Health and illness over time: the trajectory perspective in nursing science.

Background: Understanding change in health and illness over time is central to creating and evaluating interventions for individuals, families, and populations. The term health trajectory is a succinct and useful way to describe change in health status over time.

Objectives: The aims of this article were to define the notion of a health trajectory; comment on the usefulness and current status of health trajectory research for nursing science and practice; and identify and illustrate the key elements of theory, design, and statistical models for health trajectory research.

Predictors of long-term exercise adherence in a community-based sample of older women.

Background: Few studies have examined long-term exercise adherence in older women. The purpose of this study was to assess predictors of adherence to an intervention involving walking and balance exercises.

Methods: This was a randomized controlled trial with 2-year follow-up.

Does the Transtheoretical Model (TTM) explain exercise behavior in a community-based sample of older women?

Objective: To determine whether patterns of exercise adoption by older women would conform to the Transtheoretical Model (TTM) of behavior change.

Methods: Participants were randomized into an exercise group (walk 30 minutes per day, 5 days per week, plus balance exercises twice per week) or attention control (health education on topics other than exercise). The intervention was conducted over 28 weeks with 1-year follow-up.

Circumstances and consequences of falls in community-dwelling older women.

Aims: To describe the circumstances and consequences of falls reported by community-dwelling older women.

Methods: This prospective study collected data for approximately 2 years for women aged>or=70 years at risk for falling who were enrolled in the Fall Evaluation and Prevention Program.

Results: Participants (263) completed a median of 24 months of follow-up.

Design of control-group conditions in clinical trials of behavioral interventions.

Purpose: To review considerations in the design of placebo (attention) control conditions for community-based clinical trials of health behavior change interventions and to provide practical strategies for the design of control conditions.

Organizing Constructs: A well-designed control condition is an essential component of a clinical trial to foster the unambiguous interpretation of study findings.

Methods: Pitfalls in the design of control conditions in clinical trials of behavioral interventions are identified and strategies to address them are offered.

Measuring the direct healthcare costs of a fall injury event.

Background: Falls are a leading cause of injury in older adults. Obtaining cost data for a randomized controlled trial aimed at preventing falls was problematic, and an approach was needed to obtain these data on a relatively small sample of women who used healthcare services.

Approach: The study population was 272 community-dwelling women aged 70 and over who were participants in a fall prevention trial.

Exercise behavior in older adults: a test of the transtheoretical model.

The transtheoretical model (TTM) was developed as a guide for understanding behavior change. Little attention has been given, however, to the appropriateness of the TTM for explaining the adoption of exercise behavior in older adults. The purposes of this study were to determine the reliability of the TTM instruments and validate TTM predictions in 86 community-dwelling older adults (mean age 75.

Reporting violence to a health care employer: a cross-sectional study.

The purpose of this cross-sectional study was to identify individual and employment characteristics associated with reporting workplace violence to an employer and to assess the relationship between reporting and characteristics of the violent event. Current and former employees of a Midwest health care organization responded to a specially designed mailed questionnaire. The researchers also used secondary data from the employer.

Work-related violence policy: a process evaluation.

This study describes one employer's approach to evaluating employees' knowledge of a violence prevention policy and experience with work-related physical and non-physical violence. A cross-sectional design was used to collect data from a random sample of current and former employees of a Midwest health care organization via a specially designed mailed questionnaire and the employer's internal database. While 7% of employees reported experiencing physical violence in the workplace, almost half of all employees had experienced non-physical violence.