University of Southern California
University of Southern California
Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy
Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy
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Research
Research

Lifestyle Interventions for Health Promotion and Prevention

Well Elderly Study

Since 1993, when the USC Well Elderly Study was first launched, the USC Chan Division of Occupational Science and Occupational Therapy has been involved in studying the impact of a specific intervention called Lifestyle Redesign® on health in older Americans. The initial USC Well Elderly Study led by Florence Clark from 1994 through 1996 made a number of notable contributions in the research on occupational therapy and its effect on the aging population. The largest outcomes research study conducted in the field to date, results of this research were published in the Journal of the American Medical Association, the first occupational therapy study to ever earn a spot in the pages of the prestigious JAMA. The findings from this project showed that preventative occupational therapy intervention significantly slows the declines normally associated with aging, and is a cost-effective method of enabling older individuals to maintain their health and independence.

Clark and former professor Jeanne Jackson subsequently completed a study, referred to as “The USC Well Elderly Study 2,” which aimed to replicate previous study results which demonstrated that Lifestyle Redesign® cost-effectively slows the declines normally associated with aging. This research effort was also intended to build theory by simultaneously examining biological and social psychological mechanisms potentially responsible for the positive effects previously produced by the intervention. The findings of this study provided new information about the process events by which activity-based lifestyle interventions can influence aging outcomes.

Lifestyle Redesign® for Pressure Ulcer Prevention in Spinal Cord Injury (PUPS)

The Lifestyle Redesign® for Pressure Ulcer Prevention in Spinal Cord Injury — also abbreviated as “PUPS” — study was a $2.8M NIH-funded R01 study conducted by Clark from 2008 to 2014. Faculty members Stanley Azen and Erna Blanche were key collaborators, and additional USC collaborators included Clinical Pharmacy and Pharmaceutical Economics & Policy Professor Joel Hay, Professor of Preventive Medicine Jennifer Unger, and Salah Rubayi and Michael Scott from Rancho Los Amigos National Rehabilitation Center (RLANRC).

Advanced pressure ulcers are a common and medically serious complication of spinal cord injury (SCI) and are associated with extremely high treatment costs and reduced quality of life. However, preventive interventions that address this problem have received very little research attention. To address this gap, PUPS investigated the efficacy of a promising lifestyle intervention designed to prevent pressure ulcers among at-risk members of the SCI population. The six-year study involved collaboration between researchers from USC and RLANRC who have developed the intervention based on the results of a qualitative investigation of lifestyle and ulcer risk among adults with SCI. The long-term objective of this project is the identification of an intervention option that can enhance the health and life quality of the population of adults with SCI while simultaneously diminishing the heavy healthcare burden that results from the problem of SCI-related pressure ulcers.

Previous Projects

  • Lifestyle Redesign® for Pressure Ulcer Prevention in Rural Veterans with SCI (Project Directors: Michael Carlson & Florence Clark)
  • Lifestyle Redesign® for Pressure Ulcer Prevention in Spinal Cord Injury (Principal Investigator: Florence Clark)
  • Health Mediating Effects of the Well Elderly Program (Principal Investigator: Florence Clark)
  • Daily Living Context and Pressure Sores in Consumers with Spinal Cord Injury (Principal Investigator: Florence Clark)
  • Manual on Well-Elderly (Principal Investigator: Florence Clark)
  • The Effectiveness of Two Occupational Therapy Treatments for the Elderly (Principal Investigator: Florence Clark)

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