title: Effects of a health promotion program on sustaining health behaviors in older adults.
abstract: BACKGROUND
  Controversy exists regarding the optimal way to provide health promotion education to the elderly. This prospective randomized study evaluated the effectiveness of individualized assessment and counseling coupled with the receipt of a written health plan on client adherence to health behavior recommendations.
  
  
  METHODS
  Two hundred thirty-seven ethnically diverse and predominantly low-income adults 60 and older, participating for the first time in an established statewide public health prevention program delivered in both rural and urban clinics, were recruited and randomly assigned to treatment and control groups. All participants received a standardized assessment that included a health history, nutrition assessment, and limited physical exam from a public health nurse. The treatment group additionally received a written personal health plan and individualized counseling to support implementation of the plan. Both groups were interviewed after one year to determine their adherence to the original recommendations.
  
  
  RESULTS
  Seventeen preventive services and health behaviors were evaluated. There were no statistically significant differences between the groups on health care use and previous health behaviors at baseline. Using logistic regression and controlling for socioeconomic and demographic variables, we found that the treatment group that received a personal health plan and counseling completed significantly more preventive referrals and health behavior changes (P < .001).
  
  
  CONCLUSIONS
  A client-centered planning process with supportive counseling by public health nurses, combined with health plans provided to clients, can significantly increase the prevention measures taken by older adults.
authors.affiliation: Institute for Health & Aging, School of Nursing, University of California, San Francisco 94143-0646, USA. pf1965@itsa.ucsf.edu
authors.forename: P J
authors.initials: PJ
authors.lastname: Fox
authors.forename: W
authors.initials: W
authors.lastname: Breuer
authors.forename: J A
authors.initials: JA
authors.lastname: Wright
mesh_terms: D000368:Aged; D002140:California; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011203:Poverty; D015397:Program Evaluation; D011446:Prospective Studies