Texercise Select: Building an Evidence-Based Program in your own backyard Doris Howell, MPH Texas...
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![Page 1: Texercise Select: Building an Evidence-Based Program in your own backyard Doris Howell, MPH Texas A&M Program on Healthy Aging Cindy Quinn Texas A&M Program.](https://reader035.fdocuments.us/reader035/viewer/2022070409/56649e915503460f94b9678a/html5/thumbnails/1.jpg)
Texercise Select: Building an Evidence-Based Program in
your own backyardDoris Howell, MPH
Texas A&M Program on Healthy AgingCindy Quinn
Texas A&M Program on Healthy Aging
Aging in Texas Conference 2015
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Acknowledgement
The evaluation of the Texercise program was funded through the Texas Department of Aging and Disability Services and completed through a partnership between the Texas A&M Health Science Center’s Program on Healthy Aging and the Scott & White Healthcare Community Research Center for Senior Health.
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Background
• Lifestyle behaviors including physical activity are seen as key to healthy aging and well-being
• Increasing number of evidence-based programs
• Yet, a concern with program dissemination, costs and sustainability
What can we learn from practice-based
programs?
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Purpose
• Introduce Texercise Select including example of program tools
• Examine effectiveness of 2012/2013 Texercise Select study on lifestyle behaviors, mental health outcomes, and physical functioning
• Discuss conclusions
• Review current and future
steps
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Texercise Classic
• 12 week program• Community Cheerleader• 1 time a week• 12 week Daily Fitness logs and Pledge sheet
“No fancy gear, no health club dues – just a fun,practical guide to looking and feeling your best.”
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Texercise Materials
Handbook DVD Pedometers Exercise bands Fact sheets
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Texercise Select: Formation
September 2012 – August 2013 Implementation of Texercise Select for evaluation
September/October 2012 Creation of Texercise Select structured program incorporating behavioral change principles
September 2012 Texas A&M Health Science Center awarded RFI to evaluate Texercise program
2010/2011 DADS seeking evidence-based status for existing program
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Texercise Select: Program Components
Participant Engagement• Physical
activity 30-45 min
• Education focusing on physical activity and nutrition topics
Trained Facilitators• Classes
led by at least one trained facilitator
Program Length• 12 Week
Program-10 weeks of classes
• 2 x/week for 90 min each
Potential Benefits of Participation• Increased self-
efficacy (pre/post)
• Improved physical activity and nutrition behaviors
• Improved mobility (TUG)
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Texercise Select: Program Component Examples
Two-Step Action Plan
Texercises
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Texercise Select: Two-Step Action Plan
• Participants set two (one physical activity and one nutrition based) broad goals
• Each week they set a two-step action plan, a task that they can accomplish in one week’s time that helps them towards their broader 10 week goals.
• Step 1 is what task they wish to do that week
• Step 2 is how often they will do that task within the week
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Texercise Select: Texercises
• Facilitators lead participants through a series of exercises for 30-45 minutes.
• Exercises focus on improving endurance, strength, balance and flexibility
Warm-up/
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Study Methods• Participants completed assessments at baseline
and the 10-week follow-up • Multiple domains assessed including physical
activity, eating behaviors, physical functioning, and quality of life with standard instruments
• Percent improvement and effect sizes were calculated to compare study results with other programs
• See papers for more detailed analyses
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Study Characteristics
• Program Infrastructureo 4 training sessions-29 trained facilitatorso 14 workshopso 7 senior centers, 4 multipurpose facilities, 2 faith-based organizations, 1
senior housing facility
• Workshop Participantso Older: 74 years old o Female: 85% female o Non-Hispanic white : 93%o Multiple chronic conditions :
2.4 conditions
• Class attendanceo On average, attended 12 of the
20 workshop sessions
• 220 older adult enrollees with 127 completing the post test
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Physical Activity and Nutrition*
Variable Baseline Mean
Post-Tx Mean
Improvement
Effect Size
Aerobic PA 3.9 4.6 16.3% .64
PA Confidence 6.1 7.4 18.9% .38
Fruit/Veggie consumption
3.3 3.8 12.7% .31
Dietary behavior confidence
7.6 8.2 7.4% .21
Social Support for Lifestyle Behaviors
9.0 11.4 26.7% .45
*significant at p<.05
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Physical Functioning and Quality of Life*
Variable Baseline Mean
Post-Tx Mean
Improvement
Effect Size
Timed get up and go
12.9 s 11.7s 10.8% .27
General health status
2.9 2.8 7.2% .24
Unhealthy physical /mental health days
7.7 4.9 31.6% .24
Days Limited from usual activity
2.2 1.4 39.6% .17
*significant at p<.05
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Texercise Select: Program Products
Structured Program Implementation Manual
Facilitator Training Protocol
Review of Texercise History and Reach
Report on Stakeholders Perceptions
Published Manuscript on Outcomes
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Current Study• Study groups in Denton and Montgomery County• Accelerometers and TUG testing• Intervention and non intervention groups • Quality of life measures
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Texercise Select: Feedback
“(Texercise is) a win- win for everyone; the older adults are happier and healthier and have a better quality of life and there is less need for the costly services.”
“Great program!! I now carry a pedometer and walk at least 6,000 steps a day. And I try to eat 5 fruits and veggies a day. Plus the exercises are very appropriate for seniors. Thank you for hosting this program!”
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Future Directions
• Online Training• Achieve highest EBP
criteria• Offer program in
additional communities throughout Texas
• Offer Texercise program as complementary to other evidence-based programs/bundling (AMOB, CDSMP, DSMP, etc.)
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Conclusions
• A multi-component lifestyle program can have many positive effects, with some variability across domains
• Program manualization and structured training are important for ensuring lifestyle programs are delivered with fidelity.
• Important to reduce barriers to full program participation
• Widespread dissemination requires capitalizing on and expanding traditional delivery systems
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Resources• Ory, M. G., Smith, M. L., Jiang, L., Howell, D., Chen, S., Pulczinski, J. C., & Stevens, A.
B. (2014). Texercise effectiveness: Impacts on physical functioning and quality of life. Journal of Aging and Physical Activity, (in-press).
• Ory, M. G., Smith, M. L., Howell, D., Zollinger, A., Quinn, C., Swierc, S. M., & Stevens, A. B. (2014). The conversion of a practice-based lifestyle enhancement program into a formalized, testable program: From Texercise Classic to Texercise Select. Frontiers in Public Health Education and Promotion, (in-press).
• Ory MG, Smith MLS, Howell D, Zollinger A, Quinn C, Swierc S, and Stevens A. The Establishment and Evolution of Texercise: A Lifestyle Enhancement Program for Older Texans. Frontiers in Public Health Education and Promotion. In Review.
• Stevens AB, Thiel S, Thorud JL, Smith ML, Howell D, Cargill J, Swierc SM, and Ory MG. Increasing the Availability of Physical Activity Programs for Older Adults: Lessons Learned from Texercise Stakeholders. Journal of Aging and Physical Activity. In Review.
• Smith ML, Ory MG, Jiang L, Howell D, Chen S, Pulczinski J, Swierc S, and Stevens AB. Texercise Select Effectiveness: An Examination of Physical Activity and Nutrition Outcomes. Trans Behav Med. Provisionally Accepted 2014
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Questions