Health Behaviors Of Older Adults Research Articles

Social support and health behaviors of older adults during the COVID-19 pandemic in China: a moderated mediation model of loneliness and economic income

BackgroundThe literature shows that social support is an important factor influencing health behaviors. This study aimed to explore the relationships and intrinsic pathways of social support, loneliness, economic income, and health behaviors among older adults during the Corona Virus Disease 2019 (COVID-19) pandemic, and to provide a theoretical basis for the implementation of health behaviors interventions for older adults.MethodsA cluster-random-sampling survey was adopted within two towns in Dongguan, China. Demographic characteristics, social support, loneliness, economic income and health behaviors were measured. The Social Support Appraisals scale (SS-A), the ULS-8 Loneliness Scale, and the Self-rated abilities for health practice scale (SRAHPS) were used to measure social support, loneliness, and health behaviors in older adults, respectively. A moderated mediation model was built to examine the relationships among social support, loneliness, economic income, and health behaviors using the SPSS PROCESS 4.0 macro. We conducted bootstrapping of regression estimates with 5000 samples and a 95% confidence interval.Results621 older adults completed the questionnaire. Most of the participants were female, accounting for 75.0%, and the average age was 81.11 years (SD = 8.11). The median (interquartile range) of the participants’ average monthly economic income was 800 (500–1000)RMB. The results of the mediation analysis showed that loneliness partly mediated the relationship between social support and health behaviors (B = 0.024, 95%CI: 0.007, 0.042), with the mediating effect accounting for 4.56% of the total effect. The moderation mediation analysis revealed a positive moderating role of economic income in the relationship between social support and loneliness (B = 0.114, 95%CI: 0.054, 0.174). Specifically, the relationship between social support and loneliness was found to be weaker for older adults with a high economic income compared to those with a lower economic income.ConclusionThe provision of enhanced social support and the alleviation of loneliness among older adults during an epidemic can facilitate the development of healthy behaviours, particularly among those who are economically disadvantaged.

Association between the perceived built environment and health behaviors in older adults: a cross-sectional study from Beijing, China

BackgroundUnder the background of the increasing trend of population aging, the health and quality of life of older adults have become the focus of social concern. As an important part of older adults’ daily life, the design and configuration of the built environment may positively or negatively affect older adults’ health behaviors. Therefore, this study aims to explore the relationship between older adults’ perceived built environments and health behaviors, which is the association between perceived built environments and older adults’ physical activity (PA) and social interactions. This is important for optimizing the community built environment and improving the quality of life of older adults.MethodsIn this study, a questionnaire was surveyed on 916 Chinese older adults aged 60 and above. The questionnaire was used to collect demographic information and social interaction from the participants, and the Physical Activity Neighborhood Environment Scale (PANES) and the Physical Activity Scale for the Elderly (PASE) were used to assess older adults’ subjective perceptions of the built environment in their neighborhoods and their levels of PA, respectively. In data analysis, ANOVA and chi-square tests were used to compare the significance of differences between groups, and multiple linear regression model were used to estimate the association between older adults’ perceived characteristics of the built environment and their PA and social interaction.ResultsAfter controlling for confounders such as gender, age, BMI, and education level, the multiple linear regression model showed that perceived destination accessibility, neighborhood infrastructure, aesthetic qualities, and neighborhood environment indices were significantly correlated with PA (β = 0.083 ~ 0.095, P < 0.05) and social interaction (β = 0.087 ~ 0.144, P < 0.05) among older adults. In addition, neighborhood safety (β = -0.084, P < 0.05), social environment (β = 0.091, P < 0.01), and street connectivity (β = 0.112, P < 0.001) were also strongly associated with older adults’ social interaction.ConclusionsDifferent perceived built environment attributes are correlated with the health behaviors of Chinese older adults to different degrees. This finding helps to guide community planning and construction, provides an empirical basis for improving health behaviors of older adults, and provides an important reference for building healthy communities for older adults and realizing comprehensive healthy development of older adults.Trial registrationThere was no trial registration for this study, but the study was approved by the Institutional Review Board of Tsinghua University (No. THU0120230196).

Technology-Driven Intergenerational Physical Activity Intervention: An Instrumental Case Study

Intergenerational contact offers an under-explored strategic approach to challenging age stereotypes and positively influencing health behaviors in older adults and children. It is postulated that through the application of the constructs of Contact Theory, an effective platform for change could be established. Using an instrumental case study, the experiential effects of the intergenerational contact phenomenon were pragmatically explored from the perspective of a single familial dyad (61-year-old woman; 9-year-old boy). Semi-structured interviews were conducted with each participant, both during and following engagement with a remote, 12-week, technology-driven physical activity intervention focused on using daily step counts (acquired via any activity of their choice, using physical activity trackers) to collaboratively complete virtual walk routes during the COVID-19 pandemic. Through reflexive thematic analysis and interpretation of the data in line with the study’s aim and propositions, four core themes were identified: Reciprocal Encounter; Opportunity for Reflection and Re-evaluation; Platform for Change; and COVID-19. In addition to the perceived positive effects on targeted health outcomes (physical activity, sedentary behavior, health-related quality of life), facilitating intergenerational contact through virtual methods could also, through opportunities to nurture and build relationships, challenge age stereotypes.

Understanding Health Beliefs and Health Behaviors in Older Adults at Risk for Alzheimer's Disease.

There are significant public health benefits to delaying the onset of Alzheimer's disease (AD) in individuals at risk. However, adherence to brain healthy behaviors is low. The Health Belief Model proposes that specific beliefs are mediators of behavior change. To characterize health belief measures from the Science of Behavior Change Research Network (SBCRN) in an older adult population and associations between health beliefs, AD risk, and current health behaviors. A total of 172 individuals from the Rhode Island AD Prevention Registry participated. SBCRN health belief measures included assessments of future time perspective, self-efficacy, deferment of gratification, and consideration of future consequences. Outcome measures included individual AD risk index score, dementia risk awareness, and lifestyle behaviors including physical, cognitive, and social activity. Participants who were older had higher scores for AD risk, lower future time perspective, and lower generalized self-efficacy (all at p < 0.001). Higher generalized self-efficacy was related to increased physical activity (p < 0.010). Higher future time perspective (p < 0.001) and generalized self-efficacy (p = 0.48) were associated with lower AD risk score. Subjective cognitive decline (SCD) was associated with lower self-efficacy, ability to delay gratification, and a less expansive future time perspective. Greater self-efficacy and perceived future time remaining were associated with lower AD risk and greater engagement in physical activity. SCD was associated with health beliefs that may negatively affect engagement in positive brain health behaviors. Assessment of and psychoeducation about these intrapersonal health belief constructs may be important targets for behavioral interventions to reduce AD risk.

Balancing Time for Health Behaviors: Associations of Time Perspective With Physical Activity and Weight Management in Older Adults.

To examine associations between time perspective and health promotion behaviors of physical activity and weight management. Quantitative cross-sectional. This study is part of the Betula project on aging, memory, and dementia in Northern Sweden. 417 older adults aged between 55 and 85years. Swedish-Zimbardo Time Perspective Inventory; Physical Activity in the past year, past week, and in comparison with others of similar age; Weight Management = Body Mass Index (BMI; kg/m2). After controlling for age, sex, and years of education, hierarchical linear regression indicated a Balanced Time Perspective was significantly associated with more physical activity in the past year (P = .04), the past week (P < .001), and in comparison with others (P < .01). Past Negative time perspective was associated with less physical activity in the past year (P = .03), and in comparison with others (P = .03). Present Fatalistic was associated with less physical activity during the past week (P = .03), and in comparison with others (P = .01). Present Hedonistic was associated with more physical activity the past week (P = .03), and in comparison with others (P = .03). Past Negative was associated with higher BMI (P = .02), and Future Negative were associated with lower BMI (P = .01). Taken collectively, greater positivity and flexibility across time perspectives was associated with more physical activity, whereas negative oriented time perspectives related with less physical activity and poorer weight management. Time perspective can be associated with health behaviors in older adults and have implications for health across the lifespan. Health promotion interventions may target older adults' enjoyment of exercise and weight management in the present, rather than highlight potential negative health outcomes in the future.

Enhancing understanding of healthy aging based on time-varying dependencies among multidimensional health, life satisfaction, and health behaviors of older adults aged 60 years and over.

Healthy aging is a process of not only achieving good health but also increasing the life satisfaction of older adults aged 60 years and over, in which health behaviors play an important role. There is a lack of research on the time-varying dependencies between health, life satisfaction, and health behaviors, impeding a deeper understanding of healthy aging. To develop an integrated framework for modeling the interrelationships among the components of healthy aging between multiple time slices. Based on the Chinese Longitudinal Healthy Living Survey (CLHLS) data in the three waves of 2011/2012, 2014, and 2017/2018, Bayesian network and dynamic Bayesian network are jointly employed to study the relationships among the components of healthy aging within one time slice, as well as to explore the time-varying dependencies among the components between time slices. The results of structure learning reveal the direction of effects between different dimensions of health, with mental health and social health affecting physical health and self-rated health affecting both physical and mental health. In addition, health behaviors are found to affect mental health and social health, while self-rated health can influence life satisfaction. The parameters learned from the data show the magnitude and direction of concurrent effects, one-period lagged effects and two-period lagged effects between the factors, which find that the time-varying dependencies vary but are generally positive, long-term, and accumulative over time. In addition, the results of autoregressive effects show the positive predictive effects of health and life satisfaction. It confirms the influence pathway from health behaviors to multidimensional health to life satisfaction, and the time-varying dependencies among the components of healthy aging, which facilitates a deeper understanding of healthy aging. Combining the results of autoregressive effects and descriptive statistics, it further indicates that healthy aging is a comprehensive result arising from interactions of multiple factors. Policymakers should guide older adults aged 60 years and over to adopt healthier behaviors and ensure the long-term sustainability and continuity of policies.

Loneliness in older adults with diabetes mellitus: a scoping review

ABSTRACT This scoping review aimed to explore and synthesize existing research on predictors of loneliness, and the impact of loneliness on physiological and psychological health outcomes and health behaviors in older adults with diabetes. Results from 12 studies showed that low education, being unmarried/divorced/separated, having diabetes-related complications, being physically inactive, having diabetes distress, being of a certain race/ethnicity, being female, having depressive symptoms, and being younger age were consistently identified as predictors of loneliness. In addition, loneliness was found to affect both psychological (depressive symptoms and negative perceptions of diabetes) and physiological health outcomes (increased postprandial blood glucose and A1C levels, decreased cortisol levels, increased MCP-1 levels, slower gait speed, and weaker hand grip) and health behaviors (decreased engagement in physical activity, increased disability in activities of daily living and instrumental activities of daily living, and increased likelihood of antidepressant use). The results of this scoping review suggest that loneliness is a complex issue for older adults with diabetes and its effects are far-reaching. Therefore, further research should be conducted to explore the potential causal relationships between loneliness and physiological and psychological health outcomes and to identify the best interventions to reduce loneliness in older adults with diabetes. For healthcare providers, it is important to recognize that loneliness is an appropriate risk factor for older adults with diabetes that may affect psychological and physiological health outcomes and health behaviors and to address it through interventions such as social support programs, group therapy, or psychosocial counseling.

MAINTENANCE OF HEALTH BEHAVIOR CHANGE: CHALLENGES, IMPLICATIONS, AND FUTURE DIRECTIONS

Abstract Health behavior change is critical for healthy aging. Evidence-based programs are available to support a variety of health behavior changes in older adults, including programs for activity, diet, sleep, and medication adherence. Health behavior change programs are typically guided by one or more theoretical models or frameworks describing common constructs related to behavior change. Examples of such constructs include intention, motivation, self-efficacy, and self-regulation. To date, much focus has been on how such constructs relate to initiating and/or achieving behavior change. Although some models specify anticipated outcomes of behavior change over time, maintenance remains largely overlooked. This symposium presents a series of presentations exploring concepts and challenges related to maintenance of health behaviors in older adults. Together, these presentations will explore the definitions and characteristics of maintenance as described in the scientific literature, review maintenance-related trends within physical activity interventions, and discuss findings from stakeholder-engaged sessions designed to identify gaps within the theoretical and scientific literature describing maintenance. The session will conclude with recommendations for future research. This is a Health Behavior Change Interest Group Sponsored Symposium.

31 Understanding Health Beliefs and Health Behaviors in Older Adults at Risk for Alzheimer’s Disease

Objective:Given the aging population, there are significant public health benefits to delaying the onset of Alzheimer’s disease (AD) in individuals at risk. However, adherence to health behaviors (e.g., diet, exercise, sleep hygiene) is low in the general population. The Health Belief Model proposes that beliefs such as perceived threat of disease, perceived benefits and barriers to behavior change, and cues to action are mediators of behavior change. The aim of this study was to gain additional information on current health behaviors and beliefs for individuals at risk for developing AD. This information can then be used to inform behavioral interventions and individualized strategies to improve health behaviors that may reduce AD risk or delay symptom onset.Participants and Methods:Surveys were sent to the Rhode Island AD Prevention Registry, which is enriched for at-risk, cognitively normal adults (i.e., majority with a family history and/or an APOE e4 allele). A total of 177 individuals participated in this study. Participants were 68% female; 93% Caucasian and non-Hispanic; mean age of 69.2; 74% with family history of dementia; 40% with subjective memory decline. The survey included measures from the Science of Behavior Change (SoBC) Research Network to measure specific health belief factors, including individual AD risk, perceived future time remaining in one’s life, generalized self-efficacy, deferment of gratification, consideration of future consequences as well as dementia risk awareness and a total risk score for dementia calculated from a combination demographic, health and lifestyle behaviors.Results:Participants who were older had higher scores for dementia risk (r=0.78), lower future time perspective (r=-0.33), and lower generalized self-efficacy (r=-0.31) (all at p&lt;0.001). Higher education correlated with higher consideration of future consequences (r=-.31, p&lt;0.001) and lower overall dementia risk score (r=-0.23, p=0.006). Of all scales examined, only generalized self-efficacy had a significant linear relationship to both frequency (r2=0.06) and duration (r2=0.08) of weekly physical activity (p&lt;0.001). Total dementia risk score also had significant linear relationships (r2=0.19) with future time perspective (p&lt;0.001) and generalized self-efficacy (p=0.48).Conclusions:Overall, individuals who rated themselves higher in self-efficacy were more likely to exercise more frequently and for a longer duration. Individuals who had lower overall risk for dementia due to both demographic and behavioral factors were more likely to endorse higher self-efficacy and more perceived time remaining in their lives. Increasing self-efficacy and targeting perceived future time limitations may be key areas to increase motivation and participation in behavioral strategies to reduce AD risk. Developing individual profiles based on these scales may further allow for individually tailored intervention opportunities.

Apathy as a determinant of health behaviors in older adults: Implications for dementia risk reduction.

Long-term improvements in physical inactivity and other behavioral risk factors are integral to dementia risk reduction; however, sustained behavior change is challenging. Apathy, depression, and fatigue may impact engagement in health behaviors, but their presentation overlaps. This study investigates whether these symptoms are differentially associated with multiple health behaviors. In 1037 community-dwelling older adults without dementia (aged 70-90, 55% women), regression analyses examined apathy, depression, and fatigue as predictors of health behaviors (physical activity, diet, alcohol, smoking) and a behavioral risk index. Apathy was associated with reduced physical activity and alcohol use, and one or multiple behavioral risk factors. No or inconsistent relations were found between depression or fatigue and health behaviors. Apathy is relevant to multiple health behaviors and should be considered when designing health promotion for older adults, including interventions for dementia risk reduction. Findings highlight the importance of distinguishing apathy from comorbid symptoms. Novel theory-based perspective on behavioural risk factors for dementia.Higher apathy predicted less physical activity and alcohol use, and increased odds of lifestyle risk factors.Depressive symptoms were not associated with any health behavior.Apathy may be a determinant of multiple health behaviors in older adults, distinct from depression and fatigue.Considering apathy in precision prevention of dementia appears warranted.

Impact of COVID-19 on Lifestyle: A Sample of Iranian Older Adults.

The COVID-19 pandemic and prolonged quarantine affect the health behaviors of older adults. We investigated the changes in older adults' lifestyles during the pandemic in a sample of 1020 people aged 60years old and over in Tehran. The results revealed that the COVID-19 pandemic had a positive impact on nutritional behaviors and social support while having a negative impact on physical activity and anxiety in older adults. Due to the greater deterioration of health behaviors among unmarried older adults, low socio-economic status, and COVID-19 inpatients, policymakers must pay attention to interventions to promote healthy lifestyles.

Effects of Exercise Behavior, Social Cohesion, and Social Support on Health Behaviors in Older Adults: Intervention in a Multi-Component Exercise Program

Effects of Exercise Behavior, Social Cohesion, and Social Support on Health Behaviors in Older Adults: Intervention in a Multi-Component Exercise Program

Hope and healthy lifestyle behaviors in older adulthood

Objectives Hope has been associated with better health and social well-being outcomes, including emotional adjustment, positive affect, life satisfaction, reduced risk of all-cause mortality, and increased physical activity, yet how hope as a construct impacts these health benefits in older adults is not very well-understood. This study examined: (1) the relationship between hope and health behaviors in older adults; (2) how this relationship may differ across different socio-demographic groups; and (3) how hope relates to perceived future selves among older adults. Methods The study used cross-sectional data from 711 community-dwelling adults aged ≥55 years (280 men, 431 women). Survey measures included the Snyder Adult Dispositional Hope Scale (ADHS) and the Herth Hope Index (HHI), a health behaviors checklist, self-reported health, and a future self-scale. Data were analyzed using bivariate and multiple regressions. Results Hope was positively associated with healthy behaviors in older adults. Participants with higher levels of hope also reported more positive future selves and better health. The associations were similar across different racial/ethnic groups. Conclusions This study fills an important gap in our understanding of hope and its association with health behaviors in community-dwelling older adults. These findings highlight a need to promote hope in older adults in order to enhance their sense of well-being.

Promoting Healthy Behaviors in Older Adults to Optimize Health-Promoting Lifestyle: An Intervention Study.

Introduction: Exercise intervention is the easiest and most effective way to promote human health. This study combined technology and exercise to improve the health behavior of the older adults through a physical activity intervention and to enhance a health-promoting lifestyle. Materials and methods: A quasi-experimental research method was used to openly recruit 120 healthy male and female older adults over 65 years old (average age of males: 71.6 ± 1.25 years; average age of females: 72.3 ± 1.28 years), all of whom wore smart bracelets. The participants were monitored by special personnel during the same period of walking every Monday to Friday. All participants recorded their daily steps, distance walked, and calorie consumption data for a period of 8 weeks. Results: After 8 weeks of walking, all participants showed a positive medium−high correlation of various factors between healthy behaviors and the health-promoting lifestyle scales. In the post-tests of each factor of two scales, males had the highest correlation between regular physical activity and physical activity, and females had the highest correlation between regular physical activity and social support. The variabilities in the explanatory power of the health behaviors of males and females on the health-promoting lifestyle were R2 = 70.9% (p < 0.01) and R2 = 74.1% (p < 0.01), indicating that the variables of healthy behaviors have a positive effect on health-promoting lifestyles in male and female older adults. Conclusions: Walking interventions positively affect the health behaviors of older adults and encourage health-promoting lifestyles. The value of this study is in its contribution to health promotion and public health recommendations for older adults.

UTILIZING COMMUNITY ANALYSIS TO INCREASE AWARENESS OF HEALTH DISPARITIES IN OLDER OKLAHOMANS

Abstract Where we live affects us. The state of Oklahoma consistently ranks in the bottom ten percent for health outcomes, health policies, and health behaviors of older adults. Physical therapy students in Oklahoma must recognize the impact that social determinants of health have on older adults in order to fully meet the needs of their future patients. Prior to final clinical experiences, third-year Doctor of Physical Therapy students explore these concepts through individual community analysis projects in urban and rural communities across the state. The students visit their chosen community to assess access to transportation services, food, housing, and healthcare-specific to older adults. Additionally, students explore opportunities for exercise classes targeted toward older adults and the walkability of the community. Students come away with a better understanding of the wide array of social determinants of health experienced by older adults in Oklahoma and learn of opportunities to advocate for future patients in their communities.

Factors Predicting the Coronavirus Disease 2019 Preventive Behaviors of Older Adults: A Cross-Sectional Study in Bangkok, Thailand.

The coronavirus disease 2019 (COVID-19) pandemic has affected the health behaviors of older adults. Thus, the factors predicting the COVID-19 preventive behaviors of older adults during the COVID-19 outbreak should be examined. Therefore, this study aimed to assess the COVID-19 preventive behaviors of older adults and explore the factors predicting these. A cross-sectional study was performed with 400 older adults who were selected using the cluster sampling technique. The associations of all variables in preventing COVID-19 infection with COVID-19 preventive behaviors were examined using stepwise multiple regression. The study results revealed that 70.8% of the study participants had high levels of COVID-19 preventive behaviors. Among these, self-efficacy in preventing COVID-19 infection (β = 0.224) showed the highest ability to predict COVID-19 preventive behaviors, followed by COVID-19 response efficacy (β = 0.171), knowledge about COVID-19 (β = 0.110), and gender (β = −0.102). Older adults adopted protective behaviors at the beginning of the COVID-19 pandemic. The predictors of these behaviors should be considered while designing and developing appropriate COVID-19 preventive behavior interventions, aimed at inducing behavioral modifications to reduce further infection with and spread of COVID-19.

The Relationship Between Meaning in Life and Health Behaviors in Adults Aged 55 Years and Over During the COVID-19 Pandemic: the Mediating Role of Risk Perception and the Moderating Role of Powerful Others Health Locus of Control.

Coronavirus disease 2019 (COVID-19) has impacted many people's meaning in life and health behaviors. This study aimed to verify the relationship among meaning in life (MIL), epidemic risk perception, health locus of control (HLC), and preventive health behaviors among older adults after the COVID-19 outbreak was declared a pandemic. In this longitudinal study, 164 participants aged 55years and above completed the following measures at time 1 (February 19, 2021) and one month later at time 2 (March 19, 2021): Meaning in Life in the Epidemic Questionnaire, Epidemic Risk Perception Questionnaire, Multidimensional Health Locus of Control Scale, and Health Behaviors Before and After the Epidemic Survey. Hayes' SPSS Process Macro was used to analyze the mediating effect of epidemic risk perception (model 4) and the moderating role of powerful others HLC in the mediation model (model 14). The results showed that after controlling for gender, age, education level, and health behaviors at the baseline, risk perception had a significant mediating effect on the relationship between MIL and preventive health behaviors (β = .02, SE = .01, 95% CI [.00, .04]). In addition, powerful others HLC had a moderating effect on the second half of the mediating effect (β = .02, p = .02, 95% CI [.00, .03]). Specifically, compared to the older adults with low powerful others HLC, the risk perception of older adults with high powerful others HLC increased preventive health behaviors. Practitioners should adequately cultivate older adults' risk awareness and reinforce the importance of advice from doctors and professionals, thereby effectively enhancing the preventive health behaviors of older adults in China during the COVID-19 pandemic.

Unconscious or conscious? The impacts of habit and social support receipt on older adults' continued participation in online health communities

PurposeOnline health communities (OHCs) can be complementary to healthcare systems to improve the health behaviors of older adults with chronic diseases. This study aims to examine the impacts of habit and social support receipt on older adults' continued participation in OHCs. Particularly, the authors discussed the influences of social support received in two ways: social support received by initiating threads (direct social support receipt) and social support received by being exposed to the threads initiated by others (indirect social support receipt).Design/methodology/approachBased on the dual-process model (i.e. conscious process and unconscious process), the authors developed the research model. Data from one of the biggest online diabetes communities in Europe were collected. Besides, we used the support vector machine algorithm for social support classification and used the Cox proportion hazards model for model validation.FindingsOlder adults' continued participation is influenced by habit and indirect informational support. Habit moderates the relationship between direct informational support receipt and older adults' continued participation. Furthermore, direct and indirect emotional support receipt are both not associated with older adults' continued participation, regardless of their habit strength.Originality/valueThis is the first study investigating older adults' continued participation in OHCs based on the dual-process model. The findings of this study reveal that older adults' continued participation is determined by both the habit and specific conscious evaluation of benefits based on the social support receipt.

Impacting Health Behaviors of Older Adults Through a Volunteer-Led Health Literacy Program

A community based, peer volunteer-driven educational program was developed to empower older adults to improve health behaviors through health literacy. A community needs assessment determined the curricula which included classes on chronic disease management and issues impacting older adult health. Volunteers were recruited and trained on the curricula by health educators using a train-the-trainer module. 173 volunteers convened 302 workshops, and trained 2,065 unique older adults who account for 5000 attendees. Using a pretest posttest design, an outcome evaluation found statistically significant increases in knowledge among older adult workshop attendees on 6 of the 7 health topics (p<.01). Eighty-three percent of attendees reported positive health behavior changes at 3-month follow-up. The most commonly cited changes were increased physical activity and improved nutrition. Program challenges included volunteer scheduling and retention. Building a sustainable community-based, peer volunteer-driven health education program for older adults will be discussed.

Sense of purpose in life and five health behaviors in older adults

Accumulating evidence shows that a higher sense of purpose in life is associated with lower risk of chronic conditions and premature mortality. Health behaviors might partially explain these findings, however, the prospective association between sense of purpose and health behaviors is understudied. We tested whether a higher sense of purpose at baseline was associated with lower likelihood of developing unhealthy behaviors over time. Prospective data were from the Health and Retirement Study, a national sample of U.S. older adults. Our sample included 13,770 adults assessed up to five times across eight years. Among people who met recommended guidelines for a given health behavior outcome at baseline, those in the top versus lowest quartile of purpose in life had 24% lower likelihood of becoming physically inactive (95% CI: 0.68–0.85), 33% lower likelihood of developing sleep problems (95% CI: 0.58–0.79), and 22% lower likelihood of developing unhealthy body mass index (BMI) (95% CI: 0.69–0.87) in sociodemographic-adjusted models. Further there was a marginal reduction in smoking relapse (HR = 0.65, 95% CI: 0.41–1.03) and no association with heavy alcohol use (HR = 1.02, 95% CI: 0.81–1.29). Findings for physical inactivity, sleep problems, and unhealthy BMI remained evident after further adjusting for baseline health status and depression. Our results, suggest that a sense of purpose in life might emerge (with further research) as a valuable target to consider for interventions aimed at helping older adults maintain some health behaviors.