Levitz Kaykeo Biology 1615 Article Summary Assignment

Be Well; Results of a Nutrition, Exercise, and Weight Management Intervention among At-Risk Adults The objective of this article is to test how effective a multifaceted exercise and nutritional education would help older adults intervene with chronic illnesses. Studies of physical activity have been primarily been conducted on among healthy and higher functioning adults. It has rarely been tested on older nutritionally compromised adults so the researchers whom all have degrees through-out the state of California wanted to implement the Be Well program to test their hypothesis that the participants in the program would demonstrate improved health outcomes in multiple aspects. After a selection process and brief screening, the participants were chosen that met all the requirements to base findings and research off of. The research and studies of the participants were held at a Managed Care Organization, which is real similar to the participants community-dwellings. A cohort design was employed which measures were collected after the selection process and then again four months later at the end of the intervention. After getting permission from the Institutional Review Board to hold their experiment at a Managed Care Organization. To be qualified through the selection process participants had to be older than 60, diagnosed with two or more chronic conditions and have had one or more emergency room visits within the past six months. Three hundred-eighteen people who meet the requirements were contacted and sixtytwo of them were selected to participate. After the 62 agreed to participate they were sent to the Managed Care Organization to be evaluated for medical clearance. After clearance they signed a consent document before getting started. The program consisted of a consecutive 16 week period. Classes were held twice a week for two hours, which totaled 32 sessions. For every one session they participated in it consisted of an hour of low-impact physical activity followed by an

Levitz Kaykeo Biology 1615 Article Summary Assignment

hour of nutritional education. Registered dietitians and exercise specialists conducted these classes for the participants. During the program or intervention data was collected during constant in-person interviews which included self-reports. Self-reports included physical activity, depression levels and body and fitness measurements. The information was then assessed and the information was collected throughout the program. Physical activity measures were taken of three non-validated self-report items, which were: average miles walked throughout the day, weekly hours spent exercising and current level of physical activity that was measured on a 5point scale. Depression was evaluated through a validated nine item Patient Health Questionnaire. A rating of 5 or above indicated mild to severe depression while anything under 5 indicated minimal or no depression. Fitness level was tested on their performance of seven tests which was also specifically designed and used among older adults to measure their flexibility, strength and stamina. These tests included a 30-second chair stand, arm curls, steps taken on a 6 minute walk, 2 minute step in place sit and reach, back scratch and an 8 foot up and go. Participants practiced a couple times before their performance was actually measured. Body measurements of their waist, hips, chest, single leg and arm were. Body weight and body fat percentage was also taken so they could calculate BMI. After all these tests and calculations were recorded the data was then analyzed. Descriptive statistics was determined by the data to describe the overall sample and paired samples through nonparametric tests to analyze progress throughout the intervention. SPSS version 15.0 which is a statistical software program was used to analyze the data. The intervention for 62 adults was held from October 2008 to June 2008. After the intervention the data and information gathered was analyzed. After analyzing the data numerous improvements have been concluded all of which supported the hypothesis. For physical activity

Levitz Kaykeo Biology 1615 Article Summary Assignment

participants significantly increased their physical activity even outside of the Be Well program. 57% reported that they did not walk at all previous to the intervention. At the end an amazing 95.1% reported that they kept engaging in physical activity after the intervention. Depression levels also improved by the end of the intervention. 45.2% of participants reported having mild to severe depression before the intervention and at the end that number decreased to 16.4%. That brought the number to 83.6% which were not depressed after analysis. Results for fitness showed an improvement in 6 of the 7 categories. They improved 1.6 repetitions to their 30 second chair stand, 2.0 repetitions to their maximum number of arm curls, 26 steps to a 2 minute step in place, stretching improved by 1.3 inches on the sit and reach, they sped up their 8 feet up and go by 3.0 seconds and reduced the gap between their reaching fingers by 6.0 inches on the back scratch. No changed were found for their 6 minute walk. Body measurements, which is an indicator of health revealed that participants reduced five measures (waist, hips, arm, chest and leg), decreased weight by 7 pounds, reduced BMI by 2 kg/m^2 and lowered body fat percentages. This is a major improvement as most of the participants were considered obese. The older adults whom participated in the Be Well program was associated with physical and emotional health improvements among participants. Almost half of the sample exhibited depressive symptomatology when approached. This decreased by 64% at the follow up. The reduction in depression is attributed to many aspects of the intervention. Physical activity along with reduced BMI has been proven to help lower levels of depression among older adults. The intervention also supported social interaction which is another supporting factor that helps reduce depression. Anecdotal evidence taken from the participants showed that even after the intervention participants teamed up together to continue to work out even after classes and

Levitz Kaykeo Biology 1615 Article Summary Assignment

tests. Participants all made a commitments to new health goals and best of all bonded with others to start new relationships. During the Be Well program older adults showed significant improvement in most categories tested. The intervention has successfully engaged and retained older adults with multiple chronic conditions. Being placed in a community based off of physical activity and a nutrition program showed improvements in physical and emotional health. The conclusion shows the benefits of exercise and good nutrition as possible alternatives to pharmacological interventions for weight loss and depression in older adults. Along with this a combination of a support group has definitely made and showed improvements.