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.
N1 - Funding Information:
Research reported in this publication was supported by the National Institute on Aging and the National Institute of Mental Health under grant number R01AG046149. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Funding Information:
Research reported in this publication was supported by the National Institute on Aging and the National Institute of Mental Health under grant number R01AG046149 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health .
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 -