Walking: Motivating Older Adults (Research, Video 2:58)

Walking. There is a great deal of evidence supporting the health benefits of regular walking for adults. Still, many have not embraced the practice and appear to need more outside motivation. In this study on motivating older adults to walk more, outside incentives included money and donations to charity. The effects of both of these incentives in terms of their improvement and retention in levels of walking were also evaluated. Participants included 94 older adults aged 65 and older living in a Philadelphia-area retirement community.

Using digital pedometers, participants kept tract of increasing their walking progress by 50% in daily steps. Weekly progress was recorded. Participants were randomly selected for these four groups:

1) Control Group: received weekly feedback only.

2) Financial Incentives: received payment of $20 each week walking goals were met.

3) Social Goals: received donation of $20 to a charity of choice each week walking goals were met.

4) Combined: received $20 each week walking goals were met that could be received by participant, donated to a charity of choice, or divided between the participant and charity.

At the end of this 16-week experiment, conclusions indicated that donations to a charity of choice, personal financial incentives, or a combination of the two can each increase older adults' initial uptake of increased levels of walking. People the world over are living longer, and now a new study shows who is likely to live the longest. The information could help doctors and others, including the elderly, plan goals for treatment and care.

Based on this experiment, do you think older adults in need of more motivation should be paid to walk? In this video, walking speed is associated with longevity because it often reflects how well many body systems operate. However, even slower walking is encouraged if that is the walker’s preference.

Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.

Hospice and Nursing Homes Blog

African American Research Recruitment: Building Trust (Research, Video 2:10)

African Americans have a long history of valid reasons to distrust America’s healthcare system, particularly regarding medical research. Incidents go far beyond the well known Tuskegee Institute Syphilis Experiment, in which the U.S. Public Health Service allowed almost 400 African American men with the disease to go untreated, while pretending to treat them. Ultimately, the men died and unauthorized autopsies were done as part of the experiment. Numerous researched atrocities of involuntary experimentation targeting African Americans, including those in military and prison environments, can be cited throughout history to the present.

It is critically important that African Americans are informed, vigilant, and empowered when dealing with researchers and healthcare institutions. The burden of establishing trust primarily rests with America’s healthcare system that caused the distrust, not the victims who continue to suffer from ongoing tragedies of cradle-to-grave disparities impacting them even when income, health insurance, and access to care are the same among various racial-ethnic groups. In addition to generational suffering and repercussions on many levels, illnesses create long-term economic burdens and major losses of productivity in society.

An example of a church-based end-of-life dementia education research project was conducted at four large urban African American churches. Serious trust building is needed in the church community to recruit African Americans for church-based hospice and palliative care research. Not surprisingly, church leaders voiced mistrust concerns, including mistrust concerns of previous researchers who conducted investigations in their faith-based institutions. The following strategies were used to decrease the mistrust concerns:

1) Face-to-face, in-depth interviews were conducted from a convenient sample of four established AA church leaders.

2) Interviews were held in the informants' churches to promote candor and comfort in revealing sensitive information about trust /mistrust.

3) Content analysis framework was used to analyze the data.

4) Elements identified from the analysis were then used to create themes about positive and negative experiences with researchers, violation of trust, and trust building strategies.

In conclusion, findings suggest that researchers who wish to conduct successful studies in African American religious institutions must implement trust-rebuilding strategies that include mutual respect, collaboration, and partnership building. If general moral practices continue to be violated, future hospice and palliative care research within the institutions may be threatened. If this happens, benefits of church members, the African American community, and advancement of end-of-life care all suffer.

In the following video, Dr. Janel Johnson of the National Institute on Aging emphasizes the important need for African American volunteers in research studies in order to treat various diseases effectively, particularly as disease treatments have become more person-centered and working better for different people.

Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.

Hospice and Nursing Homes Blog