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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.

The Americans' Changing Lives (ACL) survey series is an ongoing, nationally representative, longitudinal study focusing especially on differences between Black and White Americans in middle and late life. These data constitute the first, second, third, fourth, fifth, and sixth waves in a panel survey covering a wide range of sociological, psychological, mental, and physical health items. Wave I of the study began in 1986 with a nation face-to-face survey of 3,617 adults ages 25 and up, with Black Americans and people aged 60 and over over-sampled at twice the rate of the others. Wave II constitutes face-to-face re-interviews in 1989 of those still alive. Survivors have been re-interviewed by telephone, and when necessary face-to-face, in 1994 (Wave III), 2001/02 (Wave IV), 2011 (Wave V), and 2019/21 (Wave VI).

Please note that for Wave VI, the majority of data collection occurred in 2019, with only a small subset (n=39) of participants surveyed in 2021.

ACL was designed and sought to investigate the following: (1) The ways in which a wide range of activities and social relationships that people engage in are broadly "productive," (2) how individuals adapt to acute life events and chronic stresses that threaten the maintenance of health, effective functioning, and productive activity, and (3) sociocultural variations in the nature, meaning, determinants, and consequences of productive activity and relationships. Among the topics covered are interpersonal relationships (spouse/partner, children, parents, friends), sources and levels of satisfaction, social interactions and leisure activities, traumatic life events (physical assault, serious illness, divorce, death of a loved one, financial or legal problems), perceptions of retirement, health behaviors (smoking, alcohol consumption, overweight, rest), and utilization of health care services (doctor visits, hospitalization, nursing home institutionalization, bed days). Also included are measures of physical health, psychological well-being, and indices referring to cognitive functioning.

Demographic information provided for individuals includes household composition, number of children and grandchildren, employment status, occupation and work history, income, family financial situation, religious beliefs and practices, ethnicity, race, education, sex, and region of residence.

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.

Since 2013, the Robert Wood Johnson Foundation (RWJF) has led the development of a pioneering national action framework to advance a "culture that enables all in our diverse society to lead healthier lives now and for generations to come." Accomplishing these principles requires a national paradigm shift from a traditionally disease and health care-centric view of health toward one that focuses on well-being. Recognizing that paradigm shifts require intentional actions, RWJF worked with RAND researchers to design an actionable path to fulfill the Culture of Health (CoH) vision. A central piece of this work is the development of measures to assess constructs underlying a CoH.

The National Survey of Health Attitudes is a survey that RWJF and RAND analysts developed and conducted as part of the foundation's CoH strategic framework. The foundation undertook this survey to measure key constructs that could not be measured in other data sources. Thus, the survey was not meant to capture the full action framework that informs CoH, but rather just selected measure areas. The questions in this survey primarily addressed the action area: making health a shared value. The survey covers a variety of topics, including views regarding what factors influence health, such as the notion of health interdependence (peer, family, neighborhood, and workplace drivers of health), values related to national and community investment for health and well-being; behaviors around health and well-being, including civic engagement on behalf of health, and the role of community engagement and sense of community in relation to health attitudes and values.

Since 2013, the Robert Wood Johnson Foundation (RWJF) has led the development of a pioneering national action framework to advance a "culture that enables all in our diverse society to lead healthier lives now and for generations to come." Accomplishing these principles requires a national paradigm shift from a traditionally disease and health care-centric view of health toward one that focuses on well-being. Recognizing that paradigm shifts require intentional actions, RWJF worked with RAND researchers to design an actionable path to fulfill the Culture of Health (CoH) vision. A central piece of this work is the development of measures to assess constructs underlying a CoH.

The National Survey of Health Attitudes is a survey that RWJF and RAND analysts developed and conducted as part of the foundation's CoH strategic framework. The foundation undertook this survey to measure key constructs that could not be measured in other data sources. Thus, the survey was not meant to capture the full action framework that informs CoH, but rather just selected measure areas. The questions in this survey primarily addressed the action area: making health a shared value. The survey covers a variety of topics, including views regarding what factors influence health, such as the notion of health interdependence (peer, family, neighborhood, and workplace drivers of health), values related to national and community investment for health and well-being; behaviors around health and well-being, including civic engagement on behalf of health, and the role of community engagement and sense of community in relation to health attitudes and values.

This study includes the results from the 2018 RWJF National Survey of Health Attitudes. This 2018 survey is considered the second wave, the first wave of the survey was conducted in 2015 (ICPSR 37405). In 2018, the study team fielded an updated version that included many of the same questions but added some new constructs that were of interest as part of the larger Culture of Health effort. This study complements the overview of the 2015 survey described in the RAND report Development of the Robert Wood Johnson Foundation National Survey of Health Attitudes (Carman et al., 2016).

Since 2013, the Robert Wood Johnson Foundation (RWJF) has led the development of a pioneering national action framework to advance a "culture that enables all in our diverse society to lead healthier lives now and for generations to come." Accomplishing these principles requires a national paradigm shift from a traditionally disease and health care-centric view of health toward one that focuses on well-being. Recognizing that paradigm shifts require intentional actions, RWJF worked with RAND researchers to design an actionable path to fulfill the Culture of Health (CoH) vision. A central piece of this work is the development of measures to assess constructs underlying a CoH.

The National Survey of Health Attitudes (NSHA) is a survey that RWJF and RAND analysts developed and conducted as part of the foundation's CoH strategic framework. The foundation undertook this survey to measure key constructs that could not be measured in other data sources. Thus, the survey was not meant to capture the full action framework that informs CoH, but rather just selected measure areas. The questions in this survey primarily addressed the action area: making health a shared value. The survey covers a variety of topics, including views regarding what factors influence health, such as the notion of health interdependence (peer, family, neighborhood, and workplace drivers of health), values related to national and community investment for health and well-being; behaviors around health and well-being, including civic engagement on behalf of health, and the role of community engagement and sense of community in relation to health attitudes and values.

This study includes the results from the 2023 RWJF National Survey of Health Attitudes. The 2023 survey is the third wave of the NSHA. The first wave was conducted in 2015 (ICPSR 37405) and the second wave in 2018 (ICPSR 37633). The 2023 report complements the overview of the 2015 survey described in the RAND report Development of the Robert Wood Johnson Foundation National Survey of Health Attitudes (Carman et al., 2016), and its subsequent topline 2018 Survey of National Health Attitudes: Description and Top-Line Summary (Carman et al., 2019) and is organized similarly for consistency. A companion set of longitudinal surveys during the COVID-19 pandemic was fielded between 2020 and 2021 and is further described in four top-line reports, COVID-19 and the Experiences of Populations at Greater Risk (Carman et al., 2020-2021).

The questions in the 2023 survey uniquely capture aspects of American mindset about health, health equity, structural racism, and wellbeing in ways that are not present in other surveys. This version of the NSHA can be viewed in three main sections: (1) individual health experiences, perspectives, and knowledge (making health a shared value); (2) health equity perspectives; and (3) community wellbeing, including climate views and barriers to community engagement. Insights from the surveys referenced above, including this one, have established a baseline and set of cross-sectional pulse checks on where the American public is regarding their recognition of social determinants of health, their understanding of health inequities including structural racism, their willingness to address those inequities and their indication of who in society should be responsible for solving health inequities.

Prescription for Health was an initiative funded by the Robert Wood Johnson Foundation in collaboration with the Agency for Healthcare Research and Quality. Under this initiative, primary care practice-based research networks (PBRNs) -- groups of ambulatory practices devoted principally to the primary care of patients -- developed, tested, and evaluated innovative strategies to improve the delivery and effectiveness of health behavior change services in primary care practice. The strategies targeted four health risk behaviors: tobacco use, unhealthy diet, lack of physical activity, and risky alcohol use. Prescription for Health was conducted in two rounds. Round one awarded grants to 17 PBRNs to test the feasibility of implementing the strategies, while round two awarded grants to ten PBRNs to measure the strategies' effectiveness and the expenses associated with them. More than a 100 primary care practices from the ten PBRNs participated in the evaluation.

This data collection comprises the data from one of the data collection efforts carried out by the second round: the responses to the Practice Information Form (PIF), a Web-based instrument which captured key organizational attributes of the participating practices. The PIF data were collected at two time points. Baseline data were collected from each practice before the intervention was implemented and follow-up data were collected approximately one year after the start of the intervention.

Information about the practices collected by the PIF include practice type and ownership; characteristics of each clinician and non-clinician staff person; number of vacancies for clinicians and non clinicians; number of exam rooms and volume of office visits; average number of new patients per month; percentages of patients in various age, race, Hispanic origin, and payer categories; and the predominant type of payment arrangement with health plans. In addition, the PIF asked whether a specific health plan controlled over half of the practice's total business; whether the practice had a pay-for-performance program; whether any payers or organizations publicly reported practice level performance information, such as patient satisfaction, chronic care/disease management, and/or preventive service delivery; and whether practices had a formal process for routinely measuring satisfaction among patients, clinicians, and other staff. The PIF also investigated how practices motivated their clinicians and staff; the level of competition among practices in local markets; the use of computers, electronic medical record systems, and patient registries; major changes that affected each practice's ability to make improvements in patient care; factors that prevented practices from translating the results of research into changes in medical practice; and the use of health risk assessment protocols or questionnaires to identify patients who may benefit from counseling or interventions. Questions about the four Prescription for Health behaviors -- physical activity, healthy eating, smoking cessation, and addressing risky drinking -- asked how practices linked patients to outside resources for each of the four behaviors; how practices used evidence-based guidelines and informed patients about recommendations for the behaviors; and which approaches practices used to support patients ready to engage in a behavior change for each of the behaviors.