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Older Adults?? Desire for Physical Competence
Abstract
To develop and provide initial psychometric support for a 16-item measure that assesses a new construct termed desire for physical competence (DPC).
A total of 157 older adults (aged 60-95) were administered the DPC along with various other questionnaires that assessed demographics, health status, social desirability, desire for control, body satisfaction, and life satisfaction. These data facilitated development and initial psychometric evaluation of the scale. An additional sample of 30 older adults was employed to examine test-retest reliability.
Based on the conceptual foundation of DPC and results from an exploratory factor analysis, a single-dimension Rasch model based on response theory was applied to the data. The proposed model fit the data quite well as indicated by the average mean square of both outfit (1.02) and infit (1.04) statistics. The DPC correlated in expected directions with age, r = -0.33 (P < 0.01), and had r values of 0.23, 0.22, 0.25 (all P values <0.01) with desire for control, body satisfaction, and the SF-36, respectively. Older adults with arthritis had lower DPC scores than those without arthritis. The measure was not confounded by social desirability, and test-retest reliability of the measure (>0.90) was excellent.
The DPC provides a tool to assess the incentive value of older adults for being physically competent. As such, it provides a more complete social cognitive foundation for studies examining physical activity behavior and the process of physical disablement.
... For purposes of this study, we collected data on several social cognitive process measures that were conceptually related to the intervention. These included: (a) a measure of performance effi cacy related to the 400 m walk, (b) a barriers effi cacy scale (Garcia and King 1991), (c) a measure of satisfaction with physical function (Reboussin et al 2000), and an 8-item measure of desire for physical competence that was adapted from work by Rejeski and colleagues (Rejeski et al 2006). ...
... The 8-item desire scale included the following items from the original scale (Rejeski et al 2006): (a) having the ability to do heavy work in the house or yard; (b) having the ability to stand up from a low, soft couch/chair; (c) having the ability to carry a ten pound object (ie, a bag of groceries) while climbing one fl ight of stairs; (d) having the ability to walk at a quick pace for a mile; (e) having the ability to get into and out of a car; (f) having the ability to do light work in the house or yard; and (g) having the ability to walk up and down a fl ight of stairs (hand rails available). ...
Background. The Short Physical Performance Battery (SPPB), which includes walking, balance, and chair stands tests, independently predicts mobility disability and activities of daily living disability. To date, however, there is no definitive evidence from randomized controlled trials that SPPB scores can be improved. Our objective was to assess the effect of a comprehensive physical activity (PA) intervention on the SPPB and other physical performance measures. Methods. A total of 424 sedentary persons at risk for disability (ages 70-89 years) were randomized to a moderate-intensity PA intervention or a successful aging (SA) health education intervention and were followed for an average of 1.2 years. Results. The mean baseline SPPB; score on a scale of 0-12, with 12 corresponding to highest performance, was 7.5. At 6 and 12 months, the PA versus SA group adjusted SPPB (+/- standard error) scores were 8.7 +/- 0.1 versus 8.0 +/- 0.1, and 8.5 +/- 0.1 versus 7.9 +/- 0.2, respectively (p <.001). The 400-meter walking speed was also significantly improved in the PA group. The PA group had a lower incidence of major mobility disability defined as incapacity to complete a 400-meter walk (hazard ratio = 0.71, 95% confidence interval = 0.44-1.20). Conclusions. A structured PA intervention improved the SPPB score and other measures of physical performance. An intervention that improves the SPPB performance may also offer benefit on more distal health outcomes, such as mobility disability.
... For purposes of this study, we collected data on several social cognitive process measures that were conceptually related to the intervention. These included: (a) a measure of performance effi cacy related to the 400 m walk, (b) a barriers effi cacy scale (Garcia and King 1991), (c) a measure of satisfaction with physical function (Reboussin et al 2000), and an 8-item measure of desire for physical competence that was adapted from work by Rejeski and colleagues (Rejeski et al 2006). The 400 m walk effi cacy scale was completed after participants had fi nished the 400 m walk test. ...
... For item two, it read the same distance that you did today, item three read half again as far (the same distance plus half of that distance), item four read twice as far, and item fi ve read three times as far. The 8-item desire scale included the following items from the original scale (Rejeski et al 2006): (a) having the ability to do heavy work in the house or yard; (b) having the ability to stand up from a low, soft couch/chair; (c) having the ability to carry a ten pound object (ie, a bag of groceries) while climbing one fl ight of stairs; (d) having the ability to walk at a quick pace for a mile; (e) having the ability to get into and out of a car; (f) having the ability to do light work in the house or yard; and (g) having the ability to walk up and down a fl ight of stairs (hand rails available). ...
A prospective design was used to examine predictors of adherence to a physical activity intervention in older adults with compromised function.
The sample included 213 men (31.1%) and women (68.9%) with an average age of 76.53 years.
The predictor variables accounted for 10% of the variance in percent attendance during adoption and transition, respectively. Adding percent attendance during adoption to the prediction of percent attendance during transition increased the explained variance in this phase to 21%. During maintenance, the predictors accounted for 13% of the variance in frequency of physical activity; this estimate increased to 46% when adding in percent attendance from the transition phase.
These results are encouraging in that the physical activity intervention appears to have been well tolerated by diverse subgroups of older adults. The role of prior behavior in predicting downstream adherence underscores the importance of developing proactive interventions for treating nonadherence in older adult populations.
... In the desire for physical activity measure, participants were asked to indicate their level of desire to perform moderate-intensity physical activity for incremental time periods (10,20,30,40,50, and 60 min) on a scale ranging from 0 (no desire whatsoever) to 4 (very strong desire). This instrument is a modification of the scale used in previous studies [71,72], and has been found to be valid and reliable (Cronbach's alpha coefficients exceeding .80), related to self-efficacy, and to be responsive to physical activity interventions. ...
... Twelve binary items were added to the mix, thus a total of 16 items were used. Item-parameter values for the items were selected from an instrument measuring self-efficacy in physical mobility (Rejeski et al., 2006;Ip et al., 2013b). The percentages of DK in the 4 poset items ranged from 10.7% to 67%. ...
Understanding beliefs, values, and preferences of patients is a tenet of contemporary health sciences. This application was motivated by the analysis of multiple partially ordered set (poset) responses from an inventory on layman beliefs about diabetes. The partially ordered set arises because of two features in the data-first, the response options contain a Don't Know (DK) option, and second, there were two consecutive occasions of measurement. As predicted by the common sense model of illness, beliefs about diabetes were not necessarily stable across the two measurement occasions. Instead of analyzing the two occasions separately, we studied the joint responses across the occasions as a poset response. Few analytic methods exist for data structures other than ordered or nominal categories. Poset responses are routinely collapsed and then analyzed as either rank ordered or nominal data, leading to the loss of nuanced information that might be present within poset categories. In this paper we developed a general class of item response models for analyzing the poset data collected from the Common Sense Model of Diabetes Inventory. The inferential object of interest is the latent trait that indicates congruence of belief with the biomedical model. To apply an item response model to the poset diabetes inventory, we proved that a simple coding algorithm circumvents the requirement of writing new codes such that standard IRT software could be directly used for the purpose of item estimation and individual scoring. Simulation experiments were used to examine parameter recovery for the proposed poset model.
... In other words, the social environment critically mediates the action a person takes. As selfdetermination theory predicts, when the psychological needs of autonomy, competence, and relatedness are satisfied, individuals are more likely to initiate and sustain in a wide range of behaviors (Losier, Bourque, & Vallerand, 1993; Rejeski, Ip, Katula, & White, 2006; Vallerand & Losier, 1999). An additional premise of self-determination theory posits that motivation exits on a continuum with amotivation on one end and intrinsic motivation on the other (Vallerand & Losier, 1999). ...
Caregiver religiosity and exercise are aspects often overlooked by dementia research while remaining important factors within the dementia caregiver experience. As a result of prior qualitative research findings, the author focused on religious components of the caregiving process in addition to exercise and various caregiver perceptions. Data was collected on the characteristics of 31 spouse and adult-child caregivers of patients diagnosed with Alzheimer's disease. Questionnaire data provide the basis for a descriptive model for patient and caregiver (prior and current) religious needs. The data suggest subjects who indicate less involvement in organized and non-organized religious activity tend to report higher levels of overall burden F (4,30) = 2.89, p < .05. In addition, variables associated with exercise predict total caregiver burden F (3, 29) = 4.5, p < .01. The present findings suggest that a lack of involvement in organized and non-organized religious activity, as well as a lack of exercise during the caregiving period, predicts higher levels of burden.
... The study intervention is designed to target barriers to physical activity in individuals with PAD. A series of questionnaires, listed in Table 3, allows for measurement of change in potential behavioral barriers to exercise in response to the intervention Desire for physical competence questionnaire and walking efficacy questionnaire-Desire for physical competence reflects older adults' motivation to perform tasks requiring distinct physiological demands (30). In the GOALS trial, the intervention aims to increase PAD participants' self-efficacy for their ability to walk varying distances at a brisk pace without stopping. ...
People with lower extremity peripheral artery disease (PAD) have greater functional impairment and faster functional decline than those without PAD. We describe methods for the Group Oriented Arterial Leg Study (GOALS), an ongoing randomized controlled clinical trial designed to determine whether a Group-Mediated Cognitive Behavioral (GMCB) intervention improves functional performance in PAD participants, compared to a health education control condition. In GOALS, PAD participants were randomized to either an intervention or a health education control condition in a parallel design. Both conditions consist of weekly group sessions with other PAD participants. In the intervention, cognitive behavioral techniques are used to assist participants in setting and adhering to home-based walking exercise goals. Participants are encouraged to walk for exercise at home at least 5days/week. In the control condition, participants receive lectures on health-related topics. After 6months of on-site weekly sessions, participants are transitioned to telephone follow-up for another 6months. Participants in the intervention are asked to continue home walking exercise. The primary outcome is change in six-minute walk performance between baseline and six-month follow-up. Secondary outcomes include change in six-minute walk performance at 12-month follow-up, and change in treadmill walking performance, the Walking Impairment Questionnaire, quality of life, and physical activity at six and 12-month follow-up. In conclusion, if our group-mediated cognitive behavioral intervention is associated with improved walking performance in individuals with PAD, results will have major public health implications for the large and growing number of people with PAD.
... In other words, the social environment critically mediates the action a person takes. As selfdetermination theory predicts, when the psychological needs of autonomy, competence, and relatedness are satisfied, individuals are more likely to initiate and sustain in a wide range of behaviors (Losier, Bourque, & Vallerand, 1993;Rejeski, Ip, Katula, & White, 2006;Vallerand & Losier, 1999). ...
A predominate motivation theory used to predict exercise behavior is self-determination theory, which posits that motivation is driven by satisfaction of three basic psychological needs: autonomy, competence, and relatedness. This study investigates the relationship between motivation, basic psychological needs satisfaction, and exercise in a sample of older adults. Significant differences were found between older adult exercisers and nonexercisers in intrinsic motivation, self-determined extrinsic motivation, nonself-determined extrinsic motivation, autonomy, competence, and relatedness. This study suggests that self-determination theory is a suitable framework to investigate older adult exercise behaviors.
... In the desire for physical activity measure, participants were asked to indicate their level of desire to perform moderate-intensity physical activity for incremental time periods (10,20,30,40,50, and 60 minutes) on a scale ranging from 0 (no desire whatsoever) to 4 (very strong desire). This instrument is a modification of the scale used in previous studies [71,72], and has been found to be valid and reliable (Cronbach alpha coefficients exceeding .80), related to self-efficacy, and to be responsive to physical activity interventions. ...
... In conclusion, IRT-based measurement and analytic methods in psychology are perpetually challenged by the increasingly complex test designs emanating from the proliferation of new applications, such as those recently arising in psychopathology (Meijer & Baneke, 2004;Sharp, Goodyer, & Croudace, 2006), exercise science (Rejeski, Ip, Katula, & White, 2006), personality inventory (Reise & Cook, 2010), and self-report health-related psychobehavioural outcomes (Reeve, Hayes, Chang, & Perfetto, 2007;Reise et al., 2007). It is my hope that the theoretical results reported here will further the understanding of how different IRT-based models function, and enhance the capacity of current psychometric tools to tackle these practical challenges. ...
Multidimensionality is a core concept in the measurement and analysis of psychological data. In personality assessment, for example, constructs are mostly theoretically defined as unidimensional, yet responses collected from the real world are almost always determined by multiple factors. Significant research efforts have concentrated on the use of simulated studies to evaluate the robustness of unidimensional item response models when applied to multidimensional data with a dominant dimension. In contrast, in the present paper, I report the result from a theoretical investigation that a multidimensional item response model is empirically indistinguishable from a locally dependent unidimensional model, of which the single dimension represents the actual construct of interest. A practical implication of this result is that multidimensional response data do not automatically require the use of multidimensional models. Circumstances under which the alternative approach of locally dependent unidimensional models may be useful are discussed.
The prevalence of type 2 diabetes continues to increase in minority and underserved patients, who are also more likely to have poorer control of diabetes and related risk factors for complications. Although the Look AHEAD trial has demonstrated improved risk factor control among overweight or obese diabetes patients who received an intensive lifestyle intervention, translating such findings into accessible programs is a major public health challenge. The purpose of this paper is to report the design and baseline characteristics of the Lifestyle Interventions for the Treatment of Diabetes study (LIFT Diabetes). The overall goal is to test the impact of a community-based lifestyle weight loss (LWL) intervention adapted from Look AHEAD on cardiovascular disease risk at 12-months and 24-months among minority and lower income diabetes patients. Secondary outcomes include body weight, physical activity, medication use, cost, resource utilization, and safety. The primary hypothesis being tested is that the LWL will result in 10% relative reduction in CVD risk compared to the DSM. We have randomized 260 overweight or obese adults with diabetes one of two 12-month interventions: a LWL condition delivered by community health workers or a diabetes self-management (DSM) education condition. The baseline demographic characteristics indicate that our sample is predominantly female, obese, low income, and ethnic minority. Translating evidence-based, lifestyle strategies, and targeting minority and underserved patients, will yield, if successful, a model for addressing the burden of diabetes and may favorably impact health disparities.
The problem of fitting unidimensional item response models to potentially multidimensional data has been extensively studied. The focus of this article is on response data that have a strong dimension but also contain minor nuisance dimensions. Fitting a unidimensional model to such multidimensional data is believed to result in ability estimates that represent a combination of the major and minor dimensions. We conjecture that the underlying dimension for the fitted unidimensional model, which we call the functional dimension, represents a nonlinear projection. In this article we investigate 2 issues: (a) can a proposed nonlinear projection track the functional dimension well, and (b) what are the biases in the ability estimate and the associated standard error when estimating the functional dimension? To investigate the second issue, the nonlinear projection is used as an evaluative tool. An example regarding a construct of desire for physical competency is used to illustrate the functional unidimensional approach.
Objectives: Identity and Social Cognitive Theories were used to study associations between physical activity (PA) identity, social cognitions (self-regulatory efficacy, proximal intentions), PA, and satisfaction with life among older adults (M age = 79.5). Methods: Eighty-four moderately active older adults completed measures of PA identity, self-regulatory efficacy, proximal intentions, past PA and satisfaction with life. Past PA was hypothesized to relate to PA identity. PA identity and self-regulatory efficacy were hypothesized predictors of proximal PA intentions and satisfaction with life. Differences between identity groups of different strength on PA, social cognitions and satisfaction with life were also explored. Results: Regressions revealed the following: Past PA was a significant predictor of PA identity (Model adj. R2 = .21; p < .001). Identity and self-regulatory efficacy were significant predictors of strength of proximal PA intentions (Model adj. R2 = .28; p < .001) and satisfaction with life (Model adj. R2 = .21; p < .001). A one-way MANOVA comparing PA identity groups on PA, social cognitions and satisfaction with life was significant (p < .001). Older adults with a strong PA identity reported more PA, stronger self-regulatory efficacy, proximal intentions, and satisfaction with life than their less strong identity counterparts. Conclusion: Findings support the compatible use of Identity and Social Cognitive Theories in exploring relationships between PA identity for older adults and social cognitions, PA and satisfaction with life. Understanding PA identity for older adults and its relationship to self-regulatory beliefs may generate productive research directions for studying the PA of this underserved population.
Background:
An accurate physical fitness survey could be useful in research and clinical care.
Purpose:
To estimate the validity and reliability of a Self-Reported Fitness (SRFit) survey; an instrument that estimates muscular fitness, flexibility, cardiovascular endurance, BMI, and body composition (BC) in adults ≥ 40 years of age.
Methods:
201 participants completed the SF-36 Physical Function Subscale, International Physical Activity Questionnaire (IPAQ), Older Adults' Desire for Physical Competence Scale (Rejeski), the SRFit survey, and the Rikli and Jones Senior Fitness Test. BC, height and weight were measured. SRFit survey items described BC, BMI, and Senior Fitness Test movements. Correlations between the Senior Fitness Test and the SRFit survey assessed concurrent validity. Cronbach's Alpha measured internal consistency within each SRFit domain. SRFit domain scores were compared with SF-36, IPAQ, and Rejeski survey scores to assess construct validity. Intraclass correlations evaluated test-retest reliability.
Results:
Correlations between SRFit and the Senior Fitness Test domains ranged from 0.35 to 0.79. Cronbach's Alpha scores were .75 to .85. Correlations between SRFit and other survey scores were -0.23 to 0.72 and in the expected direction. Intraclass correlation coefficients were 0.79 to 0.93. All P-values were 0.001.
Conclusion:
Initial evaluation supports the SRFit survey's validity and reliability.
A rating response mechanism for ordered categories, which is related to the traditional threshold formulation but distinctively different from it, is formulated. In addition to the subject and item parameters two other sets of parameters, which can be interpreted in terms of thresholds on a latent continuum and discriminations at the thresholds, are obtained. These parameters are identified with the category coefficients and the scoring function of the Rasch model for polychotomous responses in which the latent trait is assumed uni-dimensional. In the case where the threshold discriminations are equal, the scoring of successive categories by the familiar assignment of successive integers is justified. In the case where distances between thresholds are also equal, a simple pattern of category coefficients is shown to follow.
Few data on physical activity habits among populations of low socioeconomic status have been published. The authors studied physical activity habits--leisure-time physical activity, job-related physical activity, household physical activity, and walking--among 172 lower socioeconomic status women and 84 lower socioeconomic status men and compared their habits with those of 208 higher socioeconomic status women and 95 higher socioeconomic status men. All subjects resided in the greater Pittsburgh, Pennsylvania, area. Data collection occurred throughout 1986. Lower socioeconomic status women, the least active group, averaged 1,536 +/- 1,701 minutes/week (+/- standard deviation) of total physical activity, whereas higher socioeconomic status women, the most active group, averaged 2,079 +/- 1,807 minutes/week (p less than 0.0001). Higher socioeconomic status men averaged 1,952 +/- 1,799 minutes/week, and lower socioeconomic status men averaged 1,948 +/- 1,916 minutes/week. Higher socioeconomic status women spent significantly more time each week in leisure-time physical activity, job-related physical activity, and household physical activity than did lower socioeconomic status women. Lower socioeconomic status men spent significantly more time each week walking and doing household chores, whereas higher socioeconomic status men tended to be more active in leisure-time physical activity. These data suggest important quantitative and qualitative differences in physical activity among population subgroups. In view of the important role of physical activity in promoting physical and mental health, reasons for the differences among groups of varying socioeconomic status must be examined and elucidated.
Laboratory and field research indicates that the relationships between personal control and stress, coping, and adaptational outcomes are more complex than was once assumed. Believing that an event is controllable does not always lead to a reduction in stress or to a positive outcome, and believing that an event is uncontrollable does not always lead to an increase in stress or to a negative outcome. These complex relationships involving control are examined in the context of Lazarus's cognitive theory of stress and coping. The first part of the article elaborates this theory and shows how two forms of control, generalized beliefs about control and situational appraisals of control, fit into the overall model. Situational appraisals of control are explored in this section, including the question, Control over what? which must be addressed in order to explain some of the perplexing findings. The second part of the article draws on the theoretical formulation of stress and coping to examine three important issues: (a) how believing one has control in a stressful transaction can heighten threat, (b) the relationship between control and coping, and (c) pathways through which control can affect the adaptational outcomes of stressful encounters.
A new social desirability scale was constructed and correlated with MMPI scales. Comparison was made with correlations of the Edwards Social Desirability scale. The new scale correlated highly with MMPI scales and supported the definition of social desirability. Ss need to respond in "culturally sanctioned ways."
This article reports the development and validation of a scale to measure global life satisfaction, the Satisfaction With Life Scale (SWLS). Among the various components of subjective well-being, the SWLS is narrowly focused to assess global life satisfaction and does not tap related constructs such as positive affect or loneliness. The SWLS is shown to have favorable psychometric properties, including high internal consistency and high temporal reliability. Scores on the SWLS correlate moderately to highly with other measures of subjective well-being, and correlate predictably with specific personality characteristics. It is noted that the SWLS is Suited for use with different age groups, and other potential uses of the scale are discussed.
This study examined the dimensional structure and correlates of body satisfaction among middle-aged and older adult men (n = 471) and women (n = 383) who were participants in the Activity Counseling Trial. Correlates were grouped as (1) fitness parameters, (2) demographic characteristics, and (3) components of subjective well-being. Factor analyses demonstrated that body function and body appearance were independent components of satisfaction in this population. Body composition and cardiorespiratory fitness were directly related to satisfaction with body appearance; however, satisfaction with body function was most strongly related in expected directions to measures of subjective well-being. Age was positively related to both measures of body satisfaction, whereas data on race revealed that blacks were more satisfied with their body appearance and function than whites. The observed relationships for body satisfaction suggest that older adults may value body function more than body appearance. Furthermore, the associations of race and age with body satisfaction have important implications for intervention research.
This investigation examined the determinants of satisfaction with physical function for participants in an Observational Arthritis
Study in Seniors (OASIS). The sample consisted of 480 men (51%) and women (49%) over the age of 65 years who had difficulty
performing activities of daily living due to knee pain. As part of baseline testing for OASIS, participants completed a measure
that assessed satisfaction with function for six physical activities. After controlling for relevant covariates, scores on
the satisfaction index were regressed on seven conceptually relevant predictor variables. The results revealed that satisfaction
with physical function is a distinct construct from level of function, irrespective of whether the latter variable is measured
objectively or subjectively. When entered into a hierarchical regression model, 6-minute walk test data accounted for 11%
of the variance in satisfaction scores, whereas perceived difficulty accounted for an additional 22%. Moreover, a significant
interaction term between importance and perceived difficulty revealed that patients who rated the activities as important
and who had high levels of perceived difficulty had the lowest satisfaction scores. Discussion focuses on the determinants
of satisfaction with physical function with emphasis on the interaction between perceived difficulty and importance.
Two personality constructs, desire for control and locus of control, were related to depression among college students. Measures of levels of depression, desire for control, and locus of control were taken from subjects. Approximately six months later 71% of these subjects returned a questionnaire concerning their experiences with depression during that six-month period. It was found that locus of control scores, particularly the extent to which subjects perceived that their lives were controlled by chance, were significantly related to the depression levels. It was also found that high desire for control subjects who held external perceptions of control were most likely to seek nonprofessional help for depression. In addition, high desire for control subjects who perceived their lives as generally controlled by chance were most likely to have suicidal thoughts. The results are interpreted in terms of a general style that may promote a proneness to depression for certain individuals.
Building on prior conceptual schemes, this article presents a sociomedical model of disability, called The Disablement Process, that is especially useful for epidemiological and clinical research. The Disablement Process: (1) describes how chronic and acute conditions affect functioning in specific body systems, generic physical and mental actions, and activities of daily life, and (2) describes the personal and environmental factors that speed or slow disablement, namely, risk factors, interventions, and exacerbators. A main pathway that links Pathology, Impairments, Functional Limitations, and Disability is explicated. Disability is defined as difficulty doing activities in any domain of life (from hygiene to hobbies, errands to sleep) due to a health or physical problem. Feedback effects are included in the model to cover dysfunction spirals (pernicious loops of dysfunction) and secondary conditions (new pathology launched by a given disablement process). We distinguish intrinsic disability (without personal or equipment assistance) and actual disability (with such assistance), noting the scientific and political importance of measuring both. Disability is not a personal characteristic, but is instead a gap between personal capability and environmental demand. Survey researchers and clinicians tend to focus on personal capability, overlooking the efforts people commonly make to reduce demand by activity accommodations, environmental modifications, psychological coping, and external supports. We compare the disablement experiences of people who acquire chronic conditions early in life (lifelong disability) and those who acquire them in mid or late life (late-life disability). The Disablement Process can help inform research (the epidemiology of disability) and public health (prevention of disability) activities.
In summary, readers are encouraged to read carefully the IRT articles in this special issue. They provide theoretical as well as practical arguments in favor of using IRT models in the health outcomes measurement field. At the same time, readers should be aware that the IRT field is complex and software is limited and, in my judgment, not very user friendly (although some packages are better than others). In addition, sample sizes will often need to be larger than in classical measurement, at least with the more general IRT models, and applications are rarely straightforward. Considerable practical experience is needed to ensure successful applications of IRT in the development and validation of instruments for health outcomes measurement.
Efforts to evaluate the effectiveness of clinical and community-based interventions designed to impact late-life disability have been hindered significantly by limitations in current instrumentation. More conceptually sound and responsive measures of disability are needed.
Applying Nagi's disablement model, we wrote questionnaire items that assessed disability in terms of frequency and limitation in performance of 25 life tasks. We evaluated their validity and test-retest reliability with 150 ethnically and racially diverse adults aged 60 and older who had a range of functional limitations, using factor analysis and Rasch analytic techniques to examine and refine the instrument.
Our analyses resulted in a 16-item disability component with two dimensions, one focused on frequency of performance and the other addressing limitation in performance of life tasks, with two disability domains within each dimension. The frequency dimension consisted of a personal and a social role domain, and the limitation dimension consisted of an instrumental and a management role domain. Expected differences in summary scores of known-functional limitation groups support the validity of this instrument. Test-retest intraclass correlations of the reproducibility of each overall dimension summary score were moderate to high (intraclass correlation coefficients .68-.82).
The Late-Life Function and Disability Instrument has potential to assess meaningful concepts of disability across a wide variety of life tasks with relatively few items.
This is a cross-sectional investigation of living arrangements, social contacts, and level of leisure-time physical activity (LTPA) among residents of Sonoma, California, aged 55 and older.
The odds of different levels of LTPA were assessed by living arrangements and social contacts following adjustment for measures of health, functioning, physical performance, selected health behaviors, and socioeconomic status for men and women separately (n = 2,073). Level of LTPA also was examined among married couples only (subset of sample, n = 511 spouse pairs).
The relationship between living arrangements, social contacts, and LTPA varied by gender and level of LTPA. Among married couples, the LTPA of the partner was the most significant predictor of the LTPA of the participant, with the exception of those who engaged in less than brisk activity.
Living arrangements and social contacts are important determinants of LTPA and should serve as the basis for future interventions.
REJESKI, W.J., and B.C. FOCHT. Aging and physical disability: On integrating group and individual counseling with the promotion of physical activity. Exerc. Sport Sci. Rev., Vol. 30, No. 4, pp. 166–170, 2002. This review examines selected conceptual models on physical disability that have been commonly employed in the study of chronic disease and aging, and suggests including self-efficacy beliefs and physical symptoms into the main pathway of the disablement process. The resulting model of disability has direct implications for integrating group and individual counseling into exercise prescription.