Accidental Fall, Exercise, Motivation, Older Adults, Physical Activity
Conditions
Brief summary
The research team will conduct a 2 x 2 factorial experiment testing the individual and combined effects of two empirically and theoretically relevant sets of behavior change strategies on community-dwelling older adults' physical activity. To do this the investigators will randomize participants \>= 70 years old (n = 308) to 1 of 4 experimental conditions. All conditions include an evidence-based physical activity protocol endorsed by Centers for Disease Control and Prevention (CDC) for use by all older adults, including those with frailty and multiple co-morbidities and the commercially available physical activity monitor (e.g., Fitbit) to augment intervention delivery. Intervention components that are experimental and vary by condition are the sets of behavior change strategies which will be combined with the physical activity protocol and the physical activity monitor. Condition 1 has no specific behavior change strategies; Condition 2 includes an intervention component comprised of 5 interpersonal behavior change strategies, such as facilitating social support and social comparison; Condition 3 includes an intervention component comprised of 5 intrapersonal behavior change strategies, such as setting personally meaningful goals; and Condition 4 includes both sets of behavior change strategies -- 5 interpersonal strategies combined with 5 intrapersonal behavior change strategies.
Detailed description
To fully examine the effects of these experimental components, The investigators have delineated Primary, Secondary and Exploratory Aims: Primary Aim: Determine which experimental intervention component(s) increase PA among community-dwelling older adults post-intervention: immediately, 6 months, and 12 months. Hypothesis: Participants receiving the interpersonal set of behavior change strategies (conditions 2 and 4) will have clinically meaningful increases in PA post- intervention (at all 3 time-points), compared to participants not receiving these strategies (conditions 1 and 3). Secondary Aim: Determine which experimental intervention component(s)decrease fall occurrence and increase quality of life (QOL) among community-dwelling older adults 12 months post-intervention. Hypotheses: Participants receiving the set of interpersonal behavior change strategies will have clinically meaningful reductions in falls and increases in QOL, 12 months post-intervention, compared to participants not receiving these strategies. Exploratory Aim: Evaluate experimental intervention component effects on targeted psychosocial constructs (social support; readiness; self-regulation) and physical constructs (functional leg strength and balance), which are theorized as mechanisms of change--and whether these mechanisms mediate the effects of experimental intervention components on PA and falls. Hypotheses: Receiving the interpersonal behavioral change strategies, relative to not receiving these strategies, will elicit increases in targeted psychosocial constructs and increases in physical constructs, which in turn will mediate the intervention's effects on PA behavior and falls.
Interventions
BEHAVIORALOtago Exercise Program
The program has been adapted for groups and includes 5 flexibility movements (e.g., back extension and ankle, head, neck, trunk movements), 5 leg strengthening exercises (knee extensor, knee flexor, hip abductor, ankle plantar flexes, ankle dorsiflexes), 12 balance movements (knee bends, backwards walking, walking and turning, sideways walking, tandem stance, tandem walk, one leg stand, heel walking, toe walking, heel-toe walking backwards, sit to stand, stair walking), and a walking plan. The number, intensity and duration of movements are individualized according to preference and ability and they are gradually progressed.
DEVICEPhysical activity monitors (e.g., Fitbit)
We will use Fitbit Charge 2 (or an equivalent). Features essential for this research include built-in accelerometers that accurately measure steps and physical activity (PA) duration.Participants will have a brief orientation to these during baseline data collection and have the opportunity to return demonstrate. In addition, RAs will be available to help participants troubleshoot, as needed, via telephone and in person, after intervention meetings. Intervention meetings include discussions about the PAMs, but topics vary according to assigned study condition.
BEHAVIORALInterpersonal Behavior Change Strategies
The interpersonal content will include facilitated discussed about including PA into social routines, identifying and problem-solving social and environmental barriers to PA, social support for exercise, and friendly social comparisons about practicing PA outside the small group setting and interpreting/ sharing data.
BEHAVIORALIntrapersonal Behavior Change Strategies
The intrapersonal content will include encouragement and guidance to identify baseline PA patterns, develop and refine personally meaningful goals and plans, identify and problem solve personal barriers to staying physically active, integrate PA into personal routines, and monitor goal outcomes
OTHERInformation about Health and Wellness
Information about health and wellness varies in dose, according to time spent in each condition that addresses behavior change. Topics in condition 1 include sleep, vaccinations, supplements, fall risk factors, memory, hearing and pain guided by information for older adults available on the NIA and CDC websites. Topics in conditions 2 and 3 include fall risk factors and sleep. Topics in condition 4 include fall risk factors.
Sponsors
National Institute of Nursing Research (NINR)
University of Minnesota
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Masking description
The specific content of the intervention condition/arm that is assigned to each participant will be masked from data collectors/outcome assessors.
Intervention model description
Our research team will conduct a 2 x 2 factorial experiment testing the individual and combined effects of two empirically and theoretically relevant sets of behavior change strategies on community-dwelling older adults' physical activity.
Eligibility
Sex/Gender
ALL
Age
70 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* ≥70 years of age * English speaking * Low levels of PA (below recommended guidelines) * Self-reported fall risk as guided by the CDC, Steadi fall risk screener * One or more falls in the last year * Unsteadiness when standing or walking * Worries about falling * Participants who self-report the following symptoms will require clearance from a primary provider (as guided by the Exercise and Screening for You Questionnaire) * Pain, tightness or pressure in chest during PA (walking, climbing stairs, household chores, similar activities) that have not been checked and/ or treated by a healthcare provider * Current dizziness that have not been checked and/ or treated by a healthcare provider * Current, frequent falls that have not been checked and/ or treated by a healthcare provider
Exclusion criteria
* Lower extremity injury or surgery within the past 6 weeks * Inability to walk * Formal diagnosis of neurocognitive impairment or dementia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Quantity of Physical Activity Measured Objectively | Baseline and Post-Intervention (one week, six months, twelve months) | Average weekly minutes of total physical activity per week (light, moderate and vigorous intensities) as captured from PAM data (Fitbit Charge-2) |
| Physical Activity Scale for the Elderly (PASE) | Baseline and Post-Intervention (one week, six months, twelve months) | Self-report Measure of Physical Activity. PASE is a validated questionnaire to measure the amount of physical activity in people over the age of 65 including types (e.g., walking, recreational, exercise, housework, care-giving). Scores, accounting for frequency, duration and intensity of physical activity are calculated and typically range from 0 to 793, with higher value representing more physical activity. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Fall Rate | 12 months post intervention | Falls per person year, assessed via prospective monthly calendars |
| Number of Participants With Moderate or Major Injuries From Falls | 12 months post intervention | Number of injuries from falls was measured via prospective falls calendars mailed to participants monthly with return addressed/stamped envelopes. Circumstances and injuries related to each fall were documented on the calendars. Calendar documentation each fall was verified and detailed through phone conversations between participants and trained research staff. Moderate and Major injuries from falls were categorized according to the Agency for Healthcare Research and Quality with moderate injuries defined as necessitating sutures, skin glue, splinting, and or involving muscle or joint strain. Major injuries were defined as those associated with internal injuries or a need for surgery, casting, traction, or neurological consults. |
| Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Baseline and post-intervention: one-week, six months, and 12 months | Using the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Questionnaire 1.2. Two constructs from this questionnaire were converted to t scores: self-reported physical health and self-reported mental health. . Mean t scores are 50, which indicates the adult population mean with a standard deviation of 10. Higher t scores are considered better, or healthier, for self-reported physical health and mental health. No clinically relevant thresholds were described in this study. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Otago+PAM+Health / Wellness Topics Condition 1:
1. Otago Exercise Program (OEP) adapted for delivery to small groups. In total, this protocol includes 5 flexibility movements, 5 leg-strengthening movements, and 12 balance-challenging movements. The number intensity and duration (dosages) are individualized according to preference and ability. OEP movements are gradually progressed across the 8-week intervention.
2. A physical activity monitor (PAM) (Fitbit Charge 2) with initial orientation and ongoing support.
3. Health and wellness information (attention control content) guided by content in the National Instituteon Aging (NIA) and Centers for Disease Control and Prevention websites. | 78 |
| Otago + PAM + Interpersonal Strategies Condition 2:
1. Otago Exercise Program (OEP) adapted for delivery to small groups. In total, this protocol includes 5 flexibility movements, 5 leg-strengthening movements, and 12 balance-challenging movements. The number intensity and duration (dosages) are individualized according to preference and ability. OEP movements are gradually progressed across the 8-week intervention.
2. A physical activity monitor (PAM) (Fitbit Charge 2) with initial orientation and ongoing support.
3. Interpersonal behavior change strategies including peer-to-peer sharing and learning about using activities in everyday routines as prompts for movement, identifying and problem solving environmental barriers to physical activity, ways to increase social support for physical activity, and friendly social comparison of experiences performing OEP movements and home and other locations of choice, staying motivated to practice OEP movements long-term. | 78 |
| Otago, PAM, Intrapersonal Strategies Condition 3:
1. Otago Exercise Program (OEP) adapted for delivery to small groups. In total, this protocol includes 5 flexibility movements, 5 leg-strengthening movements, and 12 balance-challenging movements. The number intensity and duration (dosages) are individualized according to preference and ability. OEP movements are gradually progressed across the 8-week intervention.
2. A physical activity monitor (PAM) (Fitbit Charge 2) with initial orientation and ongoing support.
3. Intrapersonal behavior change strategies including to develop physical activity related goals and action plans, self-assess goal attainment and action plan implementation-adjust accordingly, identify and problem solve personal barriers to physical activity, develop a habit of one or more OEP movements. | 76 |
| Otago,PAM, Inter+Intra Strategies Condition 4:
1. Otago Exercise Program (OEP) adapted for delivery to small groups. In total, this protocol includes 5 flexibility movements, 5 leg-strengthening movements, and 12 balance-challenging movements. The number intensity and duration (dosages) are individualized according to preference and ability. OEP movements are gradually progressed across the 8-week intervention.
2. A physical activity monitor (PAM) (Fitbit Charge 2) with initial orientation and ongoing support.
3. Interpersonal behavior change strategies including peer-to-peer sharing and learning about using activities in everyday routines as prompts for movement, identifying and problem solving environmental barriers to physical activity, ways to increase social support for physical activity, and friendly social comparison of experiences performing OEP movements and home and other locations of choice, staying motivated to practice OEP movements long-term.
4. Intrapersonal behavior change strategies including to develop physical activity related goals and action plans, self-assess goal attainment and action plan implementation-adjust accordingly, identify and problem solve personal barriers to physical activity, develop a habit of one or more OEP movements | 77 |
| Total | 309 |
Baseline characteristics
| Characteristic | Otago+PAM+Health / Wellness Topics | Total | Otago,PAM, Inter+Intra Strategies | Otago, PAM, Intrapersonal Strategies | Otago + PAM + Interpersonal Strategies |
|---|---|---|---|---|---|
| Age, Continuous | 77.8 years STANDARD_DEVIATION 5 | 77.4 years STANDARD_DEVIATION 5 | 76.6 years STANDARD_DEVIATION 5.1 | 77.3 years STANDARD_DEVIATION 5 | 77.7 years STANDARD_DEVIATION 5 |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 1 Participants | 0 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 3 Participants | 1 Participants | 1 Participants | 1 Participants |
| Race (NIH/OMB) Black or African American | 13 Participants | 48 Participants | 9 Participants | 16 Participants | 10 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 2 Participants | 0 Participants | 1 Participants | 1 Participants |
| Race (NIH/OMB) White | 65 Participants | 255 Participants | 67 Participants | 57 Participants | 66 Participants |
| Sex: Female, Male Female | 64 Participants | 240 Participants | 58 Participants | 59 Participants | 59 Participants |
| Sex: Female, Male Male | 14 Participants | 69 Participants | 19 Participants | 17 Participants | 19 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 1 / 77 | 2 / 76 | 1 / 74 | 0 / 75 |
| other Total, other adverse events | 2 / 77 | 7 / 76 | 3 / 74 | 3 / 75 |
| serious Total, serious adverse events | 0 / 77 | 0 / 76 | 0 / 74 | 2 / 75 |
Outcome results
Primary
Physical Activity Scale for the Elderly (PASE)
Self-report Measure of Physical Activity. PASE is a validated questionnaire to measure the amount of physical activity in people over the age of 65 including types (e.g., walking, recreational, exercise, housework, care-giving). Scores, accounting for frequency, duration and intensity of physical activity are calculated and typically range from 0 to 793, with higher value representing more physical activity.
Time frame: Baseline and Post-Intervention (one week, six months, twelve months)
Population: Number analyzed at baseline and post-intervention (one week, six months, twelve months) represent the number of participants in the study at that time. Numbers decrease across longitudinal time points due to participant withdrawal or loss to follow up
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Otago+PAM+Health / Wellness Topics | Physical Activity Scale for the Elderly (PASE) | Baseline | 102.2 Total PASE Score | Standard Error 46.4 |
| Otago+PAM+Health / Wellness Topics | Physical Activity Scale for the Elderly (PASE) | One week post-intervention | 111.1 Total PASE Score | Standard Error 47.3 |
| Otago+PAM+Health / Wellness Topics | Physical Activity Scale for the Elderly (PASE) | Six months post-intervention | 106.7 Total PASE Score | Standard Error 53 |
| Otago+PAM+Health / Wellness Topics | Physical Activity Scale for the Elderly (PASE) | Twelve months post-intervention | 107.1 Total PASE Score | Standard Error 60 |
| Otago + PAM + Interpersonal Strategies | Physical Activity Scale for the Elderly (PASE) | One week post-intervention | 119.2 Total PASE Score | Standard Error 69.9 |
| Otago + PAM + Interpersonal Strategies | Physical Activity Scale for the Elderly (PASE) | Six months post-intervention | 118.2 Total PASE Score | Standard Error 65.1 |
| Otago + PAM + Interpersonal Strategies | Physical Activity Scale for the Elderly (PASE) | Twelve months post-intervention | 113.8 Total PASE Score | Standard Error 66.8 |
| Otago + PAM + Interpersonal Strategies | Physical Activity Scale for the Elderly (PASE) | Baseline | 108.3 Total PASE Score | Standard Error 66.6 |
| Otago, PAM, Intrapersonal Strategies | Physical Activity Scale for the Elderly (PASE) | Six months post-intervention | 119.5 Total PASE Score | Standard Error 65.8 |
| Otago, PAM, Intrapersonal Strategies | Physical Activity Scale for the Elderly (PASE) | One week post-intervention | 120.7 Total PASE Score | Standard Error 56.2 |
| Otago, PAM, Intrapersonal Strategies | Physical Activity Scale for the Elderly (PASE) | Twelve months post-intervention | 123.0 Total PASE Score | Standard Error 92.3 |
| Otago, PAM, Intrapersonal Strategies | Physical Activity Scale for the Elderly (PASE) | Baseline | 110.6 Total PASE Score | Standard Error 44 |
| Otago,PAM, Inter+Intra Strategies | Physical Activity Scale for the Elderly (PASE) | Twelve months post-intervention | 112.4 Total PASE Score | Standard Error 60.9 |
| Otago,PAM, Inter+Intra Strategies | Physical Activity Scale for the Elderly (PASE) | One week post-intervention | 121.1 Total PASE Score | Standard Error 58.7 |
| Otago,PAM, Inter+Intra Strategies | Physical Activity Scale for the Elderly (PASE) | Baseline | 101.8 Total PASE Score | Standard Error 48.5 |
| Otago,PAM, Inter+Intra Strategies | Physical Activity Scale for the Elderly (PASE) | Six months post-intervention | 112.2 Total PASE Score | Standard Error 60.1 |
Primary
Quantity of Physical Activity Measured Objectively
Average weekly minutes of total physical activity per week (light, moderate and vigorous intensities) as captured from PAM data (Fitbit Charge-2)
Time frame: Baseline and Post-Intervention (one week, six months, twelve months)
Population: Number analyzed at baseline and post-intervention (one week, six months, twelve months) represent the number of participants in the study at that time. Numbers decrease across longitudinal time points due to participant withdrawal or loss to follow up
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Otago+PAM+Health / Wellness Topics | Quantity of Physical Activity Measured Objectively | Baseline | 177.9 minutes per day | Standard Deviation 62.2 |
| Otago+PAM+Health / Wellness Topics | Quantity of Physical Activity Measured Objectively | one week post-intervention | 180.5 minutes per day | Standard Deviation 68.5 |
| Otago+PAM+Health / Wellness Topics | Quantity of Physical Activity Measured Objectively | twelve months post-intervention | 174.3 minutes per day | Standard Deviation 72 |
| Otago+PAM+Health / Wellness Topics | Quantity of Physical Activity Measured Objectively | six months post-intervention | 180 minutes per day | Standard Deviation 73.8 |
| Otago + PAM + Interpersonal Strategies | Quantity of Physical Activity Measured Objectively | one week post-intervention | 193.1 minutes per day | Standard Deviation 82.1 |
| Otago + PAM + Interpersonal Strategies | Quantity of Physical Activity Measured Objectively | Baseline | 167.7 minutes per day | Standard Deviation 79.1 |
| Otago + PAM + Interpersonal Strategies | Quantity of Physical Activity Measured Objectively | six months post-intervention | 185.7 minutes per day | Standard Deviation 84 |
| Otago + PAM + Interpersonal Strategies | Quantity of Physical Activity Measured Objectively | twelve months post-intervention | 190.3 minutes per day | Standard Deviation 99.1 |
| Otago, PAM, Intrapersonal Strategies | Quantity of Physical Activity Measured Objectively | one week post-intervention | 181 minutes per day | Standard Deviation 68.2 |
| Otago, PAM, Intrapersonal Strategies | Quantity of Physical Activity Measured Objectively | six months post-intervention | 175.1 minutes per day | Standard Deviation 68.9 |
| Otago, PAM, Intrapersonal Strategies | Quantity of Physical Activity Measured Objectively | Baseline | 185.9 minutes per day | Standard Deviation 70.5 |
| Otago, PAM, Intrapersonal Strategies | Quantity of Physical Activity Measured Objectively | twelve months post-intervention | 167.7 minutes per day | Standard Deviation 68.6 |
| Otago,PAM, Inter+Intra Strategies | Quantity of Physical Activity Measured Objectively | Baseline | 177.9 minutes per day | Standard Deviation 72.7 |
| Otago,PAM, Inter+Intra Strategies | Quantity of Physical Activity Measured Objectively | one week post-intervention | 209.1 minutes per day | Standard Deviation 79.2 |
| Otago,PAM, Inter+Intra Strategies | Quantity of Physical Activity Measured Objectively | six months post-intervention | 198 minutes per day | Standard Deviation 78 |
| Otago,PAM, Inter+Intra Strategies | Quantity of Physical Activity Measured Objectively | twelve months post-intervention | 192.9 minutes per day | Standard Deviation 80.4 |
Secondary
Fall Rate
Falls per person year, assessed via prospective monthly calendars
Time frame: 12 months post intervention
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Otago+PAM+Health / Wellness Topics | Fall Rate | 0.9 Falls per person year |
| Otago + PAM + Interpersonal Strategies | Fall Rate | 1.0 Falls per person year |
| Otago, PAM, Intrapersonal Strategies | Fall Rate | 0.9 Falls per person year |
| Otago,PAM, Inter+Intra Strategies | Fall Rate | 1.1 Falls per person year |
Secondary
Number of Participants With Moderate or Major Injuries From Falls
Number of injuries from falls was measured via prospective falls calendars mailed to participants monthly with return addressed/stamped envelopes. Circumstances and injuries related to each fall were documented on the calendars. Calendar documentation each fall was verified and detailed through phone conversations between participants and trained research staff. Moderate and Major injuries from falls were categorized according to the Agency for Healthcare Research and Quality with moderate injuries defined as necessitating sutures, skin glue, splinting, and or involving muscle or joint strain. Major injuries were defined as those associated with internal injuries or a need for surgery, casting, traction, or neurological consults.
Time frame: 12 months post intervention
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Otago+PAM+Health / Wellness Topics | Number of Participants With Moderate or Major Injuries From Falls | Number of moderate injurious falls | 6 Participants |
| Otago+PAM+Health / Wellness Topics | Number of Participants With Moderate or Major Injuries From Falls | Number of major injurious falls | 1 Participants |
| Otago + PAM + Interpersonal Strategies | Number of Participants With Moderate or Major Injuries From Falls | Number of major injurious falls | 2 Participants |
| Otago + PAM + Interpersonal Strategies | Number of Participants With Moderate or Major Injuries From Falls | Number of moderate injurious falls | 7 Participants |
| Otago, PAM, Intrapersonal Strategies | Number of Participants With Moderate or Major Injuries From Falls | Number of moderate injurious falls | 6 Participants |
| Otago, PAM, Intrapersonal Strategies | Number of Participants With Moderate or Major Injuries From Falls | Number of major injurious falls | 2 Participants |
| Otago,PAM, Inter+Intra Strategies | Number of Participants With Moderate or Major Injuries From Falls | Number of moderate injurious falls | 6 Participants |
| Otago,PAM, Inter+Intra Strategies | Number of Participants With Moderate or Major Injuries From Falls | Number of major injurious falls | 1 Participants |
Secondary
Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health
Using the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Questionnaire 1.2. Two constructs from this questionnaire were converted to t scores: self-reported physical health and self-reported mental health. . Mean t scores are 50, which indicates the adult population mean with a standard deviation of 10. Higher t scores are considered better, or healthier, for self-reported physical health and mental health. No clinically relevant thresholds were described in this study.
Time frame: Baseline and post-intervention: one-week, six months, and 12 months
Population: Number analyzed at baseline and post-intervention (one week, six months, twelve months) represent the number of participants in the study at that time. Numbers decrease across longitudinal time points due to participant withdrawal or loss to follow up
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Otago+PAM+Health / Wellness Topics | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Physical Health: Baseline | 39.2 T score | Standard Deviation 4.9 |
| Otago+PAM+Health / Wellness Topics | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Physical Health: Post-intervention, One week | 40.2 T score | Standard Deviation 4.7 |
| Otago+PAM+Health / Wellness Topics | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Physical Health: Post-intervention, six months | 38.7 T score | Standard Deviation 5.2 |
| Otago+PAM+Health / Wellness Topics | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Physical Health 12 months post-intervention | 39.5 T score | Standard Deviation 5.3 |
| Otago+PAM+Health / Wellness Topics | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Mental Health: Baseline | 50.8 T score | Standard Deviation 7.4 |
| Otago+PAM+Health / Wellness Topics | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Mental Health: Post-intervention, One week | 53.1 T score | Standard Deviation 7.1 |
| Otago+PAM+Health / Wellness Topics | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Mental Health: Post-intervention, Six months | 51.4 T score | Standard Deviation 7 |
| Otago+PAM+Health / Wellness Topics | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Mental Health: Post-intervention, Twelve months | 51.1 T score | Standard Deviation 7.4 |
| Otago + PAM + Interpersonal Strategies | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Mental Health: Post-intervention, One week | 52.4 T score | Standard Deviation 7.9 |
| Otago + PAM + Interpersonal Strategies | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Mental Health: Baseline | 52.3 T score | Standard Deviation 7.9 |
| Otago + PAM + Interpersonal Strategies | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Physical Health: Post-intervention, One week | 39.6 T score | Standard Deviation 5.5 |
| Otago + PAM + Interpersonal Strategies | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Mental Health: Post-intervention, Twelve months | 50.3 T score | Standard Deviation 8.3 |
| Otago + PAM + Interpersonal Strategies | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Mental Health: Post-intervention, Six months | 50.6 T score | Standard Deviation 8.2 |
| Otago + PAM + Interpersonal Strategies | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Physical Health 12 months post-intervention | 39.1 T score | Standard Deviation 6.2 |
| Otago + PAM + Interpersonal Strategies | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Physical Health: Post-intervention, six months | 38.7 T score | Standard Deviation 5.6 |
| Otago + PAM + Interpersonal Strategies | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Physical Health: Baseline | 39.5 T score | Standard Deviation 5.3 |
| Otago, PAM, Intrapersonal Strategies | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Mental Health: Post-intervention, Six months | 51.7 T score | Standard Deviation 7.4 |
| Otago, PAM, Intrapersonal Strategies | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Physical Health: Post-intervention, six months | 39.2 T score | Standard Deviation 4.5 |
| Otago, PAM, Intrapersonal Strategies | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Physical Health 12 months post-intervention | 38.9 T score | Standard Deviation 5.1 |
| Otago, PAM, Intrapersonal Strategies | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Mental Health: Baseline | 51.8 T score | Standard Deviation 8 |
| Otago, PAM, Intrapersonal Strategies | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Mental Health: Post-intervention, One week | 52.2 T score | Standard Deviation 8.3 |
| Otago, PAM, Intrapersonal Strategies | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Mental Health: Post-intervention, Twelve months | 50.3 T score | Standard Deviation 7.4 |
| Otago, PAM, Intrapersonal Strategies | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Physical Health: Baseline | 39.1 T score | Standard Deviation 4.9 |
| Otago, PAM, Intrapersonal Strategies | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Physical Health: Post-intervention, One week | 39.6 T score | Standard Deviation 4.6 |
| Otago,PAM, Inter+Intra Strategies | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Physical Health: Post-intervention, six months | 40.0 T score | Standard Deviation 5.1 |
| Otago,PAM, Inter+Intra Strategies | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Physical Health 12 months post-intervention | 39.3 T score | Standard Deviation 5.1 |
| Otago,PAM, Inter+Intra Strategies | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Physical Health: Post-intervention, One week | 40.5 T score | Standard Deviation 5 |
| Otago,PAM, Inter+Intra Strategies | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Physical Health: Baseline | 40 T score | Standard Deviation 5.1 |
| Otago,PAM, Inter+Intra Strategies | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Mental Health: Baseline | 52.9 T score | Standard Deviation 8.1 |
| Otago,PAM, Inter+Intra Strategies | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Mental Health: Post-intervention, Twelve months | 49.9 T score | Standard Deviation 8.3 |
| Otago,PAM, Inter+Intra Strategies | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Mental Health: Post-intervention, Six months | 52.8 T score | Standard Deviation 8.4 |
| Otago,PAM, Inter+Intra Strategies | Patient Reported Outcomes Measurement Information System (PROMIS) Scale v1.2 Global Health | Mental Health: Post-intervention, One week | 53.8 T score | Standard Deviation 8 |