Literature DB >> 19254939

Confronting challenges in intervention research with ethnically diverse older adults: the USC Well Elderly II Trial.

Jeanne Jackson1, Deborah Mandel, Jeanine Blanchard, Mike Carlson, Barbara Cherry, Stanley Azen, Chih-Ping Chou, Maryalice Jordan-Marsh, Todd Forman, Brett White, Douglas Granger, Bob Knight, Florence Clark.   

Abstract

BACKGROUND: Community-dwelling older adults are at risk for declines in physical health, cognition, and psychosocial well-being. However, their enactment of active and health-promoting lifestyles can reduce such declines.
PURPOSE: The purpose of this article is to describe the USC Well Elderly II study, a randomized clinical trial designed to test the effectiveness of a healthy lifestyle program for elders, and document how various methodological challenges were addressed during the course of the trial.
METHODS: In the study, 460 ethnically diverse elders recruited from a variety of sites in the urban Los Angeles area were enrolled in a randomized experiment involving a crossover design component. Within either the first or second 6-month phase of their study involvement, each elder received a lifestyle intervention designed to improve a variety of aging outcomes. At 4-5 time points over an 18-24 month interval, the research participants were assessed on measures of healthy activity, coping, social support, perceived control, stress-related biomarkers, perceived physical health, psychosocial well-being, and cognitive functioning to test the effectiveness of the intervention and document the process mechanisms responsible for its effects.
RESULTS: The study protocol was successfully implemented, including the enrollment of study sites, the recruitment of 460 older adults, administration of the intervention, adherence to the plan for assessment, and establishment of a large computerized data base. LIMITATIONS: Methodological challenges were encountered in the areas of site recruitment, participant recruitment, testing, and intervention delivery.
CONCLUSIONS: The completion of clinical trials involving elders from numerous local sites requires careful oversight and anticipation of threats to the study design that stem from: (a) social situations that are particular to specific study sites; and (b) physical, functional, and social challenges pertaining to the elder population.

Entities:  

Mesh:

Year:  2009        PMID: 19254939      PMCID: PMC3073495          DOI: 10.1177/1740774508101191

Source DB:  PubMed          Journal:  Clin Trials        ISSN: 1740-7745            Impact factor:   2.486


  39 in total

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5.  Occupation in lifestyle redesign: the Well Elderly Study Occupational Therapy Program.

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Journal:  Am J Occup Ther       Date:  1998-05

6.  Outcomes of protocol-based and adaptation-based occupational therapy interventions for low-income elderly persons on a transitional unit.

Authors:  J Spencer; G Hersch; V Eschenfelder; J Fournet; M Murray-Gerzik
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8.  Cognitive and affective disorders in the elderly: a neuroendocrine study.

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Review 9.  How to get older people included in clinical studies.

Authors:  Miles D Witham; Marion E T McMurdo
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10.  What influences recruitment to randomised controlled trials? A review of trials funded by two UK funding agencies.

Authors:  Alison M McDonald; Rosemary C Knight; Marion K Campbell; Vikki A Entwistle; Adrian M Grant; Jonathan A Cook; Diana R Elbourne; David Francis; Jo Garcia; Ian Roberts; Claire Snowdon
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  16 in total

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2.  A model for the design and implementation of a participant recruitment registry for clinical studies of older adults.

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Review 3.  Occupational therapy for elderly. Evidence mapping of randomised controlled trials from 2004-2012.

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4.  Predictors of retention among African American and Hispanic older adult research participants in the Well Elderly 2 randomized controlled trial.

Authors:  Mike Carlson; Jeanne Jackson; Deborah Mandel; Jeanine Blanchard; Jess Holguin; Mei-Ying Lai; Abbey Marterella; Cheryl Vigen; Sarah Gleason; Claudia Lam; Stan Azen; Florence Clark
Journal:  J Appl Gerontol       Date:  2013-03-21

5.  Diurnal patterns and associations among salivary cortisol, DHEA and alpha-amylase in older adults.

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7.  Methodological challenges in physical activity research with older adults.

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8.  Predictors of computer use in community-dwelling, ethnically diverse older adults.

Authors:  Julie M Werner; Mike Carlson; Maryalice Jordan-Marsh; Florence Clark
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9.  Recruiting hospitalized Mexican American elder adults and caregivers: challenges and strategies.

Authors:  Janice D Crist; Maricruz R Ruiz; Oscar H Torres-Urquidy; Alice Pasvogel; Joseph T Hepworth
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10.  Cortisol diurnal patterns, associations with depressive symptoms, and the impact of intervention in older adults: results using modern robust methods aimed at dealing with low power due to violations of standard assumptions.

Authors:  Rand R Wilcox; Douglas A Granger; Sarah Szanton; Florence Clark
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