Older Latinas please stand up! Simple intervention encourages better health

Overweight, sedentary, postmenopausal Latinas participating in a 12-week intervention program that counseled them about how to stand more and sit less greatly reduced daily sitting time, according to preliminary research to be presented at the American Heart Association's Scientific Sessions 2020.

"There is more and more research that indicates people who spend a lot of time sitting, either at work or at home, are at increased risk for cardiovascular disease and circulation problems. However, there are not many studies that have explored ways to change this behavior, particularly among older women of diverse backgrounds," said study author Gregory Talavera, M.D., M.P.H., professor of psychology at San Diego State University in San Diego, California. "Our simple intervention can substitute for or complement other lifestyle changes aimed at decreasing cardiovascular disease risk in older people who are often the most sedentary compared to people in other age groups."

Talavera and colleagues studied 254 overweight, sedentary, postmenopausal Latinas (average age 64) from disadvantaged backgrounds in San Diego from 2017 to 2019. Researchers randomly assigned the women to take part in a 12-week standing intervention program or a comparison group that received an equal number of contacts to discuss topics on healthy aging.

Women in the intervention group interacted with counselors eight times during the 12 weeks. Three of those meetings were in-person including one in each participant's home. Five were telephone sessions. The women learned how to address barriers to standing in their daily lives. The most common barriers were time and lower extremity pain due to arthritis. Counselors talked with the women about social cues, personal habits and how to change them with the goal of sitting less. Interventions included: behavioral contracts; sharing what they had learned with their family members for social support; biofeedback from a thigh-worn inclinometer (measures sitting/standing/laying down time); a small portable standing desk; and a wrist-worn timer that vibrated reminding them to stand.

The control group received written information and 12 phone counseling sessions to promote healthy aging.

While tailoring the program, researchers considered the family-oriented aspects among this group because many of the women lived in multi-generational homes. It was also important to understand the traditional/conservative gender roles within Latino communities that could impact their ability to be more physically active (within a multi-generational home in Latino communities, older women are less likely to work outside the home and more likely to be a caretaker to other family members and handle a lot of household chores).

"We provided cultural tailoring for the program, adapting an English version of the protocol into Spanish with changes that reflect Latina lifestyles such as incorporating standing time while completing household chores," Talavera said. "This program can be done in the home and could benefit women who are unable to participate in traditional physical activity."

Using data from the thigh-worn inclinometer, researchers found:

• At the start of the study, all participants spent an average of 540 minutes (9 hours) daily sitting.By 12 weeks, women in the intervention group reduced their sitting time an average of 71 minutes daily. Women in the control group that received only heart-healthy information reduced sitting time an average of 7.5 minutes daily.
• Average standing time increased nearly 50 minutes per day in the intervention group, compared to an increase of 2.5 minutes per day in the control group.
• Average stepping time increased more than 13 minutes in the intervention group, compared to nearly 5 minutes in the control group.

"These were older women with a number of health conditions that affected their ability to participate in traditional physical activities, so we were very surprised by how large of an improvement the intervention group demonstrated after only 12 weeks," Talavera said. "Many older women of diverse backgrounds experience lower extremity problems such as arthritis. We believe this easy intervention may also benefit other groups of older women."

Eligible participants self-identified as Latina and Spanish- or English-speaking with no current use of insulin or severe health conditions that would prevent participation in the study.

Co-authors are Sheila Castaneda, Ph.D.; Maria Lopez-Gurrola, M.D.; Ana Rebeca Alvarez-Malo, M.D.; Johanne Hernandez, R.N., M.B.A.; Dorothy Sears, Ph.D.; Chase Reuter, B.S.; Loki Natarajan, Ph.D.; Michelle Takemoto, Ph.D.; Ya-Ju Chang, Ph.D.; Yesenia Avitia, B.S.; Areilia Haimovich, B.S.; Luis Ornales, B.S.; Andrea De La Torre, B.S.; and Matthew Allison, M.D., M.P.H. Author disclosures are in the abstract.