There is good evidence for the benefits of physical activity in old age. The majority of older people, however, is inactive, even though many are in the physical state to be active. Community-dwelling older people with multiple illnesses have a great potential to improve or maintain their health by lifestyle changes. This could also affect the onset of institutionalization and care-dependency. Up to date, however, there is a lack of theory- and evidence-based interventions for community-dwelling older adults for changes in health behaviors.
PREFER II aimed at developing such targeted theory- and evidence-based intervention components, which sustainably support older people with multiple illnesses in changing their lifestyle. Many studies provide evidence for the importance of physical activity as a central mediator of health. This means that determinants of physical activity such as personal resources constitute an ideal target for interventions.
Within PREFER II, particularly positive views on aging, attitudes, self-efficacy, planning and self-monitoring were targeted in the intervention. These factors are important both for motivating older people with multiple illnesses to change their health behaviors and to translate such motivation into behavior.
The primary goal of the study was to develop and evaluate intervention components that aim at motivating older adults to become active and to help them initiating and maintaining behavior change. Intervention effects were evaluated in a randomized controlled trial. In addition, participatory workshops with experts for health communication, multiplicators and users of health promotion measures ensured the sustaining usability of the intervention components.
PREFER II was a cooperation project between the DZA (German Centre of Gerontology) and the Department of Health Psychology at Freie Universität Berlin. In addition, we cooperated with the Federal Association of Senior Citizens’ Organizations (BAGSO) and the German Olympic Sports Federation (DOSB).
Here are some results from PREFER II:
- The participants of the intervention group to increase physical activity combined with an intervention tool to prompt positive views on aging rated older adults as more optimistic and more satisfied 6 weeks after the group session. Participants who improved their views on aging increased their physical activity levels by 45 minutes per week over the following 7 months. Thus, views on aging changed in a positive direction and thereby promoted a healthy lifestyle. (Wolff et al., 2014)
- The participants of the active control group to increase volunteering increased their volunteering levels by 84 minutes per week 6 weeks after the group. The other groups maintained their volunteering levels in this time interval. As volunteering is known for its positive effects on health and well-being, this is a promising result of the study. (Warner et al., 2014)
- Wolff, J. K., Warner, L. M., Ziegelmann, J. P., & Wurm, S. (2014). What do targeting positive views on ageing add to a physical activity intervention in older adults? Results from a randomised controlled trial. Psychology & Health, 29(8), 915-32. doi: 10.1080/08870446.2014.896464
- Warner, L. M., Wolff, J. K., Ziegelmann, J. P., & Wurm, S. (2014). A randomized controlled trial to promote volunteering in older adults. Psychology and Aging, 29(4) 757-763. doi: 10.1037/a0036486
Design and Sample
In PREFER II several modules for promoting physical activity were developed and evaluated in a randomized controlled trial (RCT).
In the study participants’ health status, physical activity and attitudes were assessed using subjective and objective measures.
In addition to the RCT, the perspective of users and multiplicators of health promotion measures will be integrated in two participatory workshops.
The study consists of three groups: an intervention group to promote physical activity (n = 131), an active control group to promote volunteering (n = 103) and a passive control group (n = 76). The intervention group to promote physical activity is additionally divided into a subsample receiving an intervention component to prompt positive views on aging and an subsample without this component. Inclusion criteria are being community-dwelling, age 64 or older and suffering from at least two chronic conditions.
The studie was planned during 2011 and conducted in 2012 and 2013. Participants took part in five measurement occasions spread over about 15 month. The intervention group and active control group came to one group intervention session on average five weeks after the first assessment. The passive control group received information material about physical activity and volunteering after the forth assessment.