The Worksite Heart Health Improvement Project + Function Focused Care (WHHIP+FFC) intervention to increase physical activity and wellbeing among staff and residents in assisted living facilities

About This Grant

PROJECT SUMMARY / ABSTRACT Sedentary behavior is often negatively associated with cancer, cardiovascular disease, diabetes, mental health and early death among all adults. Furthermore, of concern for older adults, sedentary behavior has been linked with a decline in cognitive function, falls and reduced function and/or disability. Our team has been refining our Worksite Heart Health Improvement Project (WHHIP), which aims to improve physical activity (PA), among staff working in assisted living (AL) facilities. Our past WHHIP projects were deemed feasible and showed significant improvements in staff health behaviors and outcomes. We found residents attended PA sessions with staff, and staff encouraged residents to engage in PA as a result of participating in the WHHIP. Additionally, engaging residents in PA has been demonstrated repeatedly through Function Focused Care (FFC). FFC is a philosophy of care that teaches staff how to engage and encourage residents in PA during care interactions. One of the major challenges to implementation of FFC, however, was workers’ lack of beliefs in the benefits of PA for themselves and residents. To optimally engage staff and residents in PA we have merged the WHHIP and FCC interventions to increase PA in both groups. The WHHIP+FFC has four steps: Step 1: Development of a stakeholder team and identification of an AL champion; Step 2: Environment and policy assessments to increase PA among staff and residents; Step 3: Individual education and goal setting for PA with staff; and Step 4: Mentoring and motivation of staff to engage in and facilitate resident participation in PA. Using an incomplete stepped wedge cluster randomized trial in eight AL facilities (staff n=224, resident n=120) with six data collection timepoints we aim to: Aim 1: Evaluate the feasibility of the combined WHHIP+FFC approaches. Hypothesis 1: The WHHIP+FFC will be deemed feasible as evidenced by delivery, receipt, and enactment. Aim 2: Evaluate the impact of the WHHIP+FFC to improve PA among AL staff and residents. Hypothesis 2: AL staff exposed to the WHHIP+FFC will demonstrate improvements in objective and subjective PA and FFC engagement, and residents will demonstrate improvements in objective PA and function. Aim 3: Evaluate the impact of the WHHIP+FFC on physical and psychological outcomes. Hypothesis 3: AL staff exposed to the WHHIP+FFC will demonstrate improvements in blood pressure, sleep hours, sleep quality, body composition as well as in depression, anxiety, stress, and burnout symptoms. Aim 4: Evaluate the impact of the WHHIP+FFC on staff retention. Hypothesis 4: Organizations exposed to the WHHIP+FFC will demonstrate decreased AL staff turnover and intention to leave.