Health Mediating Effects of the Well Elderly Program

描述（由申请人提供）：以往的理论和研究表明，参与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，我们的研究小组完成的先前R01拨款表明，基于活动的干预（健康老年人干预）减少了低收入，种族多样化的老年人中各种健康相关参数的下降。在目前提出的为期四年的项目中，我们的目标是复制我们之前的结果，同时检查其积极影响的中介机制。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衰老结果的过程事件的重要新信息。

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.