ABSTRACT
PURPOSE: To evaluate the ability of a multimodal patient education initiative to improve adherence to healthy bone behaviors (HBBs) in men with prostate cancer receiving androgen deprivation therapy (ADT). METHODS: This was a pilot prospective, single-site, before-and-after clinical trial. The control arm (n = 51) received routine care. The intervention arm (n = 52) received multimodal HBB education which included a healthy bones prescription (BoneRx), focused face-to-face education with an oncology nurse or physician, and customized educational materials. The primary endpoints were feasibility of study methods and self-reported adherence to HBBs (vitamin D intake ≥ 1000 IU/day, calcium intake 1000-1500 mg/day, and exercise ≥ 150 min/week) at 3-month follow-up. Secondary endpoints included receipt of bone mineral density (BMD) testing. RESULTS: Patients were satisfied with the study intervention, found educational materials easy to understand, and felt that it increased their knowledge about osteoporosis. Although the intervention appeared to be associated with trends toward improved levels of vitamin D intake (adjusted odds ratio [OR] 1.8, 95% confidence interval [CI] 0.74-4.5), calcium intake (OR 1.5, 95% CI 0.63-3.4), and exercise (OR 1.7, 0.75-3.9) as compared to the control arm, none of these were statistically significant. Patients who received the study intervention were more likely to receive BMD testing (OR 3.3, 95% CI 1.3-8.8). CONCLUSIONS: Although a brief, tailored educational intervention was feasible to implement and improve BMD test utilization, it did not increase HBB participation. Larger, well-designed trials are needed to clarify the effect of patient education interventions on HBB adherence. TRIAL REGISTRATION: ClinicalTrials.gov ( NCT01973673 ).
Subject(s)
Androgen Antagonists/therapeutic use , Bone and Bones/drug effects , Osteoporosis/drug therapy , Patient Education as Topic/methods , Aged , Aged, 80 and over , Androgen Antagonists/pharmacology , Humans , Male , Middle Aged , Pilot Projects , Prospective StudiesABSTRACT
This study examined factors affecting adherence in a 16-week tai chi program among multi-ethnic middle-aged and older adults living in a low socioeconomic environment in Toronto. Analysis was based on data collected from three tai chi program cohorts that took place from August 2009 to March 2012. The main outcome variable, adherence, was measured by the total number of sessions attended by each of the participants. Total sample size was 210 participants with a mean age of 68.1 ± 8.6. Based on the regression model, greater adherence was significantly associated with older age, greater perceived stress, higher education, and higher mental and physical scores of Short Form-36 components. Conversely, lower adherence was significantly associated with higher baseline weekly physical activity. Our findings suggest that we target less-educated individuals with poor mental and physical health to optimize adherence for future community-based tai chi programs.
Subject(s)
Exercise , Motor Activity , Patient Compliance/statistics & numerical data , Tai Ji/methods , Age Factors , Aged , Aged, 80 and over , Cohort Studies , Educational Status , Female , Health Status , Humans , Linear Models , Male , Middle Aged , Ontario , Poverty , Regression Analysis , Retrospective Studies , Social Class , Social SupportABSTRACT
BACKGROUND AND PURPOSE: Tai Chi (TC) is a form of low to moderate physical activity that has been shown to significantly impact health and functional fitness among older adults; the impact of TC on the health and functional fitness of older adults with arthritis is not well understood. The purpose of this study was to assess the effectiveness of a 16-week TC intervention for improving functional fitness and self-reported general health among older adults with arthritis who were born outside Canada and were residing in low-income neighborhoods. METHODS: A 16-week intervention was conducted among older adults residing in 1 of 2 specified low-income neighborhoods in Canada. The analysis was limited to those who self-reported having arthritis (n = 102). Participants were encouraged to attend 2 moderate-intensity TC sessions per week for a total of 120 minutes. Functional fitness and health were assessed at baseline and at 16 weeks. RESULTS: Average attendance was 1.1 sessions per week. Functional fitness assessment results indicated that right-hand grip strength (25.6 ± 8.2 to 26.7 ± 7.8 kg), left-hand grip strength (24.9 ± 7.3 to 26.8 ± 7.1 kg), 30-second arm curl (15.6 ± 5.0 to 18.6 ± 5.7 repetitions/30 s), Timed Up-and-Go (7.4 ± 2.6 to 6.9 ± 2.6 s), and 30-second chair stand (12.0 ± 3.9 to 15.4 ± 5.8 s) improved significantly (P < 0.05) from baseline to 16 weeks. Results from the Short Form-36 indicate that physical functioning (73.1 ± 19.9 to 80.3 ± 19.4; P = 0.001), general health (61.5 ± 20.9 to 66.0 ± 20.4; P = 0.03), vitality (61.5 ± 18.9 to 67.5 ± 20.2; P = 0.008), and mental health (74.3 ± 16.5 to 78.5 ± 17.7; P = 0.04) also improved significantly over the intervention period. Improvements in physical health and physical function scores were clinically meaningful. DISCUSSION AND CONCLUSIONS: Participating in TC for 16 weeks led to significant improvements in functional fitness and components of physical and mental health among older adults with self-reported arthritis. Tai Chi seems to be a valuable mode of physical activity for this population.
