Association for Behavior Analysis International

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Fourth International Conference; Australia, 2007

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Symposium #6
International Symposium - Increasing the Healthy Activities of Older People: A Behavior Analytical Approach
Monday, August 13, 2007
9:00 AM–10:20 AM
L4 Room 1
Area: CBM/DEV; Domain: Applied Behavior Analysis
Chair: Melanie S. Burkhardt (Murdoch University)
Abstract: The changing age structure of the population and its potential impact on government provisions for healthcare has focused attention on the development of appropriate policies and service provisions. In particular, there has been an emphasis on preventative measures. To date significant resources are being directed towards largely ineffective initiatives, such as media campaigns, that aim to encourage older people to adopt healthier and more active lifestyles. We present a behavioral perspective that shows improvements in the well-being of older people involves arranging supportive contexts for more active behavior change, including the use of self-management strategies. This symposium outlines the development and evaluation of a comprehensive intervention, founded on behavioral principles that targets increases in the healthy activities of older people (aged 70+ years). Papers will describe the main components of our Back for Action Program (BAP) including how it selects, measures and reinforces the type and frequency of daily activities, and how the relative effectiveness and utility of its feedback, behavioral consultation and self-management stages has been determined. Details of single-case studies will also be presented to illustrate the implementation of the BAP in a West-Australian community. These four papers provide an overdue behavioral perspective on ways of increasing ‘healthy aging’ activities in people of advanced age. They establish an important role for behavior analysts in health promotion and healthy living initiatives.
 
A Behavioral Perspective of the Healthy Activities of Older People.
DAVID J. LEACH (Murdoch University), Melanie S. Burkhardt (Murdoch University)
Abstract: Despite considerable resources being directed towards healthy living initiatives and media campaigns urging older people to adopt more physically active lifestyles, 75.2% of Australians over the age of 65 were considered “sedentary” in a recent National Heath Survey (Australian Bureau of Statistics, 2006). From a behavioral perspective, improving the health and well-being of people of advanced age involves arranging reinforcing contingencies, supportive contexts and self-management strategies to increase more physically active behaviors. This is an area of application of ABA principles that has received surprisingly little attention from behavior analysts. The paper examines current, mainstream approaches to increasing the healthy activities of older people, presents the rationale for comprehensive, home- or centre-based behavioral programs, and describes a behavior analytic perspective as it pertains to the future of health promotion and healthy living initiatives for older people in their local communities.
 
The Back for Action Program: Measuring Activities, Providing Feedback and Teaching Self-Management.
MELANIE S. BURKHARDT (Murdoch University), David J. Leach (Murdoch University)
Abstract: This paper presents the rationale for selecting, measuring and maintaining the type and frequency of core ‘healthy aging’ behaviors targeted in our Back for Action Program (BAP) - a comprehensive, home- or centre-based program founded on applied behavior analytic principles that aims to increase the activity levels of people of advanced years (70+ years). We describe the development and application of the BAP including its objective, cost effective measurement of the type and frequency of the habitual daily activities of older people. This measurement system forms an integral component of the BAP in providing self-monitored, daily data on activity patterns which are then used for feedback and provide a focus for the behavioral consultation component of our program. We show how older people can be taught to use and interpret their own data to self-manage and increase healthier, more active activities in the longer-term. Longitudinal, daily data from single-cases will be presented to illustrate the use of the measurement systems for describing and managing the everyday activities of older people.
 
The Back for Action Program: The Importance of Functional Analysis and Behavioral Consultation.
DAVID J. LEACH (Murdoch University), Melanie S. Burkhardt (Murdoch University)
Abstract: The Back for Action Program (BAP) focuses on small cumulative increases in the amount of physical involvement in the everyday activities of older people, and the contexts that support behavior change. The purpose of this paper is to outline the rationale and describe the behavioral consultation approach utilized in our BAP. We emphasize a collaborative problem-solving approach that focuses on the functional aspects of sedentary and active behavior and addresses avoidance, as well as the use of self-monitoring to teach older people to behave in ways that maximize the likelihood of contacting natural reinforcement for the healthier more active activities in the contexts of their lives. The feasibility of behavioral consultation in the context of our program of interventions to increase the ‘healthy aging’ activities of older people is discussed. We also outline the behavioral principles that underlie the process of behavior change and guide the implementation of this component of the BAP.
 
The Back for Action Program: Relative Effects of Its Component Stages of Feedback, Consultation and Self-Management on Daily Activity Levels.
MELANIE S. BURKHARDT (Murdoch University), David J. Leach (Murdoch University)
Abstract: As has been described in earlier papers in this symposium, The Back for Action Program (BAP) is a comprehensive, home- or centre-based behavioral intervention that aims to increase daily activity levels in older people. This fourth paper describes two of the intervention stages of the BAP that consist of daily activity feedback and behavioral consultation and activation. Consultation follows a collaborative, problem-solving approach and is conducted in a minimum of 5, 1 hour sessions over a 1 month period. The sessions include a descriptive and a functional analysis of daily behavioral patterns, setting personal short and long-term activity targets, and teaching self-management skills for long-term maintenance. Longitudinal, daily data from single cases are presented to illustrate the utility and relative effectiveness of feedback, consultation and self-management in increasing the activities of older people in a West Australian community.
 

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