Advertisement

An Age-Tailored Intervention Sustains Physical Activity Changes in Older Adults: A Randomized Controlled Trial

  • Paul Gellert
  • Jochen P. Ziegelmann
  • Simon Krupka
  • Nina Knoll
  • Ralf Schwarzer
Article

Abstract

Background

A randomized controlled trial compared an age-tailored intervention to increase physical activity levels in older adults to an age-neutral intervention.

Purpose

Both interventions communicated activity planning strategies and messages to improve self-efficacy. On top of this, the age-tailored intervention also included two lifespan components that targeted present orientation and emotional focus, and fostered strategies of selection, optimization, and compensation.

Method

A total of 386 German older adults (aged 60–95 years) were randomized to receive either the age-tailored intervention (age-specific strategy training and short-term emotional focus) or the age-neutral intervention. Physical activity was measured by questionnaires at baseline (T1) and at 6-month (T2) and 12-month follow-ups (T3). Latent true change modeling was applied by creating latent change scores (T2 − T1 and T3 − T2).

Results

After controlling for gender, age, and physical and mental health, allocation to the age-tailored intervention predicted a latent physical activity difference at T3 − T2, but not at T2 − T1.

Conclusion

Compared to the age-neutral intervention, the age-tailored intervention led to superior maintenance of physical activity within these older adults.

Keywords

Lifespan Socioemotional selectivity Selection Optimization Compensation (SOC) Intervention Physical activity Latent true change 

Notes

Acknowledgment

This work was supported by the German Ministry of Education and Research (BMBF) within the project “Fostering Lifelong Autonomy and Resources in Europe: Behaviour and Successful Aging” FLARE-BSA (Project ID 01ET0801). The first author was funded by the PhD Program “Multimorbidity in Old Age” of the Robert Bosch Foundation. The content is solely the responsibility of the authors.

Conflict of interest

The authors have no conflict of interest to disclose.

References

  1. 1.
    Ayotte BJ, Yang FM, Jones RN. Physical health and depression: a dyadic study of chronic health conditions and depressive symptomatology in older adult couples. J Gerontol Series B: Psychol Sci Soc Sci. 2010;65B(4):438–48.CrossRefGoogle Scholar
  2. 2.
    Baltes PB, Baltes MM. Psychological perspectives on successful aging: The model of selective optimization with compensation. In: Baltes PB, Baltes MM, editors. Successful aging: perspectives from the behavioral sciences. New York: Cambridge University Press; 1990. p. 1–34.CrossRefGoogle Scholar
  3. 3.
    Bullinger, M., & Kirchberger, I. (1998). Fragebogen zum Gesundheitszustand [ MOS Short-Form-36 Health Survey (SF-36; Ware, J.E., Snow, K.K., Kosinski, M., & Gandek, B., 1993)—German version].Google Scholar
  4. 4.
    Carstensen LL. Evidence for a life-span theory of socioemotional selectivity. Curr Dir Psychol Sci. 1995;4:151–6.CrossRefGoogle Scholar
  5. 5.
    Carstensen LL, Mikels JA. At the intersection of emotion and cognition: aging and the positivity effect. Curr Dir Psychol Sci. 2005;14:117–21.CrossRefGoogle Scholar
  6. 6.
    Cavill N, Kahlmeier S, Racioppi F, editors. Physical activity and health in Europe: evidence for action. Copenhagen: World Health Organization; 2006.Google Scholar
  7. 7.
    Chan CB, Ryan DAJ, Tudor-Locke C. Relationship between objective measures of physical activity and weather: a longitudinal study. Int J Behav Nutr Phys Act. 2006;3:21.PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Clark DO. Physical activity and its correlates among urban primary care patients aged 55 years or older. J Gerontol Series B, Psycholog Sci Soc Sci. 1999;54(1):S41–8.CrossRefGoogle Scholar
  9. 9.
    Conn VS, Valentine JC, Cooper HM. Interventions to increase physical activity among aging adults: a meta-analysis. Annals Behav Med. 2002;24(3):190.CrossRefGoogle Scholar
  10. 10.
    Conner M, Rhodes RE, Morris B, McEachan R, Lawton R. Changing exercise through targeting affective or cognitive attitudes. Psychol Heal. 2011;26(2):133–49.CrossRefGoogle Scholar
  11. 11.
    Eid M, Schneider C, Schwenkmezger P. Do you feel better or worse? The validity of perceived deviations of mood states from mood traits. Eur J Personal. 1999;13:283–306.CrossRefGoogle Scholar
  12. 12.
    Evers A, Klusmann V, Ziegelmann JP, Schwarzer R, Heuser I. Long-term adherence to a physical activity intervention: the role of telephone-assisted vs. self-administered coping plans and strategy use. Psychol Heal. 2012;27(7):784–97. doi: 10.1080/08870446.2011.582114.CrossRefGoogle Scholar
  13. 13.
    Freund AM, Baltes PB. Life-management strategies of selection, optimization, and compensation: measurement by self-report and construct validity. J Personal Soc Psychol. 2002;82:642–62.CrossRefGoogle Scholar
  14. 14.
    Freund AM, Baltes PB. Toward a theory of successful aging: Selection, optimization, and compensation. In: Fernández-Ballesteros R, editor. Geropsychology: European perspectives for an aging world. Ashland, OH, US: Hogrefe & Huber; 2007. p. 239–54.Google Scholar
  15. 15.
    Freund AM, Hennecke M, Riediger M. Age-related differences in outcome and process goal focus. Eur J Dev Psychol. 2010;7(2):198–222.Google Scholar
  16. 16.
    Geiser C, Eid M, Nussbeck FW, Courvoisier DS, Cole DA. Analyzing true change in longitudinal multitrait-multimethod studies: application of a multimethod change model to depression and anxiety in children. Dev Psychol. 2010;46(1):29–45. doi: 10.1037/a0017888.PubMedCrossRefGoogle Scholar
  17. 17.
    Gellert P, Ziegelmann JP, Schwarzer R. Affective and health-related outcome expectancies for physical activity in older adults. Psychol Heal. 2011. doi: 10.1080/08870446.2011.607236.Google Scholar
  18. 18.
    Gollwitzer PM, Sheeran P. Implementation intentions and goal achievement: a meta-analysis of effects and processes. Adv Exp Soc Psychol. 2006;38:69–119.CrossRefGoogle Scholar
  19. 19.
    Graham JW. Adding missing-data-relevant variables to FIML-based structural equation models. Struc Equation Model: Multidiscip J. 2003;10(1):80–100.CrossRefGoogle Scholar
  20. 20.
    Graham JW. Missing data analysis: making it work in the real world. Annu Rev Psychol. 2009;60:549–76.PubMedCrossRefGoogle Scholar
  21. 21.
    Greaves CJ, Sheppard KE, Abraham C, Hardeman W, Roden M, Evans PH, et al. Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions. BMC Publ Health. 2011;11:119.CrossRefGoogle Scholar
  22. 22.
    Huy, C., & Schneider, S. (2008). Instrument für die Erfassung der physischen Aktivität bei Personen im mittleren und höheren Erwachsenenalter. Entwicklung, Prüfung und Anwendung des "German-PAQ-50 + " [Instrument for the assessment of middle-aged and older adults’ physical activity: Design, eliability and application of the German-PAQ-50+]. Zeitschrift für Gerontologie und Geriatrie, 41, 208-216. doi:  10.1007/s00391-007-0474-y
  23. 23.
    Klusmann V, Evers A, Schwarzer R, Schlattmann P, Reischies FM, Heuser I, et al. Complex mental and physical activity in older women and cognitive performance: a 6-month randomized controlled trial. J Gerontol Series Biol Sci Med Sci. 2010;65A:680–8. doi: 10.1093/gerona/glq053.CrossRefGoogle Scholar
  24. 24.
    Marcus BH, Napolitano MA, King AC, Lewis BA, Whiteley JA, Albrecht A, et al. Telephone versus print delivery of an individualized motivationally tailored physical activity intervention: Project STRIDE. Heal Psychol. 2007;26(4):401–9. doi: 10.1037/0278-6133.26.4.401.CrossRefGoogle Scholar
  25. 25.
    Miller DJ, Freedson PS, Kline GM. Comparison of activity levels using the caltrac accelerometer and five questionnaires. Med Sci Sports Exerc. 1994;26:376–82.PubMedGoogle Scholar
  26. 26.
    Muthén, L. K., & Muthén, B. O. (1998-2007). Mplus users guide. Fifth edition. Los Angeles, CA: Muthén & Muthén.Google Scholar
  27. 27.
    Paxton RJ, Motl RW, Aylward A, Nigg CR. Physical activity and quality of life: the complementary influence of self-efficacy for physical activity and mental health difficulties. Int JBehav Med. 2010;17(4):255–63. doi: 10.1007/s12529-010-9086-9.Google Scholar
  28. 28.
    Preacher KJ, Rucker DD, Hayes AF. Addressing moderated mediation hypothesis: theory, methods and prescriptions. Multivar Behav Res. 2007;42:185–227.CrossRefGoogle Scholar
  29. 29.
    Renner, B., Hankonen, N., Ghisletta, P., & Absetz, P. (2011). Dynamic psychological and behavioral changes in the adoption and maintenance of exercise. Health Psychology. doi: 10.1037/a0025302Google Scholar
  30. 30.
    Reuter T, Ziegelmann JP, Wiedemann AU, Geiser C, Lippke S, Schüz B, et al. Changes in intentions, planning, and self-efficacy predict changes in behaviors. J Heal Psychol. 2010;15(6):935–47.CrossRefGoogle Scholar
  31. 31.
    Reuter T, Ziegelmann JP, Wiedemann AU, Lippke S, Schüz B, Aiken LS. Planning bridges the intention-behaviour gap: age makes a difference and strategy use explains why. Psychol Heal. 2010;25(7):873–87.CrossRefGoogle Scholar
  32. 32.
    Schwarzer R, Luszczynska A, Ziegelmann JP, Scholz U, Lippke S. Social-cognitive predictors of physical exercise adherence: three longitudinal studies in rehabilitation. Heal Psychol. 2008;27(1):S54–63.CrossRefGoogle Scholar
  33. 33.
    Shephard RJ, Aoyagi Y. Seasonal variations in physical activity and implications for human health. Eur J Applied Physiol. 2009;107(3):251–71.CrossRefGoogle Scholar
  34. 34.
    Sniehotta FF, Scholz U, Schwarzer R, Fuhrmann B, Kiwus U, Völler H. Long-term effects of two psychological interventions on physical exercise and self-regulation following coronary rehabilitation. Int J Behav Med. 2005;12(4):244–55.PubMedCrossRefGoogle Scholar
  35. 35.
    Sniehotta FF, Schwarzer R, Scholz U, Schüz B. Action planning and coping planning for long-term lifestyle change: theory and assessment. Eur J Soc Psychol. 2005;35:565–76.CrossRefGoogle Scholar
  36. 36.
    Spence JC, Burgess JA, Cutumisu N, Lee JG, Moylan B, Taylor L. Self-efficacy and physical activity. A Quant Rev. 2006;28:172–3.Google Scholar
  37. 37.
    Steyer, R., Eid, M., & Schwenkmezger, P. (1997). Modeling true intraindividual change: True change as a latent variable. Methods of Psychological Research, Online 2, 21-33 (http://www.hsp.de/MPR/).
  38. 38.
    USDHHS. U.S. Department of Health and Human Services: Summary health statistics for U.S. adults: National Health Interview Survey, 2009. Hyattsville: DHHS; 2010.Google Scholar
  39. 39.
    van Stralen MM, De Vries H, Mudde AN, Bolman C, Lechner L. Determinants of initiation and maintenance of physical activity among older adults: a literature review. Health Psychol Rev. 2009;3(2):147–207. doi: 10.1080/17437190903229462.CrossRefGoogle Scholar
  40. 40.
    van Stralen, M. M., de Vries, H., Mudde, A. N., Bolman, C., & Lechner, L. (2011). The long-term efficacy of two computer-tailored physical activity interventions for older adults: Main effects and mediators. Health Psychology, Advance online publication, 1-11. doi: 10.1037/a0023579Google Scholar
  41. 41.
    Warner LM, Schwarzer R, Schüz B, Wurm S, Tesch-Römer C. Health-specific optimism mediates between objective and perceived physical functioning in older adults. J Behav Med. 2012;35(4):400–6. doi: 10.1007/s10865-011-9368-y.PubMedCrossRefGoogle Scholar
  42. 42.
    White SM, Wójcicki TR, McAuley E. Social cognitive influences on physical activity behavior in middle-aged and older adults. J Gerontol Series B: Psychol Sci Soc Sci. 2012;67B(1):18–26.CrossRefGoogle Scholar
  43. 43.
    Ziegelmann JP, Lippke S. Planning and strategy use in health behavior change: a life span view. Int J Behav Med. 2007;14:30–9.PubMedCrossRefGoogle Scholar
  44. 44.
    Ziegelmann JP, Lippke S, Schwarzer R. Adoption and maintenance of physical activity: Planning interventions in young, middle-aged, and older adults. Psychol Heal. 2006;21:145–63.CrossRefGoogle Scholar
  45. 45.
    Ziegelmann JP, Lippke S, Schwarzer R. Subjective residual life expectancy in health self-regulation. J Gerontol: Psychological Sci. 2006;61B:195–201.CrossRefGoogle Scholar

Copyright information

© International Society of Behavioral Medicine 2013

Authors and Affiliations

  • Paul Gellert
    • 1
    • 2
    • 6
  • Jochen P. Ziegelmann
    • 3
  • Simon Krupka
    • 1
  • Nina Knoll
    • 1
    • 4
  • Ralf Schwarzer
    • 1
    • 5
  1. 1.Division of Health PsychologyFreie Universität BerlinBerlinGermany
  2. 2.Newcastle UniversityNewcastle upon TyneUK
  3. 3.German Centre of GerontologyBerlinGermany
  4. 4.Institute of Medical PsychologyCharité—Universitätsmedizin BerlinBerlinGermany
  5. 5.University of Social Sciences and HumanitiesWarsawPoland
  6. 6.Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK

Personalised recommendations