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Biomedical subjects

Barbara Resnick

Publications and source records attributed to Barbara Resnick.

At least 37 records · Page 2Linked to original sources
PubMed2004

Enhancing treatment fidelity in health behavior change studies: best practices and recommendations from the NIH Behavior Change Consortium.

Treatment fidelity refers to the methodological strategies used to monitor and enhance the reliability and validity of behavioral interventions. This article describes a multisite effort by the Treatment Fidelity Workgroup of the National Institutes of Health Behavior Change Consortium (BCC) to identify treatment fidelity concepts and strategies in health behavior intervention research. The work group reviewed treatment fidelity practices in the research literature, identified techniques used within the BCC, and developed recommendations for incorporating these practices more consistently. The recommendations cover study design, provider training, treatment delivery, treatment receipt, and enactment of treatment skills. Funding agencies, reviewers, and journal editors are encouraged to make treatment fidelity a standard part of the conduct and evaluation of health behavior intervention research.

Benchmarking↗
PubMed2004

Reliability and validity of the self-efficacy for exercise and outcome expectations for exercise scales with minority older adults.

Older African Americans and Latinos tend to exercise less than older Whites and are more likely to have chronic diseases that could benefit from exercise. Measurement of self-efficacy of exercise and exercise outcome expectations in this older population is required if exercise is to be monitored carefully and enhanced in this population. The purpose of this study was to test the reliability and validity of the Self-Efficacy for Exercise Scale (SEE) and Outcome Expectations for Exercise Scale (OEE) in a sample of African American and Latino older adults. A total of 166 individuals, 32 males (19%) and 134 females (81%) with an average age of 72.8 +/- 8.4 years participated in the study. The SEE and OEE scales were completed using face-to-face interviews. There was evidence of internal consistency for both scales with alphas of .89 and .90 for the SEE scale and .72 and .88 for the OEE scale. There was some evidence of validity for both scales based on confirmatory factor analysis and hypothesis testing, because factor loadings were greater than .50 in all but two items in the OEE, and there were significant relationships between self-efficacy and outcome expectations and exercise behavior at all testing time-points. The measurement models showed a fair fit of the data to the models. The study provided some evidence for the reliability and validity of the SEE and OEE when used with minority older adults, and it provides some guidelines for future scale revisions and use.

Black or African American↗
PubMed2004

A longitudinal analysis of efficacy expectations and exercise in older adults.

The purpose of this study was to consider the longitudinal changes in self-efficacy and outcome expectations for exercise and the impact of these variables on maintaining regular exercise over a 4-year period in a group of older adults living in a continuing care retirement community. There were 78 individuals who completed all four surveys. The participants had at least a high school education, and the majority were Caucasian (99%), female (83%) and either widowed or never married (80%). The mean age of the participants was 84.4+/-5.1 years. Based on repeated measure analysis of covariance, controlling for mental and physical health, there was not a statistically significant difference in self-efficacy expectations (F = 2.0, p > .05) or outcome expectations (F = 2.2, p > .05) over time. There was a statistically significant decrease in exercise over time (F = 9.9, p < .05). Using path analysis it was demonstrated that self-efficacy expectations, outcome expectations, and physical health directly and indirectly influenced maintenance of regular exercise. Age, gender, and mental health had a limited and inconsistent influence on maintenance of exercise. Future research and clinical work should focus on developing and testing interventions that strengthen both self-efficacy and positive outcome expectations in older adults to facilitate maintenance of exercise behavior over time.

Aged↗
PubMed2004

Pilot testing the Readiness Estimate and Deployability Index Revised for Air Force Nurses.

The Readiness Estimate and Deployability Index Revised for Air Force Nurses (READI-R-AFN) was derived from modifications of Reineck's Readiness Instrument. Reliability and validity of the READI-R-AFN was estimated on completed questionnaires of 181 active duty Air Force nurses. The READI-R-AFN was evaluated based on item analysis, internal consistency (alpha coefficient, >0.70), confirmatory factor analysis with structural equation modeling, and hypothesis testing. The findings were supported by Flannery's model of stress resistance. There was evidence of reliability and validity of the 83-item READI-R-AFN based on internal consistency (alpha, 0.80-0.96), structural equation modeling, and hypothesis testing. The original hypothesized six dimensions were retained.

Adult↗
PubMed2004

Implementing the Falls Clinical Practice Guidelines in long-term care: an exemplary model.

This was a descriptive case study of the implementation of the Falls Clinical Practice Guideline (Falls CPG), developed by the American Medical Directors Association (AMDA). Utilizing the Falls CPG, which provides information on falls risk assessment, evaluation, and management, a series of 4 forms were developed to help staff in the implementation process. A four step approach was then used to implement the Falls CPG within the facility. Individual and cumulative evaluations of all falls were considered as well as the outcomes of the implementation process. Over the 12 months post implementation, a total of 237 falls occurred, with 52 individuals falling. Based on chart review, there was evidence that the Falls CPG was being implemented as intended. Following the implementation process there was a decrease in the number of monthly falls from an average of 31 falls per month in the 6 months prior to implementation down to 14 (first month of implementation), and 30 in the 12 months post implementation. The experience within this facility demonstrated the utility of the Falls CPG as a guide to development and implementation of a falls prevention program for long term care facilities.

Accidental Falls↗
PubMed2003

Health promotion practices of older adults: testing an individualized approach.

The world's population is getting older. Consequently, the World Health Organization has focused efforts on health promotion activities for these individuals. The purpose of this study was to explore the factors that influence health promotion behaviours and to describe the impact of an individualized approach to decision-making with regard to health promotion activities in a group of older adults living in a continuing care retirement community. The study used a single group pre- and post-test design that included a total of 134 residents. Descriptive statistics were used to describe the sample. A McNemar test was used to compare health promotion activities pre- and postintervention. Regression analysis was used to consider the factors that influenced health promotion activities in these individuals. The survey included questions about health promotion activities and both mental and physical health status. In the year between baseline and follow-up testing a geriatric nurse practitioner provided both formal and informal education about health promotion activities. With the exception of monitoring dietary fat intake, there was not a statistically significant difference in primary and secondary health promotion behaviours pre- and post-testing. There was, however, a decline in smoking and alcohol use, an increase in physical activity and a slight decline in the percentage of older adults who engaged in cancer screenings. An individualized approach may be a useful way to help older adults make health decisions and engage in those health promotion activities that will increase their quality of life.

Aged↗
PubMed2003

The impact of alcohol use in community-dwelling older adults.

The purpose of this study was to explore the use of alcohol in community-dwelling older adults and to consider differences in physical and mental health, function, cognitive status, and social supports between those who drink minimal (1 to 3 glasses weekly), moderate (4 to 7 glasses weekly), or no alcohol. A total of 3305 older adults with a mean age of 81.6 -/+ 6.0 participated in the study. Twenty-two percent (n = 709) of the participants had 1 to 3 drinks weekly, only 1% (n = 18) reported 4 to 7 drinks weekly, and none of the participants admitted to 8 or more drinks. There was no difference in drinking behavior with regard to age (F = 1.1, p >.05) or social supports (F =.39, p >.05). There was a difference in drinking behavior with regard to physical health (F = 4.9, p <.05), functional status (F = 7.7, p <.05), cognitive status (F = 11.8, p <.05), and mental health (F = 6.9, p <.05). Health care providers should use an individualized approach to alcohol use in older adults and help these individuals establish, as appropriate, safe drinking habits that will augment health and quality of life.

Activities of Daily Living↗
PubMed2003

Alcohol use in a continuing care retirement community.

The purpose of this study was to explore alcohol use among older adults living in a continuing care retirement community (CCRC) and to consider differences in overall health, number of chronic illnesses, falls, age, and exercise behavior between those who drink moderately versus those who do not. A one-time face-to-face interview was conducted with a total of 316 residents living in an urban CCRC in the northeast. The participants were 86.6 6 6.3 years of age, and the majority were women (79%), unmarried (75%), White (9%), and middle to upper socioeconomic status (100%). The majority of these individuals (63%) drank moderately, consuming at least one drink daily. No difference was found between men's and women's drinking behaviors (chi 2 = .47, p > .05). Adults who drank moderately were older (F = 8.7, p < .05), more likely to exercise regularly (chi 2 = 27, p < .05), and were more likely to have had a fall (F = 3.7, p < .05). No statistically significant difference was found between the groups related to perceptions of overall health, number of chronic illnesses, number of medications, overall or number of medications that interact with alcohol, or cognitive status. Although not statistically significant, a greater percentage of individuals who drink moderately had fractures (12%) when compared to the percentage of individuals who do not drink at least moderately (7%). Recognizing both benefits and risks to alcohol use in older adults suggests that an individual approach to educating these individuals about their use of alcohol should be conducted.

Accidental Falls↗
PubMed2003

A Model of Computer-Mediated Social Support Among Older Adults.

Internet use has been growing exponentially, and older adults are one of the fastest growing online user groups. Due to the various physiological and psychosocial changes associated with aging, older adults are prone to social isolation. The Internet and e-mail may serve as a new source of support for older adults by connecting them with friends and family members, as well as providing useful information. In this study, based on prior research findings in sociology, communications, and informatics, A Model of Computer-Mediated Social Support Among Older Adults that explains relationships among a computer-mediated social network (CMSN), perceived functional social support from that network, and psychological well-being of community dwelling older adults was proposed. The primary purpose of this study was to test this model using Structural Equation Modeling (SEM).

Aged↗
PubMed2002

Evaluating the components of the Exercise Plus Program: rationale, theory and implementation.

Recovery following a hip fracture is facilitated by participation in regular exercise. Despite the benefits of exercise, it is difficult to get older adults to initiate and adhere to regular exercise programs. The Attribution Theory of Achievement Motivation suggests that an individual's future involvement in an activity is based on assessments of prior experience with the activity. Conversely, the Theory of Self-efficacy states that self-efficacy expectations and outcome expectations are not only influenced by behavior, but also by verbal encouragement, physiological sensations and exposure to role models or self-modeling. These expectations then determine the individual's willingness to initiate and engage in a given activity. Using a 2x2 factorial design, the primary aim of this study is to compare these two theories. The effectiveness of the Exercise Plus Program will be compared to the individual components of the program (Exercise Training and Plus components) on both self-efficacy and outcome expectations, exercise behavior, activity, and specific physical and psychological outcomes. A total of 240 older women post hip fracture will be recruited from five different acute care facilities. This study will add to current knowledge by examining the impact of a combined exercise training/social learning intervention approach versus either alone.

Exercise Therapy↗
PubMed2002

End-of-life treatment preferences among older adults: a nurse practitioner initiated intervention.

PURPOSE: To explore end-of-life treatment preferences (ELTP) among older adults and to test the impact of a nurse practitioner (NP) initiated intervention to facilitate the completion of ELTPs. DATA SOURCES: A descriptive study including 135 older adults living in a continuing care retirement community. CONCLUSIONS: The findings in this study suggest that the majority of older adults do not want life sustaining interventions at the end of life, but are willing to accept interventions that will keep them comfortable. ELTP can, however, change over time. An NP-initiated teaching intervention about advance directives and ELTP significantly increased the number of individuals who completed advance directive forms. IMPLICATIONS FOR PRACTICE: With the advancement of medical technology, various life-sustaining treatments are available at the end of life. Older adults should be encouraged to establish their ELTPs while they are physically and mentally able to do so. Health care providers should initiate discussions about ELTP at regular intervals (yearly) to assist older adults in participating in decisions about their end-of-life care.

Advance Directives↗
PubMed2002

The effect of social support on exercise behavior in older adults.

The purpose of this study was to test the relationship among social supports related to exercise (family, friends, and expert support), self-efficacy expectations, outcome expectations, and exercise behavior in a sample of older adults living in a continuing care retirement community. The sample included 74 older adults with a mean age of 85.6 +/- 5.5. Path analysis using Amos 4.0 was done. The model fit the data (chi-square = 4.6, df = 3, p = .21, normed fit index of .99, relative fit index of .98, and root mean square error of approximation of .08) and explained 53% of the variance in exercise behavior. Five of the seven hypothesized paths in the model were statistically significant. Friend support indirectly influenced exercise through self-efficacy and outcome expectations. This suggests interventions to improve exercise behavior in older adults should incorporate social supports to strengthen self-efficacy and outcome expectations related to exercise.

Aged↗
PubMed2002

Testing the effect of the WALC intervention on exercise adherence in older adults.

The purpose of this study was to test the feasibility of the WALC intervention (Walk; Address pain, fear, fatigue during exercise; Learn about exercise; Cue by self-modeling), and determine its effects on self-efficacy and outcome expectations, exercise activity and free living activity, physical and mental health status, and falls and fall-related injuries. A total of 17 sedentary older women with a mean age of 88 +/- 3.7 years were randomly assigned to receive either the WALC intervention or routine care. Ninety percent of those in the treatment group initiated and engaged in a regular exercise program during the 6 months of the study. There was a statistically significant difference in self-efficacy expectations, exercise behavior, and overall activity between the two groups. Those in the treatment group had stronger self-efficacy expectations related to exercise; engaged in more exercise and more free living activity; and although not statistically significant, had stronger outcome expectations following exposure to the WALC intervention when compared with those who received routine care. To help older adults initiate and adhere to an exercise program, nurses can easily implement the WALC intervention in a variety of settings.

Aged↗
PubMedDate not supplied

Geriatric rehabilitation: the influence of efficacy beliefs and motivation.

The theory of self-efficacy is that the more one believes in the efficacy of a specific activity, the more likely (motivated) one is to perform that activity. Most of the research into self-efficacy beliefs among older adults has been quantitative and has consistently supported the influence of those beliefs on behavior. However, it has not been established how efficacy beliefs actually influence motivation in older adults, or what sources of efficacy-enhancing information help strengthen those beliefs. The purpose of this study was to better understand the factors that influence the efficacy beliefs that motivate older adults in a rehabilitation program, and to uncover the relation between efficacy beliefs, motivation, and behavior (i.e., participation in rehabilitation activities). Seventy-seven older adults, 55 women and 22 men, in an inpatient geriatric rehabilitation program were interviewed. Through content analysis, 11 major themes were identified as factors that influence efficacy beliefs and motivate people to participate in rehabilitation: personal expectations, personality, role models, verbal encouragement, progress, past experiences, spirituality, physical sensations, individualized care, social supports, and goals. The findings support the theory of self-efficacy, and are best explained within a social cognitive theory framework.

Activities of Daily Living↗
PubMedDate not supplied

Health-related quality of life: is it a good indicator of function post THR?

The purpose of this study was to explore the impact of health-related quality of life (HRQOL) measured with the Short Form Health Survey (SF-36) on Functional Recovery Status (physical and psychosocial recovery status) at base-line, 2 months, 6 months, and 12 months following total hip replacement (THR). A secondary analysis was performed using data gathered from a sample of 271 older adults post THR. Four empirically based hypothesized models were tested. None of the models fit the data, with each having significant chi2 values and chi2 /df ratios greater than 3. Different dimensions of HRQOL at baseline, 2, 6, and 12 months were related to physical recovery status, and none of the 8 dimensions of the SF-36 was significantly related to psychosocial recovery status. Overall, the results of this study do not support the hypothesis that HRQOL, as measured by the SF-36, comprehensively explains functional recovery status following THR. Clinically, these findings may be applicable to individuals at risk for poor recovery. They also may prompt practitioners to consider alternative factors that influence psychosocial recovery.

Age Distribution↗