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Preparation for Aging pp 87–103Cite as

The New Public Health Approach to Improving Physical Activity and Autonomy in Older Populations

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Abstract

A whole population (or purportedly “new”) public health approach is emerging which is characterized by (a) the promotion of health through upstream planned sociopolitical change; (b) appreciation of the ontologic and epistemologic limitations of risk-factor epidemiology to inform this new approach; (c) application of more appropriate methodologies (including both quantitative and interpretive methods); and (d) the incorporation of multi-level outcomes (including broader measures of qualities of life). Confronting this new public health, established epidemiology and community health methods are limited in three key ways: a dominant paradigm which produces atheoretical studies and the equation of infinite risks with causation; a restrictive focus on downstream individual behavior and interventions; and methodologies that produce a rigid adherence to positivist approaches which devalue complementary interpretive approaches. This paper considers the potential of the “new” public health approach to promote increased physical activity (and thereby autonomy and improved quality of life) among sedentary older adults.

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References

  • Ashton, J., and Seymour, H., 1988, “The New Public Health ” ,Open University Press, Buckingham.

    Google Scholar 

  • Barke, C.R., and Nicholas, D.R., 1990, Physical activity in older adults: the stages of change, J. Applied. Gerontol. ,9(2):216–223.

    Article  Google Scholar 

  • Basch, C., 1987, Focus group interview: an underutilized research technique for improving theory and practice in health education, Health Educ. Q. ,14:411–448.

    Article  PubMed  CAS  Google Scholar 

  • Becker, M.H., 1986, The tyranny of health promotion, Publ. Hlth. Rev. ,14:15–25.

    CAS  Google Scholar 

  • Begg, C.B., and Berlin, J.A., 1988, Publication Bias: A problem in interpreting medical data, J. Roy. Statist. Soc. A.. ,151:419–445.

    Article  Google Scholar 

  • Bernard, H.R., 1988, “Research Methods in Cultural Anthropology” ,Sage Publication, Newbury Park, CA.

    Google Scholar 

  • Blackburn, H., Luepker, R., Kline F.G., et al., 1984, The Minnesota heart health program: a research and demonstration project in cardiovascular disease prevention. in: “Behavioral Health: A Handbook of Health Enhancement and Disease Prevention ” ,J.D. Matarazzo, S.M. Weiss, J.A. Herd, N.E. Miller, and S.M. Weiss, eds., John Wiley and Sons, New York.

    Google Scholar 

  • Carmody, T.P., Senner, J.W., Manilow, M.R., and Mattarazzo, J.D., 1980, Physical exercise rehabilitation:Long-term dropout rate in cardiac patients, J. Behav. Med. ,3:163–168.

    Article  PubMed  CAS  Google Scholar 

  • Dishman, R.K., 1988, Overview, in: “Exercise Adherence Champaign” ,R. Dishman, ed.. Human Kinetics Books, IL, pp. 1–9.

    Google Scholar 

  • Durkheim, E., 1938, “Rules of Sociological Method” ,University of Chicago Press, Illinois.

    Google Scholar 

  • Esterbrook, P.J., Berlin, J.A., Gopalan, R., and Matthews, D.R., 1991, Publication bias in clinical research, Lancet ,337:867–872.

    Article  Google Scholar 

  • Elder, J., McGraw, S., and Abrams, D., 1986, Organizaitonal and community approaches to community-wide prevention of heart disease: the first two years of the Pawtucket heaert health program, Prev. Med., 15:107–117.

    Article  PubMed  CAS  Google Scholar 

  • Farquhar, J.W., Fortmann, S.P, Flora, J.A., et al., 1990, Effects of communitywide education of cardiovascular risk factors: the Stanford five-city project, JAMA ,264(3):359–365.

    Article  PubMed  CAS  Google Scholar 

  • Feyerabend, P., 1987, “Farewell to Reason” ,Verso, New York, pp. 162–91.

    Google Scholar 

  • Flay, B.R., 1986, Efficacy and effectiveness trials (and other phases of research) in the developments of health promotion programs, Prev. Med. ,15:451–474.

    Article  PubMed  CAS  Google Scholar 

  • Foucault, M.., 1973, “The Birth of the Clinic: An Archeology of Medical Perception” ,Tavistock, London.

    Google Scholar 

  • Fries, J.F., Green, L.W., and Levine, S., 1989, Health promotion and the compression of morbidity, Lancet ,1 (8636):481-483.

    Article  PubMed  CAS  Google Scholar 

  • Gholson, B., and Barker, P, 1985, Applications in the history of physics and psychology, Am. Psychol., 40:755–769.

    Article  Google Scholar 

  • Green, L.W., Lewis, F.M., 1986, “Measurement and Evaluation in Health Education and Health Promotion ”, Palo Alto, California Mayfield Publishing Company.

    Google Scholar 

  • Greenland, S., 1988, Probability versus Popper: An elaboration of the insufficiency of current Popperian approaches for epidemiologic analysis, in: “Causal Inference” ,K.J. Rothman, ed., Epidemiology Resources, Chestnut Hill, MA, pp. 95–104.

    Google Scholar 

  • Grimby, F., Grimby, A., Frändin, K., et al., 1992, Physically fit and active elderly people have a higher quality of life, Scand. J. Med. Sci. Sports ,2:225–230.

    Article  Google Scholar 

  • Grunig, L., 1990, Using focus group research in public relations, Publ. Relat. ,1:36–49.

    Article  Google Scholar 

  • Habermas, J., 1981, Theorie des kommunikatieven Handelns ,Band 1 und 2, Frankfurt am Main, Surhkamp Verlag.

    Google Scholar 

  • Hill, A.B., 1965, Environment and disease: association or causation? Proc. R. Soc. Med. ,58:295–300.

    PubMed  CAS  Google Scholar 

  • Jette, A., 1994, “Designing and evaluating psychosocial interventions for promoting self-care behaviors among older adults” ,National Invitation Conference on Research Issues Related to Self-Care and Aging, NIA.

    Google Scholar 

  • Kelsey, J.L., Thompson, W.D., and Evans, A.S., 1986, “Methods in Observational Epidemiology. Monographs in Epidemiology and Biostatistics” ,Vol. 10, Oxford University Press, New York.

    Google Scholar 

  • Kitzinger, J., 1994, The methodology of Focus Groups: the importance of interaction between research participants, Soc. Health Illn. ,16(1): 103–121.

    Article  Google Scholar 

  • Kitzinger, J., in press, Focus groups: method or madness? in: “Challenge and Innovation: Methodological Advances in AIDS Research” ,M. Boulton, ed., Falmer Press, London.

    Google Scholar 

  • Kleinbaum, D.G., Kupper, L.L., and Morgenstern, H., 1982, “Epidemiologic Research: Principles and Quantitative Methods” ,Van Nostrand Reinhold Company, New York.

    Google Scholar 

  • Kuhn,T.S., 1962, “The Structure of Scientific Revolutions” ,University of Chicago Press, Chicago.

    Google Scholar 

  • Lancet Editorial, 1994, Population health looking upstream, Lancet ,343(8895):429.

    Article  Google Scholar 

  • Last, J., 1988a, What’sclinical epidemiology? J. Pub. Health ,(Summer), 9(2):159–163.

    CAS  Google Scholar 

  • Last, J., 1988b, “A Dictionary of Epidemiology” ,Oxford University Press, New York.

    Google Scholar 

  • Marcus, B.H., Rakowski, W., Rossi, J.S., 1992a, Assesing motivational readiness and decision-making for exercise, Health Psychol. 11(4):257–261.

    Article  PubMed  CAS  Google Scholar 

  • Marcus, B.H., Rossi, J.S., Selby, V.C., et al., 1992b, The stages and process of exercise adoption and maintainence in a worksite sample, Health Psychol. 11(6):386–395.

    Article  PubMed  CAS  Google Scholar 

  • Marcus, B.H., Selby, V.C., Niaura, R.S., et al., 1992c, Self-efficacy and the stages of exercise behavior change, Res. Q. Exerc. Sport ,63(1):60–66

    PubMed  CAS  Google Scholar 

  • Marcus, B.H., Simkin, L.R., 1993, The stages of exercise behavior, J. Sports Med. Phys. Fitness ,33(1):83–88

    PubMed  CAS  Google Scholar 

  • Marmot, M., 1994, Cardiovascular Disease, J. Epidemiol. Community Health ,48:2–4.

    Google Scholar 

  • Marx, K., 1964, “Selected Writings in Sociology and Social Philosophy” ,McGraw-Hill, New York.

    Google Scholar 

  • McCormick, J., and Skrabanek, P., 1988, Coronary heart disease is not preventable by population interventions, Lancet, 2(8615):839-842.

    Article  PubMed  CAS  Google Scholar 

  • McGraw, S.A., McKinlay, S.M., McClemments, L., Lasater, T.M., Assaf, A., and Carleton, R.A., 1989,Methods in program evaluation: the process evaluation system of the Pawtucket Heart Health Program, Eval. Res. ,13:459–483.

    Article  Google Scholar 

  • McKinlay, J.B., 1974, A case for refocussing upstream -the political economy of illness. In Applying Behavioral Science to Cardiovascular Risk, Proceedings of American Heart Association Conference, Seattle, Washington..

    Google Scholar 

  • McKinlay, J.B., 1979, Epidemiological and political determinants of social policies regarding the public health, Soc. Sci. Med. ,13A:541–558.

    PubMed  CAS  Google Scholar 

  • McKinlay, J.B., 1980, Evaluating medical technology in the context of a fiscal crisis: the case of New Zealand, Milbank Mem. Fund Q. ,58(2):394–443.

    Google Scholar 

  • McKinlay, J.B., 1981, From “Promising Report” to “Standard Procedure”: seven stages in the career of a medical innovation, Milbank Mem. Fund Q. ,59(3):374–411.

    Article  CAS  Google Scholar 

  • McKinlay, J., 1992, Health Promotion Through Healthy Public Policy: The Contribution of Complementary Research Methods, Can. J. Public Health ,83:11–19.

    Google Scholar 

  • McKinlay, J.B., 1993, The promotion of health through planned sociopolitical change: challenges for research and policy, Soc. Sci. Med. ,36(2):109–117.

    Article  PubMed  CAS  Google Scholar 

  • McKinlay, S.M., Stone, E.J., and Zucker, D.M., 1989, Research design and analysis issues, Health Educ. Q., 16(2):307–313.

    Article  PubMed  CAS  Google Scholar 

  • McKinney, J.C., 1954, Constructive typology and social research, in: “An Introduction to Social Research”, Stackpole Co, Harrisburg.

    Google Scholar 

  • Mechanic, D., 1989, Medical Sociology: Some Tensions among Theory, Method, and Substance, Health Soc. Behav. ,30(2):147–160.

    Article  CAS  Google Scholar 

  • Miettinen, O.S., 1985, “Theoretical Epidemiology: Principles of Occurrence Research” ,Wiley, New York.

    Google Scholar 

  • Morgan, D., 1988, “Focus Groups as Qualitative Research” ,Sage, London.

    Google Scholar 

  • Newell, K.W., 1977, Research for an appropriate health technology, Annual Address ANZSERCH Conference.

    Google Scholar 

  • Nijhuis, H.G.J., and van der Maesen, L.J.G., 1994, The philosophical foundations of public health: an invitation to debate, J. Epidemiol. Community Health ,48:1–3.

    Article  PubMed  CAS  Google Scholar 

  • Nutbeam, D., Smith, C., Murphy, S., and Catford, J., 1993, Maintaining evaluation designs in long-term community-based health promotion programmes: heartbeat Wales case study, J. Epidemiol Commu nity Health ,47:127–133.

    Article  PubMed  CAS  Google Scholar 

  • Paffenbarger, R.S., Hyde, R.T., Wing, A.L., et al., 1993, The association of changes in physical-activity level and other lifestyle characteristics with mortality among men, New Engl. J. Med. ,328: 538–546.

    Article  PubMed  Google Scholar 

  • Pareto, V., 1963, “The Mind and Society” ,Dover, New York.

    Google Scholar 

  • Petitti, D.B., 1991, Associations are not effects, Am. J. Epidemiol ,133:101–102.

    PubMed  CAS  Google Scholar 

  • Phillips, A.N., and Smith, G.D., 1993, The design of prospective epidemiological studies more subjects or better measurements? J. Clin. Epidemiol. ,46-1203–11.

    Article  PubMed  CAS  Google Scholar 

  • Pickering, G.W., 1968, “High Blood Pressure” ,2nd edition, Churchill, London.

    Google Scholar 

  • Popper, K., 1968, “The Logic of Scientific Discovery” ,Harper and Rose, New York, pp. 276–81.

    Google Scholar 

  • Popper, K., 1974, “Conjectures and Refutations” ,Routledge and Keegan Paul, London, p. 339.

    Google Scholar 

  • Prochaska, J.O., and DiClemente, C.C., 1983, Stages and processes of self-change in smoking: towards and integrative model of change, J. Consult. Clin. Psychol. ,51:390–395.

    Article  PubMed  CAS  Google Scholar 

  • Prochaska, J.O., Rossi, J.S., and Velicer, W.F., 1990, A comparison of four minimal interventions for smoking cessation: An outcome evaluation. Paper presented at the 7th World Conference on Tobacco and Health. Perth, Australia.

    Google Scholar 

  • Reichardt, C.S., and Cook, T.D., 1979, Beyond qualitative versus quantitative methods, in: “Qualitative and Quantiative Methods in Evaluation Research” ,T.D. Cook, C.S. Reichardt, eds., Sage Publications, Beverly Hills, CA.

    Google Scholar 

  • Rose, G., 1992, “The Strategy of Preventive Medicine” ,Oxford University Press, Oxford.

    Google Scholar 

  • Rosenthal, R., 1979, The “file drawer problem” and tolerance for null results, Psychol. Bull. ,86:638–641.

    Article  Google Scholar 

  • Rossi, PH., 1994, The war between the Quals and the Quants: Is a lasting peace possible? New Directions Program Eval. ,61:23–36.

    Article  Google Scholar 

  • Rossi, P., and Freeman, H., 1993, “Evaluation: A Systematic Approach” ,Fourth edition, Sage Publications, Beverly Hills, CA.

    Google Scholar 

  • Rothman, K.J., 1986, “Modern Epidemiology” ,Little Brown and Company, Boston, p. 11.

    Google Scholar 

  • Rothman, K.J., ed., 1988, “Causal Inference” ,Epidemiology Resources, Chestnut Hill, MA pp. 15-32.

    Google Scholar 

  • Sanday, P., 1983, The ethnographic paradigm(s), in: “Qualitative Methodology” ,J. van Maanen, ed., Sage Publications, Beverly Hills, CA.

    Google Scholar 

  • Schlesselman, J.J., 1982, “Case Control Studies: Design, Conduct, Analysis” ,Oxford University Press, New York.

    Google Scholar 

  • Skrabanek, P., 1993, The epidemiology of errors, Lancet ,342:1502.

    Article  PubMed  CAS  Google Scholar 

  • Sloan, R.P., 1987, Workplace Health Promotion: A Commentary on the Evolution of a Paradigm, Health Educ. Q. ,14(2):181–194.

    Article  PubMed  CAS  Google Scholar 

  • Smith, A., 1985, The epidemiological basis of community medicine, in: “Recent Advances in Community Medicine 3” ,A. Smith, ed., Churchill Livingstone, Edinburgh, pp. 1–10.

    Google Scholar 

  • Sonstroem, R.J., 1988, Psychological models, in: “Exercise Adherence Champaign” ,R. Dishman, ed.. Human Kinetics Books, IL, pp.125–154.

    Google Scholar 

  • Spradley, J.P., 1980, “Participant Observation” ,Holt, Rinehart and Winston, New York.

    Google Scholar 

  • Strange, K.C., and Zyzanski, S.J., 1989, Integrating qualitative and quantitative research methods, Fam. Med., 21(6):449–451.

    Google Scholar 

  • Stewart, A.L., King, A.C., and Haskell, W.L., 1993, Endurance exercise and health-related quality of life in 50-65 year-old adults, Gerontologist ,33:782–789.

    Article  PubMed  CAS  Google Scholar 

  • Susser, M., 1973, “Causal Thinking in the Health Science” ,Oxford University Press, New York.

    Google Scholar 

  • Susser, M., 1988, Falsifcation, verification and causal inference in epidemiology: Reconsideration in the light of the philosophy of Sir Karl Popper, in: “Causal Inference” ,K.J. Rothman, ed.. Epidemiology Resources, Chestnut Hill, MA, pp. 33–58.

    Google Scholar 

  • Susser, M., 1991, What is a cause and how do we know one? A grammar for pragmatic epidemiology, Am. J. Epidemiol ,7:635–648.

    Google Scholar 

  • Watson, R.I., 1973, Psychology: Aprescriptive science, in: “Historical Conceptions of Psychology” ,M. Henle, J. Jaynes, and J. Sullivan, eds, Springer, New York.

    Google Scholar 

  • Weber, M., 1947, “The Theory of Social and Economic Organization” ,Oxford University Press, New York.

    Google Scholar 

  • Weed, D.L., 1988, Causal criteria and Popperian refutation, in: “Causal Inference” ,K.J. Rothman, ed., Epidemiology Resources, Chestnut Hill, MA, pp. 15–32.

    Google Scholar 

  • Whitehead, A.N., 1985, “Science and the Modern World” ,Free Association Books, London, p. 22.

    Google Scholar 

  • Yin, R.K., 1984, “Case Study Research: Design and Methods” ,Sage Publications, Beverly Hills, CA.

    Google Scholar 

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  1. New England Research Institutes, 9 Galen Street, Watertown, Massachusetts, 02172, USA

    John B. McKinlay

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  1. University of Jyväskylä, Jyväskylä, Finland

    Eino Heikkinen , Jorma Kuusinen  & Isto Ruoppila ,  & 

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McKinlay, J.B. (1995). The New Public Health Approach to Improving Physical Activity and Autonomy in Older Populations. In: Heikkinen, E., Kuusinen, J., Ruoppila, I. (eds) Preparation for Aging. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-1979-9_10

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  • DOI: https://doi.org/10.1007/978-1-4615-1979-9_10

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