council on Social Work Education, finding that they do not fully incorporate certain key elements that would make them authentically person-centered. In addition to integrating traditional social work values and practice, social work's PCC should be grounded in the principles of classical Rogerian person-centered counseling and an expanded conceptualization of personhood that incorporates Kitwood's concepts for working with persons with dementia. Critically important in such a model of care is the relationship between the caring professional and the care recipient. This article recommends new social work competencies that incorporate both the relationship-building attitudes and skills needed to provide PCC that is authentically person-centered.