The Development and Implementation of a Peer-Led Diet and Exercise Intervention in Older Urban Dwelling Veterans with Dysmobility

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Over the next ten years the share of Veterans age 65+ years will increase to over 50% of the total Veteran population. The ability to safely maintain mobility with aging is critical. Older Veterans with multiple chronic health conditions are more likely to experience mobility decline and our preliminary data show they also have decreased diet quality when compared to older non-Veterans. They further report that their reduced physical activity and poor dietary quality are related to a lack of access to exercise facilities, poor habits, and lack of motivation or boredom. While a multitude of interventions have attempted to address poor diet and physical inactivity in older adult; most have utilized resource-intensive professionally led diet OR exercise interventions, and few have focused on the unique needs of older Veterans. Peer support offers a potentially low-cost, easily scalable approach to encourage long-term dietary and physical activity change. In this proposal we seek to develop and pilot a 12-week peer-led lifestyle intervention that targets older Veterans with multiple chronic health conditions and dysmobility, in two diverse urban areas with a high percentage of underrepresented minority Veteran populations (Baltimore, MD and San Antonio, TX). We will accomplish this through two specific aims. Aim 1: Develop a theory-driven, peer-led nutrition and exercise intervention tailored for older Veterans with dysmobility. Aim 2: Determine the feasibility and acceptability of the peer-led intervention, to asses reach (recruitment, retention), adoption (satisfaction, perceived utility, attendance, engagement) and implementation (fidelity of intervention); as well as the estimated magnitude and potential impact on selected outcomes (i.e diet quality and mobility) in older 20 older Veterans with dysmobility and multiple chronic health conditions (N=10/site). Our results from Aim 2 will be compared to Gerofit data to determine long term potential of the project. With the successful development and pilot of this intervention we will be positioned to submit a multisite Rehabilitation and Research and Development (RR&D) Merit application focused on the use of peer-led interventions to improve long-term compliance to lifestyle intervention in older Veterans with multiple chronic conditions.