People reducing risk and improving strength through exercise, diet, and drug adherence (PRAISEDD): a case report on long-term single site adoption

Abstract

African-American and low-income older adults have heightened risk for cardiovascular disease (CVD). Culturally and socially congruent community-based programs can promote risk-reduction behaviors, including physical activity (PA), and can demonstrate durability. The purpose was to increase lifestyle PA and promote selfmanagement of CVD risk factors in a sample of at-risk older adults and to sustain a PA program within low-income housing. Exercise and education sessions were conducted three times/week for 12weeks. A community champion was trained to carry on the classes thereafter, with monthly inoculation visits by a nurse and exercise trainer. Outcome measures included attendance and CVD risk factor control. This ongoing community-based program, incorporating peer leadership, inoculation visits, and self-efficacy enhancement, has been sustained for over 3years with classes one to two times per week and routine attendance of about 12-18 residents. PRAISEDD demonstrates that a community-based PA program can be maintained using within-community leadership, periodic involvement of health care experts, and social support and self-efficacy enhancement. KEYWORDSPhysical activity, Cardiovascular disease, Community-based programs, African-American, Low-income INTRODUCTION African-American (AA) and low-income older adults are more likely to have hypertension, to be overweight or obese, and to have diabetes than their white counterparts, placing them at heightened risk for cardiovascular disease (CVD), stroke, myocardial infarction, peripheral vascular disease, and congestive heart failure [1]. These risk factors also commonly cluster together, and in African-Americans include combinations of obesity and hypertension (18 %), obesity, hypertension and hypercholesterolemia (13 %), or obesity, hypertension, hypercholesterolemia, and diabetes (10 %) [2], all posing significant threats to cardiovascular health in a large proportion of this population.

Involving Older Adults in Developing Physical Activity Interventions to Promote Engagement: a Literature Review

“…One case report is included, by Michael et al (2012), which reports on the phase of research following a cohort study with a single group, repeated measures design. The on-going research presented describes the development and influence of peer leadership at an exercise class, which followed a12-week pilot intervention.…”

“…The Stanford Healthy Neighborhood Discovery Tool Triangle Ystradgynlais Fitness 50+ project SMILE (So Much Improvement with a Little Exercise) programme Wheeling Walks Buman et al 2013Davies et al 2008Hickey et al 1996Reger-Nash et al 2003 Collaboration "Let's go for a walk!" "Exercise of LIFE" Ståhl et al 2008Sullivan-Marx et al 2011 Peer leadership Triangle Ystradgynlais Fitness 50+ project SMILE (So Much Improvement with a Little Exercise) programme PRAISEDD project Davies et al 2008Hickey et al 1996Michael et al 2012 Mentoring…”

“…Participants took over the running of the class six weeks after the pilot phase had begun. Sustainability was the focus of the follow-up work on the 'PRAISEDD' ('People Reducing Risk and Improving Strength Through Exercise, Diet and Drug Adherence') project (Michael et al 2012). An advanced practice nurse and an exercise trainer had led the 12-week, thrice weekly, pilot of hour-long group exercises.…”

Changing behavior throughout the life-course: Translating the success of aging research

“…Institutional buy-in, community leadership, and opportunities for booster sessions can help sustain programmatic efforts as well as the benefits participants receive from the intervention [35,36]. Behavioral interventions can have longer staying power when embedded within a multi-interventional approach that has supporting evidence-based policy and environmental strategies.…”