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Click to edit Master title style<= /div> ------=_NextPart_01C5181C.E07397F0 Content-Location: file:///C:/2AFD1ED0/RecruitingMinorityElderlyTP_files/master05.xml Content-Transfer-Encoding: quoted-printable Content-Type: text/xml; charset="utf-8" ------=_NextPart_01C5181C.E07397F0 Content-Location: file:///C:/2AFD1ED0/RecruitingMinorityElderlyTP_files/pres.xml Content-Transfer-Encoding: quoted-printable Content-Type: text/xml; charset="utf-8" ------=_NextPart_01C5181C.E07397F0 Content-Location: file:///C:/2AFD1ED0/RecruitingMinorityElderlyTP_files/slide0001.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Exercise Promotion for Older African Americans: programming for Recruitment
Exercise Promotion for Older African Americans: programming for Recruit= ment 
Thomas= R. Prohaska, PhD
Co-Director Center for Research on Hea= lth and Aging
Professor, Community Health Scienc= es
Univers= ity of Illinois at Chicago
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Refe= rences Addressing Recruitment and Retention of Minority and Non-minority Older Adults
lProhaska, et al., (2001). Exercise programs for ol= der adults: From univer= sity research to community ownership. In Myrtis Sullivan and James Kelley (Eds.) Collaborative Research: University and Community Partnership, American Public Heal= th Association, Washin= gton D.C.
l
lProhaska, T. & Peters, K. (guests eds.)(2003). Community-Based Interv= entions in Older Populations. Family &= Community= Health 26, 3
l
lRecruitment and Retention in Minority Populations (2000). S. Levkoff, T. Prohaska, P. Weitzman & M. Ory (eds.) Springer Publishing Company, New York.
l
lProhaska, T. et al., (2000) Recruitment of older A= frican Americans into Church= -based exercise programs Journal of Mental Health and Aging= , 6, 1, 53-66.
l
l
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Refer= ences (continued)
lWalcott-McQuigg, J. & Prohaska, T. (2001). Fac= tors influencing exerci= se behavior in African-American older adults. Journal of Public Health N= ursing, 18, 3, 194-203.
l
lWarren-Findlow, J., Prohaska, T. & Freedman, D. (2003). Challenges and opportunities in recruiting and retaining underrepresented <= span style=3D'position:absolute;top:59.0%;left:14.79%;width:98.12%;height:4.5%'= >populations into health promotion research. The Gerontologist, 37-46.
l
lProhaska, T. & Walcott-McQuigg. (1996). Recrui= tment of Older African-Americans:= A Focus Group Approach. Ethnicity and Aging= 1,1, 29-34.
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Concepts of Recruitment
lStages of Recruitment Attrition
lTTM approach: precontemplation, contemplation, preparation <= /div>
lRecruitment Phase approach
–Absence of exposure to the recruitment message
–Decision not to participate after exposure to recruitment message = ;
–D= ropping out between registration (informed consent) and start of program
lFactors aff= ecting recruitment and attrition (King, et al. 1992)
lPerson-based factors
lEnvironmental factors
lProgram Intervention Factors
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Preli= minary Development of Age and Culturally Appropriate Exercise Program
lProgram based on focus group findings from older African-Americans
l103 participants assigned to gender and age specific groups
lFocus group discussions guided by based on Transtheoretical Model (stages of change; pre-contemplators, contemplators, action= -maintenance)
l Discussion guide reflec= ted open-ended items reflecting HBM, Self-Efficacy and Social Support models of exercise behavior
lSearched for common and unique responses to discussion guide <= /span>questions across the focus-groups
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Focus= Group Findings
l“Do individuals in various stages of readiness to engage in exercise have different perceptions and = beliefs regarding exercise and health behavior?”
lSix themes
–1. the m= eaning of health and health activities
–2. meani= ng of exercise
–3. benef= its to participation in exercise
–4. barri= ers influencing participation
–5. self-efficacy
–6. Social support
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 Development of CHIME Exercise Prog= ram
lTailored to the individual’s ability
lProgressive exercise activities
lTherabands vs. weights
lPersonal monitoring (Pulse, Borg, BP), safety PAR-Q
lRelate to day-to-day activities
lProgram sensitive outcomes meaningful to the participants =
lProvided outcome feedback, reactivation procedures =
lPublic recognition of achievement
lRelied on church-based social structure and support
lFocused on issues of recruitment and attrition
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Findin= gs: Recruitment of Older African Americans into Church-Based Exercise Programs<= /div>
lParticipants (n=3D114) vs. Nonparticipants (n=3D55) from the same church settings
lInterviewed on demographics, measures of health, attitudes, and beliefs about exercise <= /span>
lOlder participants more likely to be married, not employed, fewer schedule conflicts, more social support for exercise.
lNonparticipants lower exercise self-efficacy, lower positive higher negative attitude toward exercise = benefits and = better emotional health.
l
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Findings: Sources of Attrition in a Church-based exercise program for older African Americans
lLogistic barriers not significantly related to pro= gram attrition
lNot enough energy the only significant motivationa= l barrier
lHealth measures (self-ratings of health, PAR-Q, le= vel of energy to do activities) significant
lMeasures of self-efficacy (level of exercise, like= lihood of finishing the pro= gram, confidence can do exercise (2X at 45 min)
lChanges in caregiver responsibilities
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Strategies for Minority Recruitment: Building Community Collaboration
lProblems= 3;
lDon’t assume “if you build it, they will come.”
–Specific plan, sensitive to the community
lRecogni= tion of Language and Cultural differences as possible barriers
lRole of Community and Family as Gatekeepers to Participation =
lLack of trust
l
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Strategies for Minority Recruitment: Building Community Collaboration
lSolutions&#= 13;
lBuild Trust
–Diversity in the research team
–Development of long-term positive relations with community
lQualitative methods to uncover recruitment barriers
–D= on’t depend on traditional cultural assumptions, Focus on “unique” = = cultural factors that differentiate participants v= s. non-participants
lIntegrate target participant preferences
–Us= e CABs to define community, identify priorities, assist in = recruitment efforts, problem solve.<= /div>
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Program Intervention Factors influencing Recruitment and Attrition
lBroad based recruitment strategy
–Large nu= mbers exposed to the recruitment message
–Self-sel= ection by minority older adults (eg. Health status)
lTargeted recruitment strategies in minority community
–Smaller exposure numbers but higher proportion minority
–Tailored targeting (location site, type of health problem)
lPhysician versus self-referral
–Physician approval required by most programs
–Minority access to physicians
–Distrust= of the medical profession
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