2010 RSVP Bone Builders Survey Results
(Grafton & Sullivan Counties in New Hamsphire)
Overview: RSVP Bone Builders involves trained volunteers leading exercise classes twice a week. The professionally designed class curriculum is geared to elders, using stretching, balance exercises, and non-impact weight training.
Why Bone Builders? Community need:
- Goal Three of New Hampshire's Bureau of Elderly and Adult Services 2010 - 2011 State Plan prioritizes wellness activities: "Empower older people to stay active and healthy through Older Americans Act Services...through evidence base health promotion programs."
- Research shows that non-impact weight training and balance exercises reduces risk for falls and fractures.
- According to the National Osteoporosis Foundation "Bone Health and Osteoporosis" report by the Surgeon General, 2004 plus other statistics on their website: approximately 58% of New Hampshire adults, (including 100,500 in Congressional District 2 - which includes our two counties,) over 50 years of age have osteoporosis or low bone mass.
- One in three women over the age of 65, and one in two over the age of 75, will fracture her hip during her lifetime.
- Osteoporosis is the main cause of all fractures in older adults and can be prevented and improved through adequate and appropriate weight-bearing exercise.
- The Centers for Disease Control and Prevention (CDC) report: Complications associated with hip fractures result in about 300,000 hospitalizations, and 50,000 deaths a year in the U.S. Up to 1.3 million fractures per year are attributable to the disease. 20% of senior citizens who suffer a hip fracture die within a year because of complications. 20% of individuals with a hip fracture end up in a nursing home within the first year.
- The annual cost of treating the disease is estimated at $18 billion.
- In a separate report, the CDC reports that "Many people who fall, even if they are uninjured, develop a fear of falling. This fear may cause them to limit activities, leading to reduced mobility and loss of physical fitness, which in turn increases their actual risk of falling. (BJ Vellas, SJ Wayne et al. Fear of falling. 1997. Age and Aging.)
- In 2007, the CDC reports 81% of fall deaths were among people aged 65 and older.
- Roybal Center for Late Life Function, Boston University: Fear of injury and falling often contributes to elders, and especially people with osteoporosis becoming inactive or homebound, resulting in isolation from friends and family, a loss of independence, and increased morbidity.
- Last year in Sullivan and Grafton counties, the State reimbursed the county nursing homes an average of about $5,000 per month for Medicaid clients.
How do we know RSVP Bone Builders works? Ideally, baseline and follow-up bone density scans would be one measure, but it is cost prohibitive.
Measurement tool: This anonymous, random survey was sent via U.S. mail in February 2011 to 150 out of 358 RSVP Bone Builders involved in our program between 1/1/2010 and 12/31/2010. Folks received a survey if their mailing address is in our database. 81 people or 54% responded!
The purpose of the survey was three-fold:
- Get feedback on customer service.
- Assess the health impact of the program on the participants.
- Apply lessons learned to improving the services to the exercisers.
Local context in Grafton and Sullivan Counties, New Hampshire: 358 exercisers attended class 13,972 times during the survey period, at fifteen classes at thirteen sites: Charlestown Senior Center; Cornish Town Hall; Durrell Methodist Church, (Bethlehem;) Goodwin Community Center, (Claremont;) Horse Meadow Senior Center, (North Haverhill;) Lincoln Greens senior housing; Littleton Area Senior Center x2; Mascoma Area Senior Center, (Canaan;) Monroe Town Hall; Orford Area Senior Services; Plainfield Fire Department; Plymouth Regional Senior Center x2; and Sugar River Mills senior housing, (Claremont.) All of these sites donate their spaces for free. Weights are usually donated by local organizations, or funded with grants. This is key to our ability to bring these classes to people.
RSVP Bone Builders Survey Highlights
THANKS TO EVERYONE WHO COMPLETED & RETURNED THE SURVEY!
- Of the four "functional capacity" items: 28% rated Significant Improvement; 49% Moderate improvement; 6% No Change; 2% Moderate Reduction; and 0% rated Significant reduction.
- Of the ten "customer service" items: 49% rated Excellent; 36% rated Good; 7% Average; and 1% rated Below Average.
- People reported being involved in RSVP Bone Builders: 20 since 2010; 15 since 2009; 10 since 2008; 1 since 2007; 9 since 2006; and 7 since 2005.
- Survey respondents reported, anecdotally, about positive changes in their: flexibility, strength, balance, muscle tone, energy level and overall well-being.
- "Least favorite" things about the class included: other class members chatting during exercises; leaders hurrying through exercises; and crowded classes. Several said they would like music.
- "Most favorite" things about the class included: doing something positive for me, results, and leaders' knowledge.
- "Camaraderie," an unexpected positive outcome last year, was still mentioned again and again this year by class members, which is notable because research shows isolation is a risk factor for elders and that social connections help keep elders healthy and safe.
- Of the seven or 9% of the survey respondents who reported falling in the past year, (one "slipped in the snow, wearing slippery slippers;" one "stubbed a toe;" one "not picking feet up enough;" one "on ice getting out of the car;" one "in the yard with nothing to get a hold on;" one "on snow," and once "on a wet floor,") no one -that's 0% of respondents - broke a bone!
- One respondent answered "No" to falling, but wrote, "However I did miss the bottom step in the cellar once and am sure stronger legs helped me survive that experience."
RSVP Bone Builders is a volunteer driven program. The classes in Grafton and Sullivan Counties, and these results, would not be possible without the 32 volunteers who donated 2,078 hours last year leading the classes. 3% of these leaders are in their 50s; 44% in their 60s; 36% in their 70s; 10% in their 80s; and 7% in their 90s.
Why RSVP Bone Builders is popular: The reasons why were clear in the comments from the surveys. The overall gist of the comments showed that the class leaders' "knowledge" and "friendliness" are important to folks, as is the "camaraderie" and class members experience. People reported positive changes in their: flexibility, strength, balance, muscle tone, and / or energy level.
- "I have done so well with my surgeries that even my surgeons feel this has helped me get going sooner."
- "No big changes but I noticed right away how much easier it was to turn my head - am therefore a safer driver."
- "Gardening used to take 2 or 3 tries to do the whole garden. do it all in 1 try now."
- "Five years ago I was diagnosed with a rare nerve disease affecting my legs and was told I probably would not walk again as very few other patients with the disease ever walked again. With excellent therapists and determination I now manage with a cane and an occassional arm. RSVP Bone Builders is a great part of my progress."
- This exercise program has improved my ability to hike in the mountains, an activity I cherish and hope to continue for the foreseeable future."
- "I am able to reach my cupboards."
- "I can lift my grandbabies with no pain."
,li>When snow shoeing, I can get up by myself when I have fallen."
- "I don't fall anymore."