Abstract

Objective: The purpose of this pilot project was to employ a goal-based, individualized behavior-change approach to promote engagement in health care self-management activities and physical activity among vulnerable older adults living in subsidized housing. The specific aims were: (1) to determine the acceptability and feasibility of a wellness coaching model among urban-dwelling, low-income older adults, and (2) to test whether participation in the wellness coaching program would result in higher activation levels, increased physical activity, and an improved, self-rated quality of life and health status when compared to a wait-list control group.

Methods: The project implemented a feasibility study and quasi-experimental design to achieve its aims. The sample included minority older adults residing in one of two subsidized housing sites, both within one large, urban housing authority. Fifteen participants (5 females and 10 males, mean age 77.4 ± 7.9 years) were assigned to the intervention group and 13 older adults (7 females and 6 males, mean age 75.8 ± 9.1 years) from another housing site comprised the wait-list control group, crossing over to the intervention after six months. The intervention was an integrative, geriatric assessment and wellness coaching program introduced to low-income older adults. InterRAI’s Health & Social Check-up and the Lifestyle Survey were the primary data collection tools. Participants also completed the Patient Activation Measure.

Results: Independent t-tests revealed statistically significant improvement in physical activity and self-reported health status and quality of life for the group receiving the intervention for one year compared with those who received the intervention for a short time period.

Conclusion: Urban-dwelling, low-income older adults were able to identify their goals and, through a wellness coaching process, engage in the development of their personal healthy aging plan, facilitating their involvement in health care self-management. Capitalizing on social networks and other low or no-cost options to support goal achievement may be a key strategy in resource-restricted environments.

Keywords: Patient activation; Personalized wellness coaching; Physical activity; Self-management; Low-income older adults; Senior housing, InterRAI