The Midwest Roybal Center for Health Promotion and Translation supports the design and testing of principle-driven, potent health promotion interventions that have strong promise of progressing through the NIH Stage Change Model. The Center continues to focus on designing interventions for older racial/ethnic minority adults but expands our focus to include cognitive health. The Center targets four thematic areas of focus to improve cognitive function, namely:

♦  Physical activity engagement and maintenance
♦  Enhancing mobility
♦  Harnessing technology to improve intervention scalability and fidelity
♦  Incorporating mechanisms of action that will sustain behavior change

Finally, the Center incorporates for the first time a Multi-modal ADRD Imaging and Connectomics Core that is enabling investigators to perform brain imaging, interpretation, and storage. The Center also promotes the uniform use across funded pilots of cognitive and physical activity measures from the NIH Toolbox; thereby, enabling the comparison of common outcomes across diverse samples and interventions.

Peixuan Zheng, PhD
College of Applied Health Sciences (Exercise Research Lab (ENRL))
Email: pxzheng@uic.edu

Exercise Training, Cognition, and Mobility in Older Adults with Multiple Sclerosis

The overall objective of the proposed randomized controlled (RCT) is to determine the feasibility and efficacy of a 16-week theory-based, remotely-delivered, combined exercise (aerobic and resistance) training intervention for improving cognitive and physical function in older adults (50+ years) with multiple sclerosis (MS) who have mild-to-moderate cognitive and walking impairment. Participants (N=50) will be randomly assigned into exercise training (combined aerobic and resistance exercise) condition or active control (flexibility and stretching) condition. The 16-week intervention will be delivered and monitored remotely within a participant’s home/community and supported by Zoom-based chats guided by social cognitive theory (SCT) via a behavioral coach.

Naoko Muramatsu, PhD, MHSA, FGSA
School of Public Health
Email: naoko@uic.edu

Promoting In-Home Activities at a Memory & Aging Clinic (Pro-Home MeC)

Physical activity (PA) has been recognized as a promising non-pharmacological intervention to slow cognitive declines associated with Alzheimer’s Disease and Alzheimer’s Disease Related Dementias (AD/ADRD). However, few interventions target adults with physical and/or cognitive impairments.PA interventions initiated at memory clinics are still scarce in the United States. The proposed project aims to assess the feasibility, acceptability, and preliminary effectiveness of a PA intervention program among sedentary older adults with mild cognitive impairment or mild dementia in collaboration with a memory and aging clinic.

Kelsey Gabel, RD, PhD
Applied Health Sciences
Email: kdipma2@uic.edu

Time Restricted Eating Plus Exercise for Weight Management

Time restricted eating (TRE) is currently the most popular form of intermittent fasting which involves confining the eating window to 8-10 hours (h) and fasting for the remaining hours of the day. TRE is unique in that during the eating window, individuals are not required to count calories or monitor food intake in any way, resulting in high adherence. Accumulating evidence suggests that TRE produces a natural energy deficit of ~350-500 kcal/d. Physical activity in combination with a healthy diet pattern is recommended for older adults. While aerobic type exercise is the most commonly recommended, retention of lean mass via resistance training, especially in older adults, may be more effective at improving mobility, neurological and psychological function, executive and cognitive functioning, and processing speed. TRE combined with physical activity has not been examined in older adults or in people with overweight or obesity. This study holds the potential to 1) decrease body weight 2) improve lean mass 3) improve insulin sensitivity, and 4) improve attention, executive functioning, and processing speed in older adults. The aims of this study will examine the effect of TRE combined with either resistance training or aerobic training on body weight, body composition, metabolic disease risk, and cognition in adults over age 50. It is hypothesized that the TRE combined with resistance training group will see the most significant improvements in body composition, insulin sensitivity and cognition due to lean mass accretion.

Susan Aguiñaga, PhD
College of Applied Health Sciences, UIUC
Email: saguina2@illinois.edu

OCEAN: Optimizing Cognition via Exercise and Nutrition

Investigators propose to test the preliminary efficacy of the refined BAILAMOS™ Latin dance program plus a culturally tailored MIND diet (Mediterranean-DASH diet intervention for neurodegenerative delay) program on cognitive function among older Latinos (ages 50+) at risk of cognitive decline. This project will test whether participants randomized to the BAILAMOS™ Latin dance plus MIND diet experience better cognitive outcomes than participants randomized to the BAILAMOS™ Latin dance plus a health education program.

Julie Bobitt, PhD
College of Medicine
Email: jbobitt@uic.edu

Evaluation of the Wits Workout Wellness Program for Older Adults

About 11% of the U.S. older adult population is at risk for or suffers from subjective cognitive decline. While some factors such as genetics and habitual physiological changes that affect brain health cannot be changed, research has shown that lifestyle changes such as participation in regular physical activity, staying socially engaged, and managing stress and diet can help to delay or reduce cognitive decline. Yet few brain health promotion programs exist and those that do fail to focus on global health and wellness as a strategy to improve brain health. Wits Workout is a holistic, 12-session, 60-minute per session, multi-modal workshop series that offers adults ages 50 and older facilitated, interactive dialogue and activities about behaviors that promote brain health. Each week includes a different themed module which has four activities and a training component.

Mansha Mirza, PhD
College of Applied Health Sciences
Email: mmirza2@uic.edu

Piloting the IPROACTIF intervention to preserve independence and functioning

Brief Description: In this pilot, a randomized control trial will be conducted to assess the preliminary efficacy of IPROACTIF, an occupational therapist-delivered primary care intervention for aging and chronic disease management.

Kueifang (Kelly) Hsieh, PhD
College of Applied Health Sciences
Email: hsieh@uic.edu

We Walk Plus Study: A Walking Program using Physical Activity Monitors and Social Media for Older Adults with Intellectual Disabilities

This study is intended to determine the feasibility and acceptability of We Walk Plus intervention to promote physical activity and improve cognition for older adults with intellectual disabilities (ID).

Tanvi Bhatt, PhD
College of Applied Health Sciences
Email: tbhatt6@uic.edu

CogXergaming to promote physical activity and cognitive function in frail older adults

Alternate forms of therapy such as exergaming with explicit cognitive training has shown promising effects in improving motor and motor function in disabled populations. These studies use a cost-effective, off the shelf device such as Nintendo Wii or Microsoft Kinect to deliver the training which is easily available and clinically translatable. Further, such training has demonstrated increase in brain connectivity enhancing cognitive functions associated with balance control. However, there is limited literature examining the effect of exergaming in older frail population and the efficacy of such training is unknown. Therefore, this study proposes a randomized controlled trial to examine the feasibility of CogXergaming program with an aim to improve locomotor-balance control, cognition, muscular system and cardiovascular fitness.

Products:

Neuromechanisms of falls in older adults with MCI: Targeting assessment and training of reactive balance control
2022 NIA $573,194  5T  R01Act  AG073152Project  02Year
BHATT, TANVI Principal Investigator(s)/ Project Leader(s)

Perturbation training for enhancing stability and limb support control for fall-risk reduction among stroke survivors
2022 NICHD $318,572  5T  R01Act  HD088543Project  05Year
BHATT, TANVI Principal Investigator(s)/ Project Leader(s)

Ulf Bronas, PhD, ATC, ATR, FSVM, FAHA
Columbia University School of Nursing
Email: ub2154@cumc.columbia.edu

A physical activity program to disrupt sedentary time in older Latinos (PAIS)

To test the feasibility of an intervention designed to replace sedentary time with physical activity in older Latinos, delivered in their homes to improve cognitive function and brain connectivity.

Products:

Accelerated Age-related Cognitive Decline: Impact of Exercise on Executive Function and Neuroplasticity (EXEC-study)
2023 NIA $520,026  5T  R01Act  AG076456Project  02Year
BRONAS, ULF G Principal Investigator(s)/ Project Leader(s)

Tanvi Bhatt, PhD
College of Applied Health Sciences
Email: tbhatt6@uic.edu

Virtual-reality Based Cognitive-motor-balance (VR-CogMoBal) Training: Examining Behavioral and Neuromarkers for Fall-risk Reduction in Older Adults With Mild Cognitive Impairment

Older adults often display gait instability, impaired balance control and cognitive decline that lead to falls and fall risks. Approximately 60% of the elderly people with cognitive deficits experience a detrimental fall each year. Such motor and cognitive impairments further decreases physical activity levels in this population leading to restricted community integration, social behavior, depression and long-term disability. With the help of computer technology, studies have employed virtual-reality based interventions to address the above-mentioned concerns including sensori-motor, balance control and cognitive impairments. Previous studies have demonstrated promising results on improving the behavioral outcomes, and have identified such interventions have the potential to improve the underlying neurophysiological outcomes as well. While VR based training studies have demonstrated remarkable improvement in the balance control and gait parameters, physical activity levels and fall risk reduction, the gains on cognitive function is less pronounced. There is little evidence that VR-based training can explicitly address the higher executive cognitive domains associated with balance control and falls. Further, the effect of VR-based training on balance control and cognitive function is unknown among the older adults with mild cognitive impairment. Therefore, to address the cognitive domains explicitly, the current study aims to test the applicability of Wii-Fit Nintendo along with an additional cognitive load delivered via VR-based cognitive-motor training paradigm (VR-CogMoBal) in older adults with mild cognitive impairment. Lastly, the study also aims to identify the effect of such training on the underlying behavioral and neural outcomes. The behavioral outcomes will be assessed via performance on dual-tasking and clinical measures in the laboratory. The underlying neural outcomes will be assessed via fMRI outcomes. In order to determine the generalizing training effect at community level, a pilot sub-study to determine the physical activity levels post 4 weeks of training will also be conducted.

Spyros Kitsiou, PhD
College of Applied Health Sciences
Email: skitsiou@uic.edu

TEXT4HF: Feasibility randomized controlled trial of a tailored text messaging intervention driven by an Artificial Intelligent Virtual Health Coach to improve self-care in older adult patients with heart failure

This randomized controlled trial aims to determine the feasibility and preliminary efficacy of a patient-centered, mobile health technology intervention (iCardia4HF) in patients with chronic Heart Failure (HF). Participants (n = 92) are recruited and randomized 1:1 to the intervention or control group. The intervention group receives a commercial HF self-care app (Heart Failure Storylines), three connected health devices that interface with the app (Withings weight scale and blood pressure monitor, and Fitbit activity tracker), and a program of individually tailored text-messages targeting health beliefs, self-care self-efficacy, HF-knowledge, and physical activity. The control group receives the same connected health devices, but without the HF self-care app and text messages. Follow-up assessments occur at 30 days and 12 weeks.

iCardia4HF: A multi-component mHealth app and tailored text-messaging intervention to promote self-care adherence and improve outcomes in patients with chronic heart failure
2023  NIH/NHLBI  $757,414  1T  R01  HL168376
KITSIOU, SPYROS Principal Investigator(s)/Project Leader(s)

Beth Marks, PhD, RN, FAAN
College Of Applied Health Sciences
Email: bmarks1@uic.edu

HealthMatters@24/7 Asynchronous Health Promotion eLearning for People Supporting Adults With Intellectual and Developmental Disabilities

The barriers faced by people with intellectual and developmental disabilities (IDD) begin in their mid to late 20s and often mirror the experiences of older adults (50+) living in the U.S. While evidence for successful population-specific health promotion programs and training, such as the 12-Week HealthMatters Program has been documented, an urgent need exists for continuous, readily available, on-demand training in these programs. Online training can substantially aid the widespread translation of evidence-based programs into practice and policy. This proposal seeks to test the effectiveness of an enhanced mode of translating the HealthMatters program into practice through the use of an on-demand e-Learning platform (HealthMatters@24/7) for staff in community based organizations (CBOs) in one state; thereby advancing the science of translational research. HO1. More CBOs in the asynchronous training program will have developed Strategic Action Plans for Health and Wellness, established Wellness Committees, and have equal or more resources and improved culture for health promotion at 1 year compared to CBOs participating in the current live HealthMatters TtT Workshop webinar. HO2. Staff in the asynchronous training group will have improved levels of learner/instructor satisfaction (job productivity, job performance, job satisfaction, organizational commitment, convenience) toward the training immediately after completing the enhanced mode of training, HM@24/7 compared to staff trained using the current live HealthMatters TtT Workshop webinar.