Tai Chi for Older Adults: Improving Physical and Psychological Health Through a Community-Based Tai Chi Program and Identifying Barriers to Participation
Manson, James Donald
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Older adults face aging challenges that occur naturally or are precipitated early in the aging cycle by physical inactivity. Using three prospective cohorts of ethnically diverse low-income older adults, this dissertation aimed to: i) assess the promoters and barriers of low-income older adults in terms of their enrollment in a locally-offered TC program, ii) examine the TC intervention effects in terms of physiological outcomes, iii), examine the TC intervention effects in terms of psychological outcomes, and, iv) assess the promoters and barriers of low-income older adults in terms of their adherence in a locally-offered TC program, with special sensitivity to ethno-cultural based issues. Results of the first objective uncovered six categories relating to enrollment with no clear barriers or promoters that related to gender and specific cultural limitations. Categories included physical and mental health, time of day, socialization, program pairing, accessibility and appropriate leadership/teacher. Results of the second objective showed significant improvements in both upper and lower body strength, low back flexibility, and the Short-Form Health Survey (SF 36) physical health scores (p < 0.05). Based on multiple linear regression analyses, no common health determinants explained a significant portion of the variation in percent changes of the musculoskeletal fitness and SF 36 measures. Results of the third objective did not find significant improvements when looking at SF 36 summary mental health scale, subjective happiness scale and the expectations regarding aging summary measure; however, there were significant improvements in two sub scales of the SF 36 of vitality (VT) and mental health (MH) in the combined cohorts and expectations regarding aging in the third of three cohorts (p < 0.05). Finally in the last objective there were ten categories found relating to adherence with no clear barriers or promoters that related to specific cultural limitations. Categories included common barriers/promoters that embraced biological, psychological, social and environmental influences. Overall, the results demonstrated that TC has the ability to be used as a good health-related PA program in a multi-ethnic, low-income, older adult population with possible potential for psychological health improvement and with key categories to help enrollment and maintain attendance.