Mobility Limitation
Conditions
Keywords
Physical activity, Dance, Latinos, Aging, Older adults, Health disparities
Brief summary
Investigators propose a randomized controlled trial (RCT) to test the efficacy of the revised 4-month BAILAMOS© program for improving lifestyle PA and health outcomes (physical and cognitive function, self-reported functional limitations, disability) in sedentary older Latinos at risk for disability relative to an attention control group.
Detailed description
Older Latinos comprised 7% of the older adult population in 2002, but are expected to constitute 20% by 2050. Physical activity (PA) can influence potential declines in the health outcomes of physical and cognitive function that lead to functional limitations (self-reported restrictions in performance) and disability (functional limitations placed in a social context). Unfortunately, Latinos aged 65-74 are 46% less likely to engage in leisure time PA than older non-Latino whites and little is known about PA maintenance among ethnic minorities compared to non-Latino whites. In part as a result of low levels of PA, the physical and cognitive function of older Latinos is poor relative to older non-Latino whites. Participation in PA has substantial potential to help older Latinos maintain both physical and cognitive function as they age. Walking and dancing are the two most commonly reported forms of PA among older Latinos. However, urban older Latinos cite unsafe neighborhoods and extreme weather conditions as significant barriers to walking. Dance is a widely popular form of PA among Latinos of all ages, and holds considerable promise as a culturally appropriate form of PA that challenges individuals both physically and cognitively. To date, PA programs designed for older Latinos are lacking. BAILAMOS© is an innovative dance program that has been developed by Dr. Marquez (PI) based on focus group input from older community-dwelling Latinos and in collaboration with an accomplished Latin dance instructor. Investigators propose a randomized controlled trial (RCT) to test the efficacy of the revised 4-month BAILAMOS© program for improving lifestyle PA and health outcomes (physical and cognitive function, self-reported functional limitations, disability) in sedentary older Latinos at risk for disability relative to an attention control group. Investigators will also test whether lifestyle PA and health outcomes can be maintained over an additional 4-months through BAILAMOS© maintenance activities, which include using indigenous dance leaders. This study will use an RCT (N=166 Treatment, 166 Control) with a health education control group that will allow investigators to examine the adoption of PA and its impact on health outcomes (first 4 months), and the short-term maintenance of PA and its impact on health outcomes (8 months) among older Latinos.
Interventions
BEHAVIORALBAILAMOS© Dance Program
BEHAVIORALHealth Education Control Group
Sponsors
National Institutes of Health (NIH)
National Institute of Nursing Research (NINR)
University of Illinois at Chicago
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
55 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* age \> 55 years old * self-identification as Latino/Hispanic * ability to speak Spanish * participation in \<3 day/week of aerobic exercise * at risk for disability * adequate cognitive status as assessed by the Mini Mental State Examination * danced \< 2 times/month over the past 12 months * willingness to be randomly assigned to treatment or control group * no plans to leave the country for more than two consecutive weeks over the next year
Exclusion criteria
* uncontrolled cardiovascular disease * uncontrolled diabetes mellitus * pacemaker in situ * severe chronic obstructive pulmonary disease (COPD) * recent healing or unhealed fracture(s) * use of an assistance device to walk (cane, walker, or wheelchair)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Minutes Per Week of Moderate to Vigorous Physical Activity | Change from baseline to post-intervention 4 months | CHAMPS PA Questionnaire assesses weekly frequency and duration of a variety of lifestyle physical activities that are meaningful and appropriate for older adults. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Physical Function Performance as Assessed by Time of 400 Meter Walk | Change from baseline to post-intervention 4 months | 400 Meter walk |
| Cognitive Function | Change from baseline to post-intervention 4 months | Working Memory: The score is the number of correctly retrieved strings in each part of the Digit Span Test plus the number of correctly reordered strings from the Digit Ordering. Higher scores indicated better outcomes. Higher change indicate better outcomes. |
| Self-Reported Functional Limitations | Change from baseline to post-intervention 4 months | Function Subscale of Late Life Function & Disability Instrument. Higher scores reflect more limitation in performing tasks. Range on questionnaire is 15-75. Change is reported here. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| BAILAMOS© Dance Program BAILAMOS© Dance Program + Maintenance Program: includes a 4-month twice-weekly adoption phase and a 4-month twice-weekly maintenance phase. Each month during adoption a new dance style is introduced by a professional dance instructor. During the 4-month maintenance phase an indigenous dance leader, trained by the professional dance instructor, will lead dance with participants twice per week
BAILAMOS© Dance Program | 167 |
| Health Education Control Group Health Education Control Group: Sedentary older Latinos randomly assigned to the health education control group will participate in classes developed for older adults and offered by the University of Illinois Extension. All classes are conducted in Spanish by extension staff using Spanish-language materials. Classes will meet one day per week for two hours, to provide equitable social contact as the treatment group.
Health Education Control Group | 166 |
| Total | 333 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Lost to Follow-up | 64 | 51 |
Baseline characteristics
| Characteristic | BAILAMOS© Dance Program | Health Education Control Group | Total |
|---|---|---|---|
| Age, Continuous | 64.14 Years STANDARD_DEVIATION 6.39 | 65.67 Years STANDARD_DEVIATION 7.68 | 64.91 Years STANDARD_DEVIATION 7.08 |
| Body Mass Index | 31.47 kg/m^2 STANDARD_DEVIATION 4.54 | 30.84 kg/m^2 STANDARD_DEVIATION 5.05 | 31.15 kg/m^2 STANDARD_DEVIATION 4.79 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 167 Participants | 166 Participants | 333 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 0 Participants | 0 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Region of Enrollment United States | 167 participants | 166 participants | 333 participants |
| Sex: Female, Male Female | 140 Participants | 141 Participants | 281 Participants |
| Sex: Female, Male Male | 27 Participants | 25 Participants | 52 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 167 | 0 / 166 |
| other Total, other adverse events | 0 / 167 | 0 / 166 |
| serious Total, serious adverse events | 0 / 167 | 0 / 166 |
Outcome results
Primary
Minutes Per Week of Moderate to Vigorous Physical Activity
CHAMPS PA Questionnaire assesses weekly frequency and duration of a variety of lifestyle physical activities that are meaningful and appropriate for older adults.
Time frame: Change from baseline to post-intervention 4 months
Population: Those randomized to intervention or control group.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BAILAMOS© Dance Program | Minutes Per Week of Moderate to Vigorous Physical Activity | 156.84 Change in minutes/week | Standard Deviation 12.57 |
| Health Education Control Group | Minutes Per Week of Moderate to Vigorous Physical Activity | 86.84 Change in minutes/week | Standard Deviation 43.9 |
Secondary
Cognitive Function
Working Memory: The score is the number of correctly retrieved strings in each part of the Digit Span Test plus the number of correctly reordered strings from the Digit Ordering. Higher scores indicated better outcomes. Higher change indicate better outcomes.
Time frame: Change from baseline to post-intervention 4 months
Population: Data from participants randomized who had baseline data.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BAILAMOS© Dance Program | Cognitive Function | .25 Items recalled correctly | Standard Deviation 1.43 |
| Health Education Control Group | Cognitive Function | .03 Items recalled correctly | Standard Deviation 1.44 |
Secondary
Physical Function Performance as Assessed by Time of 400 Meter Walk
400 Meter walk
Time frame: Change from baseline to post-intervention 4 months
Population: Participants randomized to each group with data at baseline.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BAILAMOS© Dance Program | Physical Function Performance as Assessed by Time of 400 Meter Walk | -0.31 Seconds | Standard Deviation 8.51 |
| Health Education Control Group | Physical Function Performance as Assessed by Time of 400 Meter Walk | 2.48 Seconds | Standard Deviation 13.76 |
Secondary
Self-Reported Functional Limitations
Function Subscale of Late Life Function & Disability Instrument. Higher scores reflect more limitation in performing tasks. Range on questionnaire is 15-75. Change is reported here.
Time frame: Change from baseline to post-intervention 4 months
Population: Data from participants randomized at baseline who have baseline data.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BAILAMOS© Dance Program | Self-Reported Functional Limitations | -0.51 score on a scale | Standard Deviation 9.12 |
| Health Education Control Group | Self-Reported Functional Limitations | 0.23 score on a scale | Standard Deviation 8.12 |