Maintaining Health Behavior Change in Older Adults

Jaime M. Hughes, PhD, MPH, MSW

Duke University and Durham VA Medical Centers NIA Center

Janet Prvu Bettger, ScD

Duke University School of Medicine

Susan L. Hughes, DSW

University of Illinois at Chicago

Minakshi Raj, PhD, MPH

University of Michigan

Project Description:

Emerging research suggests that initiating and maintaining health behavior change are distinct constructs, each depending upon unique goals, expectations, skills, and resources at individual, community, and population levels. Through a series of three related projects, this pilot application engages diverse stakeholders and national thought leaders to develop a theory-based, interdisciplinary conceptual model of maintenance, and discuss implications of this construct on research and training priorities. Specific activities include:

  1. Community listening sessions with patients, caregivers, providers, and community leaders
  2. Think Tank comprised of thought leaders in the field
  3. A series of educational events to be held at the Gerontological Society of America Annual Meeting in November 2020, including a Pre-Conference Workshop.

Potential Impact:

Few behavior change models or existing intervention-focused research studies actively address long-term behavior change, or maintenance. Furthermore, little attention is paid to how maintenance might be difficult for older adults who face multiple chronic conditions, competing cognitive and functional limitations, and numerous psychosocial challenges. These factors, both individually and in combination, and at both a single point in time and over time, may further complicate efforts to maintain health behaviors. By engaging clinicians, behavioral and social scientists, health services researchers, and implementation scientists, this series of projects will the potential to contribute to fill several voids within the field: first, by introducing an interdisciplinary conceptual model of maintenance; and, second, by identifying and addressing emerging educational needs for students and junior faculty hoping to advance both clinical and methodological findings in this area.

Next Steps:

Our project will result in a white paper that includes our interdisciplinary conceptual model, informed by community listening sessions and thought leader Think Tank, plus implications for future research and training programs. We will also submit a NIA R13 Conference Grant to provide an annual, in-person Pre-Conference Workshop at the Gerontological Society of America Annual Meeting focused on emerging theories, methods, and trial designs to better understand and support maintenance of health behavior change in older adults.

The importance/value of RCCN funding for this collaborative research:

Health behavior change is inherently interdisciplinary. Determinants of health behavior are built over one’s lifecourse (CDEA) and successful initiation and maintenance of health behaviors can impact an older adults’ function and independence (OAIC). However, successful initiation and maintenance may require program adaptations for special populations (ADRC, RCMAR). There is growing emphasis that successful health behavior interventions are principle-driven and built with an eye towards translation and sustainability (Roybal). RCCN plays a critical role in bringing together representatives and thought leaders from each of these NIA Centers to address the interdisciplinary challenges and opportunities surrounding initiation and maintenance of health behavior change in older adults.