TY - JOUR
T1 - Effectiveness of a Disability Preventive Intervention for Minority and Immigrant Elders
T2 - The Positive Minds-Strong Bodies Randomized Clinical Trial
AU - Alegría, Margarita
AU - Frontera, Walter
AU - Cruz-Gonzalez, Mario
AU - Markle, Sheri Lapatin
AU - Trinh-Shevrin, Chau
AU - Wang, Ye
AU - Herrera, Lizbeth
AU - Ishikawa, Rachel Zack
AU - Velazquez, Esther
AU - Fuentes, Larimar
AU - Guo, Yuying
AU - Pan, Janet
AU - Cheung, Megan
AU - Wong, Jeanine
AU - Genatios, Urania
AU - Jimenez, Aida
AU - Ramos, Zorangelí
AU - Perez, Giselle
AU - Wong, Josephine Yankau
AU - Chieng, Ching King
AU - Bartels, Stephen J.
AU - Duan, Naihua
AU - Shrout, Patrick E.
PY - 2019/12
Y1 - 2019/12
N2 - Objective: To test the acceptability and effectiveness of a disability prevention intervention, Positive Minds-Strong Bodies (PMSB), offered by paraprofessionals to mostly immigrant elders in four languages. Design: Randomized trial of 307 participants, equally randomized into intervention or enhanced usual care. Setting: Community-based organizations in Massachusetts, New York, Florida, and Puerto Rico serving minority elders. Data collected at baseline, 2, 6, and 12 months, between May 2015 and March 2019. Participants: English-, Spanish-, Mandarin-, or Cantonese-speaking adults, age 60+, not seeking disability prevention services, but eligible per elevated mood symptoms and minor to moderate physical dysfunction. Interventions: Ten individual sessions of cognitive behavioral therapy (PM) concurrently offered with 36 group sessions of strengthening exercise training (SB) over 6 months compared to enhanced usual care. Measurements: Acceptability defined as satisfaction and attendance to >50% of sessions. Effectiveness determined by changes in mood symptoms (HSCL-25 and GAD-7), functional performance (SPPB), self-reported disability (LLFDI), and disability days (WHODAS 2.0). Results: Around 77.6% of intervention participants attended over half of PM Sessions; 53.4% attended over half of SB sessions. Intent-to-treat analyses at 6 months showed significant intervention effects: improved functioning per SPPB and LLFDI, and lowered mood symptoms per HSCL-25. Intent-to-treat analyses at 12 months showed that effects remained significant for LLFDI and HSCL-25, and disability days (per WHODAS 2.0) significantly decreased 6-month after the intervention. Conclusions: PMSB offered by paraprofessionals in community-based organizations demonstrates good acceptability and seems to improve functioning, with a compliance-benefit effect showing compliance as an important determinant of the intervention response.
AB - Objective: To test the acceptability and effectiveness of a disability prevention intervention, Positive Minds-Strong Bodies (PMSB), offered by paraprofessionals to mostly immigrant elders in four languages. Design: Randomized trial of 307 participants, equally randomized into intervention or enhanced usual care. Setting: Community-based organizations in Massachusetts, New York, Florida, and Puerto Rico serving minority elders. Data collected at baseline, 2, 6, and 12 months, between May 2015 and March 2019. Participants: English-, Spanish-, Mandarin-, or Cantonese-speaking adults, age 60+, not seeking disability prevention services, but eligible per elevated mood symptoms and minor to moderate physical dysfunction. Interventions: Ten individual sessions of cognitive behavioral therapy (PM) concurrently offered with 36 group sessions of strengthening exercise training (SB) over 6 months compared to enhanced usual care. Measurements: Acceptability defined as satisfaction and attendance to >50% of sessions. Effectiveness determined by changes in mood symptoms (HSCL-25 and GAD-7), functional performance (SPPB), self-reported disability (LLFDI), and disability days (WHODAS 2.0). Results: Around 77.6% of intervention participants attended over half of PM Sessions; 53.4% attended over half of SB sessions. Intent-to-treat analyses at 6 months showed significant intervention effects: improved functioning per SPPB and LLFDI, and lowered mood symptoms per HSCL-25. Intent-to-treat analyses at 12 months showed that effects remained significant for LLFDI and HSCL-25, and disability days (per WHODAS 2.0) significantly decreased 6-month after the intervention. Conclusions: PMSB offered by paraprofessionals in community-based organizations demonstrates good acceptability and seems to improve functioning, with a compliance-benefit effect showing compliance as an important determinant of the intervention response.
KW - CHW
KW - Racial/ethnic minority elders
KW - anxiety
KW - depression
KW - disability
KW - immigrants
UR - http://www.scopus.com/inward/record.url?scp=85071669678&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85071669678&partnerID=8YFLogxK
U2 - 10.1016/j.jagp.2019.08.008
DO - 10.1016/j.jagp.2019.08.008
M3 - Article
C2 - 31494015
AN - SCOPUS:85071669678
VL - 27
SP - 1299
EP - 1313
JO - American Journal of Geriatric Psychiatry
JF - American Journal of Geriatric Psychiatry
SN - 1064-7481
IS - 12
ER -