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The health benefits of regular exercise are well documented, yet there has been limited success in the promotion of regular exercise in older African American women. Based on theoretical and evidence-based findings, the authors recommend a behavioral self-efficacy approach to guide exercise interventions in this high-risk population. Interventions should be developed that are age appropriate, group delivered in the community, focused on a single behavior, and only include general health education as a secondary purpose. Suggested cultural tailoring of exercise interventions includes addressing beliefs about exercise, focusing on the "possible self," promoting participants as "cultural consultants," and spiritual and religious strategies.

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Alzheimer's disease (AD) is one of the most feared illnesses among older adults. Although no cure exists, an emerging body of literature has outlined potentially risk-reducing behaviors. As evidence has become available on risk reduction, community organizations and advocacy groups have developed health education courses on the topic. This study examines the impact of one educational program on the audience's efficacy expectations and outcome expectations for behavior change. Participants included 53 older adults residing in a continuing care retirement community. The study used a pretest-posttest design with an experimental group (n = 33) and a control group (n = 20). Topics on weekly classes included the relationship between cardiovascular factors and AD, dietary factors implicated in AD, and mental stimulation to reduce AD risk. Class sessions consisted of lecture, discussion, and demonstration. Between-group differences were found for both efficacy (P = .016) and outcome expectations (P = .000). Within-group differences were only significant for increased outcome expectations related to literature-derived behaviors (P = .000). Future work should focus on action and prevention and on replication of the educational program's evaluation in a more diverse population.

RESUMEN

BACKGROUND: This study examined the feasibility of implementing the EnhanceFitness Program (formerly Lifetime Fitness Program), an evidence-based exercise program, at congregate-meal sites that generally serve low-income older adults. METHODS: A 12-week aerobic and strength training exercise program was held at senior centers 3 times a week. RESULTS: The mean age of the 31 participants was 73.5 years+/-6.7 years (60-86). Participants' compliance with attending the exercise class was 74%. Paired t tests were used to evaluate change after the intervention. Three out of six components of the Senior Fitness Test increased significantly after the exercise intervention (P<.003). Three out of the eight self-reported health concepts of the SF-36 demonstrated significant improvement after the exercise intervention (P<.003). CONCLUSION: These data indicate that an evidence-based exercise program can be successfully implemented in this population.

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Gerontological health care is undergoing a revolution, much like that of the feminist movement of the 1960s. Fundamental changes in health care require revisions in nursing education to ensure appropriate care of older adults in the least restrictive environment. The purpose of this study is to promote the preparation of future nurses who have the knowledge and the skills necessary to provide nursing care for the growing cohorts of older adults. A theoretical rationale for a new perspective in nursing education is discussed. An experiential clinical learning activity based on the functional model of gerontological health care is examined. This home visit clinical learning activity provides nursing students with the opportunity to practice nursing reflective of the health care needs of older adults. Strategies for replication of this clinical learning activity are provided.

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Personal care homes are becoming an integral part of the gerontological health care environment. This exploratory descriptive study compares the health characteristics of elderly personal care home residents without dementia or cognitive impairment, residents with possible early dementia, and residents with dementia. Results indicate a number of residents with possible early dementia, but without a diagnosis of dementia, may be residing in personal care homes. Additionally, the three groups may have distinctly different service needs. Residents with dementia were particularly at risk for problems with decision-making, communication, and impaired instrumental activities of daily living (IADL). Medication management for residents with dementia emerged as a particular concern. Most physical health characteristics, such as health care usage, were not significantly different in the three groups. Suggestions for strategies to promote the health and well-being of this growing population are discussed.

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