Highlights
- •This multisite clinical trial tests whether Positive Minds-Strong Bodies (PMSB), a disability prevention intervention offered in four languages, is acceptable to minority and immigrant elders and feasible to be offered by paraprofessionals.
- •The 6-month intent-to-treat analyses showed significant intervention effects in improving late-life functioning and lowering mood symptoms while the 12-month analyses showed sustained significant effects on self-reported disability, disability days, and mood symptoms.
- •The PMSB intervention shows promise in preventing disability in a diverse sample of minority and immigrant elders.
ABSTRACT
Objective
To test the acceptability and effectiveness of a disability prevention intervention,
Positive Minds-Strong Bodies (PMSB), offered by paraprofessionals to mostly immigrant
elders in four languages.
Design
Randomized trial of 307 participants, equally randomized into intervention or enhanced
usual care.
Setting
Community-based organizations in Massachusetts, New York, Florida, and Puerto Rico
serving minority elders. Data collected at baseline, 2, 6, and 12 months, between
May 2015 and March 2019.
Participants
English-, Spanish-, Mandarin-, or Cantonese-speaking adults, age 60+, not seeking
disability prevention services, but eligible per elevated mood symptoms and minor
to moderate physical dysfunction.
Interventions
Ten individual sessions of cognitive behavioral therapy (PM) concurrently offered
with 36 group sessions of strengthening exercise training (SB) over 6 months compared
to enhanced usual care.
Measurements
Acceptability defined as satisfaction and attendance to >50% of sessions. Effectiveness
determined by changes in mood symptoms (HSCL-25 and GAD-7), functional performance
(SPPB), self-reported disability (LLFDI), and disability days (WHODAS 2.0).
Results
Around 77.6% of intervention participants attended over half of PM Sessions; 53.4%
attended over half of SB sessions. Intent-to-treat analyses at 6 months showed significant
intervention effects: improved functioning per SPPB and LLFDI, and lowered mood symptoms
per HSCL-25. Intent-to-treat analyses at 12 months showed that effects remained significant for
LLFDI and HSCL-25, and disability days (per WHODAS 2.0) significantly decreased 6-month
after the intervention.
Conclusions
PMSB offered by paraprofessionals in community-based organizations demonstrates good
acceptability and seems to improve functioning, with a compliance-benefit effect showing
compliance as an important determinant of the intervention response.
Key Words
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Article info
Publication history
Published online: August 13, 2019
Accepted:
August 8,
2019
Received in revised form:
August 8,
2019
Received:
June 11,
2019
Footnotes
Trial Registration: ClinicalTrials.gov: NCT02317432
Identification
Copyright
© 2019 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
