Understanding the Mechanisms of Change in a Lifestyle Intervention for Older Adults

Article

Juang, Christine, Knight, Bob G., Carlson, Mike, Schepens Niemiec, Stacey L., Vigen, Cheryl and Clark, Florence. 2017. "Understanding the Mechanisms of Change in a Lifestyle Intervention for Older Adults." The Gerontologist. 58 (2), pp. 353-361. https://doi.org/10.1093/geront/gnw152
Article Title

Understanding the Mechanisms of Change in a Lifestyle Intervention for Older Adults

ERA Journal ID16157
Article CategoryArticle
AuthorsJuang, Christine (Author), Knight, Bob G. (Author), Carlson, Mike (Author), Schepens Niemiec, Stacey L. (Author), Vigen, Cheryl (Author) and Clark, Florence (Author)
Journal TitleThe Gerontologist
Gerontologist
Journal Citation58 (2), pp. 353-361
Number of Pages9
Year2017
Place of PublicationUnited States
ISSN0016-9013
1758-5341
Digital Object Identifier (DOI)https://doi.org/10.1093/geront/gnw152
Web Address (URL)https://academic.oup.com/gerontologist/article/58/2/353/2951102
Abstract

Purpose of the Study:
This study investigated the mechanisms of change underlying an activity-based lifestyle intervention, an occupational therapy program aimed at promoting healthy habits, and routines in older adults. We examined two activity-relevant factors as potential mediators linking the intervention to reduced symptoms of depression: activity frequency and global perceptions of activity significance. Social connections and perceived control were assessed to understand how activity-related factors relate to reduced symptoms of depression.

Design and Methods:
The sample consisted of 460 multiethnic community-dwelling older adults aged 60–95 years. Participants were randomly assigned to a 6-month lifestyle redesign intervention (n = 232) or a no-treatment control (n = 228) condition. After the 6-month period, 360 individuals completed post-testing. Latent change score models were used to represent changes from baseline over the experimental interval. Structural equation models were applied to examine the indirect effects of the intervention on reduced depressive symptoms.

Results:
The results demonstrated significant indirect effects from intervention receipt to decreased depressive symptoms via increased activity frequency and activity significance. Higher activity frequency was linked to fewer depressive symptoms via heightened social connections, whereas increased activity significance was associated with fewer depressive symptoms via enhanced perceived control.

Implications:
The results support basic principles of occupational therapy by highlighting important mediating roles of activity frequency and activity significance in reducing depressive symptoms. Understanding of these change mechanisms can help optimize activity-centered interventions to reduce depressive symptoms.

Keywordsdepression, intervention, occupational therapy, physical therapy, frequency and significance of activities, social connections, perceived control
ANZSRC Field of Research 2020420301. Aged health care
520399. Clinical and health psychology not elsewhere classified
Byline AffiliationsUniversity of Southern California, United States
School of Psychology and Counselling
Institution of OriginUniversity of Southern Queensland
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