Active for Life: Translation of Physical Activity Programs for Mid-Life and Older Adults, 2003-2007 [United States] (ICPSR 24723)
Sponsored by the Robert Wood Johnson Foundation, the Active for Life (AFL) initiative investigated how two physical activity programs for adults aged 50 and older, Active Choices (AC) and Active Living Every Day (ALED), worked in community settings. Created by researchers at Stanford University, Active Choices used lifestyle counseling and personalized telephone support to encourage older adults to be physically active. In AFL, this was a 6-month program delivered through one face-to-face meeting followed by up to eight one-on-one telephone counseling calls. Active Living Every Day, which was created by the Cooper Institute and Human Kinetics Inc., also provided lifestyle counseling to promote physical activity, but in a classroom and workbook format. During the first three years of the four-year AFL initiative, ALED was delivered as a 20-week program where participants attended weekly small group meetings, but in the last year it was shortened to 12 weekly meetings. Nine organizations received AFL grants to implement the programs during 2003-2006. Four grantees implemented the one-on-one AC model, while five implemented the group-based ALED model.
Data were collected from the AC and ALED sites for both a process and outcomes evaluation. The primary aims of the process evaluation were to (1) monitor the extent to which the grantees demonstrated fidelity to the AC and ALED models in their program implementation, (2) assess staff experiences implementing the programs, and (3) assess participants' impressions of the programs. A quasi-experimental, pre-post study design was used to assess outcomes. Primary aims of the outcomes evaluation were to evaluate the impact of AC and ALED on self-reported physical activity, and to evaluate the impact of the programs on self-reported stress, depressive symptoms, and satisfaction with body function and appearance. Secondary aims of the outcome evaluation were to (1) evaluate the impact of the programs on measures of functional fitness, (2) examine whether changes in self-reported physical activity and functional fitness were moderated by participant characteristics, including age, gender, race, baseline physical activity self-efficacy, and baseline physical activity social support, and (3) examine whether changes in self-reported physical activity were consistent with a mediation model for physical activity self-efficacy and physical activity social support.
The collection has 14 data files (datasets). Datasets 1-7 constitute the process evaluation data, and Datasets 8-14 the outcomes evaluation data:
Dataset 1 (AC Initial Face-to-Face Sessions Data) contains information about the initial face-to-face AC session: the format, date, and length of the session, whether the 8 steps required in the face-to-face session were completed, what was discussed between the health educator and the participant related to physical activity plans, interests, benefits, and barriers, and the health educator's progress notes. The file contains one record for each AC participant.
Dataset 2 (AC Completed Calls Data) comprises information about the completed AC calls, but does not cover the topics discussed on the calls. Recorded information about each call includes the date and length of the call, the health educator's progress notes, and whether the participant was assessed for injury, light activity, moderate activity, exercise goals, or exercise intentions. Each call is represented by a separate record in the data file and, typically, there are multiple records per participant.
Dataset 3 (AC Topics Discussed on Completed Calls ) contains information about the topics discussed on each completed AC call, e.g., exercise barriers/benefits, previous exercise experiences, goal setting, long term goals, injury prevention, rewards/reinforcement, social support, progress tracking, and relapse prevention. Each record in the file represents one topic and there are often multiple records per call for each participant.
Dataset 4 (AC Aggregate Call Data) aggregates the call data across calls for each AC participant. For example, for a given participant, this dataset shows the total number of calls completed, the number of calls where injury/health problems were assessed, etc. The file contains one record per participant.
Dataset 5 (ALED Sessions Data) contains information about each class session for every ALED group, including the session date, start time, and end time, learning activities covered in the session, participant evaluations of the session and the facilitator, facilitator progress notes, the number of participants who were in various stages of readiness for moderate exercise, and the number of participants who tracked physical activity and thoughts about physical activity. This file has one record for each session of every ALED group.
Dataset 6 (ALED Attendance and Tracking Data (Years 2-4)) consists of participant-level attendance and tracking data for every ALED session during the second to fourth years of the evaluation, including the participant's attendance at the session, whether the participant's stage of readiness was assessed, and whether the participant tracked thoughts about physical activity or actual physical activity. There is no participant-level ALED data for the first year. Each participant has a separate record for each session. Thus, the file contains 20 records per participant in the years 2-3, and 12 records per participant in year 4.
Dataset 7 (ALED Aggregate Attendance and Tracking Data (Years 2-4)) contains ALED attendance and tracking data for each participant in years 2-4, aggregated across the sessions. The data file has one record for each participant.
Dataset 8 (Demographics) comprises program information (e.g., program status, start date, end date, site, etc.), demographic information (e.g., age, gender, race, Hispanic origin, employment status, income, and the participant's state and ZIP code of residence), and responses to the Physical Activity Readiness Questionnaire (PAR-Q), a screening tool that was used to assess possible risks of exercising based on answers to specific health history questions. The file contains one record for each AFL participant, except for those with a status of "nonstarter" or "repeater."
Datasets 9 (Pretest Survey Data) and 10 (Posttest Survey Data) contain data from the Pretest and Posttest Surveys. The Pretest Survey was administered at the beginning of the AC and ALED programs, while the Posttest Survey was administered at their end. Topics covered by the surveys include social and recreational activities, activities undertaken for exercise, perceived stress, depressive symptoms, satisfaction with body appearance and function, social support for physical activity, self-efficacy for physical activity, neighborhood environment, health conditions, health-related quality of life, caregiving, and self-reported height and weight. Both surveys included items from the Community Health Activities Model Program for Seniors Physical Activity Questionnaire (CHAMPS), the Center for Epidemiological Studies Depression Questionnaire (CES-D), the Behavioral Risk Factor Surveillance System Questionnaires (BRFSS), and the International Physical Activity Prevalence Study Environmental Module. These data files each have one record for each participant who submitted a questionnaire.
Dataset 11 (ALED Week 12 Survey Data (Year 4)) contains responses to the ALED Week 12 Posttest Survey, which was used to evaluate the 12-week adaptation of ALED in Year 4. (In Year 4, ALED participants completed both a 12- and 20-week posttest survey). There is one record for each participant who returned this survey.
Dataset 12 (Six-Month Posttest Follow-Up Survey Data (Years 3-4)) comprises data from a special 6-month follow-up survey which was administered in years 3-4 in six of the ALED sites and one of the AC sites. Participants were questioned about their current physical activities, weight, health-related quality of life, satisfaction with bodily function, and other topics. As with Datasets 9-11, the data file contains one record for each participant who returned a questionnaire.
Dataset 13 (Functional Fitness Tests Data) contains the results of pretest and posttest functional fitness tests which were administered by one ALED grantee. Four tests were adminstered: (1) the 30-Foot Walk Test, (2) the 30-Second Chair Stand, (3) 8-Foot Up and Go, and (4) the Chair Sit and Reach Test. This participant-level data file also includes pretest height measurements plus pretest and posttest weight measurements.
Dataset 14 (Participants' Impressions of the Programs (Years 1, 3, and 4)) contains data collected by the last sections of the Posttest Survey, ALED Week 12 survey, and 6-Month Follow-up Survey. The topics it covers include the participants' impressions of the programs, participation in physical activities, and changes (compared to before they started the AFL program) in motivation to be physically active, actual level of physical activity, medical and health conditions, overall pain, flexibility/limberness, level of stress, happiness, and enjoyment of life. The file has a separate record for each survey completed by the participants. Thus, there are 1-3 records per participant.
Evaluation of Better Jobs Better Care: Clinical Manager Survey, 2004-2007 [Iowa, North Carolina, Oregon, Pennsylvania, and Vermont] (ICPSR 29063)
Funded by the Robert Wood Johnson Foundation and The Atlantic Philanthropies, Better Jobs Better Care (BJBC) was a demonstration program that sought to bring about changes in public policy and management practice that would lead to improved recruitment and retention of high-quality paraprofessional direct care workers (DCW) in nursing homes as well as in home- and community-based settings. This was to be accomplished by implementing both policy and management practice goals. Policy goals included developing initiatives related to wages and benefits, incentives for job redesign, curriculum and credentialing, professional associations, and promotion of public awareness and policies. Practice goals involved interventions related to caregiving skill development, peer mentoring, team building, top management training, supervisor training, and provider-specific interventions. The program established demonstration projects in Iowa, North Carolina, Oregon, Pennsylvania, and Vermont which enrolled long-term care establishments across the spectrum of long-term care settings: skilled nursing facilities, assisted living facilities, home care agencies, and adult day service providers.
Conducted as part of the BJBC evaluation, which used a before-after design to assess the implementation of the interventions and their impact, this survey of the top clinical manager at each participating long-term care provider explored the establishments' organizational characteristics and management practices. One version of the survey was administered at the beginning of the demonstration (Time1), and a second version, toward the end of the demonstration (Time 2). Organizational characteristics covered by the survey include nonprofit/for-profit status, whether the establishment was free standing or part of a chain, number of competing establishments, whether the DCWs were unionized, and the type and amount of services provided. Management practices investigated by the survey include participation in care planning, communication about tasks, feedback, DCW training, management communication, organizational readiness for change, professional development, and work design practices. The survey also collected information about the racial and Hispanic origin composition of DCWs and patients/residents/clients.
Evaluation of Better Jobs Better Care: Direct Care Worker Survey, 2004-2007 [Iowa, North Carolina, Oregon, Pennsylvania, Vermont] (ICPSR 29064)
Funded by the Robert Wood Johnson Foundation and The Atlantic Philanthropies, Better Jobs Better Care (BJBC) was a demonstration program that sought to bring about changes in public policy and management practice that would lead to improved recruitment and retention of high-quality paraprofessional direct care workers (DCW) in nursing homes as well as in home- and community-based settings. This was to be accomplished by implementing both policy and management practice goals. Policy goals included developing initiatives related to wages and benefits, incentives for job redesign, curriculum and credentialing, professional associations, and promotion of public awareness and policies. Practice goals involved interventions related to caregiving skill development, peer mentoring, team building, top management training, supervisor training, and provider-specific interventions. The program established demonstration projects in Iowa, North Carolina, Oregon, Pennsylvania, and Vermont which enrolled long-term care establishments across the spectrum of long-term care settings: skilled nursing facilities, assisted living facilities, home care agencies, and adult day service providers.
Conducted as part of the BJBC evaluation, this survey interviewed DCWs at two points during the demonstration. The Time 1 interview was fielded as soon as establishments enrolled in the demonstration and provided a list of their DCWs (July 2004 to December 2006), and the Time 2 interviews were completed 12 to 28 months after the Time 1 interviews (April 2006 to June 2007). Both rounds of the survey used the same self-administered questionnaire which included questions about length of employment, job satisfaction, job rewards and problems, supervision, perceptions of quality of care, job confidence, training, intent to quit, and demographic characteristics. The survey also elicited recommendations for improving DCWs' jobs by asking the open-ended question "What is the single most important thing your employer could do to improve your job as a direct care worker?"
Evaluation of Better Jobs, Better Care: Frontline Supervisor Survey, 2005-2007 [Iowa, North Carolina, Oregon, Pennsylvania, Vermont] (ICPSR 23000)
In long-term care, frontline supervisors play a central role in direct care workers' (DCW) job quality and turnover and are critical to the implementation of management changes. To better understand supervisors' perceptions of management practices, the quality of supervision, and the effect on DCW turnover and job quality, the Office of the Assistant Secretary for Planning and Evaluation in the United States Department of Health and Human Services contracted with Pennsylvania State University to conduct this survey of supervisors participating in the Better Jobs, Better Care (BJBC) demonstration. Funded by the Robert Wood Johnson Foundation and The Atlantic Philanthropies, the BJBC demonstration -- which took place in Iowa, North Carolina, Oregon, Pennsylvania, and Vermont -- tested innovative policy and practice models designed to improve the quality of DCW jobs in an effort to improve recruitment and retention of these workers and strengthen capacity to meet future demand for long-term care.
Frontline supervisors were interviewed from the four types of facilities and agencies that participated in the demonstration: skilled nursing facilities, assisted living facilities, home care agencies, and adult day service providers. The survey explored the supervisors' job responsibilities, formal training, job satisfaction, and thoughts about quitting. It investigated the culture of the organizations in which the supervisors worked, probed for problems with the supervisors' jobs, assessed how rewarding the supervisors felt their jobs were, inquired as to whether the supervisors felt respected by their clients, DCWs, and managers, gauged the supervisors' assessments of the overall competency level of the DCWs in their organizations, and explored the supervisors' beliefs about managerial support for the BJBC project, how well the BJBC programs were executed, and whether the overall impact of the project was positive.
In addition, the respondents were queried about management practices (e.g., rotation of assignments to different services or units, mechanisms to handle employee concerns, and approaches used to handle poor performance or negative behaviors among employees). They were also asked about DCW training, mentoring, and career ladder programs, DCW participation in patient/resident/client care plans, and communication among DCWs and between DCWs and their supervisors. Respondents were also asked what was the most important thing that their employer could do both to improve the jobs of DCWs and to improve their own ability to do their jobs as supervisors of DCWs. Additional information collected by the survey includes the supervisors' age, sex, race, Hispanic origin, educational attainment, nursing degree or license (LPN, RN, Diploma RN, BSN, MSN, or Advanced Practice Nurse), wages, and health insurance coverage.
This collection comprises three data files: (1) Supervisor Identification Instrument Data, (2) Supervisor Survey Data, and (3) Clinical Managers Who Are Also Supervisors Data. The first file contains information collected by the Supervisor Identification Instrument that was submitted to the clinical manager at each BJBC provider organization. This instrument instructed clinical managers to name all of the supervisors in their organization and to indicate which supervisory responsibilities each one performed. The second data file contains the responses to the Supervisor Survey questionnaire.The third data file contains the responses of clinical managers who also functioned as supervisors in their organization. These clinical managers responded to the same questions in the Supervisor Survey questionnaire, except for ten questions that were worded somewhat differently.
National Impact Study: Best Practice Physical Activity Programs for Older Adults, 2004-2006 (ICPSR 23240)
This study was one of three modules in a larger study designed to define, identify, and disseminate information about best practice physical activity programming in community-based organizations. The National Council on the Aging (NCOA), together with the Robert Wood Johnson Foundation (RWJF), conducted Module 1, a national competition for NCOA Awards for Excellence in Physical Activity Programming. The purpose of the competition was to bring national attention to best practice in physical activity programming operated by local public or non-profit organizations that serve older adults. NCOA was assisted in this endeavor by the University of Illinois at Chicago (UIC), the Healthy Aging Research Network of the Centers for Disease Control and Prevention's Prevention Research Centers, and a variety of nationally known physical activity experts. Module 2 was a census of physical activity programs for older adults that was conducted in seven locations by Healthy Aging Research Network. Module 3 was this National Impact Study, a study of best practice programming at three community-based organizations serving older adults. It was designed to answer the research question, "Do best practice physical activity programs provided by community-based organizations have a measurable impact on the health and well being of participants?" The three studied organizations were among the ten winners of the best practice competition.
Data were collected from previously sedentary, volunteer participants from each of the three organizations. The goal was to enroll 250 older adults at each site for a total of 750 subjects across the three programs. At each site, one half of all subjects (n = 125) were to be assigned to the treatment group and the other half to a control group. Subjects in the treatment group participated in the best practice program classes while the control group could enroll in other exercise classes but not the best practice program classes. The subjects were to be interviewed three times: baseline, three months, and nine months. Each interview contained two parts: (1) the administration of health and exercise related questions and (2) the administration of four physical fitness tests that assessed the respondent's strength, flexibility and aerobic endurance. Background information collected by the survey includes age, education, employment status, marital status, income, race, and Hispanic origin.