Keys to Embracing Aging: Curriculum to Promote Healthful Living Across the Life Span

Many health factors contribute to both how well and how long we live. All these factors can be categorized into four main areas: accessibility of quality health care, social and economic factors, physical environment, and health behaviors practiced across a life span (County Health Rankings, 2019). Research has suggested that 30% of our health outcomes—how well and how long we live—are due to the health behaviors we practice across our life spans (County Health Rankings, 2019). Therefore, it is imperative that Cooperative Extension educators provide comprehensive, research-based information focusing on improving health-related knowledge, attitudes, and behaviors as a part of their service to their local communities. Because health behaviors include a variety of choices (i.e., nutrition, physical activity, social activity, etc.), it is particularly valuable when a curriculum can comprehensively educate and empower individuals to adopt an overall healthful lifestyle.

Keys to Embracing Aging Program Description

Keys to Embracing Aging is a peer-reviewed, research-based, and Extension-developed curriculum that was created to provide individuals with tools to improve personal health and wellness. The lessons include challenges that encourage participants to improve their healthful practices and allow county educators to help empower participants to take control of their own lifestyles. Additionally, the Keys to Embracing Aging curriculum includes a follow-up component for encouraging and measuring positive behavior change. Based on literature on healthful living (e.g., Peel, McClure, & Bartlett, 2005), research from the world's Blue Zones (e.g., Buettner, 2008), and advice from centenarians (e.g., Jopp, Park, Lehrfeld, & Paggi, 2016; Larkin, 1999), the Keys to Embracing Aging curriculum includes straightforward preventative education and creatively encourages and challenges individuals to make healthful choices across their life spans. Using social cognitive theory (i.e., Bandura, 1977), we developed the curriculum to reinforce participants' ability to apply what they learn from each lesson, challenge, and assessment to modeling behaviors for family and community members and working to create healthful homes, communities, and work spaces. Additionally, an ecological approach helped us reinforce ways in which individuals affect and are affected by their roles in their families, communities, and greater cultures (Bronfenbrenner, 1979) and further supports the priority areas emphasized by Cooperative Extension's National Framework for Health and Wellness (ECOP Health Task Force, 2014; Rodgers & Braun, 2015).

In Keys to Embracing Aging, we succinctly and creatively packaged 12 healthful behaviors, or keys, related to increasing life quality, well-being, and longevity. The objectives for the program are that participants will

1. increase their understanding of how practicing healthful behaviors across the life span can influence future health and well-being and
2. increase the number and quality of healthful behaviors in which they engage on a daily basis to improve overall health and wellness.

The specific research-based keys to embracing aging that are covered in the curriculum are

• having a positive attitude,
• eating smart and healthfully,
• engaging in physical activity,
• engaging in brain activity,
• engaging in social activity,
• tuning in to the times,
• practicing safety,
• knowing one's health numbers,
• practicing stress management,
• addressing financial affairs,
• sleeping, and
• taking time for oneself.

Keys to Embracing Aging is designed for use with a wide variety of audiences, ranging from adolescents to older adults themselves. As such, the curriculum can easily be adapted according to specific audience, location, and time constraints. Lessons can easily be taught online or in-person, and they can be organized as quick 15-min topical presentations or as 60- to 90-min overviews or delivered as a 12-part series. Program delivery can be determined by the educational leader. A particularly effective method of presenting the material, according to pilot studies, is through a 30-day challenge approach (Kostelic & Yelland, 2019). In this design, an Extension educator or other trained leader presents one key per month across a calendar year while challenging participants to focus on developing and attaining wellness goals over 30-day challenge periods. These challenge periods provide participants the opportunity to complete at-home activity challenges and apply the knowledge gained from each lesson to create behavior change. The pilot studies have revealed that each challenge encourages participants to try and/or adopt new approaches to healthful living and that over time and with the integration of each key, healthful behaviors start to become habits.

Additionally, the 12 keys covered in the curriculum build on each other while reinforcing and supporting existing Extension programming, which educators are encouraged to use if there is demonstrated need for ongoing education on a particular topic. This means that Keys to Embracing Aging not only concisely reinforces the importance of health-related decision making but also supports and promotes relevant existing programs that can keep participants coming back to Extension. Further, Extension educators are encouraged to collaborate with other community-based entities to both deliver the educational content and engage and/or inform their participants about services.

Curriculum Materials

Materials included in the curriculum are as follows:

• fact sheet publications for the entire program and each key,
• a complete leader's guide for the entire program and each key,
• scripted PowerPoint presentations,
• detailed activity guides and corresponding worksheets,
• evaluation templates,
• a marketing flyer,
• news release and consumer tip templates,
• success story templates, and
• a three-panel educational poster.

Extension professionals can obtain the complete scripted Keys to Embracing Aging curriculum at no cost by contacting the lead authors, Drs. Kostelic and Yelland. As well, facilitation training (in-person or online) is available from the lead authors. All resources are research-based, peer-reviewed, and pilot studied; results from initial programming and pilot studies (Kostelic & Yelland, 2019) are forthcoming, and individuals can request evaluation details from the lead authors.

Conclusion and Implications

Keys to Embracing Aging is a research-based educational curriculum that focuses on improving the health and wellness of individuals across the life span in order to influence optimal and healthful aging. Preliminary data analysis has shown that individuals adopt and sustain healthful behavior changes as a result of participating in the program, particularly in the areas of healthful eating, physical activity, and social activity (Kostelic & Yelland, 2019). The free educational curriculum includes a variety of materials necessary for presenting the program successfully, and program adaptation is encouraged for use with a wide variety of audiences.

References

Bandura, A. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice Hall.

Bronfenbrenner, U. (1979). The ecology of human development. Cambridge, MA: Harvard University Press.

Buettner, D. (2008). The Blue Zones: Lessons for living longer from the people who've lived the longest. Washington, DC: National Geographic.

County Health Rankings. (2019). Health factors. Retrieved from https://www.countyhealthrankings.org/explore-health-rankings/measures-data-sources/county-health-rankings-model/health-factors

ECOP Health Task Force (2014). Cooperative Extension's National Framework for Health and Wellness. Retrieved from http://www.aplu.org/members/commissions/food-environment-and-renewable-resources/CFERR_Library/national-framework-for-health-and-wellness/file

Jopp, D. S., Park, M. S., Lehrfeld, J., & Paggi, M. E. (2016). Physical, cognitive, social and mental health in near-centenarians and centenarians living in New York City: Findings from the Fordham Centenarian Study. BMC Geriatrics, 16(1). doi:10.1186/s12877-015-0167-0

Kostelic, A. F., & Yelland, E. (2019). Keys to Embracing Aging program expansion pilot study. Unpublished raw data.

Larkin, M. (1999). Centenarians point the way to healthy ageing. The Lancet, 353, 1074. doi:10.1016/S0140-6736(05)76437-0

Peel, N. M., McClure, R. J., & Bartlett, H. P. (2005). Behavioral determinants of healthy aging. American Journal of Preventive Medicine, 28, 298–304. doi:10.1016/j.amepre.2004.12.002

Rodgers, M., & Braun, B. (2015). Strategic directions for Extension health and wellness programs. Journal of Extension, 53(3), Article 3TOT1. Available at: https://joe.org/joe/2015june/tt1.php