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Lee S.J.,University of San Francisco | Steinman M.A.,University of San Francisco | Tan E.J.,Corporation for National and Community Service
Journal of the American Geriatrics Society | Year: 2011

Objective: To evaluate how accounting for driving status altered the relationship between volunteering and mortality in U.S. retirees. Design: Observational prospective cohort. Setting: Nationally representative sample from the Health and Retirement Study in 2000 and 2002 followed to 2006. Participants: Retirees aged 65 and older (N=6,408). Measurements: Participants self-reported their volunteering, driving status, age, sex, race or ethnicity, presence of chronic conditions, geriatric syndromes, socioeconomic factors, functional limitations, and psychosocial factors. Death by December 31, 2006, was the outcome. Results: For drivers, mortality in volunteers (9%) and nonvolunteers (12%) was similar; for limited or non-drivers, mortality for volunteers (15%) was markedly lower than for nonvolunteers (32%). Adjusted results showed that, for drivers, the volunteering-mortality odds ratio (OR) was 0.90 (95% confidence interval (CI)=0.66-1.22), whereas for limited or nondrivers, the OR was 0.62 (95% CI=0.49-0.78) (interaction P=.05). The effect of driving status was greater for rural participants, with greater differences between rural drivers and rural limited or nondrivers (interaction P=.02) and between urban drivers and urban limited or nondrivers (interaction P=.81). Conclusion: The influence of volunteering in decreasing mortality seems to be stronger in rural retirees who are limited or nondrivers. This may be because rural or nondriving retirees are more likely to be socially isolated and thus receive more benefit from the greater social integration from volunteering. © 2011 The American Geriatrics Society.

Carlson M.C.,Johns Hopkins University | Chuang Y.-F.,Taipei Veterans General Hospital | Chuang Y.-F.,National Yang Ming University | Varma V.R.,Johns Hopkins University | And 12 more authors.
Alzheimer's and Dementia | Year: 2015

Introduction There is a substantial interest in identifying interventions that can protect and buffer older adults from atrophy in the cortex and particularly, the hippocampus, a region important to memory. We report the 2-year effects of a randomized controlled trial of an intergenerational social health promotion program on older men's and women's brain volumes. Methods The Brain Health Study simultaneously enrolled, evaluated, and randomized 111 men and women (58 interventions; 53 controls) within the Baltimore Experience Corps Trial to evaluate the intervention impact on biomarkers of brain health at baseline and annual follow-ups during the 2-year trial exposure. Results Intention-to-treat analyses on cortical and hippocampal volumes for full and sex-stratified samples revealed program-specific increases in volumes that reached significance in men only (P's ≤.04). Although men in the control arm exhibited age-related declines for 2 years, men in the Experience Corps arm showed a 0.7% to 1.6% increase in brain volumes. Women also exhibited modest intervention-specific gains of 0.3% to 0.54% by the second year of exposure that contrasted with declines of about 1% among women in the control group. Discussion These findings showed that purposeful activity embedded within a social health promotion program halted and, in men, reversed declines in brain volume in regions vulnerable to dementia. Clinical Trial Registration: NCT0038. © 2015 The Alzheimer's Association.

Varma V.R.,Center on Aging and Health | Tan E.J.,Corporation for National and Community Service | Wang T.,Center on Aging and Health | Xue Q.-L.,Center on Aging and Health | And 6 more authors.
Journal of Applied Gerontology | Year: 2014

Recommended levels of physical activity may represent challenging targets for many older adults at risk for disability, leading to the importance of evaluating whether low-intensity activity is associated with health benefits. We examined the cross-sectional association between low-intensity walking activity (<100 steps/min) and health and physical function in a group of older adults. Participants (N = 187; age = 66.8; 91.4% African American; 76.5% female) wore a StepWatch Activity Monitor to measure components of low-intensity walking activity. Only 7% of participants met physical activity guidelines and moderate-intensity activity (≥100 steps/min) contributed only 10% of the total steps/day and 2% of the total min/day. Greater amount, frequency, and duration of low-intensity activity were associated with better self-report and performance-based measures of physical function, better quality of life, and fewer depressive symptoms (ps <.05). The cross-sectional relationship between low-intensity activity and health outcomes important to independent function suggests that we further explore the longitudinal benefits of low-intensity activity. © The Author(s) 2013.

Tan E.J.,Corporation for National and Community Service | McGill S.,Greater Homewood Community Corporation | Tanner E.K.,Johns Hopkins Center on Aging and Health | Rebok G.W.,Johns Hopkins Center on Aging and Health | And 2 more authors.
Gerontologist | Year: 2014

Purpose: Experience Corps Baltimore City (EC) is a product of a partnership between the Greater Homewood Community Corporation (GHCC) and the Johns Hopkins Center on Aging and Health (COAH) that began in 1998. EC recruits volunteers aged 55 and older into high-impact mentoring and tutoring roles in public elementary schools that are designed to also benefit the volunteers. We describe the evolution of the GHCC-COAH partnership through the "Courtship Model." Design and Methods: We describe how community-based participatory research principals, such as shared governance, were applied at the following stages: (1) partner selection, (2) getting serious, (3) commitment, and (4) leaving a legacy. Results: EC could not have achieved its current level of success without academic-community partnership. In early stages of the "Courtship Model," GHCC and COAH were able to rely on the trust developed between the leadership of the partner organizations. Competing missions from different community and academic funders led to tension in later stages of the "Courtship Model" and necessitated a formal Memorandum of Understanding between the partners as they embarked on a randomized controlled trial. Implications: The GHCC-COAH partnership demonstrates how academic-community partnerships can serve as an engine for social innovation. The partnership could serve as a model for other communities seeking multiple funding sources to implement similar public health interventions that are based on national service models. Unified funding mechanisms would assist the formation of academic-community partnerships that could support the design, implementation, and the evaluation of community-based public health interventions. © 2013 The Author.

Varma V.R.,Johns Hopkins Center on Aging and Health | Tan E.J.,Corporation for National and Community Service | Gross A.L.,Johns Hopkins Center on Aging and Health | Harris G.,Johns Hopkins Center on Aging and Health | And 4 more authors.
American Journal of Preventive Medicine | Year: 2016

Introduction Older adults with a high number of chronic conditions and who live in environments that do not promote physical activity have great difficulty initiating and adhering to exercise programs. Novel lifestyle activity interventions that can effectively increase physical activity may address disparities in health in these populations. This study evaluates the effects of the Baltimore Experience Corps program, a community-based volunteer program, on walking activity in older adults. Methods The Baltimore Experience Corps Trial is a sex-stratified RCT that recruited participants from 2006 to 2009. Older adult participants aged ≥60 years (n=123) were from a nested objective physical activity trial within the larger Baltimore Experience Corps Trial. Participants randomized to the intervention group were placed as volunteers within the Baltimore public school system for 2 years. The primary study outcome was objectively measured total amount of walking activity measured in steps/day. Differences between intervention and control groups were measured at 12 and 24 months using linear mixed effects models. Data were analyzed in 2014. Results At 24 months, women, but not men, in the intervention group showed an increased amount of walking activity, averaging 1,500.3 (95% CI=77.6, 2,922.9) greater steps/day compared with the control group. Women in the control group showed a decline of 1,191.6 (95% CI=-2243.7, -139.5) steps/day at 24 months compared to baseline. Conclusions A community-based volunteer intervention increased walking activity among older women, who were at elevated risk for both inactivity and adverse health outcomes. Trial registration This study is registered at www.clinicaltrials.gov NCT00380562. © 2016 American Journal of Preventive Medicine.

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