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Benefit and Uptake: A Mixed Methods Study Exploring Older Adults' Experiences With a Psychoeducational and Exercise
Mayra L Sánchez González1, Mario Cruz-Gonzalez2, Daniel A Pineiro3
1Department of Physical Medicine and Rehabilitation (MLSG), Johns Hopkins University School of Medicine, Baltimore, MD.
Objectives:
Evaluate whether engaging in a combined psychoeducational and exercise-maintenance intervention was associated with the nonrecurrence of psychological distress and mobility difficulties; explore participants' perceived benefits; and identify factors associated with intervention uptake.
Design:
Convergent mixed-methods. Quantitative data included 48 participants from the maintenance phase (Months 7-12) of the Positive Minds Strong Bodies-Enhanced randomized trial, and 19 semi-structured interviews with participants who accepted or declined the intervention.
Setting:
Community-based organizations and clinics in four U.S.
Locations:
Massachusetts, Maryland, New York, and Puerto Rico. Data was collected between November 2020 and October 2024.
Participants:
Older adults (60+) with mild-to-severe depression or anxiety symptoms and minor-to-moderate mobility difficulties.
Interventions:
Up to 24 psychoeducation and up to 48 exercise drop-in maintenance group sessions to sustain and enhance the benefits of the acute phase.
Measurements:
Recurrence of psychological distress and mobility difficulties at 12 months, using the Hopkins Symptom Check List-25 and the Short Physical Performance Battery. We also identified participant-level demographic and clinical characteristics associated with intervention uptake. We compared all measurements by intervention uptake (accepted vs. declined).
Results:
There were no differences in the recurrence of psychological distress or mobility difficulties by intervention uptake (accepted vs. declined). However, those who accepted described benefits in symptom relief and daily functioning. Several factors influenced uptake decisions: age, race/ethnicity, cognitive function, and participants' appraisal of their individual and environmental needs.
Conclusions:
Older adults can reap benefits from maintenance interventions. However, their engagement hinges on alignment with personal, social, and environmental contexts.
