Targeting health-promoting activity in older adults with multiple chronic conditions and functional limitations

Abstract Nearly half of older adults in the U.S. have multiple chronic health conditions in addition to functional limitations (MCC + FL) that restrict health self-management activities. We tested an innovative combination of occupational therapy (OT) and behavioral activation (BA) to improve health self-management using the goal setting, scheduling/monitoring activities, and problem-solving components of the BA approach, as well as skill building, environmental modification, activity adaptation, and focus on daily routines from OT (BA+OT). BA+OT was delivered by occupational therapists over 10 sessions in the homes of participants. We present descriptive statistics from this single-blind randomized control pilot study of 11 older adults with MCC + FL who received BA+OT (n = 6) or enhanced usual care (UC; n = 5). Participants in both groups were given a Fitbit, and the UC group received a handout on managing chronic conditions. The BA+OT group was required to set at least one goal for improving physical activity. On average, participants were 73.1 years old (SD = 8.4), majority female (n = 8), and white (n = 1 Hispanic/Latino). They had an average of 3.9 chronic conditions (SD = 1.5), and 2.0 functional limitations (SD = 1.8). The most common chronic conditions were depression, high blood pressure, and arthritis. Aside from physical activity, the most common participant-identified goal areas were sleep hygiene and positioning, medication routines, and community access. This study is in progress (aiming for n = 40) but shows promise for improving health self-management by targeting meaningful, goal-directed, and health-promoting daily activity.