Kristin Selker - PowerPoint Presentation

Slide1

Kristin SelkerAdvisor: Brenda Diergaarde, PhDPreceptors: Elizabeth A. Rodgers, MPH & Nancy W. Glynn, PhD

Experiences Implementing Community-Based Research through the Mobility and Vitality Lifestyle Program (MoveUp): The Accelerometry Ancillary StudySlide2

MoveUp

MoveUp is a community based translational behavioral weight management program to be implemented in 26 sites with >10 adults 60-75yrs of age with a BMI ranging 27-45 with several aims to: Adapt and develop a program deliverable by community health workers (CHWs)

Pilot content and training strategies collaborating with CHWs Implement and evaluate an evidence based program’s impact on physical function

Develop strategies for sustainability 1 

BackgroundOver 1/3 of older adults 65 years and over are obeseObesity is associated with an increase of risk for other health complications such as: Heart disease, stroke, Type II Diabetes

The aging population and increasing rate of obesity will contribute to an increase of health care service use and health care spending

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Ancillary Accelerometry

Study Objective: To examine the impact of the MoveUp

intervention on changes in physical activity and fatigability in community dwelling older adults. The study utilized the first 11 sites formed for the MoveUp intervention and their program participants.

Physical activity preserves functional capacity and reduces co-morbidities

Fatigability is the perceived lack of physical energy Translates into a perceived inability to continue an activity

Limits the person physicallyAn increase in fatigability due to a lack of physical or mental energy is associated with a reduction in activity levels and plays a role in the disablement pathway

3, 4, 5

.Slide4
Methods

Data was collected at three time points at each intervention site:Baseline

5 monthsBetween 9-13 monthsAt the time of each distribution:Participants completed the Pittsburgh Fatigability Scale

Received a SenseWear Armband and wrist ActiGraph to be worn for seven days to gather objective physical activity measures

My role: To continue the implementation of the study at the sites and to gain exposure to community based research by interacting with study participants and communicating with CHWsSlide5
Ancillary Sites

4/1/2016University of Pittsburgh CAPH PRC

5

Completed sites

Active sites

LegendSlide6
Site Characteristics

Site

characteristic

N (%)

Church

2 (18)

YMCA

3 (28)

Community

Centers

4 (36)

Senior Centers

1 (9)

Library

1 (9)

6

Site characteristic

N(%)

Urban

5 (45)

Suburban

6 (55)

Location of site

Number of participants

(128 total)

LSS Bellevue

14

Completed

Homewood YMCA

5

Completed

LSS Bellevue

9

Completed

Thelma Lovett

13

Completed

Kingsley

Association

9

Completed

Kingsley Association

15

Completed

Sampson YMCA

14

Completed

Longwood

14

Active

Sewickley Library

14

Completed

RCAC

8

Active

Phipps

13

ActiveSlide7
The Accelerometers

SenseWear ArmbandWorn on the back of the left triceps for seven days

Not water proof Uses skin temperature, heat exchange and galvanic skin response (sweat) to measure:Energy expenditurePhysical activity Sleep

6ActiGraph

Worn on the non-dominant wrist for seven daysWater resistant

Uses a light sensor and 3 axis accelerometer to detect:Physical activity Sleep/wake 7Slide8
Pittsburgh Fatigability Scale

At each time point participants completed the Pittsburgh Fatigability scale to measure perceived fatigue

Fatigability is a whole-body measure describing how fatigued one gets in relation to a defined activity anchored to a specific intensity and durationAn increase in fatigue may lead to deterioration in performance or discontinuation of activity altogether

3, 4, 5Slide9
Activities Prior to Distribution

Contact CHW 2 weeks prior to visit to confirm dateObtain information on participants from database

Sex, height, weight, race, handedness, smoking status, oxygen use Use Actilife and SenseWear Professional software to enter in participant information for each monitor Record serial number of each monitor corresponding to the assigned participant

Print Pittsburgh Fatigability Scale for each participant Create completed packets for each participant including:A label on the outside of packet stating start date and wear back date

Instruction sheetAssigned SenseWear Armband and ActiGraphSlide10
Activities During Distribution

Arrive early to meet with CHW Introduce myself to the participants and follow a script to instruct them on how to complete the Pittsburgh Fatigability Scale and how to wear the activity monitors

Answer questions the participants and CHWs may have about any aspect of the study. Discuss with the participants the best method for collecting the activity monitors It is important to make collection as convenient for the participants as possibleSlide11
Distribution ScriptSlide12
After Distribution After Collection

Communicate any issues at the visitEnter completed fatigability scales

Contact any participants who were absent from the class and make appropriate arrangements Inspect devices for any damagesDownload data from devices onto computer

Print out reports from SenseWear Armband dataGive reports to Dr. Glynn for approvalMail approved reports to participants

Transfer data from computer to external hard driveClean monitors

Wash armbands and wrist strapsSlide13
Sample

SenseWear Amband ReportSlide14

Raw ActiGraph Data

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Ancillary Study Progress

Over the course of my internship I have visited all of the 11 sites

I have completed 9 distributions and interacted with 98 participantsSenseWear Armband reports have been mailed out to all participants with usable data.All remaining distributions for the three active sites will be completed by January 2017

Participant race

N (%)

African American

37 (29)

Other

6

(6)

Caucasian

85 (66)

Participant Sex

N(%)

Male

19 (15)

Female

109 (85)Slide16
Overall Experience

Having a limited number of ActiGraphs and SenseWear Armbands affected the scheduling of sites

Pushed sites out of their window for the time pointAdditional devices were damaged during the course of the studySome participants experienced allergic reactionsRequired follow upRefusals due to:Disinterest

Too much effort to completeMonitors uncomfortable Contacting absent participants was difficult

Traveling to the sites required accounting for delays and constructionSlide17
Lessons Learned

Implementing a community based research study is extremely difficultInvolves extensive interaction with participants and others involved in the studyConstant communication with participants, community health workers, and preceptorsRequires excellent time management and attention to detail handling equipment, and data for multiple sites and coordinating distribution date calendar There were many unique challenges with the older adult population

Difficult to communicate with over the phoneMust speak slower and louder as some have difficulty hearingSlide18
References

1. Core Research Project-Mobility and Vitality Lifestyle Program. University of Pittsburgh Center for Aging and population health Sept 23 2016 <http://www.caph.pitt.edu/a-weight-management-intervention-program-called-mobility-and-vitality-lifestyle-program- move-up/>

2. Fakhouri TH, Ogden CL, Carroll MD, et al. Prevalence of obesity among older adults in the United States, 2007-2010. NCHS data brief, no 106. Hyattsville, MD: National Center for Health Statistics. 2012. Retrieved from <http://www.cdc.gov/nchs/data/databriefs/db106.htm>3. Assessing Fatigability in Mobility-Intact Older Adults Eleanor M. Simonsick, Jennifer A. Schrack, PhD,Nancy W. Glynn, PhD, Luigi

Ferrucci, The American Geriatrics Society 62:347–351, 20144. Glynn, Nancy W. AdamJ santanasto

, Eleanor M. Simonsick, Robert M. Boudreau, Scott R. Beach. Richard Schulz, Anne B. Newman. The Pittsburgh Fatigability Scale for Older Adults: Development and ValidationJournal of the American Geriatrics Society 63(1) ·2014

5. Schnelle, John F. Marciei S Buchowski

, T. Alp

Ikizler

, Daniel W Durkin, Linda

Beuscher, Sandra F Simmons. The Evaluation of Two Fatigability Severity Measures in Elderly Subjects J AM Geriatr

Soc. 2012 Aug; 60(8): 1527-1533.

6. Wearable

Metobolic

, Sleep and Activity Monitoring <https://templehealthcare.wordpress.com/the-sensewear-armband/>

7.

ActiGraph

Corp.

ActiGraph

wGT

-BT, 2016. <

http://actigraphcorp.com/products-showcase/activity-monitors/actigraph-wgt3x-bt/

>

8.

Urbanek, Jacek K. Vadim Zipunnikov, Tamara Harris, William Fadel, Nancy Glynn, Annemarie Koster, Paolo

Caserotti, Ciprian Cainiceanu,

Jaroslaw Harezlak Prediction of sustained harmonic walking in the free-living environment using raw accelerometry data May 18, 2015.