title: Pilot test of an attribution retraining intervention to raise walking levels in sedentary older adults.
abstract: OBJECTIVE
  To pilot test a new behavioral intervention to increase walking in sedentary older adults.
  
  
  METHODS
  Pre-post community-based pilot study.
  
  
  METHODS
  Three senior centers in greater Los Angeles.
  
  
  METHODS
  Forty-six sedentary adults aged 65 and older.
  
  
  METHODS
  At four weekly 1-hour group sessions held at the senior centers, a trained health educator applied a theoretically grounded, standardized "attribution retraining" curriculum developed by a multidisciplinary team of investigators. Participants were taught that becoming sedentary is not inevitable with aging and that older adults should attribute being sedentary to modifiable attributes rather than to old age. A 1-hour exercise class including strength, endurance, and flexibility training followed each weekly attribution retraining session.
  
  
  METHODS
  Change from baseline in steps per week recorded using a digital pedometer was measured after 7 weeks. Age expectations (measured using the Expectations Regarding Aging-38 survey, a previously tested instrument on which higher scores indicate that the participant expects high functioning with aging and lower scores indicate that the participant expects physical and mental decline) and health-related quality of life were measured using in-person interviews.
  
  
  RESULTS
  Mean steps per week increased from 24,749 to 30,707, a 24% increase-equivalent to 2.5 miles (2-sided t-test P=.002). Age expectation scores increased 30% (P<.001), and the changes in age expectations and steps per week correlated (correlation coefficient=0.39, P=.01). Participants experienced improved mental health-related quality of life (P=.049) and reported less difficulty with activities of daily living (P=.04). More than 50% of participants reported improvements in pain, energy level, and sleep quality.
  
  
  CONCLUSIONS
  In this small pre-post community-based pilot study, a structured attribution retraining curriculum accompanied by a weekly exercise class was associated with increased walking levels and improved quality of life in sedentary older adults. Attribution retraining deserves further investigation as a potential means of increasing physical activity in sedentary older adults.
authors.affiliation: Division of Geriatrics, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA. csarkisian@mednet.ucla.edu
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Sarkisian
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Prohaska
authors.forename: Connie
authors.initials: C
authors.lastname: Davis
authors.forename: Bernard
authors.initials: B
authors.lastname: Weiner
mesh_terms: D000368:Aged; D000375:Aging / Q000523:psychology*; D001294:Attitude to Health; D001521:Behavior Therapy; D015444:Exercise / Q000523:psychology*; D005240:Feasibility Studies; D005260:Female; D015577:Geriatric Assessment; D006126:Group Processes; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008019:Life Style; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010807:Physical Endurance; D010809:Physical Fitness / Q000523:psychology; D010865:Pilot Projects; D011788:Quality of Life / Q000523:psychology; D016138:Walking / Q000523:psychology*