Development and Feasibility of an eHealth Diabetes Prevention Program Adapted for Older Adults-Results from a Randomized Control Pilot Study.

Lifestyle programs that reduce health risks and support weight loss (WL) in older adults face adherence and attendance challenges due to reduced energy requirements, impaired mobility, lack of transportation, and low social support. Tailored lifestyle and weight management programs are needed to better support healthy aging for older adults. Here, we developed and piloted an age-adapted, remotely delivered modification of the Diabetes Prevention Program (DPP). The modification includes age-appropriate goals, visuals, and examples; flexible dietary composition; remote classroom and fitness-monitoring technology; and standardized online classroom materials employing pedagogical and behavior change theory. The modifications were designed to safeguard fidelity and to boost adherence, engagement, and knowledge integration, with the convenience of a fully remote WL program for diverse older adults. Six-month pilot data are presented from older adults (55-85 years, body mass index (BMI) 27-39.9 kg/m2, N = 20) randomly allocated to an online DPP intervention with weight, diet, and activity monitored remotely, or into a waitlisted control. The intervention achieved 100% attendance and adherence to self-monitoring. The intervention group mean (±SD) body weight change was -9.5% (±4.1); 90% lost ≥ 5%. By contrast, the control group gained 2.4% (±1.8). Once thought incompatible with older adults, remote interventions are feasible for older adults and can support fidelity, adherence, engagement, and clinically significant WL. Standardized materials are provided for future implementation.

Online pragmatic interpretations of scalar adjectives are affected by perceived speaker reliability.

Linguistic communication requires understanding of words in relation to their context. Among various aspects of context, one that has received relatively little attention until recently is the speakers themselves. We asked whether comprehenders' online language comprehension is affected by the perceived reliability with which a speaker formulates pragmatically well-formed utterances. In two eye-tracking experiments, we conceptually replicated and extended a seminal work by Grodner and Sedivy (2011). A between-participant manipulation was used to control reliability with which a speaker follows implicit pragmatic conventions (e.g., using a scalar adjective in accordance with contextual contrast). Experiment 1 replicated Grodner and Sedivy's finding that contrastive inference in response to scalar adjectives was suspended when both the spoken input and the instructions provided evidence of the speaker's (un)reliability: For speech from the reliable speaker, comprehenders exhibited the early fixations attributable to a contextually-situated, contrastive interpretation of a scalar adjective. In contrast, for speech from the unreliable speaker, comprehenders did not exhibit such early fixations. Experiment 2 provided novel evidence of the reliability effect in the absence of explicit instructions. In both experiments, the effects emerged in the earliest expected time window given the stimuli sentence structure. The results suggest that real-time interpretations of spoken language are optimized in the context of a speaker identity, characteristics of which are extrapolated across utterances.