Understanding the mechanisms of change in a lifestyle intervention for older adults

Juang, Christine and Knight, Bob G. and Carlson, Mike and Schepens Niemiec, Stacey L. and Vigen, Cheryl and Clark, Florence (2017) Understanding the mechanisms of change in a lifestyle intervention for older adults. Gerontologist. ISSN 0016-9013


Purpose of the Study:

This study investigated the mechanisms of change underlying an activity-based lifestyle intervention, an occupational therapy program aimed at promoting healthy habits, and routines in older adults. We examined two activity-relevant factors as potential mediators linking the intervention to reduced symptoms of depression: activity frequency and global perceptions of activity significance. Social connections and perceived control were assessed to understand how activity-related factors relate to reduced symptoms of depression.

Design and Methods:
The sample consisted of 460 multiethnic community-dwelling older adults aged 60–95 years. Participants were randomly assigned to a 6-month lifestyle redesign intervention (n = 232) or a no-treatment control (n = 228) condition. After the 6-month period, 360 individuals completed post-testing. Latent change score models were used to represent changes from baseline over the experimental interval. Structural equation models were applied to examine the indirect effects of the intervention on reduced depressive symptoms.


The results demonstrated significant indirect effects from intervention receipt to decreased depressive symptoms via increased activity frequency and activity significance. Higher activity frequency was linked to fewer depressive symptoms via heightened social connections, whereas increased activity significance was associated with fewer depressive symptoms via enhanced perceived control.

The results support basic principles of occupational therapy by highlighting important mediating roles of activity frequency and activity significance in reducing depressive symptoms. Understanding of these change mechanisms can help optimize activity-centered interventions to reduce depressive symptoms.

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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Published online 24 January 20117. Permanent restricted access to ArticleFirst version, in accordance with the copyright policy of the publisher.
Faculty / Department / School: Current - Faculty of Health, Engineering and Sciences - School of Psychology and Counselling
Date Deposited: 27 Jan 2017 04:02
Last Modified: 11 Apr 2018 00:41
Uncontrolled Keywords: depression, intervention, occupational therapy, physical therapy, frequency and significance of activities, social connections, perceived control
Fields of Research : 11 Medical and Health Sciences > 1117 Public Health and Health Services > 111702 Aged Health Care
17 Psychology and Cognitive Sciences > 1701 Psychology > 170106 Health, Clinical and Counselling Psychology
Socio-Economic Objective: C Society > 92 Health > 9204 Public Health (excl. Specific Population Health) > 920401 Behaviour and Health
C Society > 92 Health > 9204 Public Health (excl. Specific Population Health) > 920410 Mental Health
Identification Number or DOI: 10.1093/geront/gnw152
URI: http://eprints.usq.edu.au/id/eprint/29458

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