Health Behaviors in Older Canadians. Gerontology 302. A review of Newsom’s Article. Purpose: To find out about the older population’s efforts to change behavior, improve health behaviors, and what a the key barriers to change. A survey done 1996-1997 and sample size 17,345 Canadians aged 60+
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Health Behaviors in Older Canadians Gerontology 302
A review of Newsom’s Article • Purpose: To find out about the older population’s efforts to change behavior, improve health behaviors, and what a the key barriers to change. • A survey done 1996-1997 and sample size 17,345 Canadians aged 60+ • Summary findings show a substantial number of older adults lead relatively inactive lives and fall short of standards of preventive health care visits and screening tests.
Newsom • 2/3rds of those sampled reported no efforts in the prior year to make changes to improve their health and about the same percentage thought no changes were needed. There were differences noted in gender age and education. • The implications to be discussed are as follows: How do we priorize public health methods, what interventions should be developed and how can preventive care guidelines be implemented?
Newsom • Increasing healthy behaviors has an impact on QOL, and cost benefits in the health care system. • We need to reduce high risk behaviors, and address the needs of the aging population. • There is a suggestion that older adults cannot change their behaviors or that healthy behavior is seen as little benefit. Research has shown that older adults can modify health behaviors and this has an important impact on their overall health. This can include, diet, pharmaceuticals and health behavior.
Newsom • Health behaviors-lifestyle, smoking, exercise, check-ups, screening tests, eye exams, hearing tests, flu shots, sun screens. • However, convenience sampling is not as useful as population sampling. Examining the demographics of older adults who are most likely to engage in unhealthy behaviors or neglect preventive visits and screening tests can help to target groups who are most at risk.
Newsom • Data is needed on health priorities and motivation to change, plus perceived barriers. • Sample-random sample by geographic clusters and SES. Two groups 60-74 and 75+ Education-high school or less and those with higher education. • Health Behaviors-20 different physical activities over a month’s period(walking, swimming, gardening, cycling) Frequencies were recorded. Alcohol consumptions was recorded with two questions (Similar to the Geriatric Alcohol screening test), smoking behavior, sun screen use.
Newsom • Preventive Care=Self-exams, screening tests, BP monitoring, dental, eye checks, etc. Questions were asked about women’s health issues, mammograms, pap tests, x-rays. • Reported Changes or Beliefs: Did you do anything to improve your health? What diet are you following and open ended questions about what they might do to improve their physical health-exercise, lose weight, quit smoking, take vitamins, etc. Responses tried to measure the stages of change.
Newsom • What were the results? 25% of the respondents were sedentary (less than one 15 minute physical activity per month) 40% fewer than one drink per month over the past year. 1.5% in the heavy drinking category (three drinks per day or more) 33% used a designated driver when going out drinking. 21% always used sunscreen. 94% had BP checks over the past year. 31% had not seen a dentist in 5 years. 73% had had an eye exam in the past two years. 44% had never had flu shots. 10% never had a physical check-up
Newsom • 39% had a routine check up in the past year. 47% of the females had a breast exam by an MD, 27% never performed breast self-examinations. 32% had a mammo in the past year but 30% never had one at all. 27% had a Pap smear done in the past year and 20% had never had one done. • Changes in Beliefs: 63% reported to have done nothing in the past year to change their beliefs. • 20% changed their exercise level. 46% said they ate balanced meals.
Newsom • 66% felt they should do nothing to improve their health and those who did only 59% said it would happen over the next year. The most common improvement-increase exercise, lose weight and change eating habits. Less than 3% were intending to manage stress, take vitamins or other changes. Only 20% of smokers indicated they should quit or smoke less and of course 24% were going to do that in the next year.
Newsom • 36% reported one or more barriers-the most common lack of will-power (44%) disability or health (19%) and lack of time (13%) Less than 5% felt it too costly or they were too stressed. • Gender and Age: In general with some differences, females exhibited healthier behaviors. • Discussion: A large number adults fall short on general public health goals. There is a relatively frequent contact with GP’s and this is an area for improvement of preventive care.
Newsom • Screening guidelines, modification of health behaviors and health education are all potential areas for intervention in the doctors office. • Much more work is needed in diet education and leading healthier lifestyles. There is a disproportionate focus on exercise to the exclusion of many other areas of change. • We need to improve self-efficacy if the goal is behavioral change. Intervening earlier, public health to work more actively with lower SES groups
Newsom • There were some structural faults in the research and the assessment process and tools. It relied heavily on self-reporting-negatives under-reported and positives overestimated. Possible too many complex variables to tease out clear lines of cause and effect. • So what do we need to do next?