Experience Corps: a dual trial to promote the health of older adults and children's academic success

Linda P Fried, Michelle C Carlson, Sylvia McGill, Teresa Seeman, Qian-Li Xue, Kevin Frick, Erwin Tan, Elizabeth K Tanner, Jeremy Barron, Constantine Frangakis, Rachel Piferi, Iveris Martinez, Tara Gruenewald, Barbara K Martin, Laprisha Berry-Vaughn, John Stewart, Kay Dickersin, Paul R Willging, George W Rebok, Linda P Fried, Michelle C Carlson, Sylvia McGill, Teresa Seeman, Qian-Li Xue, Kevin Frick, Erwin Tan, Elizabeth K Tanner, Jeremy Barron, Constantine Frangakis, Rachel Piferi, Iveris Martinez, Tara Gruenewald, Barbara K Martin, Laprisha Berry-Vaughn, John Stewart, Kay Dickersin, Paul R Willging, George W Rebok

Abstract

Background: As the population ages, older adults are seeking meaningful, and impactful, post-retirement roles. As a society, improving the health of people throughout longer lives is a major public health goal. This paper presents the design and rationale for an effectiveness trial of Experience Corps™, an intervention created to address both these needs. This trial evaluates (1) whether senior volunteer roles within Experience Corps™ beneficially impact children's academic achievement and classroom behavior in public elementary schools and (2) impact on the health of volunteers.

Methods: Dual evaluations of (1) an intention-to-treat trial randomizing eligible adults 60 and older to volunteer service in Experience Corps™, or to a control arm of usual volunteering opportunities, and (2) a comparison of eligible public elementary schools receiving Experience Corps™ to matched, eligible control schools in a 1:1 control:intervention school ratio.

Outcomes: For older adults, the primary outcome is decreased disability in mobility and Instrumental Activities of Daily Living (IADL). Secondary outcomes are decreased frailty, falls, and memory loss; slowed loss of strength, balance, walking speed, cortical plasticity, and executive function; objective performance of IADLs; and increased social and psychological engagement. For children, primary outcomes are improved reading achievement and classroom behavior in Kindergarten through the 3rd grade; secondary outcomes are improvements in school climate, teacher morale and retention, and teacher perceptions of older adults.

Summary: This trial incorporates principles and practices of community-based participatory research and evaluates the dual benefit of a single intervention, versus usual opportunities, for two generations: older adults and children.

Keywords: BHS; Baltimore City Commission on Aging and Retirement Education; Brain Health Study; CARE; COAH; Children's academic success; Community-based participatory research; EC; Experience Corps™; GHCC; Greater Homewood Community Corporation; Health promotion; Healthy aging; IADL; Instrumental Activities of Daily Living; Intergenerational programs; Johns Hopkins Center on Aging and Health; MMSE; MSA; Maryland School Assessment; Mini-Mental State Exam; Senior service.

Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

Figures

Fig. 1
Fig. 1
Hypothesized causal pathways of the Experience Corps™: The white boxes indicate the intervention and primary outcomes for both older adults and children and schools; the shaded boxes identify the causal pathways which the intervention is designed to effect. The steps in the causal pathway are measured in the studies. The primary outcome for each study is the distal outcome. The secondary outcomes are intermediary outcomes on the pathway to the primary outcome. The arrows represent causal directions, with solid arrows representing direct effects and dashed arrows representing indirect effects. a Hypothesized Experience Corps™ Baltimore program effects on physical, cognitive, and social health in older adults. b Hypothesized causal pathway of the Experience Corps™ Baltimore program effects on children.
Fig. 2
Fig. 2
5-Step recruitment, screening and intake process for Experience Corps™ trial volunteers.
Fig. 3
Fig. 3
Designs for the randomization of older volunteers and school selection. a Design for assigning adults to EC vs Control. The random assignment of adults who consent to participate to the main EC vs Control study is stratified by gender and by further consent or no consent to participate also in a nested brain substudy (BHS; see Section 2.3.3). b Comparison between schools accepting Experience Corps and control schools (*,this categorization was selective, as randomization was not an option). First, subclasses are formed based on the estimated propensity score between EC and eligible control schools (steps (i)–(iv) of Section 2.4.3.1). Then, among each propensity subclass k, the effect β1,k between EC and control schools on children's outcomes is estimated using the model of expression [I] of Section 2.9.2.1 (step (v) of Section 2.4.3.1), and the overall effect is estimated as a weighted average of the estimated effects β1,k (step (vi) of Section 2.4.3.1).

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