The grant, headed by Principal Investigator, Florence Clark, and Co-PI, Jeanne Jackson, and entitled Health-Mediating Effects of the Well Elderly Program, is being funded by the National Institute on Aging and will be conducted between May of 2004 and April of 2008. The high level of enthusiasm surrounding this project is a tribute to the increasing recognition of occupational science's ability to produce new knowledge that can significantly benefit the health and well-being of our nation's population.

The new grant has two main objectives. The first objective is to replicate the effects of the Well Elderly intervention. In the previous grant, the intervention was found to delay age-related declines in health, physical function, and psychosocial well-being among ethnically diverse community dwelling older men and women residing in federally subsidized apartment complexes. In the upcoming study, participants will be recruited from a broader range of settings including senior centers, medical facilities, apartment complexes, and senior education centers. This will enable generalization of the results to a wider range of elders. In addition, in the new project it is hypothesized that the intervention will produce beneficial effects in cognition, an outcome domain not included in the prior investigation.

The second major objective of the study will be to assess the intervening processes that underlie the positive effects of the intervention. In other words, an attempt will be made to determine exactly why the Well Elderly program is so successful. Toward this end, repeated assessments will be undertaken of subjects' daily patterns of occupation, approaches to coping, perceived control, social contact, and key biological markers (e.g., salivary cortisol, a key index of perceived stress), and changes on these variables will be linked to the improved outcomes that result from the intervention. This will enable a careful documentation of the intervention-based changes that lead to the beneficial outcomes.

The above goals will be achieved by using an experimental design involving the participation of 440 elderly men and women. In the first 6 months of the study, one-half of the participants will receive the Well Elderly intervention, while the remaining participants will go untreated. As in the original Well Elderly Study, the intervention will employ lifestyle redesign principles to help the elders engage in personally meaningful occupations that promote their independence, health, and life satisfaction. Using a "crossover design," following this initial phase the control participants will also be given the intervention. Over an 18 to 24 month interval, all subjects will complete an assessment battery to measure the variables noted above: patterns of occupation, styles of coping, perceived control, social support, and stress-relevant biomarkers. By correlating these measures with the main outcomes of perceived physical health and function, psychosocial well-being, and cognition, a window will be opened that sheds light on the processes that connect the Well Elderly intervention to its beneficial effects. The results will allow for improved planning of lifestyle-oriented treatment for the elderly, a rapidly mushrooming population greatly in need of preventive services.

In support of the project, Dr. Clark and Dr. Jackson have assembled an outstanding multidisciplinary research team. Co-Investigators include: Dr. Stan Azen, Professor and Director of Biometry and Clinical Trials at USC; Dr. Bob Knight, Professor of Gerontology and Professor of Psychology at USC; Dr. Doug Granger, Associate Professor of Behavioral Health at Pennsylvania State University; Dr. Chih-Ping Chou, Associate Professor of Preventive Medicine at USC; Dr. Barbara Cherry, Research Assistant Professor of Occupational Science and Occupational Therapy at USC; Dr. Maryalice Jordan-Marsh, Associate Professor of Nursing at USC; and Dr. Todd Forman, Assistant Clinical Professor of Family Medicine at USC.

Finally, it is important to note that Dr. Clark and Dr. Jackson’s ongoing work in the area of gerontology, as reflected in the new Well Elderly project, is part of a wider program of research involving the application of lifestyle redesign to varying populations that face special challenges. Other groups for which lifestyle redesign programs are being developed include obese adults, as well as adults with spinal cord injury who are at risk for medically serious pressure ulcers. Through this coordinated series of applications, occupational science research promises to help solve the emergent health care needs of the 21st century.