title: Applying the ecological model of behavior change to a physical activity trial in retirement communities: description of the study protocol.
abstract: OBJECTIVE
  To describe the intervention protocol for the first multilevel ecological intervention for physical activity in retirement communities that addresses individual, interpersonal and community influences on behavior change.
  
  
  METHODS
  A cluster randomized controlled trial design was employed with two study arms: a physical activity intervention and an attention control successful aging condition.
  
  
  METHODS
  Sixteen continuing care retirement communities in San Diego County.
  
  
  METHODS
  Three hundred twenty older adults, aged 65 years and older, are being recruited to participate in the trial. In addition, peer leaders are being recruited to lead some study activities, especially to sustain the intervention after study activities ceased.
  
  
  METHODS
  Participants in the physical activity trial receive individual, interpersonal and community intervention components. The individual level components include pedometers, goal setting and individual phone counseling. The interpersonal level components include group education sessions and peer-led activities. The community level components include resource audits and enumeration, tailored walking maps, and community improvement projects. The successful aging group receives individual and group attention about successful aging topics.
  
  
  METHODS
  The main outcome is light to moderate physical activity, measured objectively by accelerometry. Other objective outcomes included physical functioning, blood pressure, physical fitness, and cognitive functioning. Self report measures include depressive symptoms and health related quality of life.
  
  
  RESULTS
  The intervention is being delivered successfully in the communities and compliance rates are high.
  
  
  CONCLUSIONS
  Ecological Models call for interventions that address multiple levels of the model. Previous studies have not included components at each level and retirement communities provide a model environment to demonstrate how to implement such an intervention.
authors.affiliation: Department of Family and Preventive Medicine, UCSD, USA. jkerr@ucsd.edu
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Kerr
authors.forename: Dori E
authors.initials: DE
authors.lastname: Rosenberg
authors.forename: Andrea
authors.initials: A
authors.lastname: Nathan
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Millstein
authors.forename: Jordan A
authors.initials: JA
authors.lastname: Carlson
authors.forename: Katie
authors.initials: K
authors.lastname: Crist
authors.forename: Kari
authors.initials: K
authors.lastname: Wasilenko
authors.forename: Khalisa
authors.initials: K
authors.lastname: Bolling
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Castro
authors.forename: David M
authors.initials: DM
authors.lastname: Buchner
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Marshall
mesh_terms: D000368:Aged; D002985:Clinical Protocols; D003376:Counseling / Q000379:methods*; D004777:Environment; D015444:Exercise / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods; D006801:Humans; D057187:Independent Living; D008297:Male; D010379:Peer Group; D012107:Research Design; D012651:Self Medication; D012944:Social Support; D013689:Telephone