Health Mediating Effects of the Well Elderly Program

描述(由申请人提供)：以前的理论和研究表明，参加有意义的活动是提高老年人健康相关生活质量的重要因素。与这一重点一致的是，我们的研究小组之前完成的R01赠款表明，基于活动的干预(Well老年人干预)减少了低收入、种族多元化老年人中各种与健康相关的参数的下降。在目前提议的为期四年的项目中，我们的目标是复制我们以前的成果，同时审查对其积极影响负责的调解机制。这项研究的结果将提供关于以活动为基础的生活方式干预影响关键老龄化结果的过程事件的重要新信息。 在这项拟议的研究中，从洛杉矶市区不同地点招募的440名不同种族的老年人将参加一项包含半交叉设计成分的随机试验。在他们参与研究的第一个或第二个六个月阶段，每个受试者都将接受基于生活方式的干预，旨在改善各种老龄化结果。在18-24个月的时间间隔内，老年人将在4-5个时间点完成对健康活动、应对、社会支持、感知控制、与压力相关的生物标记物、感知的身体健康、心理社会健康和认知功能的评估，以测试干预的有效性，并记录导致其效果的过程机制。 这项研究有三个长期目标。首先，它将为我国快速增长的老年人口提供更有效的医疗保健服务，从而实现老年人的一项主要政策优先事项，即防止他们的健康和独立性下降。其次，它将产生有关活动如何影响老龄化结果的新信息。尽管之前的研究表明，活动模式与重要的衰老结果一致相关，但人们对活动引发的心理和生物变化如何结合起来促进成功衰老知之甚少。拟议的研究将缩小这一知识差距。第三，由于研究地点的种族多样性很大，该项目将产生对少数族裔老年人普遍适用的结果。这一结果很重要，因为我们国家老龄化人口的种族多样性日益增加。

DESCRIPTION (provided by applicant): Previous theory and research implicates participation in meaningful activity as an important factor in enhancing older adults' health-related quality of life. Consistent with this emphasis, a previous R01 grant completed by our study group demonstrated that an activity-based intervention (the Well Elderly Intervention) reduced declines in a wide variety of health-related parameters among low income, ethnically diverse elders. In the currently proposed four-year project, we aim to replicate our previous result while simultaneously examining the mediating mechanisms responsible for its positive effects. The outcomes of this study will provide important new information about the process events by which activity-based lifestyle interventions influence key aging outcomes. In the proposed study, 440 ethnically diverse elders recruited from a variety of sites in the urban Los Angeles area will participate in a randomized experiment containing a semi-crossover design component. Within either the first or second six-month phase of their study involvement, each subject will receive a lifestyle-based intervention designed to improve a variety of aging outcomes. At 4-5 points in time over an 18-24 month interval, elders will complete assessments of healthy activity, coping, social support, perceived control, stress-related biomarkers, perceived physical health, psychosocial well-being, and cognitive functioning to test the efficacy of the intervention and document the process mechanisms responsible for its effects. The study has three long-term objectives. First, it will lead to more effective health care services for our nation's rapidly growing elderly population, thereby fulfilling a major policy priority for older adults, namely, preventing declines in their health and independence. Second, it will generate new information regarding how activity influences aging outcomes. Although previous research has shown that activity patterns consistently relate to important aging outcomes, little is known about how the psychological and biological changes that stem from activities combine to promote successful aging. The proposed study will reduce this knowledge gap. Third, due to the significant ethnic diversity at the study sites, the project will produce results that generalize to minority elders. This outcome is important due to the increasing ethnic diversity of our nation's aging population.